Coinfection of the intestinal tract with Aeromonas hydrophila, Clostridium difficile and Rotavirus - a case report.

Most cases of acute diarrhea in adults are of infectious etiology, likely viral and self-limited. Among those with severe diarrhea, however, bacterial causes are responsible for most cases.Apart from the standard stool cultures, to increase the positive yield a novel multiplex molecular test can be performed simultaneously. The authors present a patient with recurrent diarrhea and detection of Aeromonas hydrophila by culturing and Rotavirus and Clostridioides difficile by multiplex molecular test. They discuss and justify which is the most likely actionable pathogen. Good communication between the physicians and interpretation on the multiple positive results in the context of clinical picture and the test employed were important for a better management and favourable outcome of the patient.

Bacteremia Following Closed and Open Dental Extraction.

AIM: To observe bacteremia following closed and open dental extraction. MATERIAL AND METHODS: The study included two subject groups each comprising 29 participants. Group I patients received a single closed dental extraction, and group II patients ­ a single open extraction. Venous blood from the cubital vein of each patient was collected in three samples ­ preoperatively, 30 seconds after surgery, and 15 minutes after surgery. Anaerobic and aerobic hemocultures (Bact/ALERT, BioMerieux, Inc., Durhamn, N.C.) were used to study the bacteremia process. RESULTS: Preoperatively, bacteremia was confirmed in 4 patients (6.9%) undergoing closed extraction and in 1 patient (1.7%) undergoing open extraction. Additionally, we found statistically significant relation between bacteremia and age (p=0.002). Thirty seconds after surgery bacteriemia was evident in 6 patients (10.3%) from group I and in 3 (5.2%) from group II. Fifteen minutes following surgery bacteremia was evident in 4 patients (6.9%) undergoing typical extraction and in one patient (1.7%) undergoing surgical extraction. No statistically significant relation between type of extraction and presence of bacteria in the bloodstream at 30 seconds (p=0.285) and at 15 minutes (p=0.166) was found. Coagulase-negative Staphylococcus was the most frequently found microorganism (22.2% of aerobic and 11.1% of anaerobic hemocultures). The results show greater significance of bacteremia at 30 seconds, compared to preoperative samples for both subject groups (p=0.03). CONCLUSIONS: Bacteremia following dental extraction is unaffected by duration of intervention, type of extraction and gender.