Background: A traveler's risk for acquiring YF is determined by multiple factors, including immunization status, use of personal protection measures against mosquito bites and local rate of virus transmission. An epidemic started in 2017 in Brazil beaches challenging physicians, because Argentinian people use to spend their holidays there and require vaccination regardless of their age. The aim of the study is to describe the outcome of vaccinating elderly people after a thorough assessment by an infectious disease specialist. Methods & Materials: We examined the clinical reports of all individuals aged ≥60 years vaccinated 2006–2018. We assessed pre-existing conditions and looked 45 days forward for symptoms ascribable to the vaccine. Results: Out of 3978 vaccines 439 were ≥60 years old (60–87, median 64). 205 were female. Most frequent comorbidities were high blood pressure (36%), diabetes (10%) and endocrine disorders other than diabetes (7%). Fifteen patients (3.4%) had ≥3 comorbidities. There were no reports of severe adverse effects among 347 patients, 92 had no data after vaccination date, we assume they did well because, due to our national proceedings, we would have been informed. As most guidelines advice precaution in vaccinating people aged ≥60 years, it was understood, even by non-specialist physicians, as a contraindication and people travelled without vaccination; 7 travelers returned ill. It is known that up to 60% of infections can be subclinical, thus the potential importation and spread of the disease is worrisome. Nowadays a 60–70 year old person is still fit to travel, the decision to vaccinate them needs to weigh the risks and benefits of the vaccination in the context of their destination-specific risk for exposure; the risk of yellow fever to any country where the infection is enzootic or has recently been epidemic continues to exceed the known risk from the vaccine. A travel medicine trained physician is the appropriate person to advise an elderly patient to get the vaccine or to avoid travelling. Conclusion: Although the number of people we vaccinated is not very high we can conclude that with a specialized thorough assessment of the individual patient the risk of vaccinate people aged ≥60 years is very low.

Background: Patients with autologous hematopoietic stem cell transplantation (HSCT) due to solid tumor, malignant and non-malignant hematological diseases may benefit from the use of systemic antibiotic prophylaxis. The aim of this study was to measure the effect of using ciprofloxacin as universal prophylaxis in patients with HSCT, admitted to an acute hospital. Methods & Materials: The study has an uncontrolled before and after quasi-experimental design, with a retrospective analysis. Pre-intervention period: 40 patients under standard care (acyclovir plus fluconazole) for autologous HSCT and post-intervention period: 168 patients under standard care plus prophylaxis with ciprofloxacin 500 mg once daily PO or 20-30 mg/kg IV bid. Comparison: suspected episodes of infection, acute diarrhea, confirmed infections (bacteremias, infections due to multiresistant gram-negative bacilli, infections due to Clostridium difficile), hospital length of stay and mortality due to infection. Statistical analysis was made with tests chosen upon the nature and distribution of the study variables. A significant p value was established at 0.05. Database and calculations: Excel for Office 365 Results: Patients who received ciprofloxacin presented: Statistically significant reduction: a) suspected episodes of infection (97.5% vs 77% - OR 0.01- IC95%: 0.001- 0.08 - p < 0.0001). Non statistically significant reduction: a) confirmed infections (45% vs 36.4% - OR 0.66 - IC 95%: 0.32-1.38 - p: 0.28); b) bacteremias (37.5% vs 25%-OR 0.77-IC95%:0.36-1.62-p:0.49); c) acute diarrhea (50% vs 38.7%- OR 0.63-IC95%: 0.31-1.26- p: 0.19); d) length of stay (average 22.9 vs 20.3 - p: 0.99) Non -statistically significant increase in: a) infections due to multiresistant gram negative bacilli (n = 0 vs 3 -O: 2.18-IC95%: 0.11- 43.2- p: 0.61) b) infections due to Clostridium difficile (n = 0 vs 1 -OR: 0.95- IC95%: 0.04-24.3 - p: 0.97) No episodes of mortality due to infection in either period. Conclusion: We conclude that prophylaxis in patients undergoing autologous HSCT reduces episodes of suspected infection. Study designs with better statistical power should be used to compare confirmed infectious episodes and further prevention, or infections related to antibiotic use.

Background: It is known that patient's flora contaminates the environment favoring microorganism's dissemination. Hospital Hygiene is therefore critical as an infection control measure. Aiming to improve it we decided to measure it and give feed-back to the cleaning staff in order to stimulate them. We also tried to assess if effectiveness gained was maintained through time. Methods & Materials: Prospective before-after study in the 30-bed CCU of a private hospital in Buenos Aires, Argentina (Ten intensive care beds, 10 intermediate care beds and 10 coronary care beds). Pre-intervention (3 months): With an invisible-ink pen we made ten marks in different surfaces of each room and controlled if they persisted 24 hours later. We calculated percentage of marks vanished. Intervention: We showed the results to the cleaning-staff and reviewed the right technique with them. Post-intervention (3 months): During the first 3 months, we evaluated the hygiene monthly and informed the results obtained. The cleaning staff was asked to complete a satisfaction survey. Follow up: After 9 months without controls we began to perform them every 3 months to assess continuity. Results: Cleaning efficacy improved statistically significant after the intervention Percentage of marks cleaned The less cleaned components were the infusion pumps (84%) and the ends of the beds (87%). The 84% of the survey-responders thought cleaning had improved and 79% perceived their work was more appreciated. Continuous controls are required to sustain achievements through time. Conclusion: To retrieve results is a beneficial strategy to improve cleaning. To analyze data together with the staff allows finding out real and specific goals. Control is essential to sustain results through time.

Background: Since the first renal transplantation performed in Boston in 1954, solid organ transplantation became a common strategy against end-stage diseases. The German Hospital in Buenos Aires performed its first renal transplantation in 2000 and since then practice grew including also liver and heart transplantations. After 15 years it is time to evaluate the current infectious complications, aiming to discover useful variables to work on. Methods & Materials: This analysis is a retrospective observational study, for which we have reviewed the medical records of all patients undergoing transplantation surgeries from 1-Jan-2014 to 31-Dec-2014. On an excel sheet we have analyzed information such as: age, gender, underlying disease, type of immune suppression, time of onset of the infectious event and type and source of microorganisms involved. Results: Forty-six patients were transplanted during 2014, 33 (71.7%) of them had at least one infectious event. Median age was 55 (8-78, 70% between 31-65 years), 74% males. There was no difference between infected and not-infected regarding these 2 points. Organs transplanted: 2 hearts, 21 kidneys and 23 livers. Percentage of infections was similar in the different groups. Twenty-seven (33%) of infectious events were due to urinary tract infections, 19 of them in renal transplants (70%, p=0.02). CMV-reactivation was seen in 12 cases, 9 (75%) of them in liver-transplantations. Primary bacteremia was in third place (9, 13%) and surgical site infection in fourth (7, 10%). Low numbers prevent from calculating rates. Most of the infections (88%) showed up during the first 3 months, only 1 (3%) after 6 months. There was a wide range of microorganisms involved, 68% bacteria (70% GNB), 19% virus, 95 fungus and 4% TB. Regarding the storage fluid, 24% presented bacterial growth. There wasn’t an increase incidence of infectious events in those in which the storage fluid was contaminated. Conclusion: Urinary tract infection was the main complication as literature mentions. Surgical site infections were not prevalent in a particular group, which rules out inappropriate surgical technique. The variety of microorganisms involved rules out a common source. CMV prophylaxis strategy in hepatic transplant patients has to be reviewed.

Background: The fact that individuals in higher income brackets have easier access to general information raises the question whether the individuals in lower brackets are receiving insufficient medical knowledge. The countrywide vaccination campaign against rubella allowed us to observe a young and healthy adult population that was a fair representation of two social strata; this was ideal for the purpose of our investigation. So, we tried to assess the degree of knowledge regarding vertically transmitted diseases by these two groups of citizens of different social and cultural levels. Methods: Our population performed two groups, the first one attending a community hospital of a very high social and cultural level in the city (GROUP #1, with 508 males and 966 females), and a second one belonging to a low income health center in a lower income area outside the city (GROUP #2, with 84 males and 94 females). Both groups responded anonymously to the survey on vertically transmitted diseases.Tabled 1Results: DiseaseHospital AlemánWilliam MorrisToxoplasmosis46%46%HIV81%76%HBV53%40%Rubella24%48%Syphilis24%30%HPV21%35% Open table in a new tab GROUP #1 showed to have a better knowledge than GROUP #2 regarding HIV and Hepatitis B (81% to 76%). However GROUP #2 identified Chagas disease and Syphilis more readily than GROUP #1 (30% to 24% and 35% to 21% respectively) as vertically transmitted diseases; for German Measles the proportion was even higher (GROUP#1: 24% and GROUP #2: 48%). Conclusion: Possibly, the higher incidence of Chagas disease and the compulsory testing for Syphilis in the health center attended by GROUP #2 are the variables that led to a slight increase of awareness of these illnesses by the latter. It is surprising though that, despite the fact that this study was conducted at the time of the German Measles vaccination process, both groups showed a low recognition level of this disease being vertically transmitted. The degree of awareness of vertically transmitted infections is generally low, and better access to information does not seem to play a determining role in the level of awareness amongst a healthy, young population. Other strategies have to be tried. Abstracts for SupplementInternational Journal of Infectious DiseasesVol. 14Preview Full-Text PDF Open Archive