ABSTRACT
Abstract Bacillus cereus is a gram positive microorganism commonly involved in gastrointestinal infection but capable of causing severe infections and bacteremia. We describe here a case of bacteremia caused by B. cereus in a previously healthy young woman admitted to the intensive care unit following emergency surgery due to a penetrating abdominal stab wound and subsequent hepatic lesion. She developed fever during admission and cultures were taken. B. cereus was isolated in blood and hepatic fluid collection cultures. Treatment was adjusted according to the isolate, with good clinical results. It is important to highlight the pathogenic potential of this microorganism and not underestimate it as a contaminant when it is isolated from blood samples.
Resumen Bacillus cereus es un microorganismo gram positivo comúnmente involucrado en infecciones gastrointestinales, pero capaz de causar infecciones graves y bacteriemia. Presentamos un caso de bacteriemia por B. cereus en una mujer joven previamente sana que ingresa en la unidad de cuidados intensivos luego de una cirugía de emergencia, debido a una herida abdominal por arma blanca con lesión hepática. La paciente desarrolla fiebre durante la internación, por lo que se toman cultivos. Se aísla B. cereus en hemocultivos y material de colección hepática. Se ajusta el tratamiento según los hallazgos, con buena evolución clínica. Esta comunicación ilustra una fuente poco común de bacteriemia por B. cereus. Asimismo, destaca el potencial patogénico de este microorganismo, cuyo hallazgo en muestras de sangre no siempre debe conducir a su rápida desjerarquización como contaminante.
Subject(s)
Adult , Female , Humans , Bacillus cereus/isolation & purification , Wounds, Stab/microbiology , Gram-Positive Bacterial Infections/microbiology , Bacteremia/microbiology , Abdominal Injuries/microbiology , Wounds, Stab/blood , Gram-Positive Bacterial Infections/blood , Bacteremia/blood , Abdominal Injuries/bloodABSTRACT
Abstract Objective The potential role of procalcitonin (PCT) in the diagnosis of catheter-related bloodstream infection (CRBSIs) is still unclear and requires further research. The diagnostic value of serum PCT for the diagnosis of CRBSI in children is evaluated here. Method This study was conducted between October 2013 and November 2014, and included patients with suspected CRBSI from 1 month to 18 years of age who were febrile, with no focus of infection, and had a central venous catheter. Levels of PCT and other serum markers were measured, and their utility as CRBSI markers was assessed. Additionally, the clinical performance of a new, automated, rapid, and quantitative assay for the detection of PCT was tested. Results Among the 49 patients, 24 were diagnosed with CRBSI. The PCT-Kryptor and PCT-RTA values were significantly higher in proven CRBSI compared to those in unproven CRBSI (p = 0.03 and p = 0.03, respectively). There were no differences in white blood cell count and C-reactive protein (CRP) levels between proven CRBSI and unproven CRBSI. Among the 24 patients with CRBSI, CRP was significantly higher among those with Gram-negative bacterial infection than in those with Gram-positive bacterial infections. PCT-Kryptor was also significantly higher among patients with Gram-negative bacterial infection than in those with Gram-positive bacterial infections (p = 0.01 and p = 0.02, respectively). Conclusions The authors suggest that PCT could be a helpful rapid diagnostic marker in children with suspected CRBSIs.
Resumo Objetivo O possível papel da procalcitonina (PCT) no diagnóstico de infecções de corrente sanguínea relacionadas a cateter (ICSRCs) ainda não está claro e precisa ser mais pesquisado. O valor diagnóstico da PCT sérica para o diagnóstico de ICSRC em crianças é avaliado neste estudo. Método Este estudo foi feito entre outubro de 2013 e novembro de 2014 e incluiu pacientes com suspeita de ICSRC de um mês a 18 anos que estavam febris, não tinham foco de infecção e tinham cateter venoso central. Foram medidos os níveis de PCT e de outros marcadores séricos, cuja utilidade como marcadores de ICSRC foi avaliada. Adicionalmente, foi testado o desempenho clínico de um novo ensaio quantitativo automatizado e rápido para a detecção de PCT. Resultados Dentre 49 pacientes, 24 foram diagnosticados com ICSRC. Os valores de PCT-Kryptor e PCT-RTA foram significativamente maiores em ICSRCs comprovadas do que em ICSRCs não comprovadas (p = 0,03 e p = 0,03, respectivamente). Não houve diferença na contagem de glóbulos brancos e nos níveis de proteína C reativa (PCR) entre ICSRCs comprovadas e ICSRCs não comprovadas. Dentre os 24 pacientes com ICSRC, a PCR era significativamente maior entre aqueles com infecção bacteriana gram-negativa do que naqueles com infecção bacteriana gram-positiva. O PCT-Kryptor também foi significativamente maior entre pacientes com infecção por bactérias gram-negativas do que naqueles com infecção por bactérias gram-positivas (p = 0,01 e p = 0,02, respectivamente). Conclusões Sugerimos que a PCT pode ser um marcador de diagnóstico rápido útil em crianças com suspeita de ICSRCs.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Calcitonin/blood , Bacteremia/diagnosis , Bacteremia/blood , Catheter-Related Infections/diagnosis , Catheter-Related Infections/blood , Reference Values , C-Reactive Protein/analysis , Immunoassay , Biomarkers/blood , Reproducibility of Results , Sensitivity and Specificity , Gram-Positive Bacterial Infections/diagnosis , Gram-Positive Bacterial Infections/blood , Gram-Negative Bacterial Infections/diagnosis , Gram-Negative Bacterial Infections/blood , Statistics, Nonparametric , Leukocyte CountABSTRACT
No abstract available.
Subject(s)
Humans , Male , Middle Aged , Base Sequence , Carnobacteriaceae/genetics , Databases, Genetic , Gram-Positive Bacterial Infections/blood , Polymerase Chain Reaction , RNA, Ribosomal, 16S/chemistry , Sequence Analysis, RNAABSTRACT
BACKGROUND: Procedures for rapid identification and susceptibility testing by direct inoculation (DI) from positive blood culture bottles into an automated system have not been standardized. This study was purposed to evaluate DI from BACTEC 9240 blood culture system (BD, USA) into MicroScan (Dade Behring, USA) or Phoenix (BD, USA). METHODS: From May to June 2006, bacterial pellets from positive aerobic bottles showing gram-positive cocci (GPC) or gram-negative rods (GNR) of single morphology were directly inoculated to MicroScan PosCombo1A and NegCombo32 and to Phoenix PMIC/ID-107 and NMIC/ID-53. In addition, the automated instruments were also inoculated from subcultures (standard inoculations, SI). Species identification and susceptibilities were compared between DI and SI and between MicroScan and Phoenix. RESULTS: A total of 108, 104, and 78 specimens were tested with MicroScan, Phoenix, and both, respectively. When DI and SI were matched, 94.8% of GPC were correctly identified with MicroScan, compared to 80.7% with Phoenix, and 93.9% of GNR were correctly identified with MicroScan, compared to 95.7% with Phoenix. DI with MicroScan and Phoenix showed correct susceptibilities in 94.6% of 1,150 and 96.5% of 660 tests (with very major error [VME] of 1.1% and 1.1%), respectively, among GPC and in 94.4% of 942 and 96.3% of 781 tests (with VME of 0.6% and 0%), respectively, of GNR. Correlation of identification/susceptibilities between MicroScan and Phoenix using DI were 81.8%/98.0% for Staphylococcus aureus and 100.0%/95.6% for Escherichia coli. CONCLUSIONS: DI warrants a reliable method for identification and susceptibility testing of both GPC and GNR in MicroScan, and those of only GNR in Phoenix.
Subject(s)
Humans , Automation , Bacterial Typing Techniques/instrumentation , Culture Media , Gram-Negative Bacteria/classification , Gram-Negative Bacterial Infections/blood , Gram-Positive Bacterial Infections/blood , Gram-Positive Cocci/classification , Microbial Sensitivity Tests/instrumentation , Reagent Kits, Diagnostic , Sensitivity and SpecificityABSTRACT
JUSTIFICATIVA E OBJETIVOS: O objetivo deste estudo foi avaliar a incidência das infecções da corrente sangüínea relacionada a cateteres, bem como o índice de complicações durante a implantação dos cateteres venosos centrais na unidade de terapia intensiva (UTI) do hospital e comparou-se o seu uso de maneira geral, ou seja, fora da UTI. MÉTODO: Após aprovação pela Comissão de Ética da Instituição, realizou-se estudo prospectivo, no período de agosto de 2005 a agosto de 2006, constituído de 840 pacientes consecutivos internados e que 101 faziam uso de cateteres venosos centrais e incluídos no estudo com curativos padronizados. RESULTADOS: Foram realizadas na UTI 101 cateterizações venosas centrais, sendo 78 com intracath e 22 com cateter de duplo-lúmen. Foram coletadas hemoculturas do sangue periférico e do cateter, com técnica asséptica, cultura da ponta do cateter central, utilizando técnica semiquantitativa e por rolamento da ponta dos últimos 3 a 5 cm do cateter. A taxa de infecção da corrente sanguínea relacionada ao cateter vascular foi de 10,89%, sendo as bactérias gram-positivas, representadas pelo Staphilococcus aureus, as predominantes. CONCLUSÃO: Este estudo demonstrou que tanto no Hospital como na UTI a utilização de acesso venoso periférico é preferencial ao cateter venoso central, sendo o intracath o mais freqüente. O índice de complicação ficou abaixo de 10% mas houve um óbito relacionado ao cateter. As infecções relacionadas ao cateter tiveram como agente mais freqüente os gram-positivos e estão de acordo com a literatura.(AU)
BACKGROUND AND OBJETIVES: The purpose of this study was to evaluate the incidence of infections of the bloodstream, related to catheters and also the rate of complications during the deployment of central venous catheters in intensive care unit (ICU) of the hospital and compared it if your use in general, ie outside the ICU. METHODS: After approval by the Ethics Committee of the institution, prospective study took place during the period August 2005 to August 2006, consists of 840 consecutive patients hospitalized and that 101 were using central venous catheters and included in the study with standardized treatment. RESULTS: We performed in ICU 101 central venous catheterizations, and intracath with 78 and 22 with a double-lumen catheter. Blood cultures were collected from peripheral blood and the catheter, with aseptic technique, culture of the catheter tip central, using Semi-quantitative technique for rolling the edge and the last 3 to 5 cm from the catheter. The rate of infection of the bloodstream related to vascular catheter was 10.89%, and gram-positive bacteria, represented by Staphylococcus aureus, the predominant. CONCLUSION: This study demonstrated that both the hospital and ICU use of the peripheral venous access is preferred to central venous catheter and where the use of he intracath to be more frequent. The complication rate was below 10% but there was one death related to the catheter. The catheter-related infections were the most frequent as a gram-positive and are in line with the literature.(AU)
Subject(s)
Humans , Blood Circulation/immunology , Gram-Positive Bacterial Infections/blood , Central Venous Catheters/adverse effects , Intensive Care Units , Prospective StudiesABSTRACT
This study evaluated the haematological changes in Nile tilapia experimentally infected with 1 x 10³ and 1 x 10(6) colony-forming units (CFU)/mL of Enterococcus sp. in the swim bladder. The experiment consisted of four treatments in triplicates: non-injected fish (NI); fish injected with 1 mL of sterile saline solution 0.65 percent (SAL); fish injected with 1 x 10³ and 1 x 10(6) CFU/mL of Enterococcus diluted in 1 mL sterile saline. Twenty-four hours after injection, the fish were anesthetized and the blood collected. The haematological tests included red blood cell (RBC) and white blood cell (WBC) counts, hematocrit, number of total thrombocytes, and differential counting of WBC. Fish injected with 1 x 10(6) CFU/mL of Enterococcus showed a higher number of thrombocytes than the other treatments. White blood cell and lymphocyte numbers increased significantly in fish injected with 1 x 10(6) CFU/mL of Enterococcus when compared to non-injected control. There was significant increase in the number of neutrophils in saline injected fish and reduced number of monocytes after injections with 1 x 10(6) CFU/mL of Enterococcus. Hematocrit increased in fish injected with 1 x 10³ and 1 x 10(6) CFU/mL of Enterococcus.
Este estudo avaliou alterações hematológicas em tilápia do Nilo infectada experimentalmente com 1 x 10³ e 1 x 10(6) unidades formadoras de colônia (CFU)/mL de Enterococcus sp. na bexiga natatória. O experimento consistiu de quatro tratamentos com três repetições cada: peixes não injetados (NI); peixes injetados com 1 mL de solução salina a 0,65 por cento esterilizada (SAL); peixes injetados com 1 x 10³ e 1 x 10(6) CFU/mL de Enterococcus diluída em 1 mL de solução salina esterilizada. Vinte e quatro horas após as injeções, os peixes foram anestesiados com benzocaína e o sangue coletado. Os testes hematológicos incluíram as contagens totais de eritrócitos (RBC), de leucócitos (WBC) e de trombócitos, o percentual do hematócrito e a contagem diferencial de leucócitos. Peixes injetados com 1 x 10(6) CFU/mL de Enterococcus mostraram maior número de trombócitos no sangue do que os dos outros tratamentos. O número de leucócitos totais e o número de linfócitos foram significativamente mais altos após injeção de 1 x 10(6) CFU/mL de Enterococcus, quando comparados ao controle não injetado. Houve aumento no número de neutrófilos nos injetados com salina e redução no número de monócitos nos injetados com 1 x 10(6) CFU/mL de Enterococcus. O hematócrito aumentou nos animais injetados com 1 x 10³ e 1 x 10(6) CFU/mL de Enterococcus.