ABSTRACT
We describe the results of carbapenem-resistant Enterobacteriaceae (CRE) screening as part of an outbreak investigation of New Delhi metallo-ß-lactamase-producing CRE at a tertiary care university teaching hospital. The manual method for CRE screening was useful for detecting patients with asymptomatic CRE carriage but was time-consuming and costly.
Subject(s)
Carbapenems/pharmacology , Disease Outbreaks , Klebsiella Infections/diagnosis , Klebsiella pneumoniae/isolation & purification , Rectum/microbiology , beta-Lactamases/biosynthesis , Adult , Aged , Colorado , Confidence Intervals , Female , Hospitals, Teaching , Humans , Intensive Care Units , Klebsiella pneumoniae/enzymology , Male , Middle Aged , Multivariate Analysis , Population Surveillance , Young AdultABSTRACT
We report the first two cases of invasive human mycoses caused by the phaeoid ascomycete, Chaetomium perlucidum, and review the English literature regarding invasive Chaetomium infections. Fatal disseminated disease involving the brain, heart, lungs, and spleen is described in an acute myelogenous leukemia patient. A second patient with a history of asthma and chronic bronchiectasis experiencing right-middle-lobe syndrome grew C. perlucidum from lung tissue. This study adds C. perlucidum to the list of other known neurotropic Chaetomium species, C. atrobrunneum and C. strumarium, and also documents this organism's ability to disseminate beyond the central nervous system.
Subject(s)
Brain Diseases/microbiology , Chaetomium/isolation & purification , Mycoses/pathology , Aged , Antifungal Agents/pharmacology , Autopsy , Brain Diseases/pathology , Chaetomium/cytology , Chaetomium/drug effects , Fatal Outcome , Female , Humans , Microbial Sensitivity Tests , Middle AgedSubject(s)
Acinetobacter , Cross Infection/microbiology , Gram-Negative Bacterial Infections/microbiology , Pseudomonas , Xanthomonas , Cross Infection/complications , Cross Infection/drug therapy , Cross Infection/epidemiology , Drug Resistance, Microbial , Gram-Negative Bacterial Infections/complications , Gram-Negative Bacterial Infections/drug therapy , Gram-Negative Bacterial Infections/epidemiology , HumansSubject(s)
Bacteria, Anaerobic/drug effects , Bacterial Infections/drug therapy , Genital Diseases, Female/drug therapy , Bacterial Infections/microbiology , Drug Resistance, Microbial , Female , Genital Diseases, Female/microbiology , Gram-Negative Anaerobic Bacteria/drug effects , Gram-Positive Bacteria/drug effects , Humans , In Vitro Techniques , Microbial Sensitivity Tests , PregnancySubject(s)
AIDS-Related Opportunistic Infections/microbiology , Streptococcal Infections/microbiology , AIDS-Related Opportunistic Infections/classification , AIDS-Related Opportunistic Infections/epidemiology , Catalase , Humans , Streptococcal Infections/classification , Streptococcal Infections/epidemiology , SuppurationABSTRACT
The maternal death rate and rate of preterm delivery associated with pneumonia during pregnancy have not decreased since the introduction of antibiotics four decades ago. We retrospectively reviewed 25 cases of pneumonia during pregnancy; these cases occurred among 32,179 deliveries. Medical complications included: bacteremia, 16%; empyema, 8%; atrial fibrillation, 4%; respiratory failure necessitating mechanical ventilation, 20%. Obstetric complications occurring during the pneumonia episode included: preterm labor, 44%; preterm delivery, 36%. A patient with cystic fibrosis died; one stillbirth and two neonatal deaths occurred. Underlying maternal disease was significantly associated with maternal medical complications (p = 0.023) and preterm delivery (p = 0.012). Significant medical and obstetric complications continue to occur frequently despite modern antimicrobial, tocolytic, and supportive therapy. Underlying maternal disease, including acquired immunodeficiency syndrome and cystic fibrosis, was associated with preterm delivery and neonatal and maternal death.
