Dolors Mariscal

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The use of microbiologic investigations in routine clinical practice, their value in guiding antibiotic prescription, and their influence on outcome were prospectively studied in 113 consecutive adults who developed ventilator-associated pneumonia (VAP). Blood cultures were performed in 78.7% of cases, protected specimen brushing in 95.5%, and(More)
OBJECTIVE Pseudomonas aeruginosa is a frequent cause of ventilator-associated pneumonia. Recent evidence suggests that production of type III secretion proteins is correlated with increased pathogenicity in both cellular and animal models of infection. The objective of this study was to determine whether this system contributes to disease severity in humans(More)
Fifty-seven patients developed an episode of catheter-related infection (CRI) in the bloodstream during their stay in the intensive care unit (cases) and were prospectively observed to establish the attributable mortality, increase in length of stay, and excess costs. Costs were estimated by multiplying the number of excess days of stay by the reimbursement(More)
STUDY OBJECTIVE To investigate the epidemiology of infection by Acinetobacter baumannii in patients with ventilator-associated pneumonia (VAP). DESIGN Prospective clinical study. SETTING Three medical-surgical ICUs in teaching hospitals. PATIENTS We followed up 707 mechanically ventilated patients and 148 episodes of VAP with etiologic diagnosis. (More)
All episodes of lower respiratory tract infection that developed among 96 patients surviving for > 24 hours after cardiac arrest were prospectively studied over an 18-month period. Pneumonia developed in 23 (24.0%) of patients after a mean of 7 days (SD, +/- 6.2 days). The development of four superinfections raised the cumulative incidence to 28.1%.(More)
BACKGROUND Catheter hub contamination is being increasingly recognized as a source of catheter-related sepsis. The authors have investigated the efficacy of a new hub design in preventing endoluminal catheter contamination and catheter-related sepsis arising at the hub. METHODS Adult surgical and intensive care patients requiring a subclavian catheter for(More)
STUDY OBJECTIVES The study documents the impact of microbiological investigations on therapeutic decisions and outcome in patients with severe community-acquired pneumonia (SCAP). DESIGN Retrospective analysis of prospectively collected data. SETTING ICUs in two teaching Spanish hospitals. PATIENTS Two hundred four consecutive patients admitted to(More)
STUDY OBJECTIVE To evaluate the effect of discordant empirical therapy on outcome in bacteremic pneumococcal community-acquired pneumonia. DESIGN Prospective observational study. SETTING A 600-bed teaching hospital with a reference area of 400,000 inhabitants. PATIENTS All patients aged > or =18 yrs with a diagnosis of community-acquired pneumonia(More)
To identify routes and patterns of colonization with Pseudomonas aeruginosa in intubated patients to design strategies of prevention for respiratory infection. Prospective and observational study in the 16-bed intensive care unit of a teaching hospital. Ninety-eight intubated patients were investigated over a 3-year period. Those ventilated less than 72 h(More)
To determine the impact of ventilator-associated pneumonia (VAP) on ICU mortality, and whether it is related to time of onset of pneumonia. Prospective cohort study. 16-bed medical-surgical ICU at a university-affiliated hospital. From 2002 to 2003, we recorded patients receiving mechanical ventilation for > 72 h. Patients developing an infection other than(More)