Staphylococcus hominis: a rare cause of endophthalmitis / Staphylococcus hominis: uma causa rara de endoftalmite

ABSTRACT Staphylococcus hominis (S. hominis) is a coagulase-negative Staphylococci and an infrequent cause of endophthalmitis. Due to its ability to produce biofilm, especially in diabetic patients, strains may acquire antibiotic resistance. We present two cases of S. hominis endophthalmitis, one with acute endophthalmitis after intravitreal bevacizumab injection and one with chronic endophthalmitis following undiagnosed penetrating ocular trauma. Although there are only four published S. hominis endophthalmitis cases in the literature, to the best of our knowledge, there has been no previously published case after intravitreal bevacizumab.

RESUMO Staphylococcus hominis (S. hominis) é um estafilococo coagulase-negativo e uma causa pouco frequente de endoftalmite. Devido à sua capacidade de produzir biofilme, especialmente em pacientes diabéticos, cepas dessa bactéria podem adquirir resistência a antibióticos. Este relato apresenta dois casos de endoftalmite por S. hominis: um de endoftalmite aguda após injeção intravítrea de bevacizumabe e outro de endoftalmite crônica após trauma ocular penetrante não diagnosticado. Embora existam apenas quatro casos de endoftalmite por S. hominis publicados na literatura, até onde sabemos não houve nenhum caso publicado anteriormente após bevacizumabe intravítreo.

Mixed bacterial-fungal infection following total hip arthroplasty: A case report / 中华创伤杂志(英文版)

Prosthetic infection is one of the severe postoperative complications of arthroplasty. Mixed bacterial-fungal prosthetic infection is rare but can be disastrous. This case was a 76-year-old female suffered from prosthetic infection following total hip replacement due to femoral neck fracture and underwent multiple debridements. The culture of periprosthetic tissue was bacteriologically sterile following the first debridement, while the Staphylococcus hominis was identified in the second debridement in the previous hospitalization where fungal infection had not been considered. Thus the pathogen spectrum of anti-infection therapy failed to contain fungus. Ultimately, the culture result of our sampled periprosthetic tissue during the third debridement was Candida albicans without bacterium in our hospital. The fungal prosthetic infection was successfully treated by a two-stage revision with antifungal drugs. Accurate diagnosis and standardized treatment is the key to the therapy of infection after hip arthroplasty, especially for mixed bacterial-fungal prosthetic infection.

Endocarditis bacteriana por Staphylococcus hominis de válvula nativa en paciente hospitalizado con COVID-19. Reporte de caso / Native valve infective endocarditis caused by Staphylococcus hominis in a patient hospitalized with Covid-19. Report of a case

RESUMEN La enfermedad del COVID-19 presenta actualmente una gama de síntomas que van desde la presencia de síntomas clásicos de compromiso de las vías respiratorias altas y bajas hasta alteraciones sensitivas como anosmia o trastornos del gusto. Las trombosis valvulares cardíacas y la endocarditis subsecuente son presentaciones extremadamente raras y poco descritas de la infección por COVID-19. Presentamos el caso de un paciente positivo para virus SARS-Cov2, quien desarrolló una bacteriemia por Staphylococcus hominis y que, ante episodios febriles persistentes y posterior evaluación de diagnósticos diferenciales, se identificó el diagnóstico de endocarditis infecciosa en válvula aórtica nativa sana -mediante ecocardiografía-, la cual fue adquirida en el hospital.

ABSTRACT Covid-19 disease shows many different manifestations, from common symptoms affecting both the upper and lower respiratory tract, and also sensorial alterations such as anosmia or taste perversion. Heart valve thrombosis and subsequent endocarditis are extremely rare manifestations and they have been scarcely described within the context of Covid-19. We present a case of a patient that was positive for SARS-Cov-2, who developed Staphylococcus hominis bacteremia. Afterwards, he developed persistent fever, and after ruling out some differential diagnoses, a diagnosis of infective endocarditis affecting a native healthy aortic valve was made, using cardiac ultrasonography. This occurrence was considered to be hospital-acquired.

Genetic location of SCCmec-associated psm-mec in Staphylococcus hominis from blood culture / 国际检验医学杂志

Objective To investigate the genetic location of SCCmec-associated psm-mec in Staphylococcus hominis isolated from blood culture,and to lay a foundation for further functional studies of psm-mec in Staphylococcus hominis.Methods 25 strains of Staphylococcus hominis isolated from positive blood culture were collected.mecA and psm-mec gene were amplified by PCR,and the SCCmec types were determined by the results of multiplex PCR assay.For analyzing the genetic location characteristic of psm-mec in SCCmec,three pair special PCR primers were used to measure mecR1/psm-mec,psm-mec/xylR and fudoh respectively.Results There were 21 strains of methicillin-resistant Staphylococcus hominis and 4 strains of methicillin-sensitive Staphylococcus hominis. The positive rate of psm-mec gene in methicillin-resistant Staphylococcus hominis was 47.6%,and no psm-mec gene was found in methicillin-sensitive Staphylococcus hominis.Among psm-mec positive strains,2 strains belonged to SCCmecⅢ,5 strains belonged to SCCmecⅢ-like,and 3 strains belonged to new SCCmec types.All of the 10 psm-mec positive strains were mecR1/psm-mec,psm-mec/xylR and fudoh gene positive.Conclusion SCCmec-associated psm-mec extensively exists in methicillin-resistant Staphylococ-cus hominis isolated from positive blood culture,which distributes mainly in typical SCCmecⅢ,SCCmecⅢ-like and new SCCmec types and locates between mecR1 and xylR gene.

Multidrug-resistant Staphylococcus hominis subsp. novobiosepticus causing septicemia in patients with malignancy.

A new subspecies of Staphylococcus hominis described by Kloos et al. in 1998 and named S. hominis subsp. novobiosepticus (SHN) has been implicated in nosocomial outbreaks. Multidrug resistance, including resistance to novobiocin and oxacillin, is a particularly important feature of SHN. In our institute, we encountered 13 cases of S. hominis subsp. hominis in cancer patients with septicemia, of which seven were methicillin resistant. The isolates were identifi ed by VITEK® 2 compact automated system, using GP REF 21342 identifi cation card and antimicrobial susceptibility testing card P-628. The biochemical reactions and antibiotic susceptibility pattern of the seven methicillin-resistant isolates were re-analyzed and patient details were re-checked to fi nally identify them as SHN. The increasing number of cases reporting isolation of SHN from biological specimens point to potential virulence and clinical importance of this bacterium.

Espondilodiscite atípica / Atypical Spondylodiscitis / Espondilodiscitis atípica

As infecções por Staphylococcus coagulase-negativo correspondem a uma pequena percentagem do total das espondilodiscites piogênicas, estando associados a estados imunocomprometidos. Apresentamos o caso clínico de um homem de 58 anos, com uma espondilodiscite L1-L2, por um micro-organismo bastante atípico, o S. hominis. A resolução da patologia só foi possível após duas cirurgias e terapia com antibióticos específicos.

Infections with coagulase-negative Staphylococcus correspond to a small percentage of the total pyogenic spondylodiscitis and are associated with immunocompromised conditions. We present a case of a 58 year old male with a L1-L2 spondylodiscitis by a very atypical microorganism, the S. hominis. Only after two surgeries and specific antibiotic therapy it was possible to eliminate the disease.

Las infecciones por Staphylococcus coagulasa-negativa corresponden a un pequeño porcentaje del total de las espondilodiscitis piogénicas, estando vinculadas a estados inmunocomprometidos. Presentamos el caso clínico de un hombre, de 58 años de edad, con una espondilodiscitis L1-L2, por un microorganismo muy atípico, el S. hominis. La solución de la patología fue posible solamente después de dos cirugías y de terapia con antibióticos específicos.

Meticillin-resistant Staphylococcus Isolates in Staphylococcus auricularis and Staphylococcus hominis and Their Drug Resistance / 中华医院感染学杂志

OBJECTIVE To investigate the prevalence of meticillin-resistant Staphylococcus (MRS) isolates in Staphylococcus auricularis and S. hominis and detect their drug resistance. METHODS MRS isolates were detected by cefoxitin disc test and susceptibilities were tested by agar dilution method. RESULTS 94.7% and 91.7% MRS isolates were in S. auricularis and S. hominis. MRS strains were resistant to most of antimicrobial agents. There were no isolates resistant to vancomycin and teicoplanin. CONCLUSIONS MRS isolates are highly prevalent in S. auricularis and S. hominis with resistance to most of antimicrobial agents.

Exertional Heat Stroke in a Young Man with Multi-organ Dysfunction and Fulminant Pneumonia

Heat stroke is defined as a core body temperature that rises above 40 degrees C accompanied by central nervous system abnormalities such delirium, convulsions or coma. Despite treatment with optimal cooling, heat stroke causes deaths by complications including rhabdomyolysis, renal failure, hepatic dysfunction, disseminated intravascular coagulation syndrome, acute respiratory distress syndrome, bowel ischemia, myocardial injury, and multiple organ failure. In some cases of survival, heat stroke it can cause irreversible CNS damage. Therefore, if exertional heat stroke is properly diagnosed in the emergency room, we must initiate early and aggressive treatment in order to prevent the multiorgan failure and high mortality associated with this condition. To our knowledge, case reports in the literature are rare describing that patients with multiple organ dysfunction and fulminant pneumonia following exertional heat stroke. This study reports on a relevant case, as well as findingsfrom the literature. The case history is presented of a 20- year-old man who presented with exertional heat stroke with sustained hyperpyrexia ongoing after the first day of admission despite optimal treatment including intensive fluid resuscitation. On the 3rd day of admission, chest infiltrated lesions were discovered. From the high-resolution computed tomography results, multifocal consolidations were discovered in both lungs. Blood cultures revealed Staphylococcus hominis. Treatment with proper antibiotics was begun after identifying the blood culture. The patient fully recovered and was discharged on the 10th day after admission.