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1.
Epidemiol Infect ; 150: e138, 2022 Jul 28.
Article in English | MEDLINE | ID: covidwho-1960187

ABSTRACT

We aimed to descriptively analyse the possible impact of the national COVID-19 interventions on the incidence of common infectious diseases in Denmark during spring and summer 2020. This observational study focused on national register data on infections caused by 16 different bacterial and viral pathogens. We included new cases registered between 1 January 2016 and 31 July 2020. The weekly number of new cases were analysed with respect to the COVID-19-related interventions introduced during 2020. We found a marked decrease in infections associated with droplet transmission coinciding with the COVID-19 interventions in spring and summer 2020. These included decreases in both viral and bacterial airway infections and also decreases in invasive infections caused by Streptococcus pneumoniae, Haemophilus influenzae and Neisseria meningitidis. There was also a reduction in cases associated with foodborne transmission during the COVID-19 lockdown period. We found no effect of the lockdown on infections by invasive beta-haemolytic streptococci group B, C and G, Staphylococcus aureus bacteraemia, Neisseria gonorrhoeae or Clostridioides difficile. In conclusion, we found that the widespread interventions such as physical distancing, less travel, hygiene measures and lockdown of schools, restaurants and workplaces together coincided with a marked decline in respiratory infections and, to a smaller extent, some foodborne-transmitted infections.


Subject(s)
Bacteremia , COVID-19 , Communicable Diseases , Staphylococcal Infections , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control , Denmark/epidemiology , Humans , Incidence , Staphylococcus aureus
2.
BMC Infect Dis ; 22(1): 631, 2022 Jul 19.
Article in English | MEDLINE | ID: covidwho-1938294

ABSTRACT

OBJECTIVES: Staphylococcus aureus bacteremia (SAB) is one of the most frequent bloodstream infections. High mortality of SAB can be significantly reduced by regular infectious disease (ID) consultations and appropriate clinical management. Because the pandemic of coronavirus disease 2019 (COVID-19) has had a negative impact on hospital ID service, it can be assumed that it has also led to decreased quality of care for SAB patients. METHODS: This study enrolled all (n = 68) patients with proven SAB who were hospitalized in Military University Hospital, Prague, in 2019 and 2020 and the quality of care indicators for SAB patients were compared. RESULTS: A total of 33 and 35 patients with SAB were hospitalized in our hospital in 2019 and 2020, respectively. The significant difference between the pandemic year 2020 and year 2019 was in ID consultations performed (74% vs. 100%; p = 0.002) and fulfilment of all quality of care indicators (66% vs. 93%; p = 0.012). Next, higher in-hospital mortality was observed in 2020 than in 2019 (6% vs. 23%; p = 0.085). There was no significant difference in the percentages of patients with performed echocardiographic examinations (66% vs. 83%; p = 0.156) and collected follow-up blood cultures (85% vs. 94%; p = 0.428). In addition, there was no difference between the two years in the adequate antibiotic therapy, sources, and bacterial origin of SAB. CONCLUSIONS: The quality of care of SAB patients significantly decreased during the COVID-19 pandemic in our institution.


Subject(s)
Bacteremia , COVID-19 , Staphylococcal Infections , Anti-Bacterial Agents/therapeutic use , Bacteremia/drug therapy , Bacteremia/epidemiology , Bacteremia/microbiology , Humans , Pandemics , Retrospective Studies , Staphylococcal Infections/drug therapy , Staphylococcal Infections/epidemiology , Staphylococcal Infections/microbiology , Staphylococcus aureus , Treatment Outcome
3.
BMC Infect Dis ; 22(1): 529, 2022 Jun 07.
Article in English | MEDLINE | ID: covidwho-1881204

ABSTRACT

BACKGROUND: Pandoraea species are multidrug-resistant glucose-nonfermenting gram-negative bacilli that are usually isolated from patients with cystic fibrosis (CF) and from water and soil. Reports of diseases, including bloodstream infections, caused by Pandoraea spp. in non-CF patients are rare, and the clinical and microbiological characteristics are unclear. The identification of Pandorea spp. is limited by conventional microbiological methods and may be misidentified as other species owing to overlapping biochemical profiles. Here, we report the first case of obstructive cholangitis with bacteremia caused by Pandoraea apista in a patient with advanced colorectal cancer. A 61-year-old man with advanced colorectal cancer who underwent right nephrectomy for renal cell carcinoma 4 years earlier with well-controlled diabetes mellitus was admitted to our hospital with fever for 2 days. The last chemotherapy (regorafenib) was administered approximately 3 weeks ago, and an endoscopic ultrasound-guided hepaticogastrostomy was performed 2 weeks ago under hospitalization for obstructive jaundice. Two days prior, he presented with fever with chills. He was treated with piperacillin-tazobactam for obstructive cholangitis and showed improvement but subsequently presented with exacerbation. Bacterial isolates from the blood and bile samples were identified as P. apista using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and 16S ribosomal RNA sequencing. Based on the susceptibility results of the isolates, he was successfully treated with oral trimethoprim-sulfamethoxazole 160 mg/800 mg/day for 14 days for P. apista infection. CONCLUSIONS: Pandoraea species are often misidentified. Therefore, multiple approaches should be used to identify them, and decisions regarding antimicrobial treatment should be based on actual in vitro susceptibility. Only seven cases of Pandoraea spp. bloodstream infections have been reported, and we report the first case of cholangitis with bacteremia.


Subject(s)
Bacteremia , Cholangitis , Colorectal Neoplasms , Cystic Fibrosis , Sepsis , Bacteremia/diagnosis , Bacteremia/drug therapy , Burkholderiaceae , Cholangitis/drug therapy , Cystic Fibrosis/microbiology , Humans , Male , Middle Aged , RNA, Ribosomal , RNA, Ribosomal, 16S/genetics , Sequence Analysis, RNA , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization/methods
4.
Rural Remote Health ; 22(2): 6347, 2022 04.
Article in English | MEDLINE | ID: covidwho-1893578

ABSTRACT

INTRODUCTION: Infections impose a significant burden on healthcare costs worldwide. We aimed to explore antibiotic- and hospital-related costs of infections needing admission in a tertiary university hospital in Greece. METHODS: We performed a prospective cohort study in the medical care unit of a tertiary university hospital in Greece, for the period May 2016 to May 2018. Patients admitted with respiratory, urinary, gastrointestinal tract, skin, soft tissue and bone infections or primary bacteremia were included in this study. Costs of hospitalization and unit cost of antibiotic regimen were retrieved from a database for Greek hospitals containing data for each International Classification of Diseases (ICD-10) code and the national formulary respectively, and manually calculated for each patient. RESULTS: Antibiotic costs represent approximately 14-40% of total hospital-related costs depending on infection studied. Skin, soft tissue and bone infections and primary bacteremia led hospital- and antibiotic-related costs, with median costs of €6370 (interquartile range (IQR) 3330.90-11 503.90), €2519.90 (IQR 431.50-8371.10), €4418.10 (IQR 2335-8281.90) and €1394.30 (IQR 519.12-6459.90), respectively. Antibiotic- and hospital-related costs significantly differs with site of infection (p<0.0001). Length of stay is strongly correlated with antibiotic- and hospital-related costs, while site of infection is moderately related to antibiotic cost (eta value 0.445), and hospital-related cost (eta value 0.387). CONCLUSION: Healthcare-related costs vary substantially depending on site of infection. Information about real-life costs can drive best decisions and help to reduce healthcare expenditures.


Subject(s)
Bacteremia , Bacterial Infections , Anti-Bacterial Agents/therapeutic use , Bacteremia/drug therapy , Bacterial Infections/drug therapy , Hospital Costs , Hospitalization , Humans , Length of Stay , Prospective Studies , Retrospective Studies
5.
Microb Drug Resist ; 28(5): 601-610, 2022 May.
Article in English | MEDLINE | ID: covidwho-1864944

ABSTRACT

This retrospective study aims to describe the etiology and resistance patterns of pathogens causing bacteremia in children with solid tumors in a tertiary pediatric hematology-oncology center in Jerusalem, Israel (2011-2019). Factors associated with multidrug-resistant (MDR) bacteremia and mortality were analyzed. A total of 228 pathogens were isolated in 126 patients; 61.0% were gram-negative rods (GNR) and 38.2% were gram-positive cocci (GPC). The most common pathogens were Klebsiella pneumoniae (19.3%), Escherichia coli (17.5%), and coagulase-negative staphylococci (16.2%). The proportion of MDR-GNR was 18.2%, while the proportion of MDR-GPC was 55.2%. In logistic regression analysis, breakthrough bacteremia on a penicillin-group antibiotic (odds ratio [OR] 5.69, [95% confidence interval 1.42-22.76], p-value = 0.014) was associated and underlying diagnosis of neuroblastoma was inversely associated (OR 0.17, [0.04-0.81], p-value = 0.026) with MDR-GNR bacteremia; while the previous hospitalizations' duration (OR 1.032/day, [1.01-1.06], p-value = 0.007) and oncologic treatment intensity (OR 2.19, [1.08-4.45, p-value = 0.03) were associated with MDR-GPC bacteremia. Shock, prolonged profound neutropenia, and pediatric intensive care unit (PICU) admission were associated with 7-day mortality; and relapsed disease, oncologic treatment intensity, prolonged profound neutropenia, and PICU admission-with 30-day mortality in the univariate analyses. Empirical antibiotic choice should be based on factors associated with MDR infections in this specific population.


Subject(s)
Bacteremia , Gram-Negative Bacterial Infections , Neoplasms , Neutropenia , Anti-Bacterial Agents/pharmacology , Bacteremia/drug therapy , Bacteremia/epidemiology , Child , Drug Resistance, Multiple , Escherichia coli , Gram-Negative Bacteria , Gram-Negative Bacterial Infections/drug therapy , Humans , Neoplasms/complications , Neoplasms/drug therapy , Neoplasms/pathology , Neutropenia/complications , Neutropenia/drug therapy , Retrospective Studies
6.
J Infect Chemother ; 28(8): 1212-1215, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1864584

ABSTRACT

A 70-year-old woman, who started on hemodialysis 7 months before for end-stage renal disease due to diabetic nephropathy and was diagnosed with symptomatic multiple myeloma 1 month before, was admitted to our hospital with critical coronavirus disease 2019 and treated with long-term immunosuppressive therapy such as steroids and tocilizumab. During treatment, Bacillus subtilis was detected in the blood cultures. We could not exclude the association of natto (fermented soybeans) with B. subtilis var. natto, which the patient had been eating every day from 8 days after admission. She was prohibited from eating natto and treated with vancomycin. Later, B. subtilis detected in the blood culture was identified as B. subtilis var. natto, which was identical with those contained in the natto that the patient consumed daily using a next-generation sequencer. Gut dysbiosis due to old age, malignant tumor, diabetes mellitus, end-stage renal disease, and intestinal inflammation caused by severe acute respiratory syndrome coronavirus 2 increased intestinal permeability and the risk of bacterial translocation, causing B. subtilis var. natto bacteremia. Therefore, careful consideration might be given to the intake of fermented foods containing live bacteria in patients with severe immunocompromised conditions.


Subject(s)
Bacteremia , COVID-19 , Kidney Failure, Chronic , Multiple Myeloma , Soy Foods , Aged , Bacillus subtilis , Bacteremia/drug therapy , COVID-19/complications , COVID-19/drug therapy , Eating , Female , Humans , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/therapy , Multiple Myeloma/complications , Multiple Myeloma/drug therapy , Renal Dialysis , Soy Foods/microbiology
7.
Niger J Clin Pract ; 25(5): 702-709, 2022 May.
Article in English | MEDLINE | ID: covidwho-1863109

ABSTRACT

Background: Epidemiology of nosocomial infections may show variability because of under-estimation of infection control measures (ICMs) in coronavirus disease 19 (COVID-19) outbreak. Aim: To investigate the Acinetobacter bacteremia outbreak developed in an intensive care unit (ICU) between March 20 to May 15, 2020, examine the risk factors, and re-evaluate ICM retrospectively. Material and Methods: A retrospective cohort analysis was conducted to determine the risk factors, pulsed field gel electrophoresis (PFGE) was performed for analysis of the outbreak, ICM practices were observed by a team, and infection control interventions were undertaken. Results: Acinetobacter bacteremia developed in 17 patients (21.5%) within 79 COVID-19 patients included in the study. The mean age of the bacteremic patients was 67.3 (SD = 14.82) years, and 82.4% of them were male; of these, 15 died, leading to 88.2% mortality. The bacteremia rate was higher compared with a 14-month period preceding the COVID-19 pandemic (17/79 versus 12/580 patients, respectively). PFGE revealed that the outbreak was polyclonal. On multi-variate analysis, the bacteremia development rate was 13.7 and 5.06 times higher with central venous catheter (CVC) use and in patients with chronic obstructive pulmonary disease (COPD), respectively. The mortality rate was higher in bacteremic patients (p = 0.0016). It was observed that ICMs were not followed completely, especially change of gloves and hand hygiene. Contamination of A. baumannii was observed in 38% of the gloves. Conclusion: COPD and CVC use were determined as risk factors for Acinetobacter bacteremia development, and failures in ICM may have led to cross-contamination of endemic A. baumannii. The outbreak could be controlled within 3 weeks of interventions.


Subject(s)
Acinetobacter Infections , Acinetobacter baumannii , Bacteremia , COVID-19 , Cross Infection , Pulmonary Disease, Chronic Obstructive , Acinetobacter Infections/drug therapy , Acinetobacter Infections/epidemiology , Aged , Anti-Bacterial Agents/pharmacology , Bacteremia/drug therapy , Bacteremia/epidemiology , COVID-19/epidemiology , Cross Infection/epidemiology , Disease Outbreaks , Drug Resistance, Multiple, Bacterial , Female , Humans , Intensive Care Units , Male , Pandemics , Pulmonary Disease, Chronic Obstructive/epidemiology , Retrospective Studies
8.
Antimicrob Resist Infect Control ; 11(1): 74, 2022 05 21.
Article in English | MEDLINE | ID: covidwho-1862157

ABSTRACT

BACKGROUND: Patients hospitalised for COVID-19 may present with or acquire bacterial or fungal infections that can affect the course of the disease. The aim of this study was to describe the microbiological characteristics of laboratory-confirmed infections in hospitalised patients with severe COVID-19. METHODS: We reviewed the hospital charts of a sample of patients deceased with COVID-19 from the Italian National COVID-19 Surveillance, who had laboratory-confirmed bacterial or fungal bloodstream infections (BSI) or lower respiratory tract infections (LRTI), evaluating the pathogens responsible for the infections and their antimicrobial susceptibility. RESULTS: Among 157 patients with infections hospitalised from February 2020 to April 2021, 28 (17.8%) had co-infections (≤ 48 h from admission) and 138 (87.9%) had secondary infections (> 48 h). Most infections were bacterial; LRTI were more frequent than BSI. The most common co-infection was pneumococcal LRTI. In secondary infections, Enterococci were the most frequently recovered pathogens in BSI (21.7% of patients), followed by Enterobacterales, mainly K. pneumoniae, while LRTI were mostly associated with Gram-negative bacteria, firstly Enterobacterales (27.4% of patients, K. pneumoniae 15.3%), followed by A. baumannii (19.1%). Fungal infections, both BSI and LRTI, were mostly due to C. albicans. Antibiotic resistance rates were extremely high in Gram-negative bacteria, with almost all A. baumannii isolates resistant to carbapenems (95.5%), and K. pneumoniae and P. aeruginosa showing carbapenem resistance rates of 59.5% and 34.6%, respectively. CONCLUSIONS: In hospitalised patients with severe COVID-19, secondary infections are considerably more common than co-infections, and are mostly due to Gram-negative bacterial pathogens showing a very high rate of antibiotic resistance.


Subject(s)
Anti-Bacterial Agents , Bacteremia , COVID-19 , Coinfection , Drug Resistance, Microbial , Fungemia , Anti-Bacterial Agents/adverse effects , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Bacteremia/complications , Bacteremia/drug therapy , Bacteremia/microbiology , COVID-19/complications , Coinfection/drug therapy , Coinfection/epidemiology , Coinfection/microbiology , Fungemia/complications , Fungemia/drug therapy , Fungemia/microbiology , Hospitalization/statistics & numerical data , Humans , Italy/epidemiology , Population Surveillance , Respiratory Tract Infections/complications , Respiratory Tract Infections/drug therapy , Respiratory Tract Infections/microbiology , Respiratory Tract Infections/virology
9.
BMJ Case Rep ; 15(5)2022 May 19.
Article in English | MEDLINE | ID: covidwho-1861603

ABSTRACT

Invasive pneumococcal disease occurs in high-risk patient population which includes patients with asplenia and primary hypocomplementaemia. Pneumococcal sepsis can rarely cause disseminated intravascular coagulation (DIC) and intravascular thrombosis of small and medium sized vessels called purpura fulminans which is associated with a high mortality rate. We present the case of an immunocompetent woman in her 50s with an intact spleen who presented with septic shock from Streptococcus pneumoniae bacteraemia. Her hospital course rapidly progressed to multiorgan dysfunction, DIC and purpura fulminans. She was treated aggressively with broad spectrum antibiotics, coagulation factor replacement, multiple vasopressor support, renal replacement therapy and mechanical ventilator support. Despite aggressive measures, she succumbed to the multiorgan failure.


Subject(s)
Bacteremia , Disseminated Intravascular Coagulation , Immune System Diseases , Pneumococcal Infections , Purpura Fulminans , Adult , Bacteremia/complications , Dacarbazine , Disseminated Intravascular Coagulation/complications , Female , Humans , Pneumococcal Infections/complications , Pneumococcal Infections/therapy , Purpura Fulminans/complications , Streptococcus pneumoniae
10.
J Infect Chemother ; 28(7): 978-981, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1851523

ABSTRACT

Netherton's syndrome, a rare congenital disorder, is clinically characterized by chronic dermatologic disorders such as ichthyosiform erythroderma and ichthyosis linearis circumflexa. Curable treatment is yet to be established, and corticosteroid ointment is required to maintain good dermatological condition. Because of the permanent skin barrier impairment, patients with Netherton's syndrome are considered to be vulnerable to cutaneous infections. However, its clinical characteristics are yet to be elucidated due to the limited number of reported cases. Herein, we describe the clinical course of a patient who developed persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. A 19-year-old Japanese woman who had been diagnosed with Netherton's syndrome in her infancy and had been applying topical corticosteroid agents all over her body since her then, was referred to our hospital because of persistent MRSA bacteremia and secondary adrenal insufficiency. The patient was diagnosed with a central line-associated bloodstream infection and was appropriately treated with antibiotics and corticosteroid therapies. We assume that the damaged skin barrier due to the congenital dermatological disorder causes a disruption in the normal bacterial flora of the skin, leading to the invasion of harmful bacteria, such as S. aureus. In addition, internal (humoral immunodeficiency by decreased antibody against bacterial polysaccharide antigens) and external (prolonged and systemic use of corticosteroid ointment) factors bring about an immunodeficiency state in such patients. We highlight that in the absence of radical treatment, clinicians need to recognize that patients with Netherton's syndrome are vulnerable to bacterial infections owing to the mixture of immunosuppressive factors.


Subject(s)
Bacteremia , Methicillin-Resistant Staphylococcus aureus , Adult , Bacteremia/drug therapy , Female , Humans , Ointments , Staphylococcus aureus , Syndrome , Young Adult
11.
Mikrobiyol Bul ; 56(2): 357-364, 2022 Apr.
Article in Turkish | MEDLINE | ID: covidwho-1818596

ABSTRACT

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection emerged in China at the end of 2019 and caused coronavirus disease 2019 (COVID-19). The lymphopenia seen in COVID-19 increases the incidence of susceptibility to other microorganisms and may cause co-infections. As the signs and symptoms of the diseases overlap with other infectious diseases and due to the intensity in health services, the diagnosis of co-infections becomes difficult and the treatment may be delayed. Therefore, infections accompanying COVID-19 cause an increase in morbidity and mortality.The isolation and quarantine measures taken during the COVID-19 process have reduced the number of infections transmitted from person to person. However, there was no significant decrease in diseases transmitted by food, such as salmonellosis. During the pandemic, salmonellosis continued to be a problem, especially in endemic areas such as Pakistan, and an increase in Salmonella infections associated with backyard poultry has been reported in countries such as the United States. A co-infection of COVID-19 and enteric fever associated with travel to Pakistan was reported for the first time in the literature in February 2021. In this case report, the first co-infection of COVID-19 and Salmonella in our country was presented. A 56-yearold male patient with no known systemic disease was admitted to the hospital with fever, shortness of breath, weakness and myalgia lasting for three days. SARS-CoV-2 polymerase chain reaction test was positive. The patient has been hospitalized and favipiravir, moxifloxacin, and methylprednisolone were started. Blood cultures were taken from the patient whose clinical picture worsened and fever continued despite of the medical treatment. Salmonella enterica spp. enterica was isolated and ceftriaxone treatment was started. The patient's anamnesis was deepened, but no diarrhea, abdominal pain, suspicious food consumption, travel history were determined. From the second day of the ceftriaxone treatment, the patient's fever decreased and no growth was detected in the control blood cultures. Ceftriaxone treatment was completed in 14 days and the patient was discharged on the 28th day. Approximately 87-95% of Salmonella strains isolated in our country are S.enterica spp. enterica, and S.enterica spp. enterica was also isolated in our case. Salmonella infections most commonly present as gastroenteritis, but the risk of bacteremia increases in case of immunosuppression. Although there was no additional disease in our case, it was considered that the infection in the form of bacteremia occurred due to an immunosuppression caused by COVID-19. In this context; drawing blood cultures of patients hospitalized with the diagnosis of COVID-19 is very important in terms of detecting co-infections and superinfections, and administering appropriate antibiotic therapy at appropriate treatment times. Presentation of first case of Salmonella bacteremia and simultaneous COVID-19 infection in our country was the strong side of our report. In addition, our case is also important as being the first SARS-CoV-2 and Salmonella co-infection unrelated to Pakistan in the literature. The limitation of our case was that S.enterica spp. enterica detected in the blood culture could not be subtyped and the stool culture could not be examined. However, this does not constitute a diagnostic requirement. In addition, the patient's pre-COVID-19 Salmonella carrier status was also unknown. As a result, patients become vulnerable to other infections due to the lymphopenia seen in COVID-19. Therefore, Salmonella bacteremia can be seen with SARS-CoV-2 infection without a comorbid condition. Drawing blood cultures in hospitalized patients with the diagnosis of COVID-19 is very important in terms of detecting concomitant infections in a short time. In patients whose clinical condition does not improve and fever continues despite of treatment, blood cultures should be taken, especially in the case of an advanced immunosuppresive treatment plan, and it should always be kept in mind that secondary infections and co-infections may occur.


Subject(s)
Bacteremia , COVID-19 , Coinfection , Lymphopenia , Salmonella Infections , Salmonella enterica , Bacteremia/drug therapy , Ceftriaxone/therapeutic use , Coinfection/drug therapy , Coinfection/epidemiology , Humans , Lymphopenia/drug therapy , Male , Middle Aged , Pakistan/epidemiology , SARS-CoV-2 , Salmonella Infections/diagnosis , Salmonella Infections/drug therapy , Salmonella Infections/epidemiology
13.
Enferm Infecc Microbiol Clin (Engl Ed) ; 40(4): 183-186, 2022 04.
Article in English | MEDLINE | ID: covidwho-1814369

ABSTRACT

INTRODUCTION: The reasons for the decrease in blood cultures were investigated and the rate and aetiology of bacteremia and contaminated blood cultures collected from COVID and non-COVID patients were assessed. METHODS: We performed a retrospective analysis in a tertiary hospital in Spain during the COVID period from 4th March 2020 to 21st June 2020. RESULTS: The number of blood cultures processed was 5313, representing 22.7% and 18.8% of decrease compared to the same months of 2019 and 2018, respectively (p=0.173). The rate of bacteremia was 1.2% higher among COVID-patients than among non-COVID patients (p<0.001). COVID patients had a higher proportion of nosocomial bacteremia (95.5%) than non-COVID patients (30.5%) (p<0.001). In COVID-positive patients, the contamination rate was 12.3% vs 5.7% in non-COVID patients (p<0.001). CONCLUSION: There was a decrease in the number of blood cultures collected during the COVID period compared to previous years. Bacteremia in COVID patients was mainly nosocomial and catheter-related.


Subject(s)
Bacteremia , COVID-19 , Cross Infection , Bacteremia/epidemiology , Bacteremia/etiology , COVID-19/epidemiology , Cross Infection/epidemiology , Humans , Pandemics , Retrospective Studies , Spain/epidemiology , Tertiary Care Centers
14.
Commun Dis Intell (2018) ; 462022 Apr 26.
Article in English | MEDLINE | ID: covidwho-1812119

ABSTRACT

From 1 January to 31 December 2020, forty-nine institutions around Australia participated in the Australian Enterococcal Sepsis Outcome Programme (AESOP). The aims of AESOP 2020 were to determine the proportion of enterococcal bacteraemia isolates in Australia that were antimicrobial-resistant, and to characterise the molecular epidemiology of the E. faecium isolates. Of the 1,230 unique episodes of enterococcal bacteraemia investigated, 93.9% were caused by either E. faecalis (54.2%) or E. faecium (39.7%). Ampicillin resistance was not detected in E. faecalis but was detected in 88.2% of E. faecium . Vancomycin non-susceptibility was detected in 0.2% of E. faecalis and 32.6% of E. faecium . Overall, 35.2% of E. faecium harboured vanA and/or vanB genes. For the vanA/B positive E. faecium isolates, 38.8% harboured the vanA gene, 60.6% the vanB gene, and 0.6% harboured both vanA and vanB . Although the percentage of E. faecium bacteraemia isolates was significantly lower than that detected in the 2019 AESOP (presumably due to the COVID-19 elective surgery restrictions placed on hospitals), it remains substantially higher than that recorded in most European countries. The E. faecium isolates detected consisted of 71 multilocus sequence types (STs), with 81.7% of these isolates classified into eight major STs each containing ten or more isolates. All major STs belonged to clonal cluster 17 (CC17), a major hospital-adapted polyclonal E. faecium cluster. The major STs (ST17, ST1424, ST80, ST796, ST78, ST1421, ST555 and ST117) were found across most regions of Australia. The predominant clone was ST17, which was identified in all regions except the Northern Territory. Overall, 40.9% of isolates belonging to the eight major STs harboured the vanA or vanB gene. The AESOP 2020 has shown enterococcal bacteraemia episodes in Australia are frequently caused by polyclonal ampicillin-resistant high-level gentamicin-resistant vanA - or vanB -positive E. faecium which have limited treatment options.


Subject(s)
Bacteremia , COVID-19 , Gram-Positive Bacterial Infections , Sepsis , Agar , Anti-Bacterial Agents/pharmacology , Bacteremia/drug therapy , Bacteremia/epidemiology , Drug Resistance, Bacterial , Enterococcus/genetics , Gram-Positive Bacterial Infections/drug therapy , Gram-Positive Bacterial Infections/epidemiology , Humans , Northern Territory , Sepsis/drug therapy , Sepsis/epidemiology
15.
Infect Disord Drug Targets ; 22(5): 77-84, 2022.
Article in English | MEDLINE | ID: covidwho-1809166

ABSTRACT

BACKGROUND: The higher mortality rate in COVID-19 patients is still a concern. Though some studies mention that elderly patients with co-morbidities are at higher risk of mortality, some others report uneventful outcomes in young patients even without co-morbidities. Secondary bacterial and fungal infections, especially with nosocomial pathogens are known to be associated with worse outcome in the ongoing pandemic as well as in the previous viral outbreaks. In such a scenario, the outcome of hospitalized COVID-19 patients can be improved by timely identification of secondary infections using appropriate biomarkers and by following appropriate infection control measures to prevent the spread of nosocomial pathogens. OBJECTIVE: The study aims to find out the prevalence of bloodstream infections (BSI) among hospitalized COVID-19 patients and to analyze their laboratory markers and outcome by comparing them with those without BSI. METHODS: In this descriptive cross-sectional study, the prevalence of secondary BSI was determined among the hospitalized COVID-19 patients by including 388 blood culture bottles collected from 293 patients, which were received in the microbiology lab within the study period. RESULTS: The overall prevalence of BSI in COVID-19 patients was 39.5% (116/293), out of which 35.5% (104/293) infections were bacterial, and 4.1% (12/293) were fungal, while 8.9% (26/293) patients grew contaminants, and 51.5% (151/293) were sterile. Common causative agents of secondary BSI were found to be MDR Klebsiella pneumoniae (10.9%) and Acinetobacter baumannii (8.8%) followed by Candida species (4.1%). Patients with co-morbidities like diabetes, hypertension and COPD were at higher risk of developing BSI with significantly higher levels of sepsis markers such as Creactive protein (CRP), procalcitonin, ferritin and Interleukin-6 (IL-6). The mortality rate was significantly higher (60.2%) in patients with BSI compared to the group of patients without BSI. CONCLUSION: Our findings suggest the necessity of early diagnosis of the secondary infections using appropriate biomarkers and following proper infection control measures to prevent the spread of the nosocomial infections and improve the outcome of hospitalized COVID-19 patients.


Subject(s)
Bacteremia , COVID-19 , Coinfection , Cross Infection , Sepsis , Aged , Anti-Bacterial Agents/therapeutic use , Bacteremia/epidemiology , Bacteremia/microbiology , Bacteria , Biomarkers , COVID-19/epidemiology , Coinfection/drug therapy , Cross Infection/epidemiology , Cross Infection/microbiology , Cross-Sectional Studies , Humans , Prevalence , Retrospective Studies , Risk Factors
16.
J Infect Chemother ; 28(3): 465-468, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1778294

ABSTRACT

Dalbavancin is a lipoglycopeptide antibiotic used off-label to treat serious gram-positive infections, including infections secondary to methicillin-resistant Staphylococcus aureus (MRSA). Dalbavancin has unique pharmacokinetic parameters and has a role in therapy for treating vulnerable patients, including intravenous drug users, who have challenges complying with typical care plans for serious infections. While there is data indicating successful clinical use of dalbavancin in patients with history of intravenous drug use as well as pharmacokinetic-pharmacodynamic data assessing dalbavancin in obesity, there is a lack of information regarding clinical effects of dalbavancin in patients with extreme obesity, especially in patients with concomitant drug use. This case report describes a 40-year-old morbidly obese female actively using intravenous drugs who developed prolonged MRSA bacteremia without a recognizable focus. Despite partial treatment with dalbavancin, the patient developed osteomyelitis and discitis of the spine with associated epidural phlegmon, likely complications of the MRSA bacteremia.


Subject(s)
Bacteremia , Methicillin-Resistant Staphylococcus aureus , Obesity, Morbid , Adult , Anti-Bacterial Agents/adverse effects , Bacteremia/drug therapy , Female , Humans , Obesity, Morbid/complications , Obesity, Morbid/drug therapy , Teicoplanin/adverse effects , Teicoplanin/analogs & derivatives
17.
JBJS Case Connect ; 11(4)2021 10 20.
Article in English | MEDLINE | ID: covidwho-1775521

ABSTRACT

CASE: A 65-year-old man experienced backache, and 9 days later, he developed cellulitis in his left foot. On the 20th day, his body temperature was 37°C, and he had intermittent and shallow cough. On the 29th day, he was diagnosed with pyogenic lumbar discitis and bacteremia. Computed tomography examinations showed no evidence of pneumonia, but his cough persisted, and an elevated d-dimer level was observed. Finally, he tested positive for coronavirus disease 2019 (COVID-19). CONCLUSIONS: This case shows possible associations among COVID-19, venous thrombosis, cellulitis, and bacteremia. Other infections may coexist with COVID-19 and mask it.


Subject(s)
Bacteremia/diagnosis , Bacteremia/etiology , COVID-19/complications , COVID-19/diagnosis , Discitis/diagnosis , Discitis/etiology , Aged , COVID-19 Nucleic Acid Testing , Delayed Diagnosis , Humans , Male , Reverse Transcriptase Polymerase Chain Reaction
18.
J Investig Med High Impact Case Rep ; 10: 23247096221084513, 2022.
Article in English | MEDLINE | ID: covidwho-1753092

ABSTRACT

The 2019 coronavirus disease (COVID-19) can present with a wide variety of clinical manifestations, including a hypercoagulable state leading to both arterial and venous thrombosis. Portal vein thrombosis (PVT) in the setting of COVID-19 has rarely been reported in the medical literature. Pylephlebitis with concomitant liver abscess is a rare complication of intra-abdominal infection. Here, we present the case of a 49-year-old man who initially presented with intermittent fevers and generalized weakness of 1-month duration and was subsequently found to have COVID-19 infection, PVT, and Bacteroides fragilis bacteremia with associated pyogenic liver abscess. The patient was treated with intravenous antibiotics and oral anticoagulation with plan to follow up outpatient with gastroenterology in 3 months to ensure resolution of PVT and liver abscess.


Subject(s)
Bacteremia , COVID-19 , Liver Abscess, Pyogenic , Venous Thrombosis , Bacteremia/complications , Bacteremia/drug therapy , Bacteroides , COVID-19/complications , Humans , Liver Abscess, Pyogenic/complications , Liver Abscess, Pyogenic/diagnosis , Liver Abscess, Pyogenic/drug therapy , Male , Middle Aged , Portal Vein , Venous Thrombosis/complications , Venous Thrombosis/drug therapy
19.
Pediatr Infect Dis J ; 41(4): e142-e145, 2022 04 01.
Article in English | MEDLINE | ID: covidwho-1752202

ABSTRACT

We reviewed all cases of Panton-Valentine leukocidin-producing Staphylococcus aureus (PVL-SA) bacteremia in Danish children between 2016 and 2021. We found 2 fatal cases with preceding viral prodrome due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Given the usual benign course of SARS-CoV-2 infection in children, awareness of possible superinfection with PVL-SA in a child with rapid deterioration is crucial to ensure adequate treatment, including antimicrobial drugs with antitoxin effect.


Subject(s)
Bacteremia , Bacterial Toxins/biosynthesis , COVID-19/complications , Exotoxins/biosynthesis , Leukocidins/biosynthesis , SARS-CoV-2 , Staphylococcal Infections/etiology , Staphylococcal Infections/mortality , Staphylococcus aureus/genetics , Adolescent , COVID-19/virology , Child , Child, Preschool , Coinfection , Comorbidity , Denmark/epidemiology , Female , Humans , Infant , Male , Methicillin-Resistant Staphylococcus aureus/genetics , Methicillin-Resistant Staphylococcus aureus/metabolism , Public Health Surveillance , Severity of Illness Index , Staphylococcal Infections/diagnosis , Staphylococcal Infections/therapy , Staphylococcus aureus/drug effects , Staphylococcus aureus/metabolism
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