RESUMO
We report a case of endocarditis caused by Streptococcus equi in an immunocompetent patient who was subsequently cured after appropriate antibiotherapy and cardiac surgery. However, it was challenging to identify the strain to the subspecies level, which highlights the necessity of developing reliable molecular tools to discriminate between the subspecies.
Assuntos
Endocardite Bacteriana/diagnóstico , Endocardite Bacteriana/microbiologia , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/microbiologia , Streptococcus equi/isolamento & purificação , Antibacterianos/uso terapêutico , Técnicas Bacteriológicas/métodos , DNA Bacteriano/química , DNA Bacteriano/genética , Endocardite Bacteriana/tratamento farmacológico , Endocardite Bacteriana/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Técnicas de Diagnóstico Molecular/métodos , RNA Ribossômico 16S/genética , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/cirurgia , Streptococcus equi/classificação , Resultado do TratamentoRESUMO
For decades, third-generation cephalosporins (3GC) have been major drugs used to treat infections due to Enterobacteriaceae; growing resistance to these antibiotics makes the rapid detection of such resistance important. The ßLacta test is a chromogenic test developed for detecting 3GC-resistant isolates from cultures on solid media within 15 min. A multicenter prospective study conducted in 5 French and Belgian hospitals evaluated the performance of this test on clinical isolates. Based on antibiotic susceptibility testing, strains resistant or intermediate to cefotaxime or ceftazidime were classified as 3GC resistant, and molecular characterization of this resistance was performed. The rates of 3GC resistance were 13.9% (332/2,387) globally, 9.4% in Escherichia coli (132/1,403), 25.6% in Klebsiella pneumoniae (84/328), 30.3% in species naturally producing inducible AmpC beta-lactamases (109/360), and 5.6% in Klebsiella oxytoca and Citrobacter koseri (7/124). The sensitivities and specificities of the ßLacta test were, respectively, 87.7% and 99.6% overall, 96% and 100% for E. coli and K. pneumoniae, and 67.4% and 99.6% for species naturally producing inducible AmpC beta-lactamase. False-negative results were mainly related to 3GC-resistant strains producing AmpC beta-lactamase. Interestingly, the test was positive for all 3GC-resistant extended-spectrum beta-lactamase-producing isolates (n = 241). The positive predictive value was 97% and remained at ≥96% for prevalences of 3GC resistance ranging between 10 and 30%. The negative predictive values were 99% for E. coli and K. pneumoniae and 89% for the species producing inducible AmpC beta-lactamase. In conclusion, the ßLacta test was found to be easy to use and efficient for the prediction of resistance to third-generation cephalosporins, particularly in extended-spectrum beta-lactamase-producing strains.
Assuntos
Cefalosporinas/farmacologia , Enterobacteriaceae/efeitos dos fármacos , Resistência beta-Lactâmica , Bélgica , Compostos Cromogênicos/metabolismo , Meios de Cultura/química , Infecções por Enterobacteriaceae/microbiologia , Reações Falso-Negativas , França , Humanos , Testes de Sensibilidade Microbiana/métodos , Valor Preditivo dos Testes , Estudos Prospectivos , Sensibilidade e EspecificidadeRESUMO
During January 2010, a husband and wife returned from Laos to France with probable parasitic disease. Increased antibodies against an Acanthamoeba polyphaga mimivirus virophage indicated seroconversion. While in Laos, they had eaten raw fish, a potential source of the virophage. This virophage, associated with giant viruses suspected to cause pneumonia, could be an emerging pathogen.
Assuntos
Anticorpos Antivirais/imunologia , Mimiviridae/imunologia , Viagem , Adulto , Anticorpos Antivirais/sangue , Feminino , França , Humanos , Laos , Masculino , Mimiviridae/genética , Proteínas Virais/genética , Proteínas Virais/imunologiaRESUMO
To assess Q fever in France, we analyzed data for 1985-2009 from the French National Reference Center. A total of 179,794 serum samples were analyzed; 3,723 patients (one third female patients) had acute Q fever. Yearly distribution of acute Q fever showed a continuous increase. Periodic variations were observed in monthly distribution during January 2000-December 2009; cases peaked during April-September. Q fever was diagnosed more often in patients in southeastern France, where our laboratory is situated, than in other areas. Reevaluation of the current positive predictive value of serologic analysis for endocarditis was performed. We propose a change in the phase I (virulent bacteria) immunoglobulin G cutoff titer to ≥1,600. Annual incidences of acute Q fever and endocarditis were 2.5/100,000 persons and 0.1/100,000 persons, respectively. Cases and outbreaks of Q fever have increased in France.
Assuntos
Adulto , Anticorpos Antibacterianos/sangue , Coxiella burnetii/imunologia , Endocardite Bacteriana/diagnóstico , Endocardite Bacteriana/epidemiologia , Endocardite Bacteriana/microbiologia , Feminino , França/epidemiologia , Humanos , Imunoglobulina G/sangue , Incidência , Masculino , Pessoa de Meia-Idade , Febre Q/diagnóstico , Febre Q/epidemiologia , Febre Q/microbiologia , Estações do AnoRESUMO
We report a case of Rickettsia honei infection in a human in Nepal. The patient had severe illness and many clinical features typical of Flinders Island spotted fever. Diagnosis was confirmed by indirect immunofluorescent assay with serum and molecular biological techniques. Flinders Island spotted fever may be an endemic rickettsiosis in Nepal.
Assuntos
Infecções por Rickettsia/diagnóstico , Rickettsia/isolamento & purificação , Idoso , Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/imunologia , Proteínas da Membrana Bacteriana Externa/genética , Exantema/patologia , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Nepal , Rickettsia/genética , Rickettsia/imunologia , Infecções por Rickettsia/microbiologiaAssuntos
Líquido Cefalorraquidiano/microbiologia , Meningite/diagnóstico , Infecções por Mycoplasma/diagnóstico , Mycoplasma hominis/isolamento & purificação , Ferimentos e Lesões/complicações , Acidentes de Trânsito , Líquido Cefalorraquidiano/química , DNA Bacteriano/química , DNA Bacteriano/genética , DNA Ribossômico/química , DNA Ribossômico/genética , Humanos , Masculino , Meningite/microbiologia , Meningite/patologia , Microscopia , Infecções por Mycoplasma/microbiologia , Infecções por Mycoplasma/patologia , Mycoplasma hominis/classificação , Mycoplasma hominis/genética , RNA Ribossômico 16S/genética , Análise de Sequência de DNA , Adulto JovemRESUMO
BACKGROUND: Escherichia coli strains causing Urinary Tract Infections (UTI) have a fecal origin. METHODS: A fecal sample was collected before Kidney Transplantation (KT) and concomitantly with urine at each of the 15 E. coli UTIs which occurred in 11 KT recipients. Unique E. coli strains were identified among 25 isolates per feces and 5 isolates per urinary sample by random amplification of polymorphic DNA. Phylogenetic group (which is correlated to virulence in the E. coli species) was determined for each E. coli strain by a PCR based method. RESULTS: Forty-three unique fecal strains and 14 unique urinary strains were identified among 650 fecal isolates and 75 urinary isolates. Urinary strains frequently (55% of the cases) belonged to a phylogroup usually not linked to virulence. They were detected in the feces collected concomitantly in 60% of the cases. Urinary strains belonging to a phylogroup usually linked to virulence were more frequently dominant in the feces (100%) than urinary strains belonging to a non-pathogenic phylogroup (42%; P<0.05). Vesical catheter was a facilitating factor only for urinary strains belonging to non-pathogenic phylogroups. Thirty-three percent of the fecal strains were persisting in two consecutive fecal samples and 62% were detected for the first time at the UTI. Numerous pathway lead to UTIs: from a unique, virulent and persisting strain to a non-virulent recently acquired strain facilitated by a vesical catheter. CONCLUSION: Our work shows the diversity of host-microbial interactions which precede extra-intestinal virulence.
Assuntos
Infecções por Escherichia coli/epidemiologia , Escherichia coli/crescimento & desenvolvimento , Infecções Oportunistas/microbiologia , Transplantados , Infecções Urinárias/microbiologia , DNA Bacteriano/isolamento & purificação , Fezes/microbiologia , Feminino , França/epidemiologia , Humanos , Transplante de Rim , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da PolimeraseRESUMO
Rickettsia species are increasingly being recognized as a cause of infection among returning travelers. Murine typhus (MT) was mistakenly thought to have disappeared in the 1970s in Tunisia, yet recent serological data show that Rickettsia typhi, the causative agent of MT, still circulates in the Tunisian population. We report here a case of MT in a woman returning from Tunisia and hospitalized in France. Her presentation was nonspecific, with acute noneruptive fever. Diagnosis was confirmed by cross-adsorption and immunoblotting. Clinicians taking care of returning travelers with fever should be aware of MT, and know how to diagnose and treat it.
Assuntos
Doxiciclina/uso terapêutico , Febre/microbiologia , Viagem , Tifo Endêmico Transmitido por Pulgas/diagnóstico , Adulto , Animais , Feminino , Humanos , Rickettsia typhi , Tunísia , Tifo Endêmico Transmitido por Pulgas/tratamento farmacológico , XenopsyllaAssuntos
Doxiciclina/uso terapêutico , Infecções por Rickettsia/diagnóstico , Infecções por Rickettsia/tratamento farmacológico , Alanina Transaminase/sangue , Antibacterianos/uso terapêutico , Aspartato Aminotransferases/sangue , França , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoAssuntos
Infecções por Actinomycetales , Bacteriemia , Bactéria Gordonia , Infecções por Actinomycetales/diagnóstico , Infecções por Actinomycetales/microbiologia , Idoso , Bacteriemia/diagnóstico , Bacteriemia/microbiologia , Infecções Relacionadas a Cateter/diagnóstico , Infecções Relacionadas a Cateter/microbiologia , França , Bactéria Gordonia/classificação , Bactéria Gordonia/genética , Bactéria Gordonia/isolamento & purificação , Humanos , Hospedeiro Imunocomprometido , MasculinoAssuntos
Bacteriemia/microbiologia , Infecções por Bactérias Gram-Negativas/microbiologia , Pessoas Mal Alojadas , Xanthomonadaceae , Bacteriemia/epidemiologia , Feminino , França/epidemiologia , Infecções por Bactérias Gram-Negativas/epidemiologia , Humanos , Pessoa de Meia-Idade , Dados de Sequência Molecular , RNA Ribossômico 16S/genética , Análise de Sequência de DNA , Xanthomonadaceae/classificação , Xanthomonadaceae/genética , Xanthomonadaceae/isolamento & purificaçãoAssuntos
Infecções por Actinomycetales/microbiologia , Actinomycetales/classificação , Endocardite Bacteriana/microbiologia , Próteses Valvulares Cardíacas/efeitos adversos , Próteses Valvulares Cardíacas/microbiologia , Infecções Relacionadas à Prótese/microbiologia , Actinomycetales/genética , Actinomycetales/isolamento & purificação , Infecções por Actinomycetales/sangue , Idoso , Bases de Dados de Ácidos Nucleicos , Ecocardiografia Transesofagiana , Endocardite Bacteriana/sangue , Endocardite Bacteriana/diagnóstico por imagem , Genes Bacterianos , Humanos , Masculino , Testes de Sensibilidade Microbiana , Dados de Sequência Molecular , Filogenia , Infecções Relacionadas à Prótese/sangueRESUMO
Transmission by the oral route of Coxiella burnetii is controversial. Our objective was to evaluate dairy products in the transmission of Q fever. Pasteurized, unpasteurized, and thermized dairy products were tested for C. burnetii by using a quantitative polymerase chain reaction specific for IS1111 and IS30A spacers, culturing in human embryonic lung fibroblasts cells, and inoculation into BALB/c mice. We tested 201 products and C. burnetii was identified in 64%. Cow milk origin products were more frequently positive than goat or ewe products (P = 0.006 and P = 0.0001, respectively), and industrial food was more frequently positive than artisanal food (P < 0.0001). Food made from unpasteurized milk contained higher bacteria concentrations than food made from pasteurized milk (P = 0.02). All cultures were negative and mice did not show signs of illness. Farm animals are highly infected in France but consumption of cheese and yogurt does not seem to pose a public health risk for transmission of Q fever.
Assuntos
Coxiella burnetii/isolamento & purificação , DNA Bacteriano/isolamento & purificação , Laticínios/microbiologia , Viabilidade Microbiana , Febre Q/transmissão , Animais , Carga Bacteriana , Bovinos/microbiologia , Células Cultivadas , Coxiella burnetii/genética , Reservatórios de Doenças/microbiologia , Fibroblastos/microbiologia , Microbiologia de Alimentos/métodos , França , Cabras/microbiologia , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Pasteurização , Reação em Cadeia da Polimerase , Saúde Pública , Ovinos/microbiologiaRESUMO
Infection caused by Mycobacterium abscessus strains is a growing cause of concern in both community-acquired and health care-associated diseases, as these organisms naturally display multiple drug resistances. We report an annotated draft genome sequence of M. abscessus strain V06705 obtained from a patient in France.
RESUMO
African tick-bite fever (ATBF) caused by Rickettsia africae is a frequent cause of fever in returned travelers. Here, we used eschar swabs and/or eschar crust samples for the molecular diagnosis of ATBF in returned travelers. In 4 of 5 patients returning from South Africa, including 3 with negative serology, R. africae was identified by molecular tools targeting 2 different genes. The findings of this study highlight the usefulness of eschar swabs and/or eschar crust samples for the diagnosis of R. africae infection.