ABSTRACT
Se presenta un caso de un hombre con diagnóstico de osteomielitis crónica con aislamiento en cultivo de hueso de Providencia rettgeri productora de carbapenemasa de tipo Nueva Delhi. El paciente presentó control de la infección por este germen con terapia antibióticacombinada con cefepime y gentamicina. Es el primer reporte de una infección por enterobacterias con este mecanismo de resistencia en la región.
We reported a case in a man with chronic osteomyelitis of an isolate of Providencia rettgeri carrying New-Delhi metallo-beta-lactamase. The isolate was obtained from the patient's bone culture. The infection was controlled with combined antibiotic therapy (cefepime and gentamicine). This is the first report of an infection produced by Enterobacteriaceae carrier of this metallo-beta-lactamase in the region.
Subject(s)
Humans , Male , Middle Aged , Osteomyelitis , Anti-Bacterial Agents , beta-Lactamases , Gentamicins , Colombia , Enterobacteriaceae , CefepimeABSTRACT
We report a suspicious case of spontaneous bacterial peritonitis (SBP) caused by Providencia rettgeri and Clostridium perfringens in a patient with alcoholic cirrhosis. The patient presented with altered mentality and was taken to the emergency room. He was diagnosed with SBP after abdominal paracentesis and computed tomography and was treated with ceftriaxone and metronidazole. The pathogens were identified under suspicion of polymicrobial infection because of Gram-staining discrepancies between broth from blood culture bottles and colonies on solid media. He died of septic shock despite transfer to the intensive care unit. Although we could not conclude which organism had the leading role in this case of SBP and septicemia, we did verify the importance of Gram staining in a microbiology laboratory in terms of quality assurance.
Subject(s)
Humans , Ceftriaxone , Clostridium perfringens , Coinfection , Emergency Service, Hospital , Intensive Care Units , Liver Cirrhosis, Alcoholic , Metronidazole , Paracentesis , Peritonitis , Providencia , Sepsis , Shock, SepticABSTRACT
Se presenta el caso de un paciente con osteomielitis por Providencia rettgeri. Recibía warfarina, por trombosis venosa profunda de miembro inferior izq.; durante su evolución antes de ingresar al Hospital General del Oeste, Caracas, Venezuela, presentó una infección secundaria a la avulsión de la uña, con varias hospitalizaciones en otros centros de salud. Hubo un antecedente no comprobado de diabetes mellitus. Se analiza el caso y se revisa la literatura en la que no se encontró descripción con compromiso de partes blandas en la literatura nacional o latinoamericana.
A case of osteomyelitis due to Providence rettgeris presented by in a patient who was receiving warfarin for a deep vein thrombosis of the left lower limb. He also presented asoft tissue infection secondary to nail avulsion and was hospitalized several times berfore being admitted to the Hospital General del Oeste, Caracas, Venezuela. There was a history of possible diabetes mellitus which was not proven. We reviewed the nationaland Latin American literature analyzed, but description of P. rettgeri was found with soft tissue involvement in reviewed literature.
Subject(s)
Humans , Male , Aged , Necrosis/surgery , Necrosis/pathology , Osteomyelitis/diagnosis , Osteomyelitis/therapy , Venous Thrombosis/surgery , Venous Thrombosis/diagnosis , Warfarin/therapeutic use , Internal MedicineABSTRACT
A prostatic abscess is a rare, but potentially serious disease. The mainstay of treatment for the prostatic abscess is antibiotic administration and drainage. Here, we experienced a 66-year-old man with a prostatic abscess caused by Providencia rettgeri, which has not been reported as a pathogenic agent of a prostatic abscess. He was cured using antibiotics, without surgical drainage. This case suggests that the appropriate selection of patients for antibiotic therapy may provide an excellent prognosis.
Subject(s)
Humans , Abscess , Anti-Bacterial Agents , Drainage , Prognosis , Prostate , ProvidenciaABSTRACT
Providencia rettgeri is a member of Enterobacteriacea that is known to cause urinary tract infection (UTI), septicemia, and wound infections, especially in immunocompromised patients and in those with indwelling urinary catheters. We experienced a case of UTI sepsis by Providencia rettgeri in a patient with spinal cord injury. The patient had only high fever without urinary symptoms or signs after high dose intravenous methylprednisolone. The laboratory results showed leukocytosis (21,900/microL, segmented neutrophils 91.1%) and pyuria. Cefepime was given empirically and it was switched to oral trimethoprim-sulfamethoxazole because P. rettgeri was identified from blood and urine culture which was susceptible to TMP-SMX. The patient was improved clinically but P. rettgeri was not eradicated microbiologically. To the best of our knowledge, this is the first case report on sepsis caused by Providencia rettgeri in Korea.
Subject(s)
Humans , Cephalosporins , Fever , Immunocompromised Host , Korea , Leukocytosis , Methylprednisolone , Neutrophils , Providencia , Pyuria , Sepsis , Spinal Cord Injuries , Trimethoprim, Sulfamethoxazole Drug Combination , Urinary Catheters , Urinary Tract Infections , Wound InfectionABSTRACT
Snakebite is very common especially in Asia. We report a rare case of Providencia rettgeri infection following snakebite on the foot. This patient was treated with early and aggressive wound debridement, daily wound dressing during hospitalization and then skin coverage with split skin graft. No anti venom was given administered. Appropriate intravenous antibiotics were given to the patient while hospitalized and oral antibiotic were prescribed upon discharge. The outcome of this treatment was successful.
ABSTRACT
BACKGROUND: VIM-2 type metallo-beta-lactamase (MBL) producing strains are presently spreading to Pseudomonas spp., Acinetobacter spp. and even to Enterobacteriaceae such as Serratia marcescens, Enterobacter cloacae and Klebsiella pneumoniae in Korea. Recently we determined the phenotype and the genotype of three MBL-producing Providencia rettgeri isolated from urinary specimen of three patients with neurosurgical ward, and analyzed the blaVIM-2 containing integron of a P. rettgeri CBU852. METHODS: EDTA-disk synergy test was used for the screening of MBL, and the PCR for blaIMP-1, blaVIM-1 and blaVIM-2 was performed. The minimal inhibitory concentration of those isolates was determined by broth microdilution method, and the genomic DNA fingerprinting analysis was performed by random amplified polymorphic DNA (RAPD). The sequence of the blaVIM-2 containing integron was determined. RESULTS: Three P. rettgeri with reduced imipenem susceptibility showed the positive EDTA-disk synergy test and blaVIM-2 was detected by PCR. Antimicrobial susceptibility test showed the resistance to all beta-lactams tested, ciprofloxacin and aminoglycoside such as gentamicin, tobramycin and amikacin, indicating multidrug resistance of those isolates. RAPD analysis showed the identical DNA fingerprint of those three isolates. The novel class 1 integron, including aacA4, blaVIM-2, orf "ii" and orf "iii", was detected in a P. rettgeri CBU852. CONCLUSIONS: In this study, the multidrug resistant P. rettgeri CBU852 had blaVIM-2 containing novel class 1 integron. The emergence of blaVIM-2 producing P. rettgeri could compromise the use of carbapenem in treatment of infections caused by MBL producing bacteria. To our knowledge, this is the first report that VIM-2 MBL gene has been detected in P. rettgeri.