A Blanco

Hospital Central de Asturias, Oviedo, Asturias, Spain

Are you A Blanco?

Claim your profile

Publications (8)14.96 Total impact

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The treatment of multidrug-resistant Acinetobacter baumannii meningitis is a serious therapeutic problem due to the limited penetration of antibiotics into the CSF. We describe the clinical features and the outcome of a group of patients with nosocomial neurosurgical meningitis treated with different therapeutic options. All patients with nosocomial post-surgical meningitis due to A. baumannii diagnosed between 1990 and 2004 were retrospectively reviewed. During the period of study, 51 cases of this nosocomial infection were identified. Twenty-seven patients were treated with intravenous (iv) monotherapy: carbapenems (21 cases), ampicillin/sulbactam (4 cases) and other antibiotics (2 cases). Four patients were treated with iv combination therapy. Nineteen patients were treated with iv and intrathecal regimens: colistin by both routes (8 cases), carbapenems plus iv and intrathecal (4 cases) or only intrathecal (5 cases) aminoglycosides, and others (2 cases). Seventeen patients died due to the infection. One patient died without treatment. The mean (SD) duration of therapy was 17.4 (8.3) days (range 3-44). Although no patients treated with colistin died, we did not observe statistically significant differences in the mortality among the groups with different treatments. Nosocomial Acinetobacter meningitis has a high mortality. Combined therapy with iv and intrathecal colistin is a useful and safe option in the treatment of nosocomial Acinetobacter meningitis.
    Journal of Antimicrobial Chemotherapy 05/2008; 61(4):908-13. · 5.34 Impact Factor
  • E Tenza, D Escudero, A Blanco
    Medicina Intensiva 09/2007; 31(6):351-351. · 1.32 Impact Factor
  • E Tenza, D Escudero, A Blanco
    Medicina Intensiva 01/2007; 31(6):351. · 1.32 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Enterococcal post-surgical meningitis is an uncommon disease. 20 episodes of nosocomial post-surgical enterococcal meningitis diagnosed between 1994 and 2003 were retrospectively studied. During the period of study 20 cases of post-surgical enterococcal meningitis (60% female, mean age 55+/-18 y, range 16-78 y) were reviewed. The mean time between admission at the hospital and surgery was 26 (SD = 15) d (range 7-61 d). The most frequent underlying diseases were: intracerebral haemorrhage (55%), brain neoplasms (25%), head trauma (15%) and hydrocephalus (5%). 11 patients had previously received antibiotic treatment. The isolates identified were Enterococcus faecalis (n = 18) (90%), E. faecium (1) and E. durans (1). 11 patients had polymicrobial infections. The treatment most frequently used was vancomycin alone or with other antibiotics (11). In 5 patients intrathecal vancomycin (20 mg/d) was also added. The mortality rate was not different in intrathecally treated patients. Cerebrospinal fluid (CSF) devices were removed in 8 patients. Four patients died due to the infection. Mortality was significantly associated with lack of removal of the CSF devices (p = 0.04). Enterococcal spp. are a cause of nosocomial meningitis associated with neurosurgical procedures and the presence of neurological devices.
    Scandinavian Journal of Infectious Diseases 02/2006; 38(8):584-8. · 1.71 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: In recent years, meningitis caused by methicillin-resistant S. aureus has increased. This study was undertaken to compare the clinical characteristics and prognosis of methicillin-resistant S. aureus (MRSA) postneurosurgical meningitis and methicillin-sensible S. aureus (MSSA) postneurosurgical meningitis. Twenty-five episodes of postneurosurgical meningitis due to S. aureus (13 methicillin-resistant strains) seen during a ten-year period were retrospectively reviewed. Most common underlying diseases were: intracerebral hemorrhage (50% of MRSA patients and 46% of MSSA patients) and neoplasm (53% of MRSA patients and 33% of MSSA patients). Eleven patients (6 of them with MRSA infection) had received antibiotic treatment previously. Thirteen patients were carriers of intraventricular catheters (8 with MRSA infection), 5 wore a ventriculoperitoneal shunt (4 with infections by MSSA), 5 cases had a CSF leakage (4 with infections by MRSA), and one patient with infection by MSSA wore an epidural catheter. Fifteen patients were cured (7 with MRSA infection), and 8 died due to the infection (27% with MSSA infection and 38% with MRSA infection). The prognosis of postneurosurgical meningitis by S. aureus does not depend on the presence of resistance to methicillin. Nowadays, the intravenous administration of vancomycin is the treatment of choice in MRSA meningitis.
    Medicina Clínica 02/2005; 124(3):102-3. · 1.25 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background and objective In recent years, meningitis caused by methicillin-resistant S. aureus has increased. This study was undertaken to compare the clinical characteristics and prognosis of methicillin-resistant S. aureus (MRSA) postneurosurgical meningitis and methicillin-sensible S. aureus (MSSA) postneurosurgical meningitis. Patients and methods Twenty-five episodes of postneurosurgical meningitis due to S. aureus (13 methicillinresistant strains) seen during a ten-year period were retrospectively reviewed. Results Most common underlying diseases were: intracerebral hemorrhage (50% of MRSA patients and 46% of MSSA patients) and neoplasm (53% of MRSA patients and 33% of MSSA patients). Eleven patients (6 of them with MRSA infection) had received antibiotic treatment previously. Thirteen patients were carriers of intraventricular catheters (8 with MRSA infection), 5 wore a ventriculoperitoneal shunt (4 with infections by MSSA), 5 cases had a CSF leakage (4 with infections by MRSA), and one patient with infection by MSSA wore an epidural catheter. Fiftteen patients were cured (7 with MRSA infection), and 8 died due to the infection (27% with MSSA infection and 38% with MRSA infection). Conclusions The prognosis of postneurosurgical meningitis by S. aureus does not depend on the presence of resistance to methicillin. Nowadays, the intravenous administration of vancomycin is the treatment of choice in MRSA meningitis.
    Medicina Clinica - MED CLIN. 01/2005; 124(3):102-103.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Postsurgical Acinetobacter baumannii meningitis is associated with relevant morbidity and mortality. It has been related to neurosurgery, intraventricular catheters (IC) or CSF fistula. Thus, features, epidemiology and clinical course of this infection were studied. Retrospective analysis of 22 episodes of nosocomial postsurgical Acinetobacter baumannii meningitis. Twenty episodes occurred in males. The mean age of patients was 46 years (range: 16-83 years). All patients were admitted to the ICU. In 50% of patients a history of intraventricular hemorrhage was recorded, 36% had had a skull fracture and the remaining patients had a brain tumor. In 18 cases the portal of entry was considered to be IC, in two an epidural catheter, and in two a CSF fistula. Patients showed a clinical picture indistinguishable from other types of meningitis, fever being the most common symptom (100%). CSF findings were consistent with bacterial meningitis. In one case the microorganism was recovered from blood. Fifteen patients recovered, three died as a direct result of the infection, and the remaining patients relapsed. Non recovery of patients was significantly associated with non removal of catheter (p < 0.05). Postsurgical Acinetobacter baumannii meningitis occurs frequently in patients previously colonized with this microorganism in other sites and is enhanced by the presence of an IC. Catheter removal is essential for recovery of patients.
    Revista Clínica Española 09/2001; 201(9):497-500. · 2.01 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Postsurgical Acinetobacter baumannii meningitis is associated with relevant morbidity and mortality. It has been related to neurosurgery, intraventricular catheters (IC) or CSF fistula. Thus, features, epidemiology and clinical course of this infection were studied. Methods Retrospective analysis of 22 episodes of nosocomial postsurgical Acinetobacter baumannii meningitis. Twenty episodes occurred in males. The mean age of patients was 46 years (range: 16-83 years). Results All patients were admitted to the ICU. In 50% of patients a history of intraventricular hemorrhage was recorded, 36% had had a skull fracture and the remaining patients had a brain tumor. In 18 cases the portal of entry was considered to be IC, in two an epidural catheter, and in two a CSF fistula. Patients shoed a clinical picture indistinguishable from other types of meningitis, fever being the most common symptom (100%). CSF findings were consistent with bacterial meningitis. In one case the microorganism was recovered from blood. Fifteen patients recovered, three died as a direct result of the infection, and the remaining patients relapsed. Non recovery of patients was significantly associated with non removal of catheter (p < 0.05). Conclusions Postsurgical Acinetobacter baumannii meningitis occurs frequently in patients previously colonized with this microorganism in other sites and is enhanced by the presence of an IC. Catheter removal is essential for recovery of patients.
    Revista Clínica Española 01/2001; 201(9):497–500. · 2.01 Impact Factor