Cardiobacterium hominis endocarditis complicated by aortic root abscess: a case report.

The present report describes a case of infective endocarditis complicated with aortic root abscess caused by Cardiobacterium hominis in a 56-year-old man. C. hominis is a microaerophilic, pleomorphic Gram-negative bacillus and member of the Haemophilus species, Aggregatibacter actinomycetemcomitans , C. hominis , Eikenella corrodens and Kingella kingae (HACEK) group, a group of bacteria known to be a rare cause of endocarditis. With prompt diagnosis and initiation of antimicrobial and surgical management, a successful outcome was achieved.

[Serotype distribution and antimicrobial susceptibility of Streptococcus pneumoniae strains isolated from middle ear fluids of children aged 0-24 months with acute otitis media]. / Középfülváladékból izolált Streptococcus pneumoniae törzsek szerotípus-megoszlása és antibiotikum-érzékenysége kétéves kor alatti gyermekeknél.

UNLABELLED: Acute otitis media is one of the most common diseases in children aged 0-24 months and Streptococcus pneumoniae is the most frequently isolated bacterial pathogen of acute otitis media. It is well established and documented that the heptavalent pneumococcal conjugate vaccine reduces the frequency of otitis media, especially caused by vaccine-serotype pneumococcus (4, 6B, 9, 14, 18C, 19F, 23F). However, this effect depends on the serotype distribution of isolated otopathogenic pneumococcal strains. OBJECTIVE: Aim of this study was to determine the serotype distribution and antimicrobial resistance of pneumococcal strains causing acute otitis media in children aged 0-24 months. PATIENTS AND METHODS: Between year 2002 and 2005 we investigated 73 pneumoccocal strains isolated from middle ear fluids of children aged 0-24 months in 10 pediatric centers in Budapest, Hungary. After bacteriological identification, pneumococcal serotyping was performed through Quellung reaction in the Microbiological Laboratory of Szent Lászlo Hospital Budapest, Hungary. Antimicrobial resistance was determined according to the international standards accepted by the Hungarian Society for Microbiology. RESULTS: The 73 strains represented 14 different serotypes. The most common were serotypes 14 (13.7 %), 19F (13.7 %), 6B (13.7 %), 23A (11 %) and 3 (9.6 %). Coverage ratio of the heptavalent pneumococcal conjugated vaccine was 63 %. Intermediate penicillin susceptibility was 41 % among all serotypes and 90 % among vaccine-serotypes. No high level penicillin resistant strains were found. Among intermediate penicillin susceptible strains serotype 9V, 14 and 19F were the most frequent. CONCLUSION: Serotype distribution of otopathogenic pneumococcal strains and coverage ratio of heptavalent conjugated pneumococcal vaccine in Hungary are similar to the result found in other geographic regions. In conclusion, we suppose that use of the pneumococcal conjugated vaccines in Hungary would provide same effectiveness against acute otitis media showed in previous multinational efficacy trials.

Serotypes and clonal types of penicillin-susceptible streptococcus pneumoniae causing invasive disease in children in five Latin American countries.

We used multilocus sequencing typing (MLST) to determine the genetic backgrounds of 185 recent penicillin susceptible Streptococcus pneumoniae isolates with serotypes that most frequently cause invasive disease in preschool age children in five Latin American countries-Argentina, Brazil, Colombia, Mexico, and Uruguay. Most of the isolates were associated with pneumonia (90/185), meningitis (74/185), and bacteremia (17/185). The collection of strains included seven serotypes-14, 6B, 5, 1, 23 F-which represent the serotypes of S. pneumoniae most frequently associated with sterile site infections in children. Also included were strains expressing serotypes 7F and 3. Comparison of serotype and multilocus sequence type allowed division of the isolates into two groups: strains expressing serotypes 1, 5, 3, and 7 were represented by a relatively few sequence types while strains expressing serotypes 6B, 14, and 23 F showed great genetic diversity. The genetic diversity of serotypes 14, 6B, and 23 F may be related to the capacity of these serotypes to colonize the nasopharynx of healthy carriers during which opportunities for diversification through genetic exchanges can occur. The findings present an interesting contrast with the results of an earlier study in which over 80% of invasive penicillin- resistant serotype 14 and 23 isolates from the same countries were found to belong to as few as two pandemic clones of S. pneumoniae.