ABSTRACT
OBJECTIVE: Streptococcus pneumoniae is a very rare cause of skin and soft tissue infections (SSTI). The aim of this study was to determine the clinical and microbiological characteristics of these infections. METHODS: The medical records of patients with SSTIs due to S. pneumoniae diagnosed at the University Hospital of Guadalajara between January 2012 and December 2020 were retrospectively reviewed. Microbiological identification was performed using conventional procedures. Antimicrobial sensitivity was performed using the MicroScan WalkAway-96 plus automatic system and E-test strips following the recommendations of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). RESULTS: Fifteen cases of SSTIs were diagnosed. 73,3% of the cases presented underlying diseases, neoplasias being the most frequent. 60% of the cases presented predisposing factors, immunosuppression being the most common. The clinical presentations were: abscesses in different locations, ulcers, surgical wounds, lactational mastitis and necrotizing fasciitis. Polymicrobial infections were detected in 73.3% and the etiology was nosocomial in 6.6%. The clinical course was favorable in 90.9% of the cases. The antibiotics with the highest percentages of sensitivity against S. pneumoniae were cefotaxime, levofloxacin, vancomycin, linezolid and rifampicin. CONCLUSIONS: S. pneumoniae should be kept in mind as a possible causative agent of SSTIs, especially in patients with neoplasias and immunosuppression. Its involvement in infections such as lactational mastitis and necrotizing fasciitis should be highlighted. The clinical evolution is favorable in most patients, but it is important to pay special attention to cases of necrotizing fasciitis due to the severity of these infections.
Subject(s)
Fasciitis, Necrotizing , Soft Tissue Infections , Anti-Bacterial Agents/therapeutic use , Fasciitis, Necrotizing/drug therapy , Female , Humans , Retrospective Studies , Soft Tissue Infections/drug therapy , Streptococcus pneumoniaeABSTRACT
Four Aeromonas strains from clinical and environmental samples differed from known species on the basis of rpoD gene sequence. Multilocus phylogenetic analysis and in silico DNA-DNA hybridization confirmed them as four new species even though their 16S rRNA gene sequence similarity with their closest relatives was >98.7%, as occurred for other Aeromonas spp.
ABSTRACT
The genus Abiotrophia comprises fastidious Gram-positive bacteria previously classified as nutritionally variant streptococci (NVS). The isolation of NVS from the central nervous system (CNS) is very rare. We describe a case of meningitis due to Abiotrophia defectiva in a patient who underwent a total hip arthroplasty 4 days previously. It is possible that the organism could be introduced through the spinal anesthesia. We also review all cases of CNS infections caused by NVS.
Subject(s)
Abiotrophia/isolation & purification , Gram-Positive Bacterial Infections/diagnosis , Meningitis, Bacterial/diagnosis , Abiotrophia/drug effects , Ampicillin/therapeutic use , Anesthesia , Anti-Bacterial Agents/therapeutic use , Arthroplasty, Replacement, Hip , Gram-Positive Bacterial Infections/drug therapy , Gram-Positive Bacterial Infections/microbiology , Humans , Male , Meningitis, Bacterial/microbiology , Microbial Sensitivity Tests , Middle Aged , Penicillins/therapeutic use , Vancomycin/therapeutic useSubject(s)
Anti-Bacterial Agents/pharmacology , Gonorrhea/microbiology , Neisseria gonorrhoeae/drug effects , Anti-Bacterial Agents/therapeutic use , Ceftriaxone/pharmacology , Ceftriaxone/therapeutic use , Drug Resistance, Bacterial , Gonorrhea/epidemiology , Humans , Microbial Sensitivity Tests , Spain/epidemiologySubject(s)
Gentian Violet , Meningococcal Infections/diagnosis , Meningococcal Infections/microbiology , Neisseria meningitidis/isolation & purification , Phenazines , Purpura/diagnosis , Purpura/microbiology , Sepsis/diagnosis , Sepsis/microbiology , Staining and Labeling , Aged, 80 and over , Humans , MaleABSTRACT
No disponible
Subject(s)
Male , Aged , Aged, 80 and over , Humans , Meningococcal Infections/diagnosis , Sepsis/microbiology , Purpura/microbiology , Sepsis/diagnosis , Fatal OutcomeABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Cellulite/complications , Cellulite/diagnosis , Cellulite/therapy , Aeromonas hydrophila/isolation & purification , Vancomycin/therapeutic use , Ampicillin Resistance , Ampicillin Resistance/physiology , Gastroenteritis/complications , Gastroenteritis/diagnosis , Amoxicillin-Potassium Clavulanate Combination/therapeutic use , Cefuroxime/therapeutic use , Ampicillin/therapeutic useABSTRACT
La mionecrosis por Aeromonas spp es excepcional. Describimos un caso de mionecrosis rápidamente progresiva por Aeromonas veronii biotipo sobria en un enfermo diabético con cirrosis hepática, cuya puerta de entrada fue un traumatismo al caer a un canal de riego. La evolución fue desfavorable y fue necesaria la amputación quirúrgica de la extremidad inferior izquierda a pesar del tratamiento antibiótico con cefotaxima y tobramicina. Aeromonas spp es un microorganismo que puede resultar muy agresivo y debe ser tenido en cuenta en el diagnóstico diferencial de las infecciones de piel y partes blandas que cursen con mionecrosis, especialmente en infecciones de heridas secundarias a traumatismos en contacto con agua
Myonecrosis due to Aeromonas spp is exceptional. We report the case of a diabetic patient with liver cirrhosis who developed a rapidly progressive myonecrosis by Aeromonas veronii biotype sobria. The portal of entry was an injury after falling down in an irrigation canal. The outcome was not favourable and surgical amputation of left leg was performed in spite of antibiotic treatment with cefotaxime and tobramicin. Aeromonas spp can be very aggressive and this microorganism should be considered in the differential diagnosis of skin and soft tissue infections with myonecrosis, specially after posttraumatic wound infections with a history of freshwater exposure
Subject(s)
Male , Aged , Humans , Cefotaxime/therapeutic use , Necrosis , Tobramycin/therapeutic use , Stevens-Johnson Syndrome/complications , Stevens-Johnson Syndrome/diagnosis , Skin Diseases, Infectious/complications , Diagnosis, Differential , Skin Diseases, Infectious/diagnosis , Skin Diseases, Infectious/drug therapy , Aeromonas/isolation & purification , Aeromonas/pathogenicity , Dermatomycoses/complications , Skin Diseases, Infectious/mortality , Skin Diseases, Infectious/pathologyABSTRACT
Myonecrosis due to Aeromonas spp is exceptional. We report the case of a diabetic patient with liver cirrhosis who developed a rapidly progressive myonecrosis by Aeromonas veronii biotype sobria. The portal of entry was an injury after falling down in an irrigation canal. The outcome was not favourable and surgical amputation of left leg was performed in spite of antibiotic treatment with cefotaxime and tobramicin. Aeromonas spp can be very aggressive and this microorganism should be considered in the differential diagnosis of skin and soft tissue infections with myonecrosis, specially after posttraumatic wound infections with a history of freshwater exposure.
Subject(s)
Aeromonas/isolation & purification , Gram-Negative Bacterial Infections/complications , Muscular Diseases/microbiology , Necrosis/microbiology , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Cefotaxime/therapeutic use , Gram-Negative Bacterial Infections/drug therapy , Gram-Negative Bacterial Infections/microbiology , Humans , Male , Muscular Diseases/drug therapy , Necrosis/drug therapyABSTRACT
Achromobacter xylosoxidans is a rare cause of bacteremia. Over a 2-week period, A. xylosoxidans subsp. xylosoxidans was isolated from blood cultures of four hemodialysis patients with long-term intravascular catheters. A culture from one atomizer that contained diluted 2.5% chlorhexidine, which had been used to disinfect the skin, yielded A. xylosoxidans subsp. xylosoxidans. No further cases were diagnosed once the use of this atomizer was discontinued. Five outbreak-related strains from the four patients and the atomizer were tested by pulsed-field gel electrophoresis (PFGE) under XbaI restriction. The isolates from the first three patients and the atomizer had identical PFGE patterns, confirming the atomizer as the source of the outbreak. The strain isolated from the fourth patient had six more bands than the outbreak strain and was considered possibly related to the outbreak strain. All patients were treated with intravenous levofloxacin. The catheter was removed in only one patient. The three patients in whom the catheter was left in place were also treated with antibiotic lock therapy with levofloxacin. All four patients were cured. This is believed to be the first reported outbreak of central venous catheter-related bacteremia due to A. xylosoxidans and the second reported outbreak with this organism associated with chlorhexidine atomizers. The use of diluted chlorhexidine via atomizers can be dangerous for the care of venous catheters and should be called into question. Patients with long-term intravascular catheter-related bacteremia due to this organism can be treated successfully with systemic antimicrobial therapy in addition to antibiotic lock therapy without catheter removal.
Subject(s)
Achromobacter denitrificans/isolation & purification , Bacteremia/epidemiology , Bacteremia/microbiology , Catheters, Indwelling/adverse effects , Disease Outbreaks , Gram-Negative Bacterial Infections/epidemiology , Gram-Negative Bacterial Infections/microbiology , Hemodialysis Units, Hospital , Aged , Aged, 80 and over , Bacteremia/diagnosis , Electrophoresis, Gel, Pulsed-Field , Environmental Monitoring , Epidemiological Monitoring , Female , Gram-Negative Bacterial Infections/diagnosis , Humans , Male , Middle Aged , TimeABSTRACT
No disponible
Subject(s)
Male , Middle Aged , Humans , Aggregatibacter actinomycetemcomitans/isolation & purification , Actinobacillus Infections/diagnosis , Endocarditis, Subacute Bacterial/microbiology , Endocarditis, Subacute Bacterial/diagnosisSubject(s)
Feces/parasitology , Hymenolepiasis/parasitology , Hymenolepis/isolation & purification , Intestinal Diseases, Parasitic/parasitology , Africa, Northern/ethnology , Animals , Anticestodal Agents/therapeutic use , Antiprotozoal Agents/therapeutic use , Child , Female , Giardiasis/complications , Giardiasis/diagnosis , Giardiasis/drug therapy , Growth Disorders/etiology , Humans , Hymenolepiasis/complications , Hymenolepiasis/diagnosis , Hymenolepiasis/drug therapy , Hymenolepiasis/epidemiology , Intestinal Diseases, Parasitic/diagnosis , Intestinal Diseases, Parasitic/drug therapy , Intestinal Diseases, Parasitic/epidemiology , Metronidazole/therapeutic use , Niclosamide/therapeutic use , Spain/epidemiologySubject(s)
Meningitis, Bacterial , Salmonella Infections , Salmonella enteritidis/isolation & purification , Aged , Humans , Male , Meningitis, Bacterial/diagnosis , Meningitis, Bacterial/drug therapy , Meningitis, Bacterial/epidemiology , Salmonella Infections/diagnosis , Salmonella Infections/drug therapy , Salmonella Infections/epidemiologyABSTRACT
BACKGROUND: The aim of this study was to know the frequency and the clinical characteristics of urinary infection by non typhi Salmonella in our area in Spain. PATIENTS AND METHODS: The clinical histories of patients with urinary infection by non typhi Salmonella diagnosed in the Hospital General del Guadalajara from January 1990 to July 1999 were reviewed. RESULTS: During the period studied nine patients with urinary infection by non typhi Salmonella were diagnosed, representing 0.056% of the urinary infection diagnosed in our hospital over the same period. All the patients presented underlying disease and five were undergoing immunosuppressor treatment. Four patients presented urological disease. The most frequent serogroup was Salmonella enteritidis (7 cases). All the episodes were symptomatic. The same microorganism was isolated in stools in four patients. The evolution was favorable in five of the nine cases. Recurrence was observed in two patients and secondary bacteremia in one. Six patients required antibiotic treatment over two or more weeks. The mean length of treatment was of 2.5 weeks. CONCLUSIONS: Urinary infection by non typhi Salmonella is predominantly observed in patients undergoing immunosuppression or with urological disease. Prolonged antibiotic treatment is recommended due to its bad evolution.
