RESUMO
Melioidosis, caused by the bacterium Burkholderia pseudomallei, is an uncommon infection that is typically associated with exposure to soil and water in tropical and subtropical environments. It is rarely diagnosed in the continental United States. Patients with melioidosis in the United States commonly report travel to regions where melioidosis is endemic. We report a cluster of four non-travel-associated cases of melioidosis in Georgia, Kansas, Minnesota, and Texas. These cases were caused by the same strain of B. pseudomallei that was linked to an aromatherapy spray product imported from a melioidosis-endemic area.
Assuntos
Aromaterapia/efeitos adversos , Burkholderia pseudomallei/isolamento & purificação , Surtos de Doenças , Melioidose/epidemiologia , Aerossóis , Encéfalo/microbiologia , Encéfalo/patologia , Burkholderia pseudomallei/genética , COVID-19/complicações , Pré-Escolar , Evolução Fatal , Feminino , Genoma Bacteriano , Humanos , Pulmão/microbiologia , Pulmão/patologia , Masculino , Melioidose/complicações , Pessoa de Meia-Idade , Filogenia , Choque Séptico/microbiologia , Estados Unidos/epidemiologiaRESUMO
We report on three cases of meningococcal disease caused by ciprofloxacin-resistant Neisseria meningitidis, one in North Dakota and two in Minnesota. The cases were caused by the same serogroup B strain. To assess local carriage of resistant N. meningitidis, we conducted a pharyngeal-carriage survey and isolated the resistant strain from one asymptomatic carrier. Sequencing of the gene encoding subunit A of DNA gyrase (gyrA) revealed a mutation associated with fluoroquinolone resistance and suggests that the resistance was acquired by means of horizontal gene transfer with the commensal N. lactamica. In susceptibility testing of invasive N. meningitidis isolates from the Active Bacterial Core surveillance system between January 2007 and January 2008, an additional ciprofloxacin-resistant isolate was found, in this case from California. Ciprofloxacin-resistant N. meningitidis has emerged in North America.
Assuntos
Anti-Infecciosos/uso terapêutico , Ciprofloxacina/uso terapêutico , Farmacorresistência Bacteriana/genética , Infecções Meningocócicas/tratamento farmacológico , Neisseria meningitidis/genética , Mutação Puntual , Adolescente , Adulto , Idoso , Sequência de Bases , Portador Sadio/microbiologia , Humanos , Lactente , Infecções Meningocócicas/microbiologia , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Neisseria meningitidis/classificação , Neisseria meningitidis/efeitos dos fármacos , Neisseria meningitidis/isolamento & purificação , Faringe/microbiologia , Estados Unidos , Adulto JovemRESUMO
In 2002, revised guidelines for preventing perinatal group B streptococcal disease were published. In 2002, all Minnesota providers surveyed reported using a prevention policy. Most screen vaginal and rectal specimens at 34-37 weeks of gestation. The use of screening-based methods has increased dramatically since 1998.
Assuntos
Assistência Perinatal/métodos , Padrões de Prática Médica , Cuidado Pré-Natal/estatística & dados numéricos , Infecções Estreptocócicas/prevenção & controle , Streptococcus agalactiae/patogenicidade , Medicina de Família e Comunidade , Feminino , Humanos , Tocologia , Minnesota , Obstetrícia , Gravidez , Infecções Estreptocócicas/diagnóstico , Inquéritos e QuestionáriosRESUMO
Vancomycin-intermediate Staphylococcus aureus (VISA) are an emerging problem. We observed a statistically significant inverse relationship in the MICs of vancomycin and oxacillin in S. aureus isolates from a patient undergoing hemodialysis who received 26 weeks of treatment with vancomycin during November 1999 through April 2000. All isolates were mecA positive and were indistinguishable by pulsed-field gel electrophoresis. The evolving susceptibility patterns of this strain highlight the challenges of detecting and treating VISA infections.