ABSTRACT
Glycopeptide-resistant Enterococcus faecium has emerged as an important nosocomial pathogen with limited therapeutic options. Here we report the successful treatment of glycopeptide-resistant E. faecium infection in two very low birth weight premature infants with the new oxazolidinone linezolid. Treatment with linezolid at a dosage of 10 mg/kg every 8 h intravenously for a duration of 16 days and 14 days, respectively, was well tolerated and led to complete clinical recovery and clearance of the organism from all body sites. The two cases support the clinical efficacy and safety of linezolid in very low birth weight premature neonates with glycopeptide-resistant E. faecium infections.
Subject(s)
Acetamides/pharmacology , Drug Resistance, Bacterial , Enterococcus faecium/drug effects , Glycopeptides/pharmacology , Infant, Very Low Birth Weight , Oxazolidinones/pharmacology , Acetamides/administration & dosage , Acetamides/pharmacokinetics , Enterococcus faecium/genetics , Enterococcus faecium/isolation & purification , Female , Gram-Positive Bacterial Infections/drug therapy , Gram-Positive Bacterial Infections/microbiology , Humans , Infant, Newborn , Linezolid , Male , Oxazolidinones/administration & dosage , Oxazolidinones/pharmacokinetics , Premature Birth , SafetyABSTRACT
BACKGROUND AND OBJECTIVES: The prevention and detection of bacterial contamination of platelet concentrates remains a major challenge for transfusion medicine. To be suitable for blood-transfusion services, the contamination detection method must be highly sensitive, easy to perform and preferably of low cost. In this spiking study, we evaluated the new optimized Scansystem Platelet Kit detection method for use on apheresis platelets. STUDY DESIGN AND METHODS: Apheresis platelet concentrates (APCs) were individually spiked with 10 colony-forming units (CFU)/ml of one of 10 different strains of bacteria. The spiked APCs were analysed at specific time-points during incubation by using the optimized Scansystem Platelet Kit. Bacterial enumeration was performed by plating onto blood agar. RESULTS: All the bacterial strains tested were detected by using the optimized Scansystem Platelet Kit when sampled 24 h after spiking. Compared to the Scansystem standard kit, sensitivity was increased to < 50 CFU/ml. The identity of the spiked bacteria was confirmed by Gram staining and DNA fingerprinting. CONCLUSION: The optimized Scansystem Platelet Kit was able to reliably detect, within 70 min, 10 transfusion-relevant bacterial species in APCs when a sample volume was taken 24 h after spiking. This is the first study carried out by using the optimized Scansystem bacterial detection that was found to have an enhanced sensitivity compared to the standard kit.
Subject(s)
Bacteria/isolation & purification , Blood Platelets/microbiology , Platelet Transfusion/standards , Bacterial Infections/prevention & control , Humans , Plateletpheresis/standards , Quality Control , Reagent Kits, Diagnostic/standards , Sensitivity and SpecificityABSTRACT
We report a case of transplacentally acquired neonatal sepsis with non-typhoid Salmonella. The infant's mother, a 36-y-old woman, presented with fever and malaise in the 25th week of gestation. Because of a pathological cardiotocogram, Caesarean section was performed a few h following admission. The premature infant had clinical signs of sepsis with multiorgan failure and died 4 d later despite intensive medical care. Maternal blood cultures and swab cultures taken from within the uterine cavity and from cutaneous and mucosal surfaces of the infant grew Salmonella virchow. This case and the few sporadic reports in the literature indicate that septicaemia due to non-typhoidal Salmonella spp. during pregnancy is highly lethal to the foetus or newborn, whereas prognosis for the mother apparently is excellent.
