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1.
Clin Infect Dis ; 76(9): 1671-1673, 2023 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-36571287

RESUMO

We report a case of progressive, severe mpox virus (MPXV) infection in a patient with AIDS despite a standard course of tecovirimat. He significantly improved after administration of vaccinia immune globulin intravenous (VIGIV) highlighting its use as an adjunct for severe disease in immunocompromised hosts.


Assuntos
Síndrome da Imunodeficiência Adquirida , Mpox , Vacínia , Masculino , Humanos , Vacínia/terapia , HIV , Imunoglobulinas , Fatores Imunológicos
2.
Open Forum Infect Dis ; 11(6): ofae294, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38868307

RESUMO

Severe mpox has been observed in people with advanced human immunodeficiency virus (HIV). We describe clinical outcomes of 13 patients with advanced HIV (CD4 <200 cells/µL), severe mpox, and multiorgan involvement. Despite extended tecovirimat courses and additional agents, including vaccinia immune globulin, cidofovir, and brincidofovir, this group experienced prolonged hospitalizations and high mortality.

3.
Cureus ; 15(7): e42385, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37621834

RESUMO

We report a case of Tissierella praeacuta bacteremia and septic thrombophlebitis of the ovarian vein as a rare puerperal complication in a young patient. She was successfully managed with subcutaneous low molecular weight heparin (LMWH) and intravenous (IV) antibiotics before transitioning to a prolonged course of oral antibiotics at discharge.

4.
Am J Infect Control ; 37(2): 121-6, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19249638

RESUMO

BACKGROUND: Carbapenems are considered the agents of choice for treatment of serious infections caused by resistant gram-negative organisms. A new group of class A beta-lactamases, known as KPC-type carbapenemases, has recently been described and poses a serious clinical challenge. METHODS: Seven patients with bloodstream infections caused by Klebsiella pneumoniae isolates with decreased susceptibility to carbapenems were identified between January and April 2005 in the intensive care units of a hospital in Manhattan. Isolate identification and susceptibility testing were performed according to National Committee for Clinical Laboratory Standards methodology. All isolates were ribotyped and screened for (bla)KPC by polymerase chain reaction. The polymerase chain reaction product underwent nucleotide sequencing for one of the isolates. Medical records were reviewed retrospectively. RESULTS: Six isolates were carbapenem-resistant with minimum inhibitory concentrations for imipenem of >8microg/mL. Ribotyping showed that all isolates belonged to a single clone. All isolates possessed (bla)KPC and nucleotide sequencing identified the allelic type KPC-2. Patients' median age was 68 years. The median duration of hospitalization was 25.5 days before the first positive blood culture. Five of 6 patients received previous broad-spectrum beta-lactam antibiotics but none received prior carbapenems. Five of 6 isolates were susceptible to polymyxin B. Three of the 5 patients were treated with polymyxin B and 1 survived. Overall, only 2 of the 6 patients survived. CONCLUSION: This report describes the first outbreak of KPC-2 carbapenemase-producing K pneumoniae bloodstream infections in a hospital in Manhattan.


Assuntos
Bacteriemia/epidemiologia , Infecção Hospitalar/epidemiologia , Infecções por Klebsiella/epidemiologia , Klebsiella pneumoniae/enzimologia , beta-Lactamases/biossíntese , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Bacteriemia/microbiologia , Técnicas de Tipagem Bacteriana , Carbapenêmicos/farmacologia , Análise por Conglomerados , Infecção Hospitalar/microbiologia , Impressões Digitais de DNA , DNA Bacteriano/genética , Feminino , Genótipo , Hospitais , Humanos , Unidades de Terapia Intensiva , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/classificação , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/isolamento & purificação , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Polimixina B/uso terapêutico , Ribotipagem , Análise de Sequência de DNA , Resistência beta-Lactâmica
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