Infección urinaria por Aerococcus sanguinicola. Patógeno emergente oportunista / Urinary tract infection by aerococcus sanguinicola. An emerging opportunistic pathogen

Los pacientes ancianos con enfermedad urológica de base tienen mayor riesgo de infecciones del trato urinario por patógenos infrecuentes. Previamente se ha infraestimado la enfermedad causada por Aerococcus, pero la espectrometría de masas podría ser un método sencillo para su identificación. En este trabajo se describen 2 casos de infección urinaria por Aerococcus sanguinicola (A. sanguinicola). Se realizó un estudio descriptivo clínico-microbiológico de la presencia de A. sanguinicola produciendo infecciones urinarias. La presencia de A. sanguinicola ocurrió en pacientes ancianos con enfermedad urológica previa y con un recuento significativo en orinas obtenidas mediante sondaje vesical. La identificación fue correcta mediante espectrometría de masas. La evolución clínica fue satisfactoria mediante el uso de amoxicilina y cefuroxima. En este trabajo informamos de la capacidad patógena de A. sanguinicola. En el urocultivo, ante un recuento significativo de microorganismos alfa-hemolíticos, deberíamos descartar que se trate de A. sanguinicola antes de informar un resultado como microbiota urogenital

Elderly patients with underlying urological disease have a greater risk of urinary tract infections due to uncommon pathogens. The disease caused by Aerococcus has been underestimated, but mass spectrometry could be a simple method for identifying this pathogen. In this study, we report 2 cases of urinary tract infection by Aerococcus sanguinicola. A descriptive clinical-microbiological study was conducted on the presence of A. sanguinicola causing urinary tract infections. The presence of A. sanguinicola occurred in elderly patients with previous urological disease and a significant count in urine obtained through bladder catheterisation. Correct identification was achieved through mass spectrometry, and the clinical outcome of administering amoxicillin and cefuroxime was satisfactory. In this study, we also report the pathogenic capacity of A. sanguinicola. When there is a significant number of alpha-haemolytic microorganisms in the urine cultures, A. sanguinicola should be ruled out before reporting a result as urogenital microbiota

Urinary tract infection by aerococcus sanguinicola. An emerging opportunistic pathogen. / Infección urinaria por Aerococcus sanguinicola. Patógeno emergente oportunista.

Elderly patients with underlying urological disease have a greater risk of urinary tract infections due to uncommon pathogens. The disease caused by Aerococcus has been underestimated, but mass spectrometry could be a simple method for identifying this pathogen. In this study, we report 2 cases of urinary tract infection by Aerococcus sanguinicola. A descriptive clinical-microbiological study was conducted on the presence of A. sanguinicola causing urinary tract infections. The presence of A. sanguinicola occurred in elderly patients with previous urological disease and a significant count in urine obtained through bladder catheterisation. Correct identification was achieved through mass spectrometry, and the clinical outcome of administering amoxicillin and cefuroxime was satisfactory. In this study, we also report the pathogenic capacity of A. sanguinicola. When there is a significant number of alpha-haemolytic microorganisms in the urine cultures, A. sanguinicola should be ruled out before reporting a result as urogenital microbiota.

Actividad y concentraciones de antibióticos en muestras clínicas de pacientes con prostatitis crónica bacteriana / Antibiotic activity and concentrations in clinical samples from patients with chronic bacterial prostatitis

Objetivos: La prostatitis crónica bacteriana (PCB) es la enfermedad urológica más frecuente en menores de 50 años, cuya clínica de larga evolución puede estar relacionada con una inadecuada pauta terapéutica. El objetivo fue analizar la sensibilidad de los microorganismos aislados de pacientes con PCB y medir las concentraciones de antibiótico semanalmente en suero, semen y orina. Material y métodos: Para el estudio de la sensibilidad antibiótica, entre enero de 2013 y diciembre de 2014 se incluyeron 60 aislados clínicos procedentes de muestras de semen de pacientes confirmados microbiológicamente con PCB, y se llevó a cabo por microdilución en caldo. Para el estudio de las concentraciones de antibióticos, entre los meses de enero y mayo de 2014 se recogieron muestras de orina, sangre y semen, semanalmente, durante 4 semanas de tratamiento de 8 pacientes con cultivo positivo para PCB, y se midieron las concentraciones mediante cromatografía de líquidos de ultra alta eficacia acoplada a espectrometría de masas en tándem (UHPLC-MS/MS). Resultados: Fosfomicina y nitrofurantoína fueron los antibióticos con mayor actividad (95,2% en ambos casos). Las concentraciones medias de antibiótico en semen durante las 4 semanas estudiadas fueron las siguientes: 1,68 mg/l; 8,30 mg/l; 2,61 mg/l; 0,33 mg/l y 2,90 mg/l, respectivamente para los pacientes 1 a 5, que recibieron levofloxacino; 1,625 mg/l para el paciente 6, que recibió ciprofloxacino 2,67 mg/l para el paciente 7, que fue tratado con ampicilina, y 1,05 mg/l para el paciente 8, que recibió doxiciclina. Se obtuvieron mayores concentraciones en las muestras de orina que en suero y semen, siendo coparables estas 2 últimas. Conclusiones: Fosfomicina se postula como principal alternativa al tratamiento empírico de la PCB por su elevada actividad in vitro. La concentración de antibiótico en semen fue superior a la concentración mínima inhibitoria frente al agente etiológico, aunque no siempre se correlacionó la negativización microbiológica con la evolución clínica favorable

Objectives: Chronic bacterial prostatitis (CBP) is the most common urological disease in patients younger than 50 years, whose long-standing symptoms could be related to an inappropriate therapeutic regimen. The objective was to analyse the sensitivity of microorganisms isolated from patients with CBP and measure the weekly antibiotic concentrations in serum, semen and urine. Material and methods: For the antibiotic sensitivity study, 60 clinical isolates were included between January 2013 and December 2014 from semen samples from patients with microbiologically confirmed CBP. Broth microdilution was performed on the samples. For the antibiotic concentration study from January to May 2014, urine, blood and semen samples were collected weekly, over 4 weeks of treatment from 8 patients with positive cultures for CBP. The concentrations were measured using ultra-high performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS). Results: The antibiotics fosfomycin and nitrofurantoin had the highest activity (95.2% in both cases). The mean antibiotic concentrations in semen during the 4 weeks studied were as follows: 1.68 mg/L, 8.30 mg/L, 2.61 mg/L, 0.33 mg/L and 2.90 mg/L, respectively, for patients 1 to 5, who were treated with levofloxacin; 1.625 mg/L for patient 6, who was treated with ciprofloxacin; 2.67 mg/L for patient 7, who was treated with ampicillin; and 1.05 mg/L for patient 8, who was treated with doxycycline. Higher concentrations were obtained in the urine samples than in serum and semen, the latter 2 of which were comparable. Conclusions: Fosfomycin is proposed as the primary alternative to the empiric treatment of CBP due to its high in vitro activity. The antibiotic concentration in semen was higher than the minimal inhibitory concentration against the aetiological agent, although microbiological negativisation was not always correlated with a favourable clinical outcome

Streptococcus agalactiae: prevention and vaccine development.

Streptococcus agalactiae, group B Streptococcus (SGB), is the most important cause of morbi-mortality among newborn population, and an important pathogen among immunossupressed adult patients. Despite the advances in the treatment and prevention of neonatal infections as a consequence of implementation of national and international recommendations for prevention of infection, there are still some improvements for the final control of the disease. In this sense, the vaccination against SGB could be an effective measure for the prevention of disease in those cases where intrapartum prophylaxis is not useful and in adult patients with risk factors for invasive infection due to SGB. This review summarizes the efforts made until now in order to establish the control of the infection, and brings some information on the current state-of-the art of vaccines against SGB, in which different strategies in their design have been used.

Antibiotic activity and concentrations in clinical samples from patients with chronic bacterial prostatitis. / Actividad y concentraciones de antibióticos en muestras clínicas de pacientes con prostatitis crónica bacteriana.

OBJECTIVES: Chronic bacterial prostatitis (CBP) is the most common urological disease in patients younger than 50 years, whose long-standing symptoms could be related to an inappropriate therapeutic regimen. The objective was to analyse the sensitivity of microorganisms isolated from patients with CBP and measure the weekly antibiotic concentrations in serum, semen and urine. MATERIAL AND METHODS: For the antibiotic sensitivity study, 60 clinical isolates were included between January 2013 and December 2014 from semen samples from patients with microbiologically confirmed CBP. Broth microdilution was performed on the samples. For the antibiotic concentration study from January to May 2014, urine, blood and semen samples were collected weekly, over 4 weeks of treatment from 8 patients with positive cultures for CBP. The concentrations were measured using ultra-high performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS). RESULTS: The antibiotics fosfomycin and nitrofurantoin had the highest activity (95.2% in both cases). The mean antibiotic concentrations in semen during the 4 weeks studied were as follows: 1.68mg/L, 8.30mg/L, 2.61mg/L, 0.33mg/L and 2.90mg/L, respectively, for patients 1 to 5, who were treated with levofloxacin; 1.625mg/L for patient 6, who was treated with ciprofloxacin; 2.67mg/L for patient 7, who was treated with ampicillin; and 1.05mg/L for patient 8, who was treated with doxycycline. Higher concentrations were obtained in the urine samples than in serum and semen, the latter 2 of which were comparable. CONCLUSIONS: Fosfomycin is proposed as the primary alternative to the empiric treatment of CBP due to its high in vitro activity. The antibiotic concentration in semen was higher than the minimal inhibitory concentration against the aetiological agent, although microbiological negativisation was not always correlated with a favourable clinical outcome.

[Tuberculous prosthetic knee joint infection: a case report and literature review]. / Artritis tuberculosa sobre prótesis de rodilla: descripción de un caso y revisión de la literatura.

OBJECTIVE: Prosthetic late infection occurs in the second month after surgery in the context of haematogenous spread from another source. Prosthetic mycobacterial infection is a rare complication whose clinical management is not standardized. CASE: Patient of 77 years with no personal history except for diabetes and a prosthetic replacement of right knee with osteoarthritis three years ago. Patient goes to hospital emergency box for 6 months pain in the right knee with mechanical inflammatory signs but no fever associated. After their return within 5 days and clinical worsening is reporting growth of Mycobacterium tuberculosis in knee aspirate and antitubercular treatment is established for 9 months. Nuclear magnetic resonance imaging studies also confirmed the diagnosis of tuberculosis spondylitis in the clinical context of the patients. After surgery, M. tuberculosis was again isolated from intraoperative samples and therefore the patient received another batch of treatment for 9 months. After a year of monitoring, the development was acceptable but few months later, the patient died for cardiovascular causes. In the literature review, 15 publications with a total of 17 clinical cases of prosthetic infection by M. tuberculosis were found from 1980 to 2014. CONCLUSIONS: Prosthetic tuberculous arthritis, although it is a rare presentation, it should be noted, especially in patients with predisposing conditions with a history of tuberculosis infection.

Evaluation of a new chemiluminescence immunoassay for laboratory diagnosis of syphilis.

The purpose of this study was to evaluate diagnostic performances of automated chemiluminescence immunoassay (CLIA) in comparison with Treponema pallidum hemagglutination test (TPHA). The specificity of CLIA was 98.9% and 99.6% for TPHA, whereas the sensitivity was 98% and 96%, respectively. Considering the suitability for automation, CLIA may represent a suitable alternative.