ABSTRACT
Intravesical instillation of Bacillus Calmette-Guerin (BCG) is the treatment of choice for superficial bladder carcinoma. Disseminated BCG infection presenting as granulomatous hepatitis or pneumonitis is a very rare complication of this treatment. Here we report a case series of seven patients previously treated with BCG presenting with pneumonitis. In two of the cases, identification of Mycobacterium bovis was achieved with molecular methods.
Subject(s)
Biological Therapy/adverse effects , Biological Therapy/methods , Carcinoma/therapy , Mycobacterium Infections/microbiology , Mycobacterium bovis/isolation & purification , Pneumonia/microbiology , Urinary Bladder Neoplasms/therapy , Aged , Humans , Lung/pathology , Male , Mycobacterium Infections/pathology , Pneumonia/pathology , Radiography, Thoracic , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Fusarium spp. can cause disseminated infections, particularly in immunocompromised patients. Fusarium verticillioides is a human pathogen, and sporadic cases of fusariosis have been reported. AIM: To report a nosocomial cluster of F. verticillioides bloodstream infections among seven immunocompetent inpatients following reconstruction works. METHODS: Identification was performed using macroscopic and microscopic morphology, and molecular assays (sequencing the nuclear ribosomal internal transcribed spacer region and translation elongation factor-1α gene). Susceptibility testing was performed in accordance with the guidelines of the Clinical and Laboratory Standards Institute. Environmental surveillance specimens were taken and cultured on Sabouraud dextrose agar plates. FINDINGS: In total, 16 blood cultures obtained from the seven patients were positive for F. verticillioides. All surveillance cultures were negative. CONCLUSIONS: In order to prevent fungaemia, it is important to implement effective infection control measures, before, during and after demolition and construction activities in healthcare settings.
Subject(s)
Cross Infection/epidemiology , Fungemia/epidemiology , Fusariosis/epidemiology , Fusarium/isolation & purification , Aged , Aged, 80 and over , Cross Infection/microbiology , Diagnostic Tests, Routine , Environmental Microbiology , Fungemia/microbiology , Fusariosis/microbiology , Fusarium/classification , Greece/epidemiology , Hospital Departments , Humans , Infection Control/methods , Male , Microbiological Techniques , Middle AgedABSTRACT
This report describes the detection of Citrobacter koseri carrying K. pneumoniae carbapenemase (KPC-2) isolated in July 2011 from a Greek patient, who was also colonised by a Klebsiella pneumoniae strain coproducing KPC-2 and Verona integron-encoded metallo-beta-lactamase (VIM)-1.
Subject(s)
Bacterial Proteins/metabolism , Citrobacter koseri/isolation & purification , Enterobacteriaceae Infections/microbiology , beta-Lactamases/metabolism , Aged, 80 and over , Ciprofloxacin/therapeutic use , Citrobacter koseri/drug effects , Citrobacter koseri/enzymology , Citrobacter koseri/pathogenicity , Drug Resistance, Multiple, Bacterial , Enterobacteriaceae Infections/drug therapy , Feces/microbiology , Greece , Humans , Klebsiella pneumoniae/drug effects , Klebsiella pneumoniae/enzymology , Klebsiella pneumoniae/isolation & purification , Klebsiella pneumoniae/pathogenicity , Male , Microbial Sensitivity TestsSubject(s)
Anti-Bacterial Agents/pharmacology , Drug Resistance, Bacterial , Klebsiella Infections/microbiology , Klebsiella pneumoniae/drug effects , Minocycline/analogs & derivatives , Europe , Female , Hospitals, University , Humans , Klebsiella pneumoniae/isolation & purification , Microbial Sensitivity Tests , Middle Aged , Minocycline/pharmacology , TigecyclineABSTRACT
Loop-mediated isothermal amplification (LAMP) is a recently developed molecular method that has been successfully implemented in the detection of Mycobacterium tuberculosis in clinical specimens. LAMP has several advantages, such as rapidity, high sensitivity, ease of application and cost-effectiveness. As a result, it is anticipated that its use for the detection of M. tuberculosis is likely to become widespread, especially in low-resource countries. The present review aimed to present this method and all of the available information on its implementation in the detection of M. tuberculosis in clinical specimens.
Subject(s)
Bacteriological Techniques/methods , DNA, Bacterial/isolation & purification , Molecular Diagnostic Techniques/methods , Mycobacterium tuberculosis/isolation & purification , Nucleic Acid Amplification Techniques/methods , Tuberculosis/diagnosis , DNA, Bacterial/genetics , Humans , Mycobacterium tuberculosis/geneticsABSTRACT
BACKGROUND: Due to its increased non-susceptibility rates, Klebsiella pneumoniae has emerged as one of the most problematic pathogens. METHODS: The level of resistance to 25 antimicrobials of K. pneumoniae isolates from a teaching hospital in Greece and the evolution trends during 2 decades were examined. RESULTS: A statistically significant increase in non-susceptibility rates was found for almost all antimicrobials examined. During 2008, the isolates presented non-susceptibility rates to aminoglycosides >50% and to quinolones >60%. Nowadays, 1 out of 10 isolates is non-susceptible to colistin. Moreover, the isolates non-susceptible to imipenem were almost doubled between 2007 (29%) and 2008 (50%). Among the imipenem-resistant isolates, 1 out of 4 was also resistant to colistin. CONCLUSION: The effectiveness of carbapenems has been compromised and the increase in resistance to colistin is rapid and steep.
Subject(s)
Anti-Bacterial Agents/pharmacology , Carbapenems/pharmacology , Colistin/pharmacology , Klebsiella Infections/microbiology , Klebsiella pneumoniae/drug effects , Klebsiella pneumoniae/isolation & purification , Anti-Bacterial Agents/therapeutic use , Carbapenems/therapeutic use , Colistin/therapeutic use , Drug Resistance, Multiple, Bacterial/physiology , Greece/epidemiology , Hospitals, University , Humans , Klebsiella Infections/drug therapy , Klebsiella Infections/epidemiology , Microbial Sensitivity TestsABSTRACT
Mycobacterium arupense is a novel mycobacterium species. It was first identified from clinical specimens in 2006 and since then there have been only two reports of its recovery from clinical samples. In the present case M. arupense was isolated from the sputum of a 62-year-old man with a malignant mass in his left kidney, who presented with a one-month history of recurrent fever, dyspnea and haemoptysis. M. arupense was identified with sequencing of hsp65 and 16S rRNA genes. In the present study, its biochemical profile along with its resistance status and hsp65 RFLP analysis is presented.
Subject(s)
Bacterial Typing Techniques , DNA Fingerprinting , Drug Resistance, Bacterial , Mycobacterium Infections/diagnosis , Mycobacterium/classification , Mycobacterium/drug effects , Polymorphism, Restriction Fragment Length , Bacterial Proteins/genetics , Chaperonin 60/genetics , DNA, Bacterial/genetics , DNA, Ribosomal/genetics , Humans , Kidney Neoplasms/complications , Male , Middle Aged , Molecular Sequence Data , Mycobacterium/genetics , Mycobacterium/isolation & purification , Mycobacterium Infections/microbiology , Mycobacterium Infections/pathology , RNA, Ribosomal, 16S/genetics , Sequence Analysis, DNA , Sputum/microbiologyABSTRACT
Mycobacterium thermoresistibile is a non-tuberculous mycobacterium strongly associated with human infections. Since 1966, there have only been six reports of its isolation from clinical samples. We report on the first case from Europe and review all the previous cases. Identification was achieved with sequencing of the 16S rRNA and hsp65 genes. This study presents its phenotypic and biochemical profile, susceptibilities to selected antibiotics and hsp65 polymerase chain reaction-restriction fragment length polymorphism profile with BsteII and Hae III .
Subject(s)
Mycobacterium Infections/diagnosis , Mycobacterium/classification , Mycobacterium/isolation & purification , Aged , Bacterial Proteins/genetics , Bacterial Typing Techniques , Chaperonin 60 , Chaperonins/genetics , Cluster Analysis , DNA, Bacterial/chemistry , DNA, Bacterial/genetics , DNA, Ribosomal/chemistry , DNA, Ribosomal/genetics , Europe , Humans , Male , Microbial Sensitivity Tests , Molecular Sequence Data , Mycobacterium Infections/microbiology , Phylogeny , Polymorphism, Restriction Fragment Length , RNA, Ribosomal, 16S/genetics , Sequence Analysis, DNAABSTRACT
A total of 10420 Gram-positive cocci (including staphylococci, enterococci and various groups of streptococci) collected from clinically significant specimens in ten Greek hospitals during 2006--2007 were tested for their susceptibility to daptomycin. The minimum inhibitory concentration (MIC) was determined by the broth microdilution method. Daptomycin demonstrated very high activity against Enterococcus faecalis (MIC at which 50% of the isolates were inhibited (MIC50) = 1mg/L and MIC at which 90% of the isolates were inhibited (MIC90) = 1.36 mg/L), Enterococcus faecium (MIC50 = 1.36 mg/L and MIC90 = 1.90 mg/L), Streptococcus pyogenes (MIC50 = 0.12 mg/L and MIC90 = 0.50mg/L), Streptococcus agalactiae (MIC50 = 0.09 mg/L and MIC90 = 0.12 mg/L), Streptococcus pneumoniae (MIC50 = 0.24 mg/L and MIC90 = 0.5 mg/L) and viridans group streptococci (MIC50 = 0.50 mg/L and MIC90 = 0.89 mg/L). Resistance to linezolid and vancomycin for enterococci and to penicillin for streptococci appears to be independent of reduced susceptibility to daptomycin. On the other hand, daptomycin was also active against meticillin-resistant Staphylococcus aureus (MIC50 = 0.44 mg/L and MIC90 = 0.78 mg/L) and meticillin-resistant coagulase-negative staphylococci (MIC50 = 0.24 mg/L and MIC90 = 0.44 mg/L); however, 0.9% of the staphylococci tested had an MIC > 1mg/L, which is the Clinical and Laboratory Standards Institute breakpoint proposed for susceptibility. For all tested organism groups, resistance to daptomycin was not associated with glycopeptide resistance.
Subject(s)
Anti-Bacterial Agents/pharmacology , Daptomycin/pharmacology , Gram-Positive Bacterial Infections/microbiology , Gram-Positive Cocci/drug effects , Drug Resistance, Bacterial/genetics , Electrophoresis, Gel, Pulsed-Field , Genes, Bacterial/drug effects , Greece , Humans , Microbial Sensitivity TestsSubject(s)
Anti-Bacterial Agents/pharmacology , Gram-Positive Cocci/drug effects , Minocycline/analogs & derivatives , Gram-Positive Bacterial Infections/microbiology , Gram-Positive Cocci/isolation & purification , Greece , Humans , Microbial Sensitivity Tests , Minocycline/pharmacology , TigecyclineABSTRACT
Mycobacterium malmoense was isolated from a broncho-alveolar lavage sample of a 73-year-old cancer (small cell lung carcinoma) patient in Crete, representing the first reported case of this pathogen in Greece. The isolate was considered to be a colonizer and the patient did not receive any antimycobacterial treatment while he received chemotherapy to which he responded favourably. No signs of pulmonary infection were noted during the course of his disease. This case provides evidence of the ubiquitous nature of this mycobacterial species, believed until recently to favour cooler climates. We, therefore, propose that the index of suspicion for this pathogen should be raised particularly in patients with underlying immunodeficiency, cancer and chronic lung disease, irrespective of the geographic location.
Subject(s)
Bronchoalveolar Lavage Fluid/microbiology , Mycobacterium/isolation & purification , Aged , Carcinoma, Small Cell , Greece , Humans , Lung Neoplasms , MaleABSTRACT
During 2005-2006, a total of 865 Enterococcus faecium isolated from patients from eight Greek hospitals were tested for susceptibility to quinupristin/dalfopristin (Q/D). Among them, 250 genetically unrelated strains (28.9%) were found to be intermediate-resistant to Q/D (minimum inhibitory concentration (MIC) 1.5-4 mg/L); all were resistant to dalfopristin (MIC=16-64 mg/L), whilst 69% were resistant to quinupristin, carrying the ermB gene. No strain was found to carry any of the known genes, such as vatE and vatD, involved in Q/D resistance, indicating that a non-transferable undetermined mechanism is responsible for the expression of low-level Q/D resistance. The high percentage of Q/D-intermediate-resistant E. faecium in Greece was not associated with prior consumption of the agent or with the veterinary use of virginiamycin.
Subject(s)
Drug Resistance, Bacterial , Enterococcus faecium/drug effects , Gram-Positive Bacterial Infections/microbiology , Virginiamycin/pharmacology , Acetyltransferases/genetics , Bacterial Proteins/genetics , Enterococcus faecium/isolation & purification , Greece , Humans , Microbial Sensitivity TestsSubject(s)
Bacterial Typing Techniques , DNA, Bacterial/analysis , Mycobacterium tuberculosis/classification , Mycobacterium/classification , Reagent Kits, Diagnostic , Animals , Cattle , Genotype , Humans , Mycobacterium/genetics , Mycobacterium/isolation & purification , Mycobacterium Infections/microbiology , Mycobacterium bovis/classification , Mycobacterium bovis/genetics , Mycobacterium bovis/isolation & purification , Mycobacterium tuberculosis/genetics , Mycobacterium tuberculosis/isolation & purification , Species SpecificityABSTRACT
In order to determine the resistance patterns and evolution trends of four common Enterobacteriaceae (Escherichia coli, Proteus spp., Klebsiella spp. and Enterobacter spp.), aminoglycoside resistance phenotypes of 8917 non-repetitive strains, isolated over an 8-year period, were analysed. Phenotypes were defined by examining the susceptibility of the strains to a panel of aminoglycosides, using disk diffusion method. A large diversity of different resistance phenotypes was encountered. A significant progressive increase in the proportions of wild-type E. coli strains was noted. Among resistant strains of Enterobacter spp. and Klebsiella spp., the incidence of phenotype KTANt (kanamycin, tobramycin, amikacin and netilmicin), indicative of AAC(6')-I production, was very high (66.7 and 46.5%, respectively). Phenotypes indicative for gentamicin-modifying enzymes as well as broad-spectrum combinations (combinations of gentamicin-modifying enzymes with AAC(6')-I) were infrequent.