Peptostreptococcus anaerobius: Pathogenicity, identification, and antimicrobial susceptibility. Review of monobacterial infections and addition of a case of urinary tract infection directly identified from a urine sample by MALDI-TOF MS.

Peptostreptococcus anaerobius is a gram-positive anaerobic coccus (GPAC) found in the gastrointestinal and vaginal microbiota. The organism is mainly found in polymicrobial and scarcely in monobacterial infections such as prosthetic and native endocarditis. Anaerobic bacteria have rarely been reported as the cause of urinary tract infection (UTI). Although GPAC are susceptible to most antimicrobials used against anaerobic infections, P. anaerobius has shown to be more resistant. Herein, we report a case of UTI caused by P. anaerobius from a 62-year-old man with a history of urological disease. Surprisingly, the microorganism was directly identified by Matrix-Assisted Laser Desorption-Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) from the urine sample. The isolate was successfully identified by phenotypic methods, MALDI-TOF MS, and 16S rRNA gene sequencing. P. anaerobius showed no ß-lactamase-producing activity, was resistant to penicillin, ampicillin, ciprofloxacin and levofloxacin, and displayed intermediate susceptibility to ampicillin-sulbactam and amoxicillin-clavulanic acid. Successful treatment was achieved with oral amoxicillin-clavulanic acid. Antimicrobial susceptibility testing (AST) should be performed on P. anaerobius isolates due to their unpredictable AST patterns and because empirically administered antimicrobial agents may not be active. This report shows that MALDI-TOF MS, directly used in urine specimens, may be a quick option to diagnose UTI caused by P. anaerobius or other anaerobic bacteria. This review is a compilation of monobacterial infections caused by P. anaerobius published in the literature, their pathogenicity, identification, and data about the antimicrobial susceptibility of P. anaerobius.

First case of bacteraemia due to Acinetobacter schindleri harbouring blaNDM-1 in an immunocompromised patient.

Clinically significant NDM-1-producing Acinetobacter schindleri has not yet been described in the literature. We report the first case of bacteraemia due to an A. schindleri strain harbouring blaNDM-1 recovered from an immunocompromised patient. Our report reinforces the fact that NDM-1 can easily be acquired by Acinetobacter species.

First nosocomial outbreak of VIM-16-producing Serratia marcescens in Argentina.

Seven metallo-ß-lactamase-positive isolates of Serratia marcescens were recovered from three patients hospitalized in a neonatal ward in an Argentinean hospital during the period July-September 2011. All the isolates were multidrug-resistant, they belonged to a single clone, and carried a blaVIM-16 -containing class I integron structure. This represents the first nosocomial outbreak of metallo-ß-lactamase in Enterobacteriaceae in Argentina.

The effect of occupational therapy intervention on mothers of children with cerebral palsy.

Using the interviewing techniques and ethnographic methodology reported by Hinojosa, we explored the relationships between mothers of preschool children with cerebral palsy and their children's occupational therapists. Data from two interviews with five mothers were transcribed, organized into topics, and, through constant comparative analysis, formulated into themes. One theme, "Is anybody listening?" suggested that professionals often disregard information provided by the mothers; a second theme, "Not another one," revealed the importance of continuity of care and the patient hardship of frequently changing therapists. Consistent with Hinojosa's study, all of the mothers sought duplicative therapy. All of the mothers had established positive relationships with their occupational therapists and described them as skilled agents of change who were effective in helping their children and who were valuable sources of information and support.

Skeletal changes in thalassemia major.

The authors clinically and radiographically examined 72 patients with homozygous beta thalassemia. The clinical data were compared to the degree of osteoporosis calculated by Singh's method. The results indicate a high incidence of skeletal changes in patients with thalassemia, including lower limb-length discrepancy (16.6%), upper limb-length discrepancy (5.5%), axial deviation of the limbs (8.3%), osteochondrosis (2.7%), and osteopenia (25%). Based on their observations, the authors identify skeletal changes of adulthood (osteopenia) and childhood (limb-length discrepancy, axial deviation, osteochondrosis). The authors hypothesize that osteoporotic changes are caused principally by hyperplasia of the bone marrow, which widens the medullary space and increases intramedullary pressure, leading eventually to osteoporosis.

The biomechanics of pelvic osteotomy according to the Chiari method.

The authors analyze the biomechanical effectiveness of pelvic osteotomy according to the Chiari method. This type of operation reduces joint loading and increases the joint support surface. The authors examined 18 patients aged an average of 31 years. This series shows that the effectiveness of pelvic osteotomy according to the Chiari method is particularly observed in cases in which joint morphology is best preserved.