Rickettsioses – from ticks to travellers

Ref ID: 17712


M. Jensenius*

Author address:

Oslo, NO)

Full conference title:

22nd European Congress of Clinical Microbiology and Infectious Diseases


Rickettsioses are acute and potentially severe zoonotic infections
caused by obligate intracellular, gram-negative bacteria belonging to
the Rickettsiales order, and are transmitted to humans by various
arthropods, including ticks, mites and fleas. They have a worldwide
distribution, but are particularly widespread in tropics. Recently,clinical medicine. An universal goal is to start appropriate treatment as
soon as possible. It is logical that these facts are also valid in patients
with invasive fungal infections (IFI). The problem is that IFI are often
not easily recognisable and that we can only suspect them in patients at
risk. While prospective, randomized studies are lacking, retrospective
studies used different criteria of timing, although majority defined time
as a period between culture sampling and start of appropriate treatment.
Despite this, results uniformly showed that delay is associated with
poorer outcome. In patients with candidemia, the importance of timing
was assessed analyzing the time period between the time when positive
blood cultures were drawn and start of AFT. Delay in treatment “¡12 or
“¡24 hours increased hospital mortality 1.5-2.06 fold. Negative impact
of delayed diagnosis and consequent AFT was shown in patients with
candidemia: a 24-delay in blood culture positivity would almost double
the risk of patients’ death. Studies in hematological patients with
invasive aspergillosis or zygomycosis showed that delay of appropriate
antifungal therapy (AFT) for more than 10 or 6 days after the
appearance of first symptoms almost doubled the mortality rates. The
negative impact of treatment delay on patients’ outcome urges
physicians to start AFT empirically at high-risk patients with clinically
suspected IFI (empirical therapy) or after positive new diagnostic tests
associated with imaging findings (pre-emptive therapy, mostly for
moulds infections). To avoid overtreatment with new, expensive
antifungals, rapid diagnostic tests are necessary.

Abstract Number: S148

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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