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1.
Acta ortop. mex ; 33(4): 232-236, jul.-ago. 2019. tab
Article in Spanish | LILACS | ID: biblio-1284945

ABSTRACT

Resumen: Introducción: Las infecciones por enterobacterias productoras de β-lactamasas de espectro extendido (BLEEs) ocasionan una gran carga a los sistemas de salud. Poco se conoce de las infecciones osteoarticulares, por lo que este trabajo estudió la prevalencia de estas infecciones en un hospital de tercer nivel. Material y métodos: Estudio de prevalencia en pacientes de un servicio de traumatología durante 2016, con criterios de infección proporcionados por el CDC de Atlanta, Georgia. Se utilizó el sistema VITEK® 2 AST-N272 (bioMérieux) para la identificación bacteriana a nivel de especie y para las pruebas de susceptibilidad antimicrobiana. Resultados: Se reportaron 7.85% (n = 86) con infecciones osteoarticulares; 22.09% (n = 19) fueron por enterobacterias BLEEs. Con un promedio de 77.1 días de hospitalización (DE 37.7) (46-200 días); el aislamiento del microorganismo se produjo 15 días posteriores al ingreso; 16 (84.2%) pacientes presentaron osteomielitis, tres (15.8%) tuvieron infección protésica de rodilla o cadera. El promedio de días de tratamiento fue de 60 días (21-129 días); 18 pacientes (94.7%) fueron dados de alta con resolución de su cuadro infeccioso; un paciente falleció con infección sobreagregada por neumonía debida a K. pneumoniae resistente a carbapenémicos. Discusión: La prevalencia de infecciones osteoarticulares por enterobacterias BLEEs no se pudo calcular con precisión, pero consideramos que se encuentra dentro de lo esperado, las medidas de control de infecciones requieren tener estándares más elevados y falta desarrollar programas de uso racional de antimicrobianos para controlar la aparición de estas patologías.


Abstract: Introduction: Infections of enterobacteria producing extended-spectrum ß-lactamases place a heavy burden on health systems. Little is known in osteoarticular infections, so this work studied the prevalence of these infections in a third-level hospital. Material and methods: Prevalence study in patients of a Traumatology Service during 2016, with infection criteria provided by the CDC in Atlanta, Georgia. The VITEK® 2 AST-N272 (bioMérieux) system was used for bacterial identification at the species level and for antimicrobial susceptibility tests. Results: 7.85% (n = 86) were reported with osteoarticular infections; 22.09% (n = 19) were by enterobacteria BLEEs. An average of 77.1 days of hospitalization (SD 37.7) (46-200 days); isolation of the microorganism occurred 15 days after entry. Sixteen (84.2%) patients had osteomyelitis, three (15.8%) had a prosthetic knee or hip infection. The average number of treatment days was 60 days (21-129 days). Eighteen patients (94.7%) were discharged with resolution of their infectious picture; one patient died with infection over aggregated pneumonia due to carbapenem-resistant K. pneumoniae. Discussion: The prevalence of osteoarticular infections by enterobacteria BLEEs could not be accurately calculated, but we consider it to be within what is expected, infection control measures require higher standards and there is a lack of development programs to use antimicrobials rationally to control the emergence of these pathologies.


Subject(s)
Humans , Bone Diseases, Infectious/diagnosis , Bone Diseases, Infectious/therapy , Bone Diseases, Infectious/epidemiology , Enterobacteriaceae/isolation & purification , Enterobacteriaceae Infections/diagnosis , Enterobacteriaceae Infections/drug therapy , Enterobacteriaceae Infections/epidemiology , beta-Lactamases , Prevalence , Anti-Bacterial Agents
2.
Article in French | AIM, AIM | ID: biblio-1264223

ABSTRACT

Introduction: Les entérobactéries constituent les principales causes d'infections bactériennes.Ce sont des Bactéries Multi- résistantes (BMR)fréquentes par production de BLSE(Bêtalactamases à spectre élargi).Ceci constitue un problème de santé publique majeur car cette résistance est à l'origine d'une impasse thérapeutique et conduit à une prescriptiond'antibiotiques à large spectre (carbapénèmes). Notre étude prospective allant du 01 janvier au 31 décembre 2017 a porté sur 50 souches d'entérobactéries isolées au laboratoire et a pour but de caractériser les types de bêtalactamases.Méthodologie : Les souches ont été ré-isolées d'abord sur milieu Mueller Hinton, ensuite identifiées par la morphologie et les caractères biochimiques des entérobactéries. Les méthodes suivantes ont été réalisées pour la mise en évidence des classes de BLSE. - Méthode de rapprochement des disques (synergie entre un disque Amoxicilline + Acide clavulanique (AMC) et les disques de Céphalosporine de 3ieme (C3G) : BLSE de classe A. - Méthode de Dongeun Yong et al. utilisant l'EDTA (Ethylène Diamine Tétra-acétique) 0,5 M, PH 7 (Inhibition du zinc présent sur le site actif de l'enzyme par l'EDTA): BLSE de classe B. Résultat : Les souches d'entérobactéries étaient réparties ainsi : Enterobacter spp : 40%, Escherichia coli : 32%, Klebsiella pneumoniae : 24% et Klebsiella oxytoca : 4%. Cinquante-six pour cent 56% des souches produisaient une BLSE de classe A (image « bouchon de champagne ») et 14% une BLSE de classe B avec restauration de l'activité de l'imipenème après association de l'EDTA. Enterobacter spp était la souche la plus représentée avec 12 souches sécrétrices d'une BLSE de classe A et 5 souches de classe B, suivie d'E. coli avec 08 souches sécrétrices d'une BLSE de classe A et 01 souche de classe B. K. pneumoniae et K. oxytoca comptaient respectivement 06 et 02 souches sécrétrices de BLSE de classe A. Conclusion : L'acquisition par les entérobactéries et la transmission de résistance, par production de BLSE de classe A ou B est un problème majeur de santé publique causant une véritable impasse thérapeutique. Aujourd'hui, la prévalence de la résistance par production de Métallo-bêtalactamase (MBL) est faible comparée à celle de BLSE de classe A. Ainsi, des stratégies de diagnostic et de maîtrise de la diffusion doivent être appliquées rigoureusement


Subject(s)
Amoxicillin , Drug Resistance, Multiple, Bacterial , Enterobacteriaceae Infections , Enterobacteriaceae Infections/diagnosis , Enterobacteriaceae Infections/prevention & control , Enterobacteriaceae Infections/transmission , Senegal
3.
Arch. argent. pediatr ; 116(6): 744-748, dic. 2018. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-973689

ABSTRACT

La enfermedad granulomatosa crónica es una inmunodeficiencia primaria infrecuente, debida a un defecto en la actividad microbicida de los fagocitos, originada por mutaciones en los genes que codifican alguna de las subunidades del complejo enzimático nicotinamida adenina dinucleótido fosfato oxidasa. La incidencia estimada es 1 en 250 000 recién nacidos vivos. Puede presentarse desde la infancia hasta la adultez, por lo general, en menores de 2 años. Las infecciones bacterianas y fúngicas, en conjunto con las lesiones granulomatosas, son las manifestaciones más habituales de la enfermedad. Los microorganismos aislados más frecuentemente son Aspergillus spp., Staphylococcus aureus, Serratia marcescens, Nocardia spp. Se reporta el caso clínico de un varón de 1 año de vida en el que se diagnosticó enfermedad granulomatosa crónica a partir de infecciones múltiples que ocurrieron simultáneamente: aspergilosis pulmonar invasiva, osteomielitis por Serratia marcescens y granuloma cervical por Enterobacter cloacae.


Chronic granulomatous disease is an uncommon primary immunodeficiency due to a defect of the killing activity of phagocytes, caused by mutations in any of the genes encoding subunits of the superoxide-generating phagocyte NADPH oxidase system. The incidence is 1 in 250 000 live births. It can occur from infancy to adulthood, usually in children under 2 years. Bacterial and fungal infections in association with granuloma lesions are the most common manifestations of the disease. Aspergillus species, Staphylococcus aureus, Serratia marcescens, Nocardia species are the most common microorganisms isolated. We describe here a case of a 1-year-old boy with chronic granulomatous disease and invasive pulmonary aspergillosis, Serratia marcescens osteomyelitis and Enterobacter cloacae cervical granuloma.


Subject(s)
Humans , Male , Infant , Serratia Infections/diagnosis , Enterobacteriaceae Infections/diagnosis , Pulmonary Aspergillosis/diagnosis , Granulomatous Disease, Chronic/diagnosis , Osteomyelitis/diagnosis , Osteomyelitis/metabolism , Serratia marcescens/isolation & purification , Serratia Infections/microbiology , Enterobacter cloacae/isolation & purification , Enterobacteriaceae Infections/microbiology , Granulomatous Disease, Chronic/microbiology
4.
Braz. j. microbiol ; 49(4): 914-918, Oct.-Dec. 2018. tab
Article in English | LILACS | ID: biblio-974286

ABSTRACT

ABSTRACT The global emergence of carbapenemases led to the need of developing new methods for their rapid detection. The aim of this study was to evaluate the performance of the rapid tests for carbapenemase-producing and non-producing Enterobacteriaceae. Carbapenem non-susceptible Enterobacteriaceae from a surveillance study submitted to a multiplex real time PCR for carbapenemase detection were included in this study. The isolates were subjected to the rapid phenotypic tests Carba NP, Blue-Carba and Carbapenem Inactivation Method (CIM). A total of 83 carbapenemase-producing (43) and non-producing (40) isolates were included in the study. The sensitivity/specificity were 62.7%/97.5%, 95.3%/100%, and 74.4%/97.5% for Carba NP, Blue-Carba and CIM, respectively. Both Carba NP and Blue-Carba presented their final results after 75 min of incubation; the final results for CIM were obtained only after 8 h. Failure to detect OXA-370 carbapenemase was the main problem for Carba NP and CIM assays. As the Blue-Carba presented the highest sensitivity, it can be considered the best screening test. Conversely, CIM might be the easiest to perform, as it does not require special reagents. The early detection of carbapenemases aids to establish infection control measures and prevent carbapenemases to spread reducing the risk of healthcare associated infections and therapeutic failure.


Subject(s)
Humans , Bacterial Proteins/analysis , beta-Lactamases/analysis , Enterobacteriaceae/enzymology , Enterobacteriaceae Infections/microbiology , Enzyme Assays/methods , Bacterial Proteins/genetics , Bacterial Proteins/metabolism , beta-Lactamases/genetics , beta-Lactamases/metabolism , Brazil , Carbapenems/pharmacology , Polymerase Chain Reaction , Sensitivity and Specificity , Enterobacteriaceae/isolation & purification , Enterobacteriaceae/drug effects , Enterobacteriaceae/genetics , Enterobacteriaceae Infections/diagnosis , Anti-Bacterial Agents/pharmacology
5.
Rev. chil. infectol ; 35(3): 253-261, 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-959439

ABSTRACT

Resumen Introducción: Las Enterobacteriaceae productoras de carbapenemasas (EPC) han tomado gran importancia en salud pública a una escala global, haciendo necesario implementar test rápidos para su detección oportuna. Objetivo: Evaluar tres metodologías para el tamizaje de EPC en hisopados rectales. Materiales y Métodos: Estudio prospectivo transversal. Se evaluaron 73 hisopados rectales por tres metodologías. Se realizó identificación y evaluación de susceptibilidad por sistemas automatizados y la producción de carbapenemasas se confirmó por test de Hodge modificado, sinergia con ácido borónico y EDTA. Resultados: Método 1 (ChromID CARBA®): detectó 20 muestras positivas (27,4%), 5 falsos positivos (6,9%), con índice de concordancia de 93,2%, sensibilidad 100% y especificidad de 90%. Método 2 (HB&L Carbapenemase®): detectó 17 muestras positivas (23,3%) y 3 falsos negativos (4,1%). La sensibilidad y especificidad fue 85 y 100% respectivamente, con concordancia de 95,9%. Método 3 (Xpert Carba-R®): detectó 19 muestras positivas (57,5 %) y 1 falso negativo (3,1%), sensibilidad 95%, especificidad 100% e índice de concordancia de 97%. Discusión: Existe amplia variedad de metodologías para búsqueda y detección rápida de microorganismos productores de carbapenemasas. La elección del método debe tener como requisito una buena sensibilidad y especificidad, rapidez y costo efectividad.


Background: Carbapenemase-producing Enterobacteriaceae (CPE) have taken great importance on public health at global scale, which makes it necessary to implement rapid test for its prompt detection. Aim: To evaluate three screening methods to detect CPE in rectal swabs. Material and Methods: Transverse study, prospective. Seventy three rectal swabs were evaluated by three methodologies. Microorganism identification and susceptibility testing were made using automated systems. Carbapenemase production was confirmed by modified Hodge test and synergy tests using boronic acid and EDTA. Results: The method 1 (ChromID CARBA®) detected 20 positive samples (27.4%), 5 false positives (6.9 %), with concordance index of 93.2%, sensitivity 100% and specificity of 90%. Method 2 (HB&L Carbapenemase®) detected 17 positive samples (23.3%) and 3 false negatives (4.1%). The sensitivity and specificity of the assay were 85% and 100%, with concordance index of 95.9%. Method 3 (Xpert Carba-R®) detected 19 positive samples (57.5%) and 1 false negatives (3.1%), sensitivity 95%, specificity 100% and concordance index of 97%. Discussion: There is a wide variety of methodologies for rapid detection of carbapenemase-producing microorganisms. Choosing the best method must have as requirement a good sensitivity, specificity, and cost-effectiveness.


Subject(s)
Humans , Rectum/microbiology , Mass Screening/methods , Bacteriological Techniques/methods , Enterobacteriaceae Infections/diagnosis , Enterobacteriaceae Infections/microbiology , Carbapenem-Resistant Enterobacteriaceae/isolation & purification , Cross-Sectional Studies , Prospective Studies , Sensitivity and Specificity
6.
Article in English | WPRIM | ID: wpr-48264

ABSTRACT

BACKGROUND: The emergence of carbapenemase-producing Enterobacteriaceae (CPE) represents a major clinical problem because these bacteria are resistant to most antibiotics. CPE remain relatively uncommon in Korea. We report the prevalence, clinical characteristics, and molecular epidemiology of CPE isolates collected from five university hospitals in Korea. METHODS: Between January and December 2015, 393 non-duplicated isolates that were nonsusceptible to ertapenem were analyzed. Production of carbapenemase, extended-spectrum β-lactamase, and AmpC β-lactamase was determined by genotypic tests. Antimicrobial susceptibility profiles were determined by using an Etest. Clonality of Klebsiella pneumoniae carbapenemase (KPC)-2-producing and oxacillinase (OXA)-232-producing Klebsiella pneumoniae isolates was determined by pulsed-field gel electrophoresis (PFGE). RESULTS: Of the 393 isolates tested, 79 (20.1%) were CPE. Of these 79 isolates, 47 (59.5%) harbored the bla(OXA-232) gene while the remaining isolates carried genes bla(KPC-2) (n=27), bla(IMP-1) (n=4), and bla(NDM-1) (n=1). Among the 24 KPC-2 K. pneumoniae isolates from hospital B, 100% were resistant to carbapenems, 8% to colistin, and 0% to tigecycline. Among the 45 OXA-232 K. pneumoniae at hospital C, 95% were resistant to ertapenem, 68% to imipenem, 95% to meropenem, 10% to colistin, and 24% to tigecycline. PFGE analysis revealed a unique pattern for KPC-2 K. pneumoniae and identified 30 isolates belonging to the dominant pulsotypes (PT)1 and PT2 among 41 OXA-232 K. pneumoniae isolates. CONCLUSIONS: CPE strains are present in Korea, with the majority of K. pneumoniae isolates producing OXA-232 and KPC-2. The prevalence and predominant genotypes of CPE show hospital-specific differences.


Subject(s)
Aged , Anti-Bacterial Agents/pharmacology , Bacterial Proteins/genetics , Drug Resistance, Bacterial , Electrophoresis, Gel, Pulsed-Field , Enterobacteriaceae/drug effects , Enterobacteriaceae Infections/diagnosis , Female , Genotype , Hospitals , Humans , Male , Microbial Sensitivity Tests , Middle Aged , Prevalence , Republic of Korea/epidemiology , beta-Lactamases/genetics
7.
Article in English | IMSEAR | ID: sea-163468

ABSTRACT

Citrobacter species have been reported to cause a wide spectrum of infections in humans and invasive infections are associated with a high mortality rate, with 33 to 48% of patients succumbing to Citrobacter bacteraemia. The high mortality rate associated with Citrobacter infections may be due in part to ineffective empirical antibiotic therapy. Citrobacter has been found to produce SHV and TEM derived Extended spectrum beta lactamases in addition to chromosomal inducible AmpC beta - lactamases which could be contributing to increasing drug resistance. The aims of the study were to detect the prevalence of Citrobacter infections with its associated risk factors, antibiotic susceptibility patterns and determination of beta-lactamase activity- both extended spectrum beta - lactamase and AmpC beta-lactamase activity among Citrobacter isolates. The isolates were identified by standard microbiological procedures. ESBL detection was by double disc diffusion method and AmpC beta-lactamase detection was done using Cefotaxime and Cefoxitin discs. C. braakii (33.3%) was the commonest genomospecies identified followed by C. freundii (21.3%) and C. amalonaticus (16.66 %) among 150 Citrobacter isolates. Diabetes mellitus was the major risk factor. Imipenem (100%)was most effective whereas 98% showed resistance to Ampicillin; carbapenems and fourth generation Cefipime showed better sensitivity than third generation cephalosporins. The study highlights the need for informed antibiotic treatment guided by routine antimicrobial susceptibility and knowledge of the ESBL status of the isolate, the outcome of which undoubtedly will be better patient care.


Subject(s)
CITROBACTER --ISOLATION & , Citrobacter/microbiology , Enterobacteriaceae Infections/diagnosis , Enterobacteriaceae Infections/microbiology , Humans , beta-Lactamases/biosynthesis , beta-Lactamases/classification , beta-Lactamases/metabolism
8.
Clin. biomed. res ; 35(1): 43-48, 2015. ilus, tab
Article in Portuguese | LILACS | ID: lil-780277

ABSTRACT

Enterobactérias pertencem a um grupo grande e heterogêneo de bacilos Gram-negativos cujo habitat natural é o cólon de humanos e animais, sendo microrganismos amplamente distribuídos na natureza. Devido a essas características são frequentemente responsáveis por infecções hospitalares. O principal objetivo desse estudo foi avaliar a concordância entre as provas bioquímicas manuais e o sistema automatizado BD Phoenix 100 na identificação de enterobactérias, a partir da análise de registros de pacientes hospitalizados. Métodos: No período de agosto de 2011 a abril de 2012, foram realizados 303 exames no Laboratório Exame de Análises Clinicas pelos métodos manual e automatizado, os quais foram submetidos a análise dos dados. Resultados: Do total, 27,7% foram positivos para enterobactérias. Os microrganismos mais frequentes isolados foram a Klebsiella pneumoniae (36,9%) e Escherichia coli (29,8%). O estudo apresentou uma alta concordância entre os métodos, principalmente na identificação dos gêneros, caso em que a concordância chegou a 97% dos registros. Na identificação das espécies, as bactérias dos gêneros Klebsiella spp. e Serratia spp. não tiveram suas espécies identificadas pelo método manual em sete dos registros observados, sendo identificadas somente pela automação. Da mesma forma, algumas amostras de Escherichia coli não foram detectadas pelo método manual, que as identificou como indeterminadas em quatro dos registros analisados. Conclusão: Verificou-se uma boa concordância entre os métodos na identificação das principais enterobactérias isoladas de amostras clínicas...


Enterobacteriaceae are microorganisms that are widely distributed in nature and belong to a large and heterogeneous group of Gram-negative bacilli whose natural habitat is the colon of human beings and animals and are. Because of these characteristics they are often responsible for hospital infections. The main objective of this study was to assess the agreement between manual biochemical tests and the BD Phoenix 100 automated system in the identification of the Enterobacteriaceae, based on an analysis of hospitalized patients’ records. Methods: In the period between August 2011 and April 2012, 303 tests were made at Laboratório Exame de Análises Clinicas by the manual and automated methods, which were subjected to analysis. Results: Results revealed that 27.7% of the tests were positive for Enterobacteriaceae. The most commonly isolated microorganisms were Klebsiella pneumoniae (36.9%) and Escherichia coli (29.8%). The study showed a high agreement between the methods, especially in the identification of genders, in which case agreement reached 97% of records. When it comes to identifying the species, seven samples of Klebsiella spp. and Serratia spp. bacteria had their species identified only by the automated method and not by the manual method. Similarly, some samples of Escherichia coli, were not detected by the manual, which identified them as indeterminate in four of the records analyzed. Conclusions: There was a good agreement between both methods in identifying the major Enterobacteriaceae isolated from clinical samples...


Subject(s)
Humans , Enterobacteriaceae Infections/diagnosis , Laboratory Test , Microbial Sensitivity Tests , Inpatients/statistics & numerical data
9.
Article in English | WPRIM | ID: wpr-29328

ABSTRACT

BACKGROUND: We evaluated the combined use of the modified Hodge test (MHT) and carbapenemase inhibition test (CIT) using phenylboronic acid (PBA) and EDTA to detect carbapenemase-producing Enterobacteriaceae (CPE) and metallo-beta-lactamase (MBL)-producing Pseudomonas spp. METHODS: A total of 49 isolates of CPE (15 Klebsiella pneumoniae carbapenemase [KPC], 5 Guiana extended-spectrum beta-lactamase [GES]-5, 9 New Delhi metallo-beta-lactamase [NDM]-1, 5 Verona integron-encoded metallo-beta-lactamase [VIM]-2, 3 imipenem-hydrolyzing beta-lactamase [IMP], and 12 oxacillinase [OXA]-48-like), 25 isolates of MBL-producing Pseudomonas spp. (14 VIM-2 and 11 IMP), and 35 carbapenemase-negative controls were included. The MHT was performed for all isolates as recommended by the Clinical and Laboratory Standards Institute. Enhanced growth of the indicator strain was measured in mm with a ruler. The CIT was performed by directly dripping PBA and EDTA solutions onto carbapenem disks that were placed on Mueller-Hinton agar plates seeded with the test strain. RESULTS: Considering the results of the MHT with the ertapenem disk in Enterobacteriaceae and Pseudomonas spp., the CIT with the meropenem disk in Enterobacteriaceae, and the imipenem disk in Pseudomonas spp., three combined disk tests, namely MHT-positive plus PBA-positive, EDTA-positive, and MHT-positive plus PBA-negative plus EDTA-negative, had excellent sensitivity and specificity for the detection of KPC- (100% sensitivity and 100% specificity), MBL- (94% sensitivity and 100% specificity), and OXA-48-like-producing isolates (100% sensitivity and 100% specificity), respectively. CONCLUSIONS: Combined use of the MHT and CIT with PBA and EDTA, for the detection of CPE and MBL-producing Pseudomonas spp., is effective in detecting and characterizing carbapenemases in routine laboratories.


Subject(s)
Bacterial Proteins/antagonists & inhibitors , Boronic Acids/chemistry , Disk Diffusion Antimicrobial Tests/methods , Edetic Acid/chemistry , Enterobacteriaceae/drug effects , Enterobacteriaceae Infections/diagnosis , Humans , Pseudomonas/drug effects , Pseudomonas Infections/diagnosis , Sensitivity and Specificity , beta-Lactamases/chemistry
10.
Article in English | WPRIM | ID: wpr-62997

ABSTRACT

BACKGROUND/AIMS: Acute pyelonephritis (APN) is the most common cause of community-onset bacteremia in hospitalized elderly patients. The objectives of this study were to investigate the differences in the clinical and microbiological data of hospitalized elderly and non-elderly women with community-onset APN. METHODS: Women with community-onset APN as a discharge diagnosis were identified from January 2004 to December 2013 using an electronic medical records system. We compared the clinical and microbiologic data in elderly and non-elderly women with community-onset APN due to Enterobacteriaceae. RESULTS: Of the 1,134 women with community-onset APN caused by Enterobacteriaceae, 443 were elderly and 691 were non-elderly women. The elderly group had a lower frequency of upper and lower urinary tract symptoms/signs than the non-elderly. The incidence of bacteremia, extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae, patients with a C-reactive protein (CRP) level > or = 15 mg/dL, and patients with a leukocyte count > or = 15,000/mm3 in the blood, were significantly higher in the elderly group than in the non-elderly group. The proportion of patients requiring hospitalization for 10 days or more was significantly higher in the elderly group compared to the non-elderly group (51.5% vs. 26.2%, p < 0.001). The clinical cure rates at 4 to 14 days after the end of therapy were 98.3% (338/344) and 97.4% (519/533) in the elderly and non-elderly groups, respectively (p = 0.393). CONCLUSIONS: Elderly women with APN exhibit higher serum CRP levels, a higher frequency of bacteremia, a higher proportion of ESBL-producing uropathogens, and require a longer hospitalization than non-elderly women, although these patients may not complain of typical urinary symptoms.


Subject(s)
Acute Disease , Adult , Age Factors , Aged , Anti-Bacterial Agents/therapeutic use , Community-Acquired Infections/diagnosis , Electronic Health Records , Enterobacteriaceae Infections/diagnosis , Female , Hospitalization , Hospitals, University , Humans , Middle Aged , Pyelonephritis/diagnosis , Remission Induction , Republic of Korea , Retrospective Studies , Risk Factors , Sex Factors , Time Factors , Treatment Outcome , Urinary Tract Infections/diagnosis
11.
Article in English | WPRIM | ID: wpr-214110

ABSTRACT

BACKGROUND/AIMS: Providencia species frequently colonize urinary catheters and cause urinary tract infections (UTIs); however, bacteremia is uncommon and not well understood. We investigated the clinical features of Providencia bacteremia and the antibiotic susceptibility of Providencia species. METHODS: We identified cases of Providencia bacteremia from May 2001 to April 2013 at a tertiary care hospital. The medical records of pertinent patients were reviewed. RESULTS: Fourteen cases of Providencia bacteremia occurred; the incidence rate was 0.41 per 10,000 admissions. The median age of the patients was 64.5 years. Eleven cases (78.6%) were nosocomial infections and nine cases (64.3%) were polymicrobial bacteremia. The most common underlying conditions were cerebrovascular/neurologic disease (n = 10) and an indwelling urinary catheter (n = 10, 71.4%). A UTI was the most common source of bacteremia (n = 5, 35.7%). The overall mortality rate was 29% (n = 4); in each case, death occurred within 4 days of the onset of bacteremia. Primary bacteremia was more fatal than other types of bacteremia (mortality rate, 75% [3/4] vs. 10% [1/10], p = 0.041). The underlying disease severity, Acute Physiologic and Chronic Health Evaluation II scores, and Pitt bacteremia scores were significantly higher in nonsurvivors (p = 0.016, p =0.004, and p = 0.002, respectively). Susceptibility to cefepime, imipenem, and piperacillin/tazobactam was noted in 100%, 86%, and 86% of the isolates, respectively. CONCLUSIONS: Providencia bacteremia occurred frequently in elderly patients with cerebrovascular or neurologic disease. Although Providencia bacteremia is uncommon, it can be rapidly fatal and polymicrobial. These characteristics suggest that the selection of appropriate antibiotic therapy could be complicated in Providencia bacteremia.


Subject(s)
APACHE , Adolescent , Adult , Aged , Anti-Bacterial Agents/therapeutic use , Bacteremia/diagnosis , Child , Cross Infection/diagnosis , Cross-Sectional Studies , Drug Resistance, Bacterial , Enterobacteriaceae Infections/diagnosis , Female , Hospital Mortality , Humans , Incidence , Male , Microbial Sensitivity Tests , Middle Aged , Predictive Value of Tests , Providencia/drug effects , Republic of Korea , Retrospective Studies , Risk Factors , Tertiary Care Centers , Treatment Outcome , Young Adult
12.
Article in English | WPRIM | ID: wpr-56420

ABSTRACT

A multiplex PCR protocol was established to simultaneously detect major bacterial pathogens in olive flounder (Paralichthys olivaceus) including Edwardsiella (E.) tarda, Streptococcus (S.) parauberis, and S. iniae. The PCR assay was able to detect 0.01 ng of E. tarda, 0.1 ng of S. parauberis, and 1 ng of S. iniae genomic DNA. Furthermore, this technique was found to have high specificity when tested with related bacterial species. This method represents a cheaper, faster, and reliable alternative for identifying major bacterial pathogens in olive flounder, the most important farmed fish in Korea.


Subject(s)
Animals , Edwardsiella tarda/genetics , Enterobacteriaceae Infections/diagnosis , Fish Diseases/diagnosis , Fisheries/methods , Flatfishes , Multiplex Polymerase Chain Reaction/economics , Sensitivity and Specificity , Streptococcal Infections/diagnosis , Streptococcus/genetics
13.
Braz. j. infect. dis ; 17(6): 726-728, Nov.-Dec. 2013. tab
Article in English | LILACS | ID: lil-696980

ABSTRACT

Neonatal septicemia is the most important cause of neonatal mortality. A wide variety of bacteria both aerobic and anaerobic can cause neonatal sepsis. Genus Pantoea is a member of Enterobacteriaceae family that inhabits plants, soil and water and rarely causes human infections, however, Pantoea dispersa has not been reported as a causative organism for neonatal sepsis. We hereby report two neonates with early onset sepsis caused by Pantoea dispersa. Early detection and appropriate antibiotic therapy can improve overall outcome of this rare infection in neonates.


Subject(s)
Humans , Infant, Newborn , Male , Enterobacteriaceae Infections/microbiology , Pantoea , Sepsis/microbiology , Cesarean Section , Disinfection , Enterobacteriaceae Infections/diagnosis , Infant, Premature , Operating Rooms , Sepsis/diagnosis
14.
Braz. j. infect. dis ; 17(5): 626-628, Sept.-Oct. 2013.
Article in English | LILACS | ID: lil-689892

ABSTRACT

Cedecea represents a genus in the Enterobacteriaceae family that has been rarely associated with human infection. The clinical relevance of Cedecea lapagei has yet to be elucidated. This is the first reported case of pneumonia due to C. lapagei in a patient with acute promyelocytic leukemia.


Subject(s)
Adult , Humans , Male , Enterobacteriaceae Infections/microbiology , Enterobacteriaceae/isolation & purification , Pneumonia, Bacterial/microbiology , Enterobacteriaceae Infections/diagnosis , Enterobacteriaceae Infections/epidemiology , Enterobacteriaceae/classification , Leukemia, Promyelocytic, Acute/complications , Mexico/epidemiology , Pneumonia, Bacterial/diagnosis , Pneumonia, Bacterial/epidemiology
15.
Rev. chil. infectol ; 30(1): 86-89, feb. 2013. ilus
Article in Spanish | LILACS | ID: lil-665585

ABSTRACT

Cedecea lapagei is a gram-negative, facultative anaerobic, non-spore-forming bacteria, belonging to the family Enterobacteriaceae. It has been reported as a pathogen in few cases of bacterial peritonitis, wound infection, chemicals burns and pneumonia. We report a case of traumatic wound infection by this pathogen with a pertinent review.


Cedecea lapagei es un bacilo gramnegativo, anaerobio facultativo, no formador de esporas, perteneciente a la familia Enterobacteriaceae. Se han comunicado escasos casos en la literatura científica entre los cuales se destacan una peritonitis bacteriana, una infección de herida por quemadura química y una neumonía. A continuación se presenta el caso de una infección por este patógeno en una herida traumática. Se realiza una revisión bibliográfica del tema.


Subject(s)
Adult , Humans , Male , Enterobacteriaceae Infections/diagnosis , Foot Injuries/microbiology , Wound Infection/microbiology , Wound Infection/diagnosis
16.
Braz. j. microbiol ; 44(1): 145-151, 2013. tab
Article in English | LILACS | ID: lil-676900

ABSTRACT

Diarrhoea among growing and finishing pigs is an important problem in many herds. The prevalence of L. intracellularis, B. pilosicoli, B. hyodysenteriae, Salmonella spp., enterotoxigenic E. coli, Trichuris suis and the occurrence of mixed infection were investigated. Fecal samples for forty-six herds with diarrhea or a history of diarrhea were randomly collected in Minas Gerais state, Brazil. The enteric pathogens were detected by culture (E. coli and Salmonella sp.), PCR (L. intracellularis and Brachyspira spp.) and eggs counts (T. suis). The overall herd prevalence of L. intracellularis, Salmonella enterica serotype Typhimurium and enterotoxigenic E. coli were 19.56%, 6.52%, 10.86% respectively. Mixed infection was diagnosed in 30.43% of herds, and L. intracellularis and Salmonella enterica serotype Typhimurium are main pathogens association (10.87%). B. pilosicoli was diagnosed only in two herds, always associated with mixed infections. B. hyodysenteriae and T. suis were not demonstrated in any sample. These pathogens have been reported world-wide but studies regarding epidemiology in Brazil are few. This study contributes to establish of prevention programs for the control enteropathogens in grower finish herds in Brazil.


Subject(s)
Animals , Diagnostic Techniques and Procedures , Dysentery, Bacillary/diagnosis , Enterobacteriaceae/isolation & purification , Enterobacteriaceae/pathogenicity , In Vitro Techniques , Enterobacteriaceae Infections/diagnosis , Swine , Diagnosis , Epidemiology , Methods , Methods , Virulence
17.
Indian J Med Microbiol ; 2012 Jul-Sept; 30(3): 352-354
Article in English | IMSEAR | ID: sea-143984

ABSTRACT

Edwardsiella tarda is very seldom a cause for gastroenteritis in humans. This organism can also cause extraintestinal infections, such as soft tissue infections, meningitis, peritonitis, osteomyelitis, endocarditis and hepatobiliary tract disease, particularly in the setting of compromised immunity. We describe, for the first time a case of E. tarda sepsis with multiple liver abscesses associated with Cushing's syndrome as a result of recreational aquatic exposure.


Subject(s)
Adolescent , Cushing Syndrome/complications , Edwardsiella tarda/isolation & purification , Enterobacteriaceae Infections/diagnosis , Enterobacteriaceae Infections/microbiology , Enterobacteriaceae Infections/pathology , Humans , Liver Abscess/complications , Liver Abscess/diagnosis , Liver Abscess/microbiology , Liver Abscess/pathology , Male , Radiography, Abdominal , Sepsis/complications , Sepsis/diagnosis , Sepsis/microbiology , Sepsis/pathology , Tomography, X-Ray Computed
18.
J. bras. med ; 99(3): 34-39, Out.-Dez. 2011. tab
Article in Portuguese | LILACS | ID: lil-612618

ABSTRACT

A colangite aguda corresponde à infecção ascendente das vias biliares e geralmente está relacionada com as bactérias entéricas - gram-negativas, anaeróbios e enterococos. O fator patogênico mais importante é o obstrutivo, pois a presença de bactérias na bile não é suficiente para causar infecção das vias biliares se não estiver presente o componente obstrutivo. Dentre eles, a coledocolitíase é o principal elemento em cerca de 70% a 80% dos casos. Clinicamente, a tríade clássica - febre com calafrios, dor do hipocêndrio direito e icterícia - descrita por Charcot em 1877 manifesta-se em cerca de 70% a 80% dos pacientes. A ultrassonografia abdominal (e mais raramente a colangiopancreatografia por ressonância magnética) deve ser o método de escolha, por ser hábil em detectar dilatação da via biliar acima do local da obstrução e também por poder revelar sua causa. A terapêutica da colangite bacteriana aguda deve alicerçar-se na ressuscitação volêmica, antibioticoterapia e desobstrução da via biliar com consequente drenagem, sendo esta última a pedra angular da terapia emergencial da colangite aguda, que pode ser feita por via endoscópica (CPRE) ou transparietal (PTC).


Acute cholangitis corresponds to the ascending infection of the biliary tract and is usually associated with enteric bacteria - gram-negative, anaerobes and enterococci. The most important pathogenic factor is the obstruction because the presence of bacteria in bile is not sufficient to cause infection of the biliary tract in the absence of one obstructive component. Among these, choledocholithiasis is the main element in about 70% to 80% of cases. Clinically, the classic triad - fever with chills, pain in the right hypochondrium and jaundice - described by Charcot in 1877, manifests itself in about 70% to 80% of patients. The abdominal ultrasound (and, less frequently, magnetic resonance cholangiopancreatography) should be the method of choice because it is able to detect bile duct dilation above the site of the obstruction and also to reveal its cause. The treatment of acute bacterial cholangitis must be based on fluid resuscitation, antibiotics and clearing of the bile duct with subsequent drainage, the latter being the cornerstone of emergency therapy of acute cholangitis, which can be performed endoscopically (ERCP) or transparietal (PTC).


Subject(s)
Humans , Male , Female , Anti-Bacterial Agents/therapeutic use , Clinical Laboratory Techniques , Cholangitis/diagnosis , Cholangitis/etiology , Cholangitis/therapy , Cholangitis , Choledocholithiasis/complications , Diagnostic Imaging , Bile Duct Diseases/diagnosis , Enterobacteriaceae Infections/diagnosis , Cholangiopancreatography, Magnetic Resonance , Cholecystectomy, Laparoscopic/methods , Bile Duct Diseases
20.
Article in English | WPRIM | ID: wpr-31547

ABSTRACT

Skull base osteomyelitis (SBO) is difficult to diagnose when a patient presents with multiple cranial nerve palsies but no obvious infectious focus. There is no report about SBO with septic pulmonary embolism. A 51-yr-old man presented to our hospital with headache, hoarseness, dysphagia, frequent choking, fever, cough, and sputum production. He was diagnosed of having masked mastoiditis complicated by SBO with multiple cranial nerve palsies, sigmoid sinus thrombosis, and septic pulmonary embolism. We successfully treated him with antibiotics and anticoagulants alone, with no surgical intervention. His neurologic deficits were completely recovered. Decrease of pulmonary nodules and thrombus in the sinus was evident on the follow-up imaging one month later. In selected cases of intracranial complications of SBO and septic pulmonary embolism, secondary to mastoiditis with early response to antibiotic therapy, conservative treatment may be considered and surgical intervention may be withheld.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Anticoagulants/therapeutic use , C-Reactive Protein/analysis , Cranial Nerve Diseases/complications , Diagnosis, Differential , Enterobacter aerogenes/isolation & purification , Enterobacteriaceae Infections/diagnosis , Humans , Lung/pathology , Magnetic Resonance Imaging , Male , Mastoiditis/complications , Middle Aged , Osteomyelitis/complications , Pulmonary Embolism/complications , Sinus Thrombosis, Intracranial/complications , Skull Base , Sputum/microbiology , Tomography, X-Ray Computed
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