RESUMO
BACKGROUND: Infectious diseases are a common problem in people who travel to countries with poor hygiene standards. Pregnant travellers are subjected to increased risk because of the higher probability of complications in case of certain infectious diseases and the variability of prenatal care quality in these countries. CASE DESCRIPTION: A pregnant patient presented herself at the emergency department with recurring fever and chills, a month after she had been to Indonesia. This was associated with a Salmonella infection; the placenta was the infection reservoir. CONCLUSION: Travelling while pregnant is not without risk. Quick diagnosis and treatment of infections, which may sometimes have an atypical presentation during pregnancy, can be of crucial importance. It is extra important for pregnant people to get travel advice before the trip, so that risks, alarming symptoms and additional hygiene measures can be discussed.
Assuntos
Complicações Infecciosas na Gravidez , Infecções por Salmonella , Doença Relacionada a Viagens , Viagem , Adulto , Feminino , Humanos , Indonésia , Administração dos Cuidados ao Paciente , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/prevenção & controle , Complicações Infecciosas na Gravidez/terapia , Cuidado Pré-Natal/métodos , Serviços Preventivos de Saúde/métodos , Salmonella/isolamento & purificação , Infecções por Salmonella/diagnóstico , Infecções por Salmonella/prevenção & controle , Infecções por Salmonella/terapiaRESUMO
A case series of 14 patients with Raoultella bacteremia was compared with 28 Klebsiella oxytoca and 28 Klebsiella pneumoniae bacteremia cases. Forty-three percent of Raoultella bacteremia cases were associated with biliary tract disease, compared to 32% and 22% of patients with K. oxytoca and K. pneumoniae bacteremia, respectively.
Assuntos
Bacteriemia/microbiologia , Doenças Biliares/complicações , Doenças Biliares/microbiologia , Infecções por Enterobacteriaceae/microbiologia , Enterobacteriaceae/isolamento & purificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Bacteriemia/epidemiologia , Doenças Biliares/epidemiologia , Infecções por Enterobacteriaceae/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Ninety-nine clinical isolates previously identified as Klebsiella oxytoca were evaluated using matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS). Eight isolates were identified as Raoultella spp., being 5 Raoultella spp. and 3 K. oxytoca, by 16S rRNA sequencing. These isolates were correctly identified by applying the 10% differential rule for the MALDI-TOF MS score values. This approach might be useful to discriminate Raoultella species from K. oxytoca.
Assuntos
Técnicas Bacteriológicas/métodos , Enterobacteriaceae/química , Enterobacteriaceae/classificação , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos , DNA Bacteriano/química , DNA Bacteriano/genética , DNA Ribossômico/química , DNA Ribossômico/genética , Humanos , Dados de Sequência Molecular , RNA Ribossômico 16S/genética , Análise de Sequência de DNARESUMO
We present descriptions of two human Mycobacterium microti infections: one of a patient with pulmonary disease and one of a patient with osteomyelitis of the hip. Both patients had acid-fast bacilli and a positive Mycobacterium tuberculosis complex PCR from clinical specimens, but mycobacterial cultures remained negative. The microbiological diagnosis was established by molecular methods.
Assuntos
Mycobacterium/isolamento & purificação , Tuberculose Osteoarticular/diagnóstico , Tuberculose Osteoarticular/microbiologia , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/microbiologia , Quadril/microbiologia , Humanos , Pulmão/microbiologia , Masculino , Pessoa de Meia-Idade , Mycobacterium/classificação , Reação em Cadeia da Polimerase/métodosRESUMO
OBJECTIVE: To identify risk factors for surgical site infection (SSI) in patients with rheumatoid arthritis (RA) with special attention for anti-tumor necrosis factor (anti-TNF) treatment. METHODS: All patients with RA who had undergone elective orthopedic surgery since introduction of anti-TNF were included in a retrospective parallel-cohort study with a one-year followup. Primary endpoint was a SSI according to the 1992 Centers for Disease Control and Prevention criteria and/or antibiotic use. Cohort 1 did not use anti-TNF, cohort 2 used anti-TNF but had either stopped (2A) or continued anti-TNF preoperatively (2B), the cutoff point being set at 4 times the half-life time of the drug. Infection rates were compared between cohorts, and logistic regression analysis was performed to examine risk factors. RESULTS: In total, 1219 (768 patients) procedures were included, and crude infection risks were 4.0% (41/1023), 5.8% (6/104), and 8.7% (8/92) in cohorts 1, 2A, and 2B, respectively. Elbow surgery (OR 4.1, 95% CI 1.6-10.1), foot/ankle surgery (OR 3.2, 95% CI 1.6-6.5), and prior skin or wound infection (OR 13.8, 95% CI 5.2-36.7) were associated with increased risk of SSI, whereas duration of surgery (OR 0.42, 95% CI 0.23-0.78) and sulfasalazine use (OR 0.21, 95% CI 0.05-0.89) were associated with decreased risk. Perioperative use of anti-TNF was not significantly associated with an increase in SSI rates (OR 1.5, 95% CI 0.43-5.2). CONCLUSION: The most important risk factor for SSI is history of SSI or skin infection. Although our study was not powered to detect small differences in infection rates, perioperative continuation of anti-TNF does not seem to be an important risk factor for SSI.
