Invasive fungal disease in hemato-oncological and hematopoietic stem cell transplantation patients from Hospital Clinico Universidad Catolica, Santiago-Chile using revised EORTC/MSG diagnostic criteria Introduction: Invasive fungal disease (IFD) is a severe complication occurring mostly in haematooncological (H-O) patients and hematopoietic stem cell transplant (HSCT) receptors. Our aim was to describe the IFD occurring in our H-O and HSCT patients according to the EORTC/MSG revised criteria. Patients and Methods: IFD surveillance was performed in adult patients of the

Introduction:The surveillance of febrile neutropenia (FN) episodes in every center allows adapt the antibiotic therapy guidelines to local epidemiology. Aim: To characterize clinical features and compare the FN etiology between hematological cancer (HC) and solid organ cancer (SOC) in our center. Patients and Methods: Surveillance study in adult patients with FN admitted to Hospital Clinico Universidad Católica, in Santiago, Chile, from January 2004 to August 2007. Results: 154 FN episodes corresponding to 87 patients were included. Mean age: 47 ± 6 years-old; 71% had HC and 29% SOC. A clinical and/or microbiologically documented infection was recognized in 76%. Gastrointestinal 31.5%, upper respiratory 30.3% and lower respiratory 16.9% were the more frequent clinical focus. In 30.5% blood culture resulted positive: gram negative rods 51%, gram positive cocci 41% and yeasts 8%; being Escherichia coli 22%, S. coagulase negative (SCoN) 20% and Klebsiella pneumoniae 12% most frequent bacteria; 22.2% Enterobacteriaceae were ESBL producers and 55.6% SCoN were methicillin resistant. In 18.3% of FN episodes the etiology was not established. Highest mortality was observed in episodes with microbiologically documented infection (14.5% vs 1.3%, p < 0.005). A clinical observed focus and positive blood cultures were more frequently obtained among HC than SOC associated episodes: 37.3% vs 13.6%; (p < 0.01) and 67.2% vs 50%; (p = 0.045), respectively. Conclusions: The etiological profile of FN in our center and the necessity to continue the surveillance was described. Future studies are needed regarding risk factors of invasive infection that have worst prognosis.

Introducción G ran parte de la patología psiquiátrica tiene curso crónico y recidivante, con frecuente necesidad de hospitalización. Los servicios de hospitalización psiquiátrica cuentan cada vez con menor número de camas, con estadías más breves, y se focalizan en el manejo de crisis agudas de la patología de base para un pronto retorno a la comunidad 1,2 pudiendo, en este contexto, ser más frecuentes las readmisiones hospitalarias. Se estima que las tasas de readmisión de los pacientes hospitalizados serían cerca de un 40-50% antes de un año desde el alta del hospital y que cerca del 50% de todos los pacientes que ingresan a psiquiatría ya han estado hospitalizados previamente 3 . En consideración de estos hechos incluso se ha planteado que las tasas de readmisiones, principalmente aquellas tempra-