Background: Advances in the treatment of heart failure (HF) have resulted in reduced mortality and hospitalization rates. On the other hand, when hospitalized, patients are at high risk of death.
The health care-related infections are well-known in a critical care setting, but reports of those infections in solid organ transplanted patients are scarce. We developed a study of retrospective cohort in a tertiary teaching hospital for 14 months. Eighty-one patients underwent solid organ transplants. The global incidence of health care-related infection was 42.0%. Fifteen percent of the cases were occurrences of surgical site infections, 14.0% pneumonias, 9.0% primary blood stream infections, 4.0% urinary tract infections and 2.0% skin infection. The most prevalent etiologic agents were K. pneumoniae (8.6%), P. aeruginosa (7.4%); A. baumannii (5.0%) and S. aureus (2.5%). Mortality was 18.0%, none of then related to health care infections. The high rate of those infections, mainly surgical site infections, suggests a demand for stricter measures to prevent and control health care-related infections.
Background: Respiratory tract infections were associated with acute exacerbations of heart failure (HF). However, the role of the influenza virus, a major agent of such infections, in this population remained unclear. Method: During the influenza virus seasons of 2013 and 2014 we prospectively assessed influenza respiratory illnesses in a cohort of adults primarily hospitalized for management of acute decompensated HF and a cohort of HF outpatients. Qualitative RT-PCR for influenza A (A/H1, A/H12009pdm, A/H3) and B virus testing was performed on nasopharyngeal swab samples. Result: A total of 121 patients were included, 58.3% males (n = 70), mean age 57.7 years old (±14.0), mean left ejection fraction 35.3 (±9.8). Of these, 50.4% were inpatients (n = 61). The prevalence of symptoms of respiratory infections was 28.0% (n = 34) and 4.9% (n = 6) of all samples were positive for influenza virus. Only influenza A was detected and all cases were among inpatients. Influenza-positive patients had a greater need for antimicrobials (83.3%, n = 5; 16.3%, n = 9; p = 0.001) and for mechanical ventilation (50.0%, n = 3; 3.6%, n = 2; p < 0.001) than Influenza-negative patients. The prevalence of influenza virus was not related to mortality (OR 4.58; p = 0.16). Conclusion: Although not common, the influenza virus infection resulted in worst outcomes, with a greater need for antimicrobials and mechanical ventilation. Immunization and antiviral treatment in high risk patients may positively impact their outcomes.
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