Showing papers by "Hospital General Universitario Gregorio Marañón published in 2005"

Efficacy of a comprehensive geriatric intervention in older patients hospitalized for hip fracture: a randomized, controlled trial.

Abstract: Objectives: To evaluate whether an early multidisciplinary geriatric intervention in elderly patients with hip fracture reduced length of stay, morbidity, and mortality and improved functional evolution. Design: Randomized, controlled intervention trial. Setting: Orthopedic ward in a university hospital. Participants: Three hundred nineteen patients aged 65 and older hospitalized for hip fracture surgery. Intervention: Participants were randomly assigned to a daily multidisciplinary geriatric intervention (n=155) or usual care (n=164) during hospitalization in the acute phase of hip fracture. Measurements: Primary endpoints were in-hospital length of stay and incidence of death or major medical complications. Secondary endpoints were the rate of recovery of previous activities of daily living and ambulation ability at 3, 6, and 12 months. Results: Median length of stay was 16 days in the geriatric intervention group and 18 days in the usual care group (P=.06). Patients assigned to the geriatric intervention showed a lower in-hospital mortality (0.6% vs 5.8%, P=.03) and major medical complications rate (45.2% vs 61.7%, P=.003). After adjustment for confounding variables, geriatric intervention was associated with a 45% lower probability of death or major complications (95% confidence interval=7–68%). More patients in the geriatric intervention group achieved a partial recovery at 3 months (57% vs 44%, P=.03), but there were no differences between the groups at 6 and 12 months. Conclusion: Early multidisciplinary daily geriatric care reduces in-hospital mortality and medical complications in elderly patients with hip fracture, but there is not a significant effect on length of hospital stay or long-term functional recovery.

Saccharomyces cerevisiae Fungemia: An Emerging Infectious Disease

Abstract: Background. Saccharomyces cerevisiae is well known in the baking and brewing industry and is also used as a probiotic in humans. However, it is a very uncommon cause of infection in humans. Methods. During the period of 15–30 April 2003, we found 3 patients with S. cerevisiae fungemia in an intensive care unit (ICU). An epidemiological study was performed, and the medical records for all patients who were in the unit during the second half of April were assessed. Results. The only identified risk factor for S. cerevisiae infection was treatment with a probiotic containing Saccharomyces boulardii (Ultralevura; Bristol-Myers Squibb). This probiotic is used in Europe for the treatment and prevention of Clostridium difficile–associated diarrhea. The 3 patients received the product via nasograstric tube for a mean duration of 8.5 days before the culture result was positive, whereas only 2 of 41 control subjects had received it. Surveillance cultures for the control patients admitted at the same time did not reveal any carriers of the yeast. Strains from the probiotic capsules and the clinical isolates were identified as S. cerevisiae, with identical DNA fingerprinting. Discontinuation of use of the product in the unit stopped the outbreak of infection. A review of the literature identified another 57 cases of S. cerevisiae fungemia. Overall, 60% of these patients were in the ICU, and 71% were receiving enteral or parenteral nutrition. Use of probiotics was detected in 26 patients, and 17 patients died. Conclusions. Use of S. cerevisiae probiotics should be carefully reassessed, particularly in immunosuppressed or critically ill patients. Saccharomyces cerevisiae is a well-known yeast used in the food industry. It has now been demonstrated that this yeast can cause different forms of invasive infection [1–3], frequently after administration as a probiotic for the treatment of antibiotic-related diarrhea [4]. We report an outbreak of S. cerevisiae fungemia in an intensive care unit (ICU) that was traced, by means of molecular methods, to the use of probiotics, and we review all cases of S. cerevisiae fungemia that have been reported in the literature.

Infections Due to Scedosporium apiospermum and Scedosporium prolificans in Transplant Recipients: Clinical Characteristics and Impact of Antifungal Agent Therapy on Outcome

Abstract: Background. Unique characteristics, impact of therapy with antifungal agents, and outcome of infections with Scedosporium species were assessed in transplant recipients.Methods. The patients comprised a total of 80 transplant recipients with Scedosporium infections, including 13 patients from our institutions (University of Pittsburgh Medical Center [Pittsburgh, PA], University of Maryland [Baltimore], Duke University Medical Center [Durham, NC], Emory University [Atlanta, GA], and Hospital Gregorio Maranon [Madrid, Spain]) and 67 reported in the literature. The transplant recipients were compared with 190 non—transplant recipients with scedosporiosis who were described in the literature.Results. Overall, 69% of the infections in hematopoietic stem cell transplant (HSCT) recipients and 53% of the infections in organ transplant recipients were disseminated. HSCT recipients, compared with organ transplant recipients, were more likely to have infections caused by Scedosporium prolificans (P = .045), to have an earlier onset of infection (P = .007), to be neutropenic (P < .0001), and to have fungemia (P = .04). Time elapsed from transplantation to Scedosporium infection in transplant recipients has increased in recent years (P = .002). The mortality rate among transplant recipients with scedosporiosis was 58%. In a logistic regression model using amphotericin B as comparison treatment, voriconazole was associated with a trend towards better survival (odds ratio [OR], 10.40; P = .08). Presence of disseminated infection (OR, 0.20; P = .03) predicted lower survival, and receipt of adjunctive surgery as treatment (OR, 5.52; P = .02) independently predicted a better survival in this model.Conclusions. Scedosporium infections in transplant recipients were associated with a high rate of dissemination and a poor outcome overall. The use of newer triazole agents warrants consideration as a therapeutic modality for these infections.

Spatio-temporal nonrigid registration for ultrasound cardiac motion estimation

Abstract: We propose a new spatio-temporal elastic registration algorithm for motion reconstruction from a series of images. The specific application is to estimate displacement fields from two-dimensional ultrasound sequences of the heart. The basic idea is to find a spatio-temporal deformation field that effectively compensates for the motion by minimizing a difference with respect to a reference frame. The key feature of our method is the use of a semi-local spatio-temporal parametric model for the deformation using splines, and the reformulation of the registration task as a global optimization problem. The scale of the spline model controls the smoothness of the displacement field. Our algorithm uses a multiresolution optimization strategy to obtain a higher speed and robustness. We evaluated the accuracy of our algorithm using a synthetic sequence generated with an ultrasound simulation package, together with a realistic cardiac motion model. We compared our new global multiframe approach with a previous method based on pairwise registration of consecutive frames to demonstrate the benefits of introducing temporal consistency. Finally, we applied the algorithm to the regional analysis of the left ventricle. Displacement and strain parameters were evaluated showing significant differences between the normal and pathological segments, thereby illustrating the clinical applicability of our method.

Mycobacterium tuberculosis infection in recipients of solid organ transplants.

Abstract: Tuberculosis is a serious opportunistic infection that may affect transplant recipients. The incidence of tuberculosis among such persons is 20-74 times higher than that for the general population, with a mortality rate of up to 30%. The most common form of acquisition of tuberculosis after transplantation is the reactivation of latent tuberculosis in patients with previous exposure. Clinical presentation is frequently atypical and diverse, with unsuspected and elusive sites of affection. Manifestations include fever of unknown origin and allograft dysfunction. Coinfection with other pathogens is not uncommon. New techniques, such as PCR and quantification of interferon- gamma , have been developed to achieve more-rapid and -accurate diagnoses. Treatment requires control of interactions between antituberculous drugs and immunosuppressive therapy. Prophylaxis against latent tuberculosis is the main approach to treatment, but many issues remain unsolved, because of the difficulty in identifying patients at risk (such as those with nonreactive purified protein derivative test results) and the toxicity of therapy.

Risk Factors for Invasive Aspergillosis in Solid-Organ Transplant Recipients: A Case-Control Study

Abstract: Background To facilitate the design of strategies for prevention of invasive aspergillosis in solid-organ transplant recipients, this study investigates whether the development of early-onset and late-onset aspergillosis are related to different risk factors, thereby distinguishing 2 risk populations for this serious complication. Methods A retrospective case-control study was performed, including 156 cases of proven or probable invasive aspergillosis in patients recruited from 11 Spanish centers since the start of the centers' transplantation programs. Results Among all patients, 57% had early-onset IA (i.e., occurred during the first 3 months after transplantation). Risk factor analysis in this group identified as significantly associated risk factors a more complicated postoperative period, repeated bacterial infections or cytomegalovirus disease, and renal failure or the need for dialysis. Among patients with late-onset infections (i.e., occurred > 3 months after transplantation), who comprised 43% of cases, the patients at risk were older, were in an overimmunosuppressed state because of chronic transplant rejection or allograft dysfunction, and had posttransplantation renal failure. Conclusions Risk factors in patients with early-onset cases and patients with late-onset cases of posttransplantation invasive aspergillosis are not the same, a fact that could have implications for the preventive approaches used for this infection.

Significance and Meaning of Neurological Signs in Schizophrenia: Two Decades Later

Abstract: Objective: Patients with schizophrenia are characterized by neurological abnormalities, which can be assessed by bedside clinical examination. These abnormalities have been argued to represent core features of the illness. We review studies published since our last review in 1988 that address the validity of neurological signs as a trait feature of schizophrenia. Methods: We conducted a literature search in the following computer databases: MEDLINE, PSYCHLIT, EMBASE, and COCHRANE. The search was limited to articles published from January 1988 to May 2005. Results: Neurological signs occur in the majority of patients with schizophrenia. Their occurrence is independent of demographic and most medication variables. Neurological signs are strongly associated with negative symptoms and cognitive impairments. There is also evidence to suggest that their occurrence is under genetic control. Conclusions: There is compelling evidence to suggest the hypothesis that neurological signs represent a trait feature of schizophrenia.

The Chemokine Receptor CCR7 Activates in Dendritic Cells Two Signaling Modules That Independently Regulate Chemotaxis and Migratory Speed

Abstract: CCR7 is necessary to direct dendritic cells (DCs) to secondary lymphoid nodes and to elicit an adaptative immune response. Despite its importance, little is known about the molecular mechanisms used by CCR7 to direct DCs to lymph nodes. In addition to chemotaxis, CCR7 regulates the migratory speed of DCs. We investigated the intracellular pathways that regulate CCR7-dependent chemotaxis and migratory speed. We found that CCR7 induced a G(i)-dependent activation of MAPK members ERK1/2, JNK, and p38, with ERK1/2 and p38 controlling JNK. MAPK members regulated chemotaxis, but not the migratory speed, of DCs. CCR7 induced activation of PI3K/Akt; however, these enzymes did not regulate either chemotaxis or the speed of DCs. CCR7 also induced activation of the GTPase Rho, the tyrosine kinase Pyk2, and inactivation of cofilin. Pyk2 activation was independent of G(i) and Src and was dependent on Rho. Interference with Rho or Pyk2 inhibited cofilin inactivation and the migratory speed of DCs, but did not affect chemotaxis. Interference with Rho/Pyk2/cofilin inhibited DC migratory speed even in the absence of chemokines, suggesting that this module controls the speed of DCs and that CCR7, by activating its components, induces an increase in migratory speed. Therefore, CCR7 activates two independent signaling modules, one involving G(i) and a hierarchy of MAPK family members and another involving Rho/Pyk2/cofilin, which control, respectively, chemotaxis and the migratory speed of DCs. The use of independent signaling modules to control chemotaxis and speed can contribute to regulate the chemotactic effects of CCR7.

The expression of GLP‐1 receptor mRNA and protein allows the effect of GLP‐1 on glucose metabolism in the human hypothalamus and brainstem

Abstract: In the present work, several experimental approaches were used to determine the presence of the glucagon-like peptide-1 receptor (GLP-1R) and the biological actions of its ligand in the human brain. In situ hybridization histochemistry revealed specific labelling for GLP-1 receptor mRNA in several brain areas. In addition, GLP-1R, glucose transporter isoform (GLUT-2) and glucokinase (GK) mRNAs were identified in the same cells, especially in areas of the hypothalamus involved in feeding behaviour. GLP-1R gene expression in the human brain gave rise to a protein of 56 kDa as determined by affinity cross-linking assays. Specific binding of 125I-GLP-1(7-36) amide to the GLP-1R was detected in several brain areas and was inhibited by unlabelled GLP-1(7-36) amide, exendin-4 and exendin (9-39). A further aim of this work was to evaluate cerebral-glucose metabolism in control subjects by positron emission tomography (PET), using 2-[F-18] deoxy-D-glucose (FDG). Statistical analysis of the PET studies revealed that the administration of GLP-1(7-36) amide significantly reduced (p < 0.001) cerebral glucose metabolism in hypothalamus and brainstem. Because FDG-6-phosphate is not a substrate for subsequent metabolic reactions, the lower activity observed in these areas after peptide administration may be due to reduction of the glucose transport and/or glucose phosphorylation, which should modulate the glucose sensing process in the GLUT-2- and GK-containing cells.

Interleukin-7 receptor alpha (IL-7Ralpha) deficiency: cellular and molecular bases. Analysis of clinical, immunological, and molecular features in 16 novel patients.

Abstract: Analysis of gene-targeted mice and patients with severe combined immunodeficiency due to mutations of the alpha chain of the interleukin-7 receptor (IL-7Ralpha) has shown important differences between mice and humans in the role played by IL-7 in lymphoid development. More recently, it has been shown that IL-7Ralpha is also shared by the receptor for another cytokine, thymic stromal lymphopoietin (TSLP). In this review, we discuss recent advances in IL-7- and TSLP-mediated signaling. We also report on the clinical and immunological features of 16 novel patients with IL-7Ralpha deficiency and discuss the results of hematopoietic stem cell transplantation.

A Noninvasive Method for Assessing Impaired Diastolic Suction in Patients With Dilated Cardiomyopathy

Abstract: Background— Diastolic suction is a major determinant of early left ventricular filling in animal experiments. However, suction remains incompletely characterized in the clinical setting. Methods and Results— First, we validated a method for measuring the spatio-temporal distributions of diastolic intraventricular pressure gradients and differences (DIVPDs) by digital processing color Doppler M-mode recordings. In 4 pigs, the error of peak DIVPD was 0.0±0.2 mm Hg (intraclass correlation coefficient, 0.95) compared with micromanometry. Forty patients with dilated cardiomyopathy (DCM) and 20 healthy volunteers were studied at baseline and during dobutamine infusion. A positive DIVPD (toward the apex) originated during isovolumic relaxation, reaching its peak shortly after mitral valve opening. Peak DIVPD was less than half in patients with DCM than in control subjects (1.2±0.6 versus 2.5±0.8 mm Hg, P<0.001). Dobutamine increased DIVPD in control subjects by 44% (P<0.001) but only by 23% in patients with DCM ...

Estudio PREVENCAT: control del riesgo cardiovascular en atención primaria

Abstract: Fundamento y objetivo: Muchos estudios de factores de riesgo cardiovascular (FRCV) realizados en nuestro medio se centran en solo uno El estudio PREVENCAT se diseno para estimar el control de los principales FRCV en poblacion asistida en atencion primaria que presenta hipertension arterial (HTA), diabetes mellitus tipo 2 (DM-2) y/o hipercolesterolemia (HC) y para conocer la prevalencia de sindrome metabolico en estos pacientes Pacientes y metodo: Estudio multicentrico, transversal, en pacientes con HTA, DM-2 y/o HC, reclutados de forma consecutiva por medicos de atencion primaria en Espana Se evaluaron la presion arterial, el colesterol, la glucemia basal, la obesidad, el tabaquismo y el ejercicio fisico, y se estimaron el grado de control de estos FRCV y la prevalencia del sindrome metabolico Resultados: Se incluyo en el estudio a 2649 pacientes (un 51,6% mujeres) con una media (desviacion estandar) de edad de 64 (11,3) anos de edad El diagnostico mas frecuente fue la HTA (78,9%), seguido de HC (58,4%) y de DM-2 (37,4%) En toda la muestra, el porcentaje de pacientes que tenia bien controlada o basalmente normal la presion arterial, el colesterol y la glucemia basal fue del 40,0% (intervalo de confianza [IC] del 95%, 38,2-41,9), del 42,6% (IC del 95%, 40,5-44,7) y del 62,7% (IC del 95%, 60,8-64,5), respectivamente El 15,6% de los casos (IC del 95%, 14,3-17,0) tenia un indice de masa corporal menor o igual a 25 kg/m2, el 87,5% no fumaba en la actualidad (IC del 95%, 86,2-88,8) y el 46,2% practicaba ejercicio fisico regular (IC del 95%, 44,3-48,1) El 40% de los pacientes presentaba 2 o menos FRCV bien controlados La prevalencia del sindrome metabolico fue del 50,6% (IC del 95%, 48,7-52,5) Conclusiones: El control de los FRCV considerados en poblacion atendida en atencion primaria es insuficiente Apenas uno de cada 2 pacientes con HTA, DM-2 o HC esta controlado El control del sobrepeso y el sedentarismo es aun peor

FOXP3, a selective marker for a subset of adult T-cell leukaemia/lymphoma.

Abstract: FOXP3 is a forkhead transcription factor family member, implicated in T-cell regulation, activation and differentiation. FOXP3 has been shown to be a master control gene for the development and function of CD4+/CD25+ regulatory T-cells (T(reg)). In this study, FOXP3 protein expression has been analysed using a new anti-FOXP3 monoclonal antibody in 172 paraffin-embedded lymphoma samples. FOXP3 expression in tumour cells was confined to adult T-cell leukaemia/lymphoma (ATLL) cases (17/25, 68%), with some variability in the intensity of the staining and the proportion of positive cells. No other lymphoma types studied exhibited FOXP3 expression in the malignant population. The selective expression of FOXP3 by tumour cells in ATLL makes this antibody a potentially useful diagnostic tool.

Histone Deacetylase 6 Regulates Human Immunodeficiency Virus Type 1 Infection

Abstract: Efficient human immunodeficiency virus (HIV)-1 infection depends on multiple interactions between the viral gp41/gp120 envelope (Env) proteins and cell surface receptors. However, cytoskeleton-associated proteins that modify membrane dynamics may also regulate the formation of the HIV-mediated fusion pore and hence viral infection. Because the effects of HDAC6-tubulin deacetylase on cortical α-tubulin regulate cell migration and immune synapse organization, we explored the possible role of HDAC6 in HIV-1-envelope-mediated cell fusion and infection. The binding of the gp120 protein to CD4+-permissive cells increased the level of acetylated α-tubulin in a CD4-dependent manner. Furthermore, overexpression of active HDAC6 inhibited the acetylation of α-tubulin, and remarkably, prevented HIV-1 envelope-dependent cell fusion and infection without affecting the expression and codistribution of HIV-1 receptors. In contrast, knockdown of HDAC6 expression or inhibition of its tubulin deacetylase activity strongly enhanced HIV-1 infection and syncytia formation. These results demonstrate that HDAC6 plays a significant role in regulating HIV-1 infection and Env-mediated syncytia formation.

The psychosocial impact of hair loss among men: a multinational European study.

Abstract: Objective: Hair plays an important role in determining self-image, social perceptions, and psychosocial functioning. The objectives of this survey were to identify the impact of hair loss on the se...

Manejo del síndrome coronario agudo sin elevación del segmento ST en España. Estudio DESCARTES (Descripción del Estado de los Síndromes Coronarios Agudos en un Registro Temporal Español)

Abstract: Introduccion y objetivos Se dispone de escasa informacion acerca de la situacion asistencial a escala poblacional de los sindromes coronarios agudos sin elevacion del segmento ST (SCASEST) en Espana. El objetivo es conocer la situacion de la atencion medica a los pacientes con SCASEST en Espana, desde una perspectiva representativa de la realidad estatal. Pacientes y metodo Registro prospectivo de pacientes consecutivos con SCASEST ingresados en 52 hospitales espanoles con distintos recursos cardiologicos, seleccionados al azar y que cumplieron con los criterios de control de calidad del estudio. Resultados Entre abril y mayo de 2002 se recluto a 1.877 pacientes con una edad promedio de 69 anos. El 93% tenia algun factor de riesgo y 73% antecedentes cardiovasculares. Un 76% presentaba un electrocardiograma anormal y un 53% elevacion de las troponinas. El 27% fue ingresado en una unidad coronaria o de cuidados intensivos. Se estudio al 56% de los pacientes mediante ecocardiografia, al 39% mediante una prueba de deteccion de isquemia y al 41% mediante coronariografia. En el hospital, un 88% recibio aspirina, un 81% heparina, un 37% clopidogrel, un 12% inhibidores de la glucoproteina IIb/IIIa, un 63% bloqueadores beta, un 46% inhibidores de la enzima de conversion de la angiotensina y un 52% estatinas. Se realizo revascularizacion coronaria en el 24% de los pacientes. El diagnostico final fue angina en el 54%, infarto en el 28% y otros diagnosticos en el 18%. La mortalidad fue del 3,7% a los 28 dias y del 7,8% a 6 los meses. Conclusiones DESCARTES es el primer registro representativo de la actividad asistencial en la atencion a los SCASEST en Espana. Se demuestra que, pese a que son pacientes de alto riesgo, reciben una atencion suboptima segun lo recomendado.

Psychosocial Factors and Health-Related Quality of Life in Hemodialysis Patients

Abstract: Several sociodemographic and clinical variables are known to influence the health-related quality of life (HRQOL) of patients with kidney disease, yet the relationship between psychological factors and the HRQOL measured by the Kidney Disease Quality of Life Short-Form (KDQOL-SF) is incompletely understood. The objective of this study was to examine the relationship between psychosocial status (depressive symptoms, trait anxiety, and social support) and KDQOL-SF scales in hemodialysis (HD) patients by controlling the effects of sociodemographic and clinical variables. The HRQOL of 194 patients from 43 dialysis centers in Spain was assessed by completing the KDQOL-SF, and evaluating depressive symptoms (Cognitive Depression Index), trait anxiety (Trait Anxiety Inventory) and degree of social support (Scale of Perceived Social Support). We also recorded several sociodemographic and clinical variables. Two regression models were estimated for each of the 19 scales in the KDQOL-SF. In the first model, we only included sociodemographic and clinical-factors, while the second model also took into consideration psychosocial variables. These last factors (trait anxiety and depressive symptoms, not social support) were found to increase the proportion of explained variability, with highest standardized regression coefficients observed for most KDQOL-SF scales. Depressive symptoms were related to a poor HRQOL when there was a strong physical component, while trait anxiety was mainly related to emotional upset and social relationships. We were able to conclude that trait anxiety and depressive symptoms are strongly associated with the HRQOL assessed by the KDQOL-SF in HD patients. The effects of these factors should therefore be considered when evaluating the quality of life of this type of patient.

Randomized double-blind placebo-controlled trial of early octreotide in patients with postoperative enterocutaneous fistula.

Abstract: Somatostatin and octreotide both enhance closure of gastrointestinal fistulas. The present trial was undertaken to test whether early combined treatment with parenteral nutrition and octreotide 100 micrograms every 8 h by subcutaneous injection had a beneficial effect compared with parenteral nutrition plus placebo. Thirty-one patients with post-operative gastrointestinal or pancreatic fistula were randomly assigned to receive parenteral nutrition plus octreotide (14 patients) or placebo (17) within 8 days of fistula onset. The percentage reduction in output and rate of spontaneous closure within 20 days were analysed. Mean(s.d.) reduction in output was similar after octreotide and placebo at 24 h (66(43) versus 68(47) per cent, P = 0.9), 48 h (60(46) versus 57(43) per cent, P = 0.8) and 72 h (62(50) versus 66(49) per cent, P = 0.9) after starting the combined treatment. Closure within 20 days was observed in eight of 14 fistulas in patients given octreotide and in six of 17 in those receiving placebo (P = 0.4). Administration of octreotide, within 8 days of fistula onset, associated with parenteral nutrition does not significantly increase the spontaneous fistula closure rate compared with parenteral nutrition plus placebo.

A prospective, randomized, and comparative study of 3 different methods for the diagnosis of intravascular catheter colonization.

Abstract: Background. Demonstration of catheter tip colonization is usually performed by use of Maki's semiquantitative technique, although the superiority of quantitative techniques has been claimed on the basis of their purported ability to detect both endoluminal and exoluminal microorganisms. Methods. We prospectively compared Maki's semiquantitative technique and the quantitative methods of sonication and vortexing for the detection of colonization of intravascular catheter tips and catheter-related bloodstream infections. All 3 techniques were performed on the tip of each catheter, and the order in which each technique was performed was randomly assigned. Results. Of the 1000 catheter tips that were processed, 329 (32.9%) had positive results for at least 1 of the 3 techniques when a breakpoint of ≥100 colony-forming units (cfu)/catheter segment was used for the quantitative techniques and a breakpoint of ≥15 cfu was used for Maki's technique. Eighty-two of the catheter tips for which results were positive were from patients with catheter-related bloodstream infections. For each technique, the likelihood of detection decreased progressively depending on the order in which the technique was performed (i.e., second vs. first and third vs. second). The likelihood of detection of catheter colonization for each technique, when the technique was performed first and when 2 breakpoints (≥100 cfu/catheter segment [criterion B] and ≥1000 cfu/catheter segment [criterion A]) were used for the quantitative techniques and a breakpoint of ≥15 cfu was used for Maki's technique, was as follows: 99.1% and 100% for Maki's technique, 95.1% and 92.9% for sonication, and 93.1% and 72.8% for vortexing (for criteria B and A, respectively). No inferiority of Maki's technique could be demonstrated when results were compared according to whether catheter placement was short term (i.e., <7 days) or long term (i.e., ≥7 days), either for the detection of colonization or for the detection of catheter-related bloodstream infections. Conclusions. According to data from the present study, the quantitative techniques of sonication and vortexing were not superior to Maki's technique under the test conditions used. The greater simplicity of Maki's semiquantitative technique makes it the procedure of choice for routine work in the microbiology laboratory.