RESUMO
BACKGROUND AND OBJECTIVES: Clostridium difficile infections (CDI) include self-limiting antibiotic associated diarrhoea (AAD), antibiotic-associated colitis, and pseudomembranous colitis. The present study aimed at detecting C. difficile toxin in stool samples of patients with AAD and analyzing the antibiotic use and presence of other risk factors in these patients. MATERIALS AND METHODS: In this study, which was conducted on 660 samples, a 2- step strategy was used. In the first step, glutamate dehydrogenase (GDH) was detected in stool samples by enzyme-linked immunofluorescent assay (ELFA). In the second step, GDH positive samples were tested for C. difficile toxin A and B by ELFA. Nucleic acid amplification test (NAAT) was also performed on few samples that were found to be GDH positive and toxin negative or equivocal by ELFA. RESULTS: Of the 660 samples screened, toxin was detected in 8.8% (58/660) by ELFA and 9.7% (64/660) by NAAT. GDH was detected in 23.8% (157/660) and toxin in 36.9% (58/157) of the GDH positives. Most of the toxin positive patients were on one or more antibiotics prior to developing diarrhoea. The implicated antibiotics were meropenem, amikacin, colistin and cephalosporins. Diabetes, hypertension, use of proton pump inhibitors, previous hospitalization, malignancy and chemotherapy were found to be the risk factors in our study. CONCLUSION: Prevalence of GDH was 23.8% (157/660) by ELFA. Toxin prevalence was 9.7% (64/660). Detection rates of C. difficile associated diarrhoea (CDAD) increased with inclusion of NAAT testing by ELFA.
Assuntos
Abscesso Abdominal/microbiologia , Achromobacter denitrificans/isolamento & purificação , Infecções por Bactérias Gram-Negativas/microbiologia , Nefropatias/microbiologia , Antibacterianos/uso terapêutico , Humanos , Doenças Renais Císticas/cirurgia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos UrológicosRESUMO
Coryneform bacteria belonging to the genus Brevibacterium have emerged as opportunistic pathogens. Of the nine known species of Brevibacterium isolated from human clinical samples, Brevibacterium casei is the most frequently reported species from clinical specimens. We report the first case of B. casei brain abscess in an immunocompetent patient successfully treated by surgery and antimicrobial therapy.
Assuntos
Infecções por Actinomycetales/diagnóstico , Infecções por Actinomycetales/microbiologia , Abscesso Encefálico/diagnóstico , Abscesso Encefálico/microbiologia , Brevibacterium/classificação , Brevibacterium/isolamento & purificação , Infecções por Actinomycetales/patologia , Infecções por Actinomycetales/terapia , Adulto , Antibacterianos/administração & dosagem , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Abscesso Encefálico/patologia , Abscesso Encefálico/terapia , Brevibacterium/genética , DNA Bacteriano/química , DNA Bacteriano/genética , DNA Ribossômico/química , DNA Ribossômico/genética , Desbridamento , Humanos , Imageamento por Ressonância Magnética , Masculino , Dados de Sequência Molecular , RNA Ribossômico 16S/genética , Radiografia , Análise de Sequência de DNARESUMO
We describe a case of bacteraemia caused by Weissella confusa in a 48-year-old male who was operated on for adenocarcinoma of the gastro-oesophageal junction and maintained on total parenteral nutrition. Blood cultures were positive for a vancomycin-resistant streptococcus-like organism which was identified as W. confusa by 16S rRNA gene sequencing.