ABSTRACT
Infections due to multidrug-resistant organisms continue to increase, and therapeutic options remain scarce. Given this challenge, it has become necessary to use older antimicrobials for treatment of these pathogens. We report three patients with lower urinary tract infections caused by Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae who were successfully treated with a seven-day course of oral fosfomycin monotherapy.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Fosfomycin/therapeutic use , Klebsiella Infections/drug therapy , Klebsiella pneumoniae/drug effects , Urinary Tract Infections/drug therapy , Aged , Aged, 80 and over , Disk Diffusion Antimicrobial Tests , Female , Humans , Klebsiella Infections/microbiology , Klebsiella pneumoniae/enzymology , Male , Middle Aged , Treatment Outcome , Urinary Tract Infections/microbiology , beta-Lactamases/metabolismABSTRACT
We evaluated a new phenotypic test for carbapenemase detection. A total of 100 Enterobacteriaceae isolates were selected. The test was compared with conventional PCR for bla(KPC) and bla(NDM) detection. We found 100% sensitivity and specificity, suggesting that this test may be a feasible alternative for rapid carbapenemase detection.
Subject(s)
Anti-Bacterial Agents/pharmacology , Bacterial Proteins/genetics , Carbapenems/pharmacology , Enterobacteriaceae/enzymology , Enterobacteriaceae/genetics , Polymerase Chain Reaction/methods , beta-Lactamases/genetics , Enterobacteriaceae/drug effects , Enterobacteriaceae/isolation & purification , Enterobacteriaceae Infections/microbiology , HumansABSTRACT
Non cholera Vibrio may cause conjunctivitis, wound infection, gastroenteritis and serious sepsis. Transmission to men is through contact with skin, mucosa or wounds exposed to marine water, and consumption of certain barely cooked or raw seafood, more frequently in the summer. This is one of the first cases of severe infection related to Vibrio vulnificus described in Brazil. The patient was an old man, who ingested seafood in Guarujá, a seashore city near São Paulo, 3 days before hospitalization. He was admitted to the emergency room in an ill state with septic shock. On 2 sets of blood culture a highly virulent microorganism was isolated, Vibrio vulnificus, which leads to sepsis and frequently to death in susceptible patients. The objective of this report was to use this case to discuss clinical aspects, microbiological diagnosis and treatment of the infection caused by this agent, besides the review of epidemiology, associated risk factors and prevention before consuming or getting in contact with seafood, especially in patients with greater susceptibility to this kind of infection.
