Review of airway illnesses by kytococcus and rothia and a look at inhalatory vancomycin as a treatment support.

Seriously compromised patients may acquire deep airway ailments by Gram positive, commensal bacteria including Kytococcus and Rothia, pathogenic tracts of which still remain quite unexplored. Resistances they express have been poorly investigated over the years, and no published guidelines for susceptibility testing and antibiotic therapy exist. We would therefore revise the current knowledge about these opportunistic organisms' clinical impact, as well as discuss on recent patents focusing on lung infection management. Particularly, these deal with the use of inhalatory vancomycin, even as lipidic complex, that appears a promising adjunctive treatment to systemic antimicrobials.

What do we know about Candida guilliermondii? A voyage throughout past and current literature about this emerging yeast.

Candida guilliermondii is an uncommon isolate throughout most of the world, the behaviour of which as an environmental fungus, a human saprophyte and an agent of serious infections has been emphasised over the years. Notably, illnesses caused by this pathogen mostly involve compromised cancer hosts and commonly lead patients to unfavourable outcomes. It is of concern that the yeast may acquire or inherently express reduced in vitro sensitivity to all antifungal classes, although widespread resistance has not yet been described, and poor correlation exists between MICs and clinical outcome. However, the organism appears as constitutively less susceptible to polyenes and echinocandins than other yeast-like fungi, so that the emergence of such pathogen in the clinical settings is of concern and may appear as a new challenge in the context of mycoses and antifungal therapy.

Drug sensitivity and clinical impact of members of the genus Kocuria.

Organisms in the genus Kocuria are Gram-positive, coagulase-negative, coccoid actinobacteria belonging to the family Micrococcaceae, suborder Micrococcineae, order Actinomycetales. Sporadic reports in the literature have dealt with infections by Kocuria species, mostly in compromised hosts with serious underlying conditions. Nonetheless, the number of infectious processes caused by such bacteria may be higher than currently believed, given that misidentification by phenotypic assays has presumably affected estimates of the prevalence over the years. As a further cause for concern, guidelines for therapy of illnesses involving Kocuria species are lacking, mostly due to the absence of established criteria for evaluating Kocuria replication or growth inhibition in the presence of antibiotics. Therefore, breakpoints for staphylococci have been widely used throughout the literature to try to understand this pathogen's behaviour under drug exposure; unfortunately, this has sometimes created confusion, thus higlighting the urgent need for specific interpretive criteria, along with a deeper investigation into the resistance determinants within this genus. We therefore review the published data on cultural, genotypic and clinical aspects of the genus Kocuria, aiming to shed some light on these emerging nosocomial pathogens.

Bacterial contamination of platelets and septic transfusions: review of the literature and discussion on recent patents about biofilm treatment.

In spite of the improvements in transfusion safety occurred in the last decades, platelet septic transfusions still represent a cause for concern. Microbial screening of blood products cannot ensure transfusion sterility, so that pathogen inactivation methods and a timely management of infectious events actually play the most relevant role. Biofilm production has been associated to several human illnesses; also, it promotes bacterial adherence to platelet bags and colonization of recipient's catheter after transfusion. Therefore, facing biofilm communities is required to reduce the contamination risk and the occurrence of post-infusion events. In this context, the use of tigecycline as a wide-spectrum antibiofilm drug is discussed, along with recent patents about biofilm treatment by quorum-sensing blockers, bacteriophage-based therapy and antibiofilm oral compounds.

Enterococcus raffinosus sinusitis post-Aspergillus flavus paranasal infection, in a patient with myelodysplastic syndrome: report of a case and concise review of pertinent literature.

A case of Enterococcus raffinosus nosocomial sinusitis which appeared to complicate a previous Aspergillus flavus paranasal infection is presented. This uncommon enterococcal species is rarely responsible for human diseases, and has never previously been associated with sinusitis.

Pan-azole-resistant Candida guilliermondii from a leukemia patient's silent funguria.

Isolation of Candida non-albicans yeasts as commensals or pathogens from hospitalised hosts is acquiring increasing importance, due to the frequent drug resistance expressed by such organisms.Particularly, the recover of antifungal resistant C. guilliermondii is of worrisome concern, even if recovered as a saprophyte, since commensal yeasts may behave as reservoirs for resistance elements;furthermore, they may enter the bloodstream after chemotherapy-related mucosal damage has developed,thus causing life-threatening and difficult-to-treat fungemias. This communication deals with the unusual isolation of a pan-azole resistant C. guilliermondii strain from a leukaemic patient with silent candiduria and emphasizes the importance of monitoring less recurring species within the nosocomial setting to better understand fungal epidemiology within the wards and face the spread of resistance determinants. Also, we highlight the controversial significance of silent candiduria, clinical relevance of which should be investigated case by case, to exclude and/or prevent candiduria as well as renal impairment.

Epidemiology, pathogenicity and emerging resistances in Staphylococcus pasteuri: from mammals and lampreys, to man.

Staphylococcus pasteuri is a coagulase-negative, Gram positive organism which is emerging as an agent of nosocomial infections and a blood derivatives contaminant, though its role in causing human disease mostly remains controversial. Despite the paucity of isolates recovered, this bacterium has recently appeared to express resistance against several classes of antibiotic compounds, such as methicillin/oxacillin, macrolides, lincosamides, streptogramins, tetracyclines, chloramphenicol, streptomycin, fosfomycin, as well as quaternary ammonium compounds. Also, authors will discuss some essential patents related to the topic reviewed.

A case report of the eradication of pseudomonas aeruginosa from leg ulcer in a patient with essential thrombocythemia.

A patient treated with hydroxyurea had a lower extremity ulcer that was found infected with Pseudomonas aeruginosa. Drug discontinuation and ceftazidime treatment did not initially lead to resolution due to misidentification of inducible betalactamases expressed by the organism and subsequent clinical failure of the cephalosporin in eradicating infection. These class C enzymes may be strongly induced after betalactam exposure and confer resistance to penicillins, cephalosporins, betalactamase inhibitors but not to carbapenems. Though hydroxyurea represents a major cause of essential thrombocythemia-related ulcers, lesion infections by difficult-to-treat organisms should be eradicated to promote wound healing.

Comparison between the BACTEC 9240 and the Pall eBDS system for detection of bacterial platelet concentrate contamination.

BACKGROUND: Only two commercially available automated systems have been cleared by the FDA for screening of bacterial contamination in platelet (PLT) products. These are the Pall eBDS (Pall Corp.), based on measurement of oxygen consumption by contaminant organisms, and the BacT/ALERT (bioMérieux), revealing increasing carbon dioxide concentration due to bacterial growth. STUDY DESIGN AND METHODS: The authors compared the performance of the Pall eBDS with the BACTEC 9240 (bioMérieux) in detecting PLT contamination. Serial dilutions of 10 bacterial species frequently associated with PLT contamination were prepared in an apheresis PLT unit per organism. Units were from single donors. After 30 minutes from seeding PLT units, a volume of suspension achieving a final bacterial concentration of 1 to 10 colony-forming units/mL for each unit was inoculated in two Pall bags and a BACTEC bottle, and the same was done after 24 hours from seeding. Measurements were performed at 24 and 30 hours. RESULTS: Significant differences between the two instruments were only found when screening PLT units after 24 hours from seeding. The Pall system showed a higher sensitivity than BACTEC 9240, because it revealed 97 and 98% of positive samples at 24 and 30 hours of incubation, respectively, whereas the second detected 86 and 90% of contaminated products. Significance was lost after 35-hour incubation with the BACTEC 9240. CONCLUSIONS: By comparing the two instruments, their performances were found to be comparable; the Pall system appeared as a more suitable method when using 24 to 30 hours as times for readings, but the significant difference was lost after 35-hour incubation.

Graft versus host disease-related Hafnia alvei colonization and probable infection.

We describe the case of a graft versus host disease (GvHD) patient, in whom Hafnia alvei was cultured as a single organism, and at high bacterial counts from stool samples, from the onset of the disease until its resolution. This case is a further example of the contentious role of this species in causing human intestinal disease. Furthermore, it focuses on enteric damage by GvHD as a risk factor for acquiring H. alvei colonization, and probably infection.