27 results on '"bloodstream"'
Search Results
2. Rare Spiroplasma Bloodstream Infection in Patient after Surgery, China, 2022
- Author
-
Ningning Xiu, Chao Yang, Xiaowei Chen, Jianping Long, and Pinghua Qu
- Subjects
Spiroplasma ,bloodstream ,infection ,surgery ,China ,bacteria ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
We report a case of Spiroplasma bloodstream infection in a patient in China who developed pulmonary infection, acute respiratory distress syndrome, sepsis, and septic shock after emergency surgery for type A aortic dissection. One organism closely related to Spiroplasma eriocheiris was isolated from blood culture and identified by whole-genome sequencing.
- Published
- 2024
- Full Text
- View/download PDF
3. Bloodstream Infections in the South of Iran: Microbiological Profile and Antibiotic-Resistance Patterns of Isolated Bacteria
- Author
-
Mojtaba Anvarinejad, Masoomeh Khalifeh, Jalal Mardaneh, Gholamreza Pouladfar, and Mohammad Ali Dehyadegari
- Subjects
bloodstream ,bacterial infections ,drug resistance ,microbial resistance ,Medicine - Abstract
Objectives: Bloodstream infection (BSI) causes significant morbidity and mortality in patients, especially in developing countries. Changes in the epidemiological pattern of microorganisms, as well as the growth of antibacterial resistance have become important health concerns in Iran. The aims of this study were to evaluate the spectrum of pathogens causing BSIs in hospitalized patients in Shiraz, Iran, and their corresponding antimicrobial resistance patterns. Materials and Methods: In this retrospective study, 1585 positive blood samples were analyzed from March 2013 to March 2014. Samples from all hospitals within Shiraz were transferred to Professor Alborzi Clinical Microbiology Center. Then, the isolates were identified according to standard methods such as the analytical profile index system, and antibiotic susceptibility patterns were established consistent with the recommendations of the Clinical and Laboratory Standards Institute. Results: Coagulase-negative staphylococci (39%), Staphylococcus aureus (15.3%), Escherichia coli (8.5%), Pseudomonas spp. (7.5%), Enterococcus spp. (7.3%), and Acinetobacter spp. (6.6%) were the most frequent bacteria isolated from blood cultures. Linezolid and vancomycin (VA) had the highest effectiveness against gram-positive bacteria and gram-negative bacteria had high sensitivity to polymyxin B and colistin. Totally, 56.2% of Enterococcus isolates were VA-resistant (VRE) and 55.2% (122) of S. aureus were methicillin-resistant (MRSA). Finally, 59.02% (72) of E. coli isolates, 33.3% (5) of Serratia spp., and 42.85% (33) of Klebsiella spp. were extended-spectrum β-lactamase (ESBL) positive. Conclusions: Considering the results, the emergence of resistant strains such as MRSA, VRE, and ESBL is an alarming threat that would be a severe clinical issue with critical restrictions on antibiotic therapy.
- Published
- 2021
4. Incidence of invasive non-typhoidal Salmonella in Blantyre, Malawi between January 2011-December 2019 [version 1; peer review: 2 approved]
- Author
-
Heather Galloway, Nicholas A. Feasey, Brigitte Denis, Melita Gordon, Clemens Masesa, Catherine N. Wilson, Angeziwa Chunga, Sithembile Bilima, and Niza Silungwe
- Subjects
Salmonella ,infection ,bloodstream ,surveillance ,antimicrobial resistance ,eng ,Medicine ,Science - Abstract
Background: The Malawi-Liverpool Wellcome Trust Clinical Research Programme (MLW) has undertaken sentinel surveillance of bloodstream infection and meningitis at Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi for 20 years. Previously, three epidemics of Salmonella bloodstream infection have been identified. Here we provide updated surveillance data on invasive non-typhoidal Salmonella disease from 2011 – 2019. Methods: Surveillance data describing trends in invasive non-typhoidal Salmonella disease and associated antimicrobial susceptibility profiles are presented for the period January 2011 – December 2019. Results: Between January 2011-December 2019, 128,588 blood cultures and 40,769 cerebrospinal fluid cultures were processed at MLW. Overall, 1.00% of these were positive for S. Typhimurium, 0.10% for S. Enteritidis, and 0.05% positive for other Salmonella species. Estimated minimum incidence of invasive non-typhoidal Salmonella (iNTS) disease decreased from 21/100,000 per year in 2011 to 7/100,000 per year in 2019. Over this period, 26 confirmed cases of Salmonella meningitis were recorded (88.5% S. Typhimurium). Between 2011-2019 there was a substantial decrease in proportion of S. Typhimurium (78.5% to 27.7%) and S. Enteritidis (31.8% in 2011 to 0%) that were multidrug-resistant. Resistance to fluoroquinolones and third-generation generation cephalosporins (3GC) remained uncommon, however 3GC increased amongst Salmonella spp. and S. Typhimurium in the latter part of the period. Conclusions: The total number of iNTS bloodstream infections decreased between 2011-2019. Although the number multidrug resistance (MDR) S. Typhimurium and S. Enteritidis isolates has fallen, the number of MDR isolates of other Salmonella spp. has increased, including 3GC isolates.
- Published
- 2022
- Full Text
- View/download PDF
5. Large Outbreaks of Fungal and Bacterial Bloodstream Infections in a Neonatal Unit, South Africa, 2012–2016
- Author
-
Erika van Schalkwyk, Samantha Iyaloo, Serisha D. Naicker, Tsidiso G. Maphanga, Ruth S. Mpembe, Thokozile G. Zulu, Mabatho Mhlanga, Sibongile Mahlangu, Motlatji B. Maloba, Grace Ntlemo, Kgomotso Sanyane, Dini Mawela, and Nelesh P. Govender
- Subjects
disease outbreaks ,fungi ,candidemia ,Candida krusei ,bloodstream ,neonatal sepsis ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
Candidemia is a major cause of healthcare-associated infections. We describe a large outbreak of Candida krusei bloodstream infections among infants in Gauteng Province, South Africa, during a 4-month period; a series of candidemia and bacteremia outbreaks in the neonatal unit followed. We detected cases by using enhanced laboratory surveillance and audited hospital wards by environmental sampling and epidemiologic studies. During July–October 2014, among 589 patients, 48 unique cases of C. krusei candidemia occurred (8.2% incidence). Risk factors for candidemia on multivariable analyses were necrotizing enterocolitis, birthweight
- Published
- 2018
- Full Text
- View/download PDF
6. The Development of Ultrasound Method of the Study of the Inferior Alveolar Arteries
- Author
-
GR R Bakhteeva, AV V Lepilin, NL L Erokina, SS S Savelieva, and LM M Chibrikova
- Subjects
ultrasound study ,bloodstream ,inferior alveolar artery ,mandible ,prevention of osteomyelitis ,Medicine - Abstract
А^ - the development of ultrasound method of the study of inferior alveolar arteries and their normal data of blood circulation. Materials and methods. In 20 men the apparatus «Vivid E9» the study of the bipolar bloodstream in the inferior alveolar arteries was performed. Results. In the study of the facial arteries the following results were obtained: PS - 55,7+0,9 cm/s, ED - 10,15+0,3 cm/s, TAMX - 52,0+1,1 cm/s, PI - 1,32+0,06, RI - 0,77+0,03, PS/ED - 2,30+0,1, HR - 35,36+1,9 bpm. In the study of the inferior alveolar arteries the following results were determined: PS bloodstream 57,96+0,7 cm/s; ED bloodstream 5,47+0,1 cm/s; TAMX 17,22+0,5 cm/s; PI 3,05+0,1; RI 0,91+0,05; PS/ ED 10,60+0,2; HR 69,48+0,4 Ьрм. Conclusion. The methodology of ultrasound study of the inferior alveolar arteries and bloodstream parameters in them was developed.
- Published
- 2018
- Full Text
- View/download PDF
7. Prevalence of Bloodstream Infections and their Etiology in COVID-19 Patients Admitted in a Tertiary Care Hospital in Jaipur
- Author
-
Hemant Malhotra, Daisy Bacchani, Rajat Vohra, Richa Sharma, Ekadashi Rajni, Vedprakash Mamoria, and Vishnu K Garg
- Subjects
medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Coinfections ,Bacteremia ,Bloodstream ,Antimicrobial resistance ,Critical Care and Intensive Care Medicine ,Blood culture ,Sepsis ,03 medical and health sciences ,0302 clinical medicine ,Pandemic ,Epidemiology ,medicine ,Original Research ,Antibiotic stewardship ,medicine.diagnostic_test ,business.industry ,Blood epidemiology ,COVID-19 ,030208 emergency & critical care medicine ,Retrospective cohort study ,medicine.disease ,030228 respiratory system ,Emergency medicine ,Etiology ,business - Abstract
Background World is in grip of coronavirus disease-2019 (COVID-19) pandemic right now. Majority of studies center around its epidemiological and clinical characteristics. Information regarding secondary bacterial infections is limited. This retrospective observational study was done to determine the prevalence and characteristics of bloodstream infections in COVID-19 patients admitted in a tertiary care center in Jaipur. Materials and methods All blood cultures received from COVID-19 positive patients admitted in designated COVID care ICUs and wards were included in the study. A predesigned pretested questionnaire was used to collect relevant data. Blood cultures were done using BD BACTEC™ FX40, and identification and antimicrobial susceptibility testing of isolates were done by VITEK® 2 COMPACT. Results One thousand five hundred seventy-eight (1578) COVID-19 positive patients were admitted in center during 5-month study period from whom 158 blood cultures were received. Out of these, 15 (9.4%) were positive. Median age of patients with positive blood culture was 54 years and included 10 males and 5 females. Ten (67%) patients needed intensive care in ICU. Significant correlation of blood culture positivity was found with parameters like ICU admission, presence of an indwelling device, underlying comorbidity, raised biochemical markers, and adverse clinical outcome. Conclusions Incidence of bloodstream infections is low for COVID-19 patients. Antibiotic prophylaxis needs to be used with caution, and prompt discontinuation should be done based on clinical judgment. How to cite this article Rajni E, Garg VK, Bacchani D, Sharma R, Vohra R, Mamoria V, et al. Prevalence of Bloodstream Infections and their Etiology in COVID-19 Patients Admitted in a Tertiary Care Hospital in Jaipur. Indian J Crit Care Med 2021;25(4):369–373.
- Published
- 2021
8. Experimental approbation of methodological and hardware-software speck-visualization in diagnosis of microcirculation of human surface biological tissues
- Author
-
I. V. Kishkevich, K. N. Runkevich, M. M. Mezhennaya, T. V. Kalilec, R. A. Laschetko, and S. K. Dzik
- Subjects
bloodstream ,Vital activity ,medicine.medical_specialty ,speckle visualization ,speckle image ,TK7800-8360 ,business.industry ,Tissue level ,Direct participation ,tissue perfusion ,Diabetology ,Blood flow ,contrast ,Rapid assessment ,Microcirculation ,blood microcirculation ,Circulatory system ,Medicine ,Electronics ,business ,Intensive care medicine - Abstract
In modern clinical practice, the assessment of the state of blood microcirculation and the diagnosis of microcirculatory disorders are extremely relevant in a variety of diseases: in cardiology, diabetology, oncology, dermatology, dentistry, surgery and resuscitation. Microcirculatory disorders are very diverse both in their pathogenesis and in clinical manifestations. Therefore, in the pattern of various diseases and extreme conditions, as well as in the correction of microcirculatory disorders the methods are needed for both operative assessment of the state of blood flow at tissue level and for its long-term monitoring. The interest in the study of the microvascular bed of the circulatory system is sparked by the significant role of capillaries in the implementation of the basic processes of the body's vital activity, in the trophic support of organs and their direct participation in tissue and cellular respiration. The health and life expectancy of a person depend on the coordinated work of the heart, large blood lines, and microcirculation vessels. The authors have studied modern optical methods for diagnosing microcirculation. The feasibility of using the speckle imaging method for noninvasive rapid assessment of the state of the microvasculature of human surface biological tissues has been substantiated. To implement the speckle-visualization method, methodological and software have been developed. The processing parameters that are most optimal from the point of view of the ratio of spatiotemporal resolution and computation time have been experimentally substantiated. The purpose of this work is the experimental testing of the developed methodological and hardware speckle imaging for the diagnosis of microcirculation of human surface biological tissues. The authors have carried out the studies of the state of microcirculation in the superficial blood vessels of the skin during physiotherapeutic procedures and in the imitation of pathology. The results of the studies have proved the feasibility of using the developed software for a high-quality diagnosis of the state of microcirculation of human surface biological tissues: primary changes in microcirculation are revealed, further changes to occur during physiotherapeutic procedures are visualized.
- Published
- 2020
9. Application of mNGS to describe the clinical and microbial characteristics of severe burn a tanker explosion at a tertiary medical center: a retrospective study patients following
- Author
-
Man Huang and Jing Wu
- Subjects
medicine.medical_specialty ,Explosions ,Infectious and parasitic diseases ,RC109-216 ,Bloodstream ,Sensitivity and Specificity ,Medical microbiology ,Internal medicine ,medicine ,Humans ,Blood culture ,Retrospective Studies ,Cause of death ,medicine.diagnostic_test ,business.industry ,Research ,Incidence (epidemiology) ,Fungi ,High-Throughput Nucleotide Sequencing ,Retrospective cohort study ,Microbiological ,medicine.disease ,mNGS ,Infectious Diseases ,Tropical medicine ,Severe burn ,Burns ,business ,Multiple organ dysfunction syndrome ,Total body surface area - Abstract
Background Multiple organ dysfunction syndrome secondary to infection is the leading cause of death in burn patients. Bloodstream infection (BSI) and the prognosis of burn patients are negatively correlated. Metagenomic next-generation sequencing (mNGS) can detect many potential pathogens and may be more valuable for patients with severe burns. Methods We retrospectively explored the utility of mNGS in describing the clinical and microbial characteristics of severely burned patients with BSI. We compared mNGS with blood culture. Results Fourteen patients (127 blood samples) developed 71 episodes of BSIs with 102 unique causative pathogens. The median total body surface area was 93%. The overall 90-day mortality was 43%. In total, 17 (23.9%) episodes were polymicrobial, and 61 (86.1%) episodes originated from the wound. In total, 62/71 cases (87%) showed positive findings by mNGS, while 42/71 cases (59%) showed positive findings using blood culture. We found that mNGS outperformed culture, especially in terms of fungi (27% vs. 6%, p Conclusions The incidence of BSI and polymicrobial in patients with large-area severe burns is high. mNGS has potential value in the diagnosis of fungal infections and coinfections in such patients. In addition, mNGS may provide unique guidance for antibiotic therapy in complicated BSI.
- Published
- 2021
10. Toxic Metal Species and ‘Endogenous’ Metalloproteins at the Blood–Organ Interface: Analytical and Bioinorganic Aspects
- Author
-
Jürgen Gailer, Tristen G. Bridle, and Premkumari Kumarathasan
- Subjects
Chronic exposure ,bloodstream ,Erythrocytes ,Pharmaceutical Science ,Organic chemistry ,Endogeny ,chronic exposure ,01 natural sciences ,Inorganic pollutants ,Analytical Chemistry ,toxic metals/metalloids ,bioinorganic chemistry ,03 medical and health sciences ,Plasma ,Cytosol ,QD241-441 ,mechanism of toxicity ,Metals, Heavy ,Drug Discovery ,Blood plasma ,Metalloproteins ,medicine ,Metalloprotein ,Humans ,Metabolomics ,Physical and Theoretical Chemistry ,030304 developmental biology ,Pollutant ,chemistry.chemical_classification ,0303 health sciences ,Chemistry ,010401 analytical chemistry ,metalloprotein ,Bioinorganic chemistry ,0104 chemical sciences ,Heavy Metal Poisoning ,Red blood cell ,medicine.anatomical_structure ,Biochemistry ,Gene Expression Regulation ,Chemistry (miscellaneous) ,Perspective ,Molecular Medicine ,biomarker ,Biomarkers - Abstract
Globally, human exposure to environmental pollutants causes an estimated 9 million deaths per year and it could also be implicated in the etiology of diseases that do not appear to have a genetic origin. Accordingly, there is a need to gain information about the biomolecular mechanisms that causally link exposure to inorganic environmental pollutants with distinct adverse health effects. Although the analysis of blood plasma and red blood cell (RBC) cytosol can provide important biochemical information about these mechanisms, the inherent complexity of these biological matrices can make this a difficult task. In this perspective, we will examine the use of metalloentities that are present in plasma and RBC cytosol as potential exposure biomarkers to assess human exposure to inorganic pollutants. Our primary objective is to explore the principal bioinorganic processes that contribute to increased or decreased metalloprotein concentrations in plasma and/or RBC cytosol. Furthermore, we will also identify metabolites which can form in the bloodstream and contain essential as well as toxic metals for use as exposure biomarkers. While the latter metal species represent useful biomarkers for short-term exposure, endogenous plasma metalloproteins represent indicators to assess the long-term exposure of an individual to inorganic pollutants. Based on these considerations, the quantification of metalloentities in blood plasma and/or RBC cytosol is identified as a feasible research avenue to better understand the adverse health effects that are associated with chronic exposure of various human populations to inorganic pollutants. Exposure to these pollutants will likely increase as a consequence of technological advances, including the fast-growing applications of metal-based engineering nanomaterials.
- Published
- 2021
11. Efficacy of Antimicrobial-Impregnated Catheters for Prevention of Bloodstream Infections in Pediatric Patients: A Meta-Analysis
- Author
-
Xuan Yue and Li Lai
- Subjects
bloodstream ,medicine.medical_specialty ,Population ,Subgroup analysis ,Pediatrics ,RJ1-570 ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,030225 pediatrics ,Internal medicine ,Medicine ,030212 general & internal medicine ,education ,antibiotic impregnated ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,catheter ,Odds ratio ,Confidence interval ,meta-analysis ,Catheter ,nosocomial infection ,Meta-analysis ,Pediatrics, Perinatology and Child Health ,Systematic Review ,business - Abstract
Background: Multiple Randomized controlled trials (RCTs) have evaluated the efficacy of antimicrobial-impregnated catheters to prevent catheter-related bloodstream infections (CRBSI). However, the RCTs showed contradictory results, the studies were limited in sample size and methodology quality. Thus, we conducted a meta-analysis to overcome these RCT limitations.Methods: We designed a meta-analysis of RCTs comparing antimicrobial-impregnated and conventional catheters for the prevention of CRBSI. We conducted a detailed search of various databases for RCTs published before November 2019. We calculated mean differences (MDs) and pooled odds ratios (ORs) with 95% confidence intervals (CIs) using a random-effects model.Results: We included five RCTs with a total of 2,294 patients. The incidence of CRBSI between the two groups was 0.50 (95% CI, 0.19–1.27), with evidence of heterogeneity (I2 = 55%). The difference was not statistically significant (p = 0.15). On subgroup analysis based on the age of the sample, there was no difference in the rate of CRBSI in the neonatal population [0.42 (95% CI, 0.08–2.27 I2 = 61% p = 0.31] as well as pediatric population [0.45 (95% CI, 0.12–1.67 I2 = 39% p = 0.23]. The summary OR on the incidence of catheter colonization between antimicrobial-impregnated and conventional catheters was 0.64 (95% CI, 0.17–2.35), with no evidence of heterogeneity (I2 = 0%) and a non-significant difference (p = 0.50).Conclusions: To conclude, analysis of a limited number of heterogeneous studies mostly with a small sample indicates that the CRBSI and catheter colonization rates are similar between conventional and antimicrobial-impregnated catheters in the pediatric and neonatal population. There is an urgent need for large-scale RCTs focusing on different antimicrobial-impregnated catheters in these patients to further enhance current evidence.
- Published
- 2021
12. Prevalence of Candida bloodstream isolates from patients in two hospitals in Vietnam
- Author
-
Minoru Nagi, Do Quyet, Le Bach Quang, Dang Duc Anh, Tran Thi Thanh Nga, Nguyen Duy Bac, Miyazaki Yoshitsugu, Le Tran Anh, Nguyen Khac Luc, Do Ngoc Anh, and Hoang Thi Thu Ha
- Subjects
Microbiology (medical) ,medicine.medical_specialty ,lcsh:QR1-502 ,Germ tube ,Bloodstream ,01 natural sciences ,Microbiology ,lcsh:Microbiology ,Species level ,Polymorphism (computer science) ,0502 economics and business ,Epidemiology ,medicine ,Prevalence ,Candida ,Vietnam ,0101 mathematics ,Candida albicans ,biology ,business.industry ,010102 general mathematics ,05 social sciences ,biology.organism_classification ,Ho chi minh ,Candida spp ,Original Article ,business ,Blood stream ,050203 business & management - Abstract
Background and Objectives: Identification of yeasts provides helpful information for appropriate administration of an- ti-fungal treatments; however, few reports from the Vietnam have been published. This study has been performed to find the prevalence of Candida blood stream isolates from patients in two hospitals in Vietnam. Materials and Methods: Candida spp. were isolated from blood cultures in two hospitals, Vietnam between May 2013 and May 2015. Participating hospitals were 103 Military Hospital, Ha Noi city (550 beds) and Cho Ray Hospital, Ho Chi Minh city (1800 beds). All the bloodstream isolates were identified to species level by the germ tube test and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). In addition, unknown isolates were subjected to PCR sequencing. Results: A total of 93 Candida isolates were isolated from blood cultures during the study period. The results of this study showed that C. tropicalis (n = 47, 50.54%) was the most common agent, followed by Candida albicans/dubliniensis (n = 18, 19.35%), C. parapsilosis (n = 16, 17.20%), C. glabrata (n = 6, 6.45%), C. mesorugosa (n = 5, 5.38%) and C. krusei (n = 1, 1.08%), respectively. Conclusion: The frequency of the non-albicans Candida species in blood is increasing, especially C. tropicalis. Addi- tional investigations should be made to clarify the epidemiological profile of invasive Candida bloodstream in Vietnam.
- Published
- 2019
13. Resistance to Echinocandins Complicates a Case of Candida albicans Bloodstream Infection: A Case Report
- Author
-
Giuseppe Migliorisi, Guido Scalia, Salvatore Massimo Oliveri, Maddalena Calvo, Laura Trovato, Albino Boraccino, Stefania Stefani, Nicolò Musso, and Dafne Bongiorno
- Subjects
bloodstream ,Microbiology (medical) ,Echinocandin ,QH301-705.5 ,Urinary system ,Case Report ,Plant Science ,law.invention ,echinocandins ,resistance ,03 medical and health sciences ,0302 clinical medicine ,law ,Bloodstream infection ,Candida albicans ,polycyclic compounds ,Medicine ,030212 general & internal medicine ,Biology (General) ,Ecology, Evolution, Behavior and Systematics ,0303 health sciences ,biology ,030306 microbiology ,business.industry ,mutations ,bacterial infections and mycoses ,biology.organism_classification ,medicine.disease ,Intensive care unit ,Corpus albicans ,Immunology ,business ,Multiple organ dysfunction syndrome ,Echinocandins ,FKS1 ,medicine.drug - Abstract
Invasive candidiasis is known to be one of the most common healthcare-associated complications and is caused by several Candida species. First-line drugs, particularly echinocandins, are effective, but there are increasing reports of resistance to these molecules, though rarely related to C. albicans. Even though the rate of echinocandins resistance remains low (Candida albicans affecting a critically ill patient, who died in an intensive care unit following therapeutic failure and multiple organ dysfunction syndrome. This case highlights the need to suspect pan-echinocandin resistance in patients with prolonged echinocandin exposure, particularly in the presence of urinary tract colonization. Our study shows the importance of sequencing to predict therapeutic failure in patients treated with echinocandins and persistent candidemia.
- Published
- 2021
14. Increased Virulence of Bloodstream Over Peripheral Isolates of P. aeruginosa Identified Through Post-transcriptional Regulation of Virulence Factors
- Author
-
Caitríona Hickey, Bettina Schaible, Scott Nguyen, Daniel Hurley, Shabarinath Srikumar, Séamus Fanning, Eric Brown, Bianca Crifo, David Matallanas, Siobhán McClean, Cormac T. Taylor, and Kirsten Schaffer
- Subjects
bloodstream ,0301 basic medicine ,Microbiology (medical) ,Proteome ,THP-1 Cells ,Immunology ,lcsh:QR1-502 ,Virulence ,Bacteremia ,Bloodstream ,Biology ,medicine.disease_cause ,Microbiology ,Real-time polymerase chain reaction ,lcsh:Microbiology ,03 medical and health sciences ,proteomics ,Pseudomonas ,Pseudomonas infections ,medicine ,Pathogen ,Innate immunity ,Innate immune system ,Virulence factors ,Pseudomonas aeruginosa ,Immunogenicity ,Gene expression profiling ,infection ,pseudomonas ,3. Good health ,virulence ,030104 developmental biology ,Infectious Diseases ,rpoN ,Infection - Abstract
The factors influencing the virulence of P. aeruginosa in the development of invasive infection remain poorly understood. Here, we investigated the role of the host microenvironment in shaping pathogen virulence and investigated the mechanisms involved. Comparing seven paired genetically indistinguishable clinical bloodstream and peripheral isolates of P. aeruginosa, we demonstrate that isolates derived from bloodstream infections are more virulent than their peripheral counterparts (p = 0.025). Bloodstream and peripheral isolates elicited similar NF-kB responses in a THP-1 monocyte NF-kappaB reporter cell line implicating similar immunogenicity. Proteomic analysis by mass spectrometry identified multiple virulence and virulence-related factors including LecA and RpoN in significantly greater abundance in the bacterial supernatant from the bloodstream isolate in comparison to that from the corresponding peripheral isolate. Investigation by qPCR revealed that control of expression of these virulence factors was not due to altered levels of transcription. Based on these data, we hypothesize a post-transcriptional mechanism of virulence regulation in P. aeruginosa bloodstream infections influenced by surrounding microenvironmental conditions. Science Foundation Ireland
- Published
- 2018
15. Rapid emergence of colistin resistance and its impact on fatality among healthcare-associated infections
- Author
-
Pınar Ergen, Emel Yilmaz, Y. Tezer, H. Demirkaya, Yusuf Ziya Demiroglu, Cigdem Ataman Hatipoglu, Seniha Başaran, A. Tümtürk, Ilkay Karaoglan, Nazlim Aktug Demir, Mehtap Aydin, Özlem Kurt Azap, O. Memikoğlu, C. Karakoc, Suda Tekin, Halis Akalin, Hüseyin Bilgin, Alpay Azap, Onder Ergonul, Şebnem Erdinç, Gule Aydin, Onur Ural, Fusun Can, Şirin Menekşe, Ş.E. Çakar, Lutfiye Mulazimoglu, Şiran Keske, Şafak Kaya, Hikmet Eda Alışkan, S.A. Çavuş, C. Yardımcı, İstinye Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, and Karakoc, Zehra Cagla
- Subjects
0301 basic medicine ,Microbiology (medical) ,Adult ,Male ,medicine.medical_specialty ,Klebsiella pneumoniae ,030106 microbiology ,Bacteremia ,Bloodstream ,Microbial Sensitivity Tests ,medicine.disease_cause ,03 medical and health sciences ,0302 clinical medicine ,Colistin Mic ,Internal medicine ,Case fatality rate ,Gram-Negative Bacteria ,medicine ,Humans ,030212 general & internal medicine ,Aged ,Retrospective Studies ,Aged, 80 and over ,Cross Infection ,biology ,Gram-Negative ,Pseudomonas aeruginosa ,business.industry ,Colistin ,General Medicine ,Odds ratio ,Middle Aged ,biology.organism_classification ,Confidence interval ,Acinetobacter baumannii ,Anti-Bacterial Agents ,Health Care ,Infectious Diseases ,Carbapenems ,Female ,business ,Gram-Negative Bacterial Infections ,Enterobacter cloacae ,medicine.drug - Abstract
This article describes the emergence of resistance and predictors of fatality for 1556 cases of healthcare-associated Gram-negative bloodstream infection in 2014 and 2015. The colistin resistance rate in Klebsiella pneumoniae was 16.1%, compared with 6% in 2013. In total, 660 (42.4%) cases were fatal. The highest fatality rate was among patients with Acinetobacter baumannii bacteraemia (58%), followed by Pseudomonas aeruginosa (45%), Klebsiella pneumoniae (41%), Enterobacter cloacae (32%) and Escherichia coli (28%). On multi-variate analysis, the minimum inhibitory concentrations for carbapenems [odds ratio (OR) 1.02, 95% confidence interval (CI) 1.01-1.04; P = 0.002] and colistin (OR 1.1, 95% CI 1.03-1.17; P = 0.001) were found to be significantly associated with fatality. (C) 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved. WOS: 000426316700011 29248504 Q1
- Published
- 2017
16. In vitro antifungal susceptibility of candidemia agents and detection of their biofilm production by two different methods
- Author
-
Iman Qoraan, Egemen Gokbolat, and Yasemin Oz
- Subjects
Microbiology (medical) ,Antifungal ,Hospitalized patients ,medicine.drug_class ,Biofilm ,Biology ,biochemical phenomena, metabolism, and nutrition ,Microbiology ,In vitro ,Virulence factor ,QR1-502 ,chemistry.chemical_compound ,chemistry ,Amphotericin B ,antifungal susceptibility, biofilm formation, bloodstream, Candida, XTT ,medicine ,Anidulafungin ,Caspofungin ,Molecular Biology ,antifungal susceptibility ,biofilm formation ,bloodstream ,Candida ,XTT ,medicine.drug - Abstract
Candida bloodstream infections are a significant cause of morbidity and mortality in hospitalized patients. The most important contribution of biofilm is the higher antifungal resistance than planktonic cells. We aimed to investigate the biofilm formation rate and antifungal susceptibility characteristics of our bloodstream isolates, and evaluate two different biofilm detection methods. A total of 200 bloodstream Candida isolates were included. The biofilms were formed on 96-well microtiter plates and measured by spectrophotometric percent transmittance and 2,3-bis(2- methoxy-4-nitro-5-sulfo-phenyl)-2H-tetrazolium- 5-carboxanilide colorimetric assay. In addition antifungal susceptibilities of these isolates were evaluated against caspofungin, anidulafungin and amphotericin B by reference method. Biofilm production rate was considerably high among our bloodstream isolates. The most important biofilm producer species was C. tropicalis; C. glabrata had the lowest biofilm production rate. The consistency rate between biofilm detection methods was 66%. Remarkable antifungal resistance was not observed among our isolates in general. In conclusion, biofilm production in Candida species is an important virulence factor, and its rate is considerably high in bloodstream isolates. At present, a standardized method has not been established to detect the biofilm formation.
- Published
- 2017
17. Healthcare-associated Gram-negative bloodstream infections: Antibiotic resistance and predictors of mortality
- Author
-
Emel Yilmaz, Serda Gulsun, Cigdem Ataman Hatipoglu, Ilkay Karaoglan, Fusun Can, Y. Tezer, Hikmet Eda Alışkan, Suda Tekin, Mehtap Aydin, Gulsen Yoruk, Şebnem Erdinç, Aynur Engin, H. Cabadak, Alpay Azap, Halis Akalin, Asuman Inan, Funda Şimşek, Hüseyin Bilgin, Aysegul Yesilkaya, Şafak Kaya, Lutfiye Mulazimoglu, Özlem Kurt Azap, Onder Ergonul, Funda Timurkaynak, Turhan Togan, Seniha Başaran, Serap Şimşek Yavuz, Ebru Kurşun, Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı., Yılmaz, Emel, Akalın, Halis, AAU-8952-2020, and [Ergonul, O. -- Tekin, S. -- Can, F.] Koc Univ, Sch Med, Infect Dis & Clin Microbiol Dept, Istanbul, Turkey -- [Aydin, M. -- Timurkaynak, F.] Baskent Univ, Sch Med, Istanbul Hosp, Infect Dis & Clin Microbiol Dept, Etimesgut Ankara, Turkey -- [Azap, A.] Ankara Univ, Fac Med, Infect Dis & Clin Microbiol Dept, TR-06100 Ankara, Turkey -- [Basaran, S. -- Yavuz, S. S.] Istanbul Univ, Istanbul Med Sch, Infect Dis & Clin Microbiol Dept, Istanbul, Turkey -- [Kaya, S. -- Gulsun, S.] Diyarbakir Training & Res Hosp, Infect Dis & Clin Microbiol Dept, Diyarbakir, Turkey -- [Yoruk, G.] Istanbul Training & Res Hosp, Infect Dis & Clin Microbiol Dept, Istanbul, Turkey -- [Kursun, E. -- Aliskan, H. E.] Baskent Univ, Sch Med, Adana Hosp, Infect Dis & Clin Microbiol Dept, Adana, Turkey -- [Yesilkaya, A. -- Azap, O.] Baskent Univ, Sch Med, Ankara Hosp, Infect Dis & Clin Microbiol Dept, Ankara, Turkey -- [Simsek, F.] Okmeydani Training & Res Hosp, Infect Dis & Clin Microbiol Dept, Istanbul, Turkey -- [Yilmaz, E. -- Akalin, H.] Uludag Univ, Sch Med, Infect Dis & Clin Microbiol Dept, Bursa, Turkey -- [Bilgin, H. -- Mulazimoglu, L.] Marmara Univ, Sch Med, Infect Dis & Clin Microbiol Dept, Istanbul, Turkey -- [Hatipoglu, C. -- Erdinc, S.] Ankara Numune Training & Res Hosp, Infect Dis & Clin Microbiol Dept, Ankara, Turkey -- [Cabadak, H. -- Tezer, Y.] Ankara Specialty Hosp, Infect Dis & Clin Microbiol Dept, Ankara, Turkey -- [Togan, T.] Baskent Univ, Sch Med, Konya Hosp, Infect Dis & Clin Microbiol Dept, Konya, Turkey -- [Karaoglan, I.] Gaziantep Univ, Sch Med, Infect Dis & Clin Microbiol Dept, Gaziantep, Turkey -- [Inan, A.] Haydarpasa Numune Training & Res Hosp, Infect Dis & Clin Microbiol Dept, Istanbul, Turkey -- [Engin, A.] Cumhuriyet Univ, Sch Med, Infect Dis & Clin Microbiol Dept, Sivas, Turkey
- Subjects
0301 basic medicine ,Male ,Acinetobacter baumannii ,Pediatrics ,Turkey ,Ventilator associated pneumonia ,Klebsiella pneumoniae ,Epidemiology ,Healthcare associated infection ,Antibiotic resistance ,medicine.medical_treatment ,Bacteremia ,Bloodstream ,Piperacillin plus tazobactam ,Turkey (republic) ,0302 clinical medicine ,Controlled clinical trial ,Prevalence ,030212 general & internal medicine ,Middle aged ,Carbapenem ,APACHE ,Drug resistance, bacterial ,Surveillance ,Intensive care units ,biology ,Mortality rate ,Antibiotic agent ,Healthcare ,Klebsiella-pneumoniae ,General Medicine ,Prognosis ,Classification ,Gram-negative ,Multicenter study ,Clinical trial ,Retrospective study ,Gram-negative bacteria ,Pseudomonas aeruginosa ,Infectious diseases ,Female ,lthInfectious diseases ,Central venous catheter ,Impactenterobacteriaceae ,Human ,Microbiology (medical) ,Adult ,medicine.medical_specialty ,030106 microbiology ,Gram-negative bacterial infections ,Cephalosporin ,Gram negative bacterium ,Outcomes ,Cause of death ,Major clinical study ,Bloodstream infection ,Microbiology ,Article ,03 medical and health sciences ,Cross infection ,Intensive care ,Internal medicine ,Enterobacter cloacae ,medicine ,Escherichia coli ,Humans ,Intensive care unit ,Mortality ,Aged ,Program ,Drug effects ,business.industry ,Colistin ,Quinoline derived antiinfective agent ,Aminoglycoside antibiotic agent ,Odds ratio ,Survival analysis ,medicine.disease ,biology.organism_classification ,Nonhuman ,Beta-Lactamases ,Carbapenem-Resistant Enterobacteriaceae ,Klebsiella Pneumoniae ,Confidence interval ,Retrospective studies ,Pneumonia ,Risk factors ,Isolation and purification ,Gram negative infection ,Risk factor ,business ,Controlled study ,Public, environmental & occupational health - Abstract
WOS: 000389233700014, PubMed ID: 27717604, This article describes the prevalence of antibiotic resistance and predictors of mortality for healthcare-associated (HA) Gram-negative bloodstream infections (GN-BSI). In total, 831 cases of HA GN-BSI from 17 intensive care units in different centres in Turkey were included; the all-cause mortality rate was 44%. Carbapenem resistance in Klebsiella pneumoniae was 38%, and the colistin resistance rate was 6%. Multi-variate analysis showed that age > 70 years [odds ratio (OR) 2, 95% confidence interval (CI) 1.22-3.51], central venous catheter use (OR 2.1, 95% CI 1.09-4.07), ventilator- associated pneumonia (OR 1.9, 95% CI 1.1-3.16), carbapenem resistance (OR 1.8, 95% CI 1.11-2.95) and APACHE II score (OR 1.1, 95% CI 1.07-1.13) were significantly associated with mortality. (C) 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
- Published
- 2016
18. Neonatal bloodstream infections in a Ghanaian Tertiary Hospital:Are the current antibiotic recommendations adequate?
- Author
-
Stephanie Bjerrum, Mercy J. Newman, Christabel Enweronu-Laryea, Noah Obeng-Nkrumah, and Appiah Korang Labi
- Subjects
0301 basic medicine ,Male ,Pediatrics ,Cefotaxime ,Antibiotics ,Resistance ,Drug Resistance, Bacterial/drug effects ,Bacteremia ,Bloodstream ,Ghana ,Tertiary Care Centers ,Drug Resistance, Multiple, Bacterial ,Ampicillin ,Blood culture ,Neonatal sepsis ,medicine.diagnostic_test ,Anti-Bacterial Agents ,Infectious Diseases ,Practice Guidelines as Topic ,Gentamicin ,Neonatal Sepsis ,Research Article ,medicine.drug ,medicine.medical_specialty ,Drug Resistance, Multiple, Bacterial/drug effects ,medicine.drug_class ,030106 microbiology ,Infections ,lcsh:Infectious and parasitic diseases ,Anti-Bacterial Agents/pharmacology ,03 medical and health sciences ,Cloxacillin ,Bacteremia/drug therapy ,Drug Resistance, Bacterial ,medicine ,Humans ,lcsh:RC109-216 ,Hospitals, Teaching ,Ghana/epidemiology ,Retrospective Studies ,Bacteria ,business.industry ,Neonatal Sepsis/drug therapy ,Infant, Newborn ,Neonates ,medicine.disease ,Bacteria/drug effects ,business - Abstract
Background Diagnosis of bloodstream infections (BSI) in neonates is usually difficult due to minimal symptoms at presentation; thus early empirical therapy guided by local antibiotic susceptibility profile is necessary to improve therapeutic outcomes. Methods A review of neonatal blood cultures submitted to the microbiology department of the Korle-Bu Teaching Hospital was conducted from January 2010 through December 2013. We assessed the prevalence of bacteria and fungi involved in BSI and the susceptibility coverage of recommended empiric antibiotics by Ghana Standard Treatment guidelines and the WHO recommendations for managing neonatal sepsis. The national and WHO treatment guidelines recommend either ampicillin plus gentamicin or ampicillin plus cefotaxime for empiric treatment of neonatal BSI. The WHO recommendations also include cloxacillin plus gentamicin. We described the resistance profile over a 28-day neonatal period using multivariable logistic regression analysis with linear or restricted cubic splines. Results A total of 8,025 neonatal blood culture reports were reviewed over the four-year period. Total blood culture positivity was 21.9 %. Gram positive organisms accounted for most positive cultures, with coagulase negative staphylococci (CoNS) being the most frequently isolated pathogen in early onset infections (EOS) (59.1 %) and late onset infections (LOS) (52.8 %). Susceptibility coverage of early onset bacterial isolates were 20.7 % to ampicillin plus cefotaxime, 32.2 % to the combination of ampicillin and gentamicin, and 71.7 % to cloxacillin plus gentamicin. For LOS, coverage was 24.6 % to ampicillin plus cefotaxime, 36.2 % to the combination ampicillin and gentamicin and 63.6 % to cloxacillin plus gentamicin. Cloxacillin plus gentamicin remained the most active regimen for EOS and LOS after exclusion of BSI caused by CoNS. For this regimen, the adjusted odds of resistance decreased between 12-34 % per day from birth to day 3 followed by the slowest rate of resistance increase, compared to the other antibiotic regimen, thereafter until day 28. The trend in resistance remained generally unchanged after excluding data from CoNS. Multidrug resistant isolates were significantly (p-value
- Published
- 2016
19. Trends in paediatric and adult bloodstream infections at a Ghanaian referral hospital: a retrospective study
- Author
-
Appiah-Korang Labi, Juliana Ewuramma Mbiriba Labi, Noah Obeng-Nkrumah, Georgina Awuah-Mensah, and Naa Okaikor Addison
- Subjects
0301 basic medicine ,Male ,Pediatrics ,Antibiotic susceptibility ,Antibiotics ,Bacteremia ,Drug resistance ,Bloodstream ,medicine.disease_cause ,Ghana ,Medical microbiology ,Blood culture ,Child ,medicine.diagnostic_test ,General Medicine ,Middle Aged ,Anti-Bacterial Agents ,Infectious Diseases ,Staphylococcus aureus ,Child, Preschool ,Female ,Cloxacillin ,Infants ,medicine.drug ,Microbiology (medical) ,Adult ,medicine.medical_specialty ,Adolescent ,medicine.drug_class ,030106 microbiology ,Microbial Sensitivity Tests ,Gram-Positive Bacteria ,Infections ,Meropenem ,03 medical and health sciences ,Antibiotic resistance ,Internal medicine ,Drug Resistance, Bacterial ,Gram-Negative Bacteria ,medicine ,Humans ,Adults ,Hospitals, Teaching ,Gram-Positive Bacterial Infections ,Aged ,Retrospective Studies ,business.industry ,Research ,Infant ,Cephalosporins ,Blood Culture ,Thienamycins ,business ,Gram-Negative Bacterial Infections - Abstract
Background Bloodstream infections (BSI) are life-threatening emergencies. Identification of the common pathogens and their susceptibility patterns is necessary for timely empirical intervention. Methods We conducted a 4-year retrospective analysis of blood cultures from all patients excluding neonates at the Korle-Bu Teaching hospital, Ghana, from January 2010 through December 2013. Laboratory report data were used to determine BSI, blood culture contamination, pathogen profile, and antimicrobial resistance patterns. Results Overall, 3633 (23.16 %) out of 15,683 blood cultures were positive for various organisms. Pathogen-positive cultures accounted for 1451 (9.3 %, 95 % CI 8.5–9.8 %). Infants recorded the highest true blood culture positivity (20.9 %, n = 226/1083), followed by the elderly (13.3 %, n = 80/601), children (8.9 %, n = 708/8000) and adults (7.2 %, n = 437/6000) (p = 0.001 for Marascuilo’s post hoc). Overall occurrence of BSI declined with increasing age-group (p = 0.001) but the type of isolates did not vary with age except for Citrobacter, Escherichia coli, Klebsiella, Salmonella, and Enterococcus species. Gram negative bacteria predominated in our study (59.8 %, n = 867/1451), but the commonest bacterial isolate was Staphylococcus aureus (21.9 %, n = 318/1451)—and this trend run through the various age-groups. From 2010 to 2013, we observed a significant trend of yearly increase in the frequency of BSI caused by cephalosporin-resistant enterobacteria (Chi square for trend, p = 0.001). Meropenem maintained high susceptibility among all Gram-negative organisms ranging from 96 to 100 %. Among Staphylococcus aureus, susceptibility to cloxacillin was 76.6 %. Conclusion Our study shows a significantly high blood culture positivity in infants as compared to children, adults and the elderly. There was a preponderance of S. aureus and Gram-negative bacteria across all age-groups. Meropenem was the most active antibiotic for Gram-negative bacteria. Cloxacillin remains a very useful anti-staphylococcal agent. Electronic supplementary material The online version of this article (doi:10.1186/s12941-016-0163-z) contains supplementary material, which is available to authorized users.
- Published
- 2016
20. Susceptibility trends including emergence of linezolid resistance among coagulase-negative staphylococci and meticillin-resistant Staphylococcus aureus from invasive infections
- Author
-
Decousser, Jean-Winoc, Desroches, Marine, Bourgeois-Nicolaos, Nadège, Potier, Julien, Jehl, François, Lina, Gérard, Cattoir, Vincent, Vandenesch, François, Doucet-Populaire, Florence, Group, Microbs Study, AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Henri Mondor [Créteil], Bactéries, Pathogènes et Santé (UBaPS), Faculté de Pharmacie, Université Paris-Sud - Paris 11 (UP11)-Université Paris-Sud - Paris 11 (UP11), Faculté de Médecine, CHU Strasbourg-Université Louis Pasteur - Strasbourg I, Pathogénie des Staphylocoques – Staphylococcal Pathogenesis (StaPath), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre National de Reference des Staphylocoques, Université de Lyon, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Novartis (France), CHU Henri Mondor, Centre International de Recherche en Infectiologie - UMR (CIRI), Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)
- Subjects
Resistance ,Drug Resistance ,Drug resistance ,Bloodstream ,Levofloxacin ,medicine.disease_cause ,chemistry.chemical_compound ,Methicillin ,Staphylococcus epidermidis ,Drug Resistance, Multiple, Bacterial ,Pharmacology (medical) ,Prospective Studies ,Staphylococci ,biology ,Bacterial ,General Medicine ,Staphylococcal Infections ,23S ,Hospitals ,3. Good health ,Anti-Bacterial Agents ,RNA, Ribosomal, 23S ,Infectious Diseases ,Staphylococcus aureus ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,[SDV.IMM]Life Sciences [q-bio]/Immunology ,France ,Osteoarticular ,Coagulase ,Rifampin ,Multiple ,Microbiology (medical) ,Methicillin-Resistant Staphylococcus aureus ,Microbial Sensitivity Tests ,Staphylococcal infections ,Microbiology ,Antibiotic resistance ,Bacterial Proteins ,Daptomycin ,medicine ,Humans ,Matrix-Assisted Laser Desorption-Ionization ,Ribosomal ,Spectrometry ,Linezolid ,Mass ,medicine.disease ,biology.organism_classification ,Methicillin-resistant Staphylococcus aureus ,[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,chemistry ,Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ,RNA ,Gentamicins ,Fusidic Acid - Abstract
International audience; Multiresistance in staphylococci constitutes a major challenge for the antimicrobial chemotherapy of invasive infections such as bacteraemia or bone and joint infections (BJIs). A nationwide prospective study was performed to detect antimicrobial resistance trends among staphylococci causing invasive infections. Between October 2011 and February 2012, 367 meticillin-resistant Staphylococcus aureus (MRSA) and 695 coagulase-negative staphylococci (CoNS) were collected from 37 French hospitals, mainly from bacteraemia (59.9%) and osteoarticular infections (29.0%). Minimum inhibitory concentrations (MICs) were determined by broth microdilution, and specific screening and confirmation tests were performed to detect heterogeneous vancomycin-intermediate S. aureus (hVISA). Staphylococcal isolates exhibiting a linezolid MIC\textgreater4 mg/L were further characterised to determinate their clonal relationships and the mechanism of resistance. MRSA exhibited additional resistances, including levofloxacin (82% associated resistance), gentamicin (13.6%), fusidic acid (13.6%) and rifampicin (6.5%), compromising oral step-down therapy in BJIs. Only two hVISA strains (0.5%) were identified. Among the CoNS, mainly Staphylococcus epidermidis (506/695; 72.8%), resistance to first- and second-line agents was more common. Linezolid resistance was identified in 10 CoNS (1.4%). The most frequent linezolid resistance mechanism was the G2576T mutation in 23S rDNA (9/10). For the first time in France, the cfr gene was found in five related sequence type 2 (ST2) S. epidermidis from two different hospitals, in association with ribosomal RNA and L3 ribosomal protein mutations. These national data must be considered when selecting empirical treatment for invasive staphylococcal infections. Moreover, the emergence and spread of linezolid-resistant CoNS carrying the cfr gene is of concern.
- Published
- 2015
21. Bloodstream infections in cystic fibrosis: Nine years of experience in both adults and children
- Author
-
Daniel Peckham, Miles Denton, James Cargill, Christine Etherington, and Steven P. Conway
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Cystic Fibrosis ,Bacteremia ,Bloodstream ,Outcomes ,Cystic fibrosis ,Catheters, Indwelling ,Internal medicine ,medicine ,Humans ,In patient ,Blood culture ,Pediatrics, Perinatology, and Child Health ,Child ,Gram-Positive Bacterial Infections ,Retrospective Studies ,biology ,medicine.diagnostic_test ,business.industry ,Candidiasis ,Retrospective cohort study ,Staphylococcal Infections ,bacterial infections and mycoses ,biology.organism_classification ,medicine.disease ,Surgery ,Stenotrophomonas maltophilia ,medicine.anatomical_structure ,Pediatrics, Perinatology and Child Health ,Etiology ,Candida spp ,Female ,Infection ,business ,Gram-Negative Bacterial Infections ,Respiratory tract - Abstract
Background We report the aetiology and outcome of bloodstream infections (BSI) occurring at two regional cystic fibrosis (CF) centres (one adult, one paediatric) between 1998 and 2006. Methods A retrospective analysis of all positive blood cultures during the study period was performed. Results During the study period 1691 blood culture sets were taken. Fifty-seven clinically significant episodes of BSI in 48 people with CF (36 adult, 12 paediatric) were identified, along with 28 other episodes considered to be contamination or not clinically significant. The most common BSIs were caused by coagulase-negative staphylococci (13) Candida spp (10), and Stenotrophomonas maltophilia (8). The majority (82%) of significant BSIs were considered to originate from totally-implantable vascular access devices (TIVADs); only 9% were attributed to the lower respiratory tract. The TIVAD was removed in two-thirds of cases of TIVAD-associated BSI. There were three deaths (60% of cases) attributable to BSI originating from the lower respiratory tract but no deaths attributable to TIVAD-associated BSI. Conclusion Most significant BSIs in patients with CF originate from TIVADs. Targeted antimicrobial therapy and appropriate early device removal is associated with good clinical outcome. BSI originating from the lower respiratory tract is associated with poor clinical outcome.
- Published
- 2012
- Full Text
- View/download PDF
22. Performance of two resin-containing blood culture media in detection of bloodstream infections and in direct matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) broth assays for isolate identification: clinical comparison of the BacT/Alert Plus and Bactec Plus systems
- Author
-
Teresa Spanu, Maurizio Sanguinetti, Giulia De Angelis, Massimo Antonelli, Mario Tumbarello, Eloisa Sofia Tanzarella, Viviana Di Florio, Flavio De Maio, Alessia Giaquinto, Barbara Fiori, Lara Campana, and Tiziana D'Inzeo
- Subjects
Microbiology (medical) ,bloodstream ,Adult ,Male ,Microbiological Techniques ,Bacilli ,Adolescent ,Population ,Settore MED/17 - MALATTIE INFETTIVE ,Sensitivity and Specificity ,Settore MED/07 - MICROBIOLOGIA E MICROBIOLOGIA CLINICA ,Microbiology ,Young Adult ,fluids and secretions ,Intensive care ,Sepsis ,Yeasts ,medicine ,Humans ,Blood culture ,Prospective Studies ,education ,Aged ,Aged, 80 and over ,education.field_of_study ,medicine.diagnostic_test ,biology ,Bacteria ,business.industry ,blood culture media ,Becton dickinson ,MALDI-TOF mass spectrometry ,Bacteriology ,Middle Aged ,Antimicrobial ,biology.organism_classification ,equipment and supplies ,bacterial infections and mycoses ,Culture Media ,Matrix-assisted laser desorption/ionization ,Blood ,Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ,resin ,Female ,business ,Anaerobic exercise - Abstract
We compared the clinical performances of the BacT/Alert Plus (bioMérieux) and Bactec Plus (Becton Dickinson) aerobic and anaerobic blood culture (BC) media with adsorbent polymeric beads. Patients ≥16 years old with suspected bloodstream infections (BSIs) were enrolled in intensive care units and infectious disease wards. A single 40-ml blood sample was collected from each and used to inoculate (10 ml/bottle) one set of BacT/Alert Plus cultures and one set of Bactec Plus cultures, each set consisting of one aerobic and one anaerobic bottle. Cultures were incubated ≤5 days in the BacT/Alert 3D and Bactec FX instruments, respectively. A total of 128 unique BSI episodes were identified based on the recovery of clinically significant growth in 212 aerobic cultures (106 BacT/Alert and 106 Bactec) and 151 anaerobic cultures (82 BacT/Alert and 69 Bactec). The BacT/Alert aerobic medium had higher recovery rates for Gram-positive cocci ( P = 0.024), whereas the Bactec aerobic medium was superior for recovery of Gram-negative bacilli ( P = 0.006). BacT/Alert anaerobic medium recovery rates exceeded those of the Bactec anaerobic medium for total organisms ( P = 0.003), Gram-positive cocci ( P = 0.013), and Escherichia coli ( P = 0.030). In terms of capacity for diagnosing the 128 septic episodes, the BacT/Alert and Bactec sets were comparable, although the former sets diagnosed more BSIs caused by Gram-positive cocci ( P = 0.008). They also allowed earlier identification of coagulase-negative staphylococcal growth (mean, 2.8 h; P = 0.003) and growth in samples from patients not on antimicrobial therapy that yielded positive results (mean, 1.3 h; P < 0.001). Similarly high percentages of microorganisms in BacT/Alert and Bactec cultures (93.8% and 93.3%, respectively) were identified by direct matrix-assisted laser desorption ionization–time of flight mass spectrometry assay of BC broths. The BacT/Alert Plus media line appears to be a reliable, timesaving tool for routine detection of BSIs in the population we studied, although further studies are needed to evaluate their performance in other settings.
- Published
- 2014
23. Trends of Staphylococcus aureus bloodstream infections in a neonatal intensive care unit from 2000-2009
- Author
-
Olajide Dolapo, Ramasubbareddy Dhanireddy, and Ajay J. Talati
- Subjects
Methicillin-Resistant Staphylococcus aureus ,Pediatrics ,medicine.medical_specialty ,Staphylococcus aureus ,Neonatal intensive care unit ,Methicillin-sensitive ,Bloodstream ,medicine.disease_cause ,Staphylococcal infections ,Sepsis ,Enterocolitis, Necrotizing ,Vancomycin ,Intensive care ,Intensive Care Units, Neonatal ,medicine ,Pneumonia, Bacterial ,Birth Weight ,Humans ,Pediatrics, Perinatology, and Child Health ,Hospital Mortality ,Retrospective Studies ,business.industry ,Incidence (epidemiology) ,Mortality rate ,Clindamycin ,Soft Tissue Infections ,Infant, Newborn ,Skin Diseases, Bacterial ,Pneumonia ,Length of Stay ,Staphylococcal Infections ,medicine.disease ,Methicillin-resistant ,Tennessee ,Anti-Bacterial Agents ,Pediatrics, Perinatology and Child Health ,Necrotizing enterocolitis ,business ,Research Article - Abstract
Background Invasive methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) infections are major causes of numerous neonatal intensive care unit (NICU) outbreaks. There have been increasing reports of MRSA outbreaks in various neonatal intensive care units (NICUs) over the last decade. Our objective was to review the experience of Staphylococcus aureus sepsis in our NICU in the last decade and describe the trends in the incidence of Staphylococcus aureus blood stream infections from 2000 to 2009. Methods A retrospective perinatal database review of all neonates admitted to our NICU with blood cultures positive for Staphylococcus aureus from (Jan 1st 2000 to December 31st 2009) was conducted. Infants were identified from the database and data were collected regarding their clinical characteristics and co-morbidities, including shock with sepsis and mortality. Period A represents patients admitted in 2000-2003. Period B represents patients seen in 2004-2009. Results During the study period, 156/11111 infants were identified with Staphylococcus aureus blood stream infection: 41/4486 (0.91%) infants in Period A and 115/6625 (1.73%) in Period B (p
- Published
- 2013
24. Global distribution and epidemiologic associations of Escherichia coli clonal group A, 1998-2007
- Author
-
Megan E. Menard, James R. Johnson, Michael A. Kuskowski, Arjana Tambić Andrašević, Chris Kosmidis, Peter Collignon, Tsai-Ling Lauderdale, David M. Gordon, and Joel N. Maslow
- Subjects
bloodstream ,medicine.medical_specialty ,endocrine system ,clonal group A ,lcsh:Medicine ,Urinary infection ,drug resistance ,community-acquired ,hospital-acquired ,clonality ,Biology ,medicine.disease_cause ,Group A ,Microbiology ,lcsh:Infectious and parasitic diseases ,Antibiotic resistance ,Drug Resistance, Multiple, Bacterial ,Trimethoprim, Sulfamethoxazole Drug Combination ,geographic distribution ,medicine ,Escherichia coli ,Humans ,lcsh:RC109-216 ,antimicrobial resistance ,Pathogen ,Escherichia coli Infections ,Models, Statistical ,Sulfamethoxazole ,Public health ,lcsh:R ,Antimicrobial ,Trimethoprim ,Anti-Bacterial Agents ,Phylogeography ,trimethoprim/sulfamethoxazole ,Escherichia coli clonal group A (CGA) ,hosts ,medicine.drug - Abstract
Escherichia coli clonal group A (CGA) was first reported in 2001 as an emerging multidrug- resistant extraintestinal pathogen. Because CGA has considerable implications for public health, we examined the trends of its global distribution, clinical associations, and temporal prevalence for the years 1998-2007. We characterized 2, 210 E. coli extraintestinal clinical isolates from 32 centers on 6 continents by CGA status for comparison with trimethoprim/sulfamethoxazole (TMP/SMZ) phenotype, specimen type, inpatient/outpatient source, and adult/child host ; we adjusted for clustering by center. CGA prevalence varied greatly by center and continent, was strongly associated with TMP/SMZ resistance but not with other epidemiologic variables, and exhibited no temporal prevalence trend. Our findings indicate that CGA is a prominent, primarily TMP/SMZ-resistant extraintestinal pathogen concentrated within the Western world, with considerable pathogenic versatility. The stable prevalence of CGA over time suggests full emergence by the late 1990s, followed by variable endemicity worldwide as an antimicrobial drug- resistant public health threat.
- Published
- 2012
25. Clustering of Enterococcus faecalis infections in a cardiology hospital neonatal intensive care unit
- Author
-
Dirceu Carrara, Cristhieni Rodrigues, Rogério Zeigler, Sarita Scorzoni Lessa, Rinaldo Focaccia Siciliano, Daiane Cais, Tânia Mara Varejão Strabelli, David Everson Uip, and Suzi Neres
- Subjects
Microbiology (medical) ,Male ,bloodstream ,medicine.medical_specialty ,Neonatal intensive care unit ,Bathing ,medicine.medical_treatment ,lcsh:QR1-502 ,Bacteremia ,Microbial Sensitivity Tests ,Enterococcus faecalis ,lcsh:Microbiology ,lcsh:Infectious and parasitic diseases ,Fatal Outcome ,Internal medicine ,Flora (microbiology) ,Intensive Care Units, Neonatal ,medicine ,Cluster Analysis ,Humans ,lcsh:RC109-216 ,Medical prescription ,Intensive care medicine ,Gram-Positive Bacterial Infections ,Cross Infection ,biology ,business.industry ,Outbreak ,Infant ,biology.organism_classification ,neonatal intensive care unit ,infection ,Diarrhea ,Infectious Diseases ,Cardiology ,Female ,medicine.symptom ,business ,Sentinel Surveillance ,Central venous catheter ,clustering - Abstract
Early identification of an outbreak is one of the main advantages of routine epidemiological surveillance. Enterococcus spp. used to be regarded as microorganisms of low pathogenicity, because they are part of the normal microbial flora of the gastrointestinal and genitourinary tract. Recently, they have emerged as important pathogenic agents, sometimes causing infections with high mortality rates. We studied a clustering of primary bloodstream infections caused by Enterococcus faecalis in a cardiology hospital neonatal intensive care unit (NICU). Four cases of primary bloodstream infection by E. faecalis were detected from April 15 to May 13, 2004, during active infection surveillance. The isolates were sensitive to glycopeptides. Some aspects of the management of these patients, including the date of insertion and placement of a central venous catheter, prescription of a specific medication, contiguity of beds, personnel attending the patients, and occurrence of diarrhea were analyzed to look for factors that might affect the spread of the microorganisms. Measures taken to hamper the spread included contact precautions throughout the unit, cleansing and disinfection of equipment and surfaces, bathing children with 2% chlorhexidine-gluconate-containing soap, professional reeducation, and reinforcement of all measures to prevent infections. We suggest that there is a need to re-evaluate preventive infection measures and to review the strategies aimed at decreasing the nosocomial infection rate in the NICU.
26. Health and economic outcomes of the detection of Klebsiella pneumoniae-produced extended-spectrum β-lactamase (ESBL) in a hospital with high prevalence of this infection
- Author
-
Adauto Castelo, J.R. do Carmo Filho, Ruy Guilherme Rodrigues Cal, Helio S. Sader, Alexandre R. Marra, Sergio Barsanti Wey, and Carlos Alberto Pires Pereira
- Subjects
Microbiology (medical) ,Adult ,medicine.medical_specialty ,Carbapenem ,medicine.drug_class ,Klebsiella pneumoniae ,Cephalosporin ,Bacteremia ,Microbial Sensitivity Tests ,Bloodstream ,beta-Lactamases ,Microbiology ,Cohort Studies ,Hospital ,Internal medicine ,Epidemiology ,medicine ,Humans ,Agar diffusion test ,Diffusion methods ,Retrospective Studies ,Academic Medical Centers ,High prevalence ,biology ,business.industry ,General Medicine ,Antimicrobial ,biology.organism_classification ,bacterial infections and mycoses ,Hospitals ,Anti-Bacterial Agents ,Cephalosporins ,Klebsiella Infections ,Detection ,Infectious Diseases ,Treatment Outcome ,Carbapenems ,ESBL ,Costs and Cost Analysis ,business ,Infection ,Brazil ,medicine.drug - Abstract
Summary Introduction Klebsiella pneumoniae is of high prevalence in hospital infections, mainly in bloodstream infections (BSI), and some produce extended-spectrum β -lactamase (ESBL). For hospitals with a high prevalence of strains producing this enzyme, there is no reference material to show whether the use of the E-test method for their detection, which can be quite expensive, is actually required. Objective To evaluate the cost-benefit of the disk diffusion and E-test methods for the detection of ESBL-producing K. pneumoniae strains in hospitals where a high prevalence of this resistance mechanism in BSI is found. Methods One hundred and eight patients with K. pneumoniae BSI were evaluated retrospectively. ESBL-producing strains were identified by the disk diffusion method and by the E-test method. We estimated the costs of both diagnostic methods based on antimicrobial therapy adequacy. Results Fifty-two percent of K. pneumoniae infections were due to ESBL-producing strains. The disk diffusion method yielded a positive predictive value (PPV) of 94.7% (95% CI: 88.9–100%) and a negative predictive value (NPV) of 96.1% (CI 95%: 90.8–101.4%) in relation to the E-test. We evaluated cost-effectiveness, i.e., we analyzed the cost of both E-test and disk diffusion methods with carbapenem and cephalosporins, and found that the use of the disk diffusion method accounts for approximately US$3300. Conclusions In hospitals with a high prevalence of ESBL-producing strains, the disk diffusion method can be used to detect ESBL-producing K. pneumoniae without compromising the clinical progression of patients with BSI. The E-test showed higher accuracy but this method was more expensive than the disk diffusion method. However, the use of the E-test method was demonstrated to be more cost-effective, as we evaluated cost based on antimicrobial therapy adequacy.
- Full Text
- View/download PDF
27. Recurrent catheter-related bloodstream infections: risk factors and outcome
- Author
-
Matthew H. Samore, Ayşe Erbay, Gregory J. Stoddard, and Onder Ergonul
- Subjects
Microbiology (medical) ,Adult ,Male ,medicine.medical_specialty ,Catheterization, Central Venous ,Staphylococcus ,Bloodstream ,Cohort Studies ,Catheters, Indwelling ,Blood product ,Risk Factors ,Recurrence ,Sepsis ,medicine ,Humans ,Risk factor ,Retrospective Studies ,Central line ,Catheter insertion ,business.industry ,Hazard ratio ,Transfusion Reaction ,General Medicine ,Middle Aged ,Staphylococcal Infections ,medicine.disease ,Surgery ,Catheter ,Infectious Diseases ,Bacteremia ,Female ,business ,Catheter related infections ,Cohort study - Abstract
Summary Objective To identify risk factors for recurrent catheter related bloodstream infections (CR-BSIs). The study was undertaken at the University of Utah Hospital and involved patients who had a CR-BSI followed by catheter removal and reinsertion between January 1998 and February 2002. Design A retrospective chart review for the cohort study of catheters initially infected, which were then followed to study risk factors for a subsequent infection. Both central line and peripherally inserted central line catheters were included in the study. A recurrent CR-BSI was defined as positive blood cultures after three negative cultures, coupled with positive catheter tip culture or no other evident new source of infection. Results Twenty-five (34%) of 73 patients had a recurrent CR-BSI. The first CR-BSI occurred a mean of 20.4 days after catheter insertion whereas recurrence developed a mean of 12.1 days after reinsertion ( p =0.392). Coagulase-negative staphylococci (60%) were the most common cause of recurrent infection. The recurrence was more common among the patients who were given blood product transfusion (hazard ratio (HR) 2.3; confidence interval (CI) 1.02–5.67, p =0.049). In 20 (27%) patients, catheters were changed over a guidewire. The guidewire catheter exchange was not found to be associated with an increased risk of recurrent infection ( p =0.582). Conclusion Catheter replacement to a new site, instead of rewiring, was not shown to decrease the risk for recurrent infection. The transfusion of blood products was associated with an increased risk for recurrent infection.
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.