Infection due to Roseomonas spp: a case report

ABSTRACT Male patient, 68 years old, immunocompromised, presented himself with fever and malaise for 15 days. At his hospitalization, peripheral blood and Schilley catheter blood cultures were collected, in addition to computed tomography that showed the presence of a peri-pancreatic collection. The material was drained and the samples were sent to the laboratory. Blood culture was positive for pink coconuts identified by mass spectrometry as Roseomonas spp. with the diagnosis of Bloodstream Infection being closed.

Bacteremia após a colangiopancreatografia retrógrada endoscópica, com e sem procedimento terapêutico: frequência, fatores associados e significado clínico / Bacteremia after endoscopic retrograde cholangiopancreatography with or without therapeutic procedure: frequency, associated factors and clinical manifestations

Objetivo. O objetivo do presente estudo foi avaliar a freqüência, os fatores associados e a manifestaçöes clínica de bacteremia em pacientes submetidos à colangiopancreatografia retrógrada endoscópica (CPRE), associada ou näo Ó realizaçäo de procedimento terapêutico. Casuística. Foram analisadas prospectivamente 46 colangiopancreatografias retrógradas endoscópicas (CPREs) realizadas em 42 pacientes. Os pacientes foram divididos em três subgrupos na dependência da utilizaçäo de antibióticos, da presença de obstruçäo do ducto biliar e/ou pancreático e da realizaçäo de procedimentos terapêuticos. Método. A pesquisa de bacteremia foi realizada mediante coleta de hemoculturas seriadas antes e após a CPRE. Foram utilizados, como meio para as hemoculturas, frascos tipo Bactec, capazes de receber maiores volumes de sangue e com resinas para adsorçäo de antibioóticos. A análise de positividade das hemoculturas foi realizada no sistema Bactec 9240Ô, e a identificaçäo das bactrérias, por meio de rotina do Laboratório Central da instituiçäo e com o sistema autoScan/Microscan. Resultados. Foi detectada bacteremia após sete exames; entretanto, em dois os microrganismos isolados foram considerados contaminantes. Em cinco exames ocorreu bacteremia verdadeira (freqüência, 10,9 por cento). Foram identificados os microrganismos: Streptococcus viridans, Corynebacterium sp., Enterobacter cloacae, Klebsiella oxytoca e Enterobacter aerogenes. Os episódios de bacteremia foram detectados com maior freqüência nas hemoculturas realizadas imediatamente após os exames (p<0,05), e foram restrito aos pacientes que näo estavan utilizando antibióticos (p=0,0192). Näo houve manifestaçäo clínica dos episódios de bacteremia. Conclusöes. Concluiu-se que os episódios de bacteremia ocorreram exclusivamente nos pacientes que näo estavam utilizando antibiótico e foram transitórios e completamente assintomáticos.

[Bacteremia after endoscopic retrograde cholangiopancreatography with and without therapeutic procedure: frequency, associated factors and clinical significance]. / Bacteremia após a colangiopancreatografia retrógrada endoscópica, com e sem procedimento terapêutico: freqüência, fatores associados e significado clínico.

PURPOSE: To determine the frequency, associate factors and clinical features of bacteremia in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP), with or without therapeutic procedures. METHODS: Prospectively, 42 consecutives patients undergoing 46 endoscopic retrograde cholangiopancreatographies (ERCPs) from August to December 1994 were analyzed. The search for bacteremia was done by drawing 6 blood samples for cultures from peripheral blood. Two blood samples were collected before the ERCP and 4 of them after. The bottles used for cultures were Bactec bottles. The bottles were incubated in the Bactec 9240 system, and eventual bacteria detect were identificated by the manual routine of the laboratory and also with the autoScan/Microscan system. RESULTS: All blood cultures obtained before the ERCPs were negatives. Bacteremia were detected after 7 endoscopic procedures. In two episodes of bacteremia, the microorganism identified (Staphylococcus epidermidis) was considered to be a contaminant. The other 5 episodes of bacteremia were considered true bacteremia (frequency- 10.9%), and the microorganisms identified were: Streptococcus viridans, Corynebacterium sp., Enterobacter cloacae, Klebsiello oxytoca and Enterobacter aerogenes. This episodes were more frequent in the blood cultures obtained immediately after the ERCPs (p < 0.05), and occurred exclusively in the patients who were not receiving antibiotics (p = 0.0192). Clinical manifestation of the episodes of bacteremia were not detected. CONCLUSION: The episodes of bacteremia occurred exclusively in the patients who were not receiving antibiotics, were transient and completely no symptomatic.