RESUMO
BACKGROUND: Laribacter hongkongensis is an emerging pathogen related to gastroenteritis that can cause invasive and even fatal disease. The aim of this review is to describe the clinical presentation, epidemiology, treatment options and implications for the clinical microbiology laboratory. METHODS: We searched Pubmed using the term Laribacter hongkongensis with limitations human and language English, and identified 35 publications with eight reports on human cases. RESULTS: We describe our first case of prolonged, travel-related gastroenteritis where Laribacter hongkongensis was isolated as the sole pathogen. Our review suggests that L. hongkongensis causes non-bloody acute diarrhoea with potential for invasive disease, since three cases of bacteraemia and one case of dialysis related peritonitis have been described previously. L. hongkongensis has primarily been described in Asia, but reports from Europe, North America and Australia suggests a worldwide distribution. Broad culturing with subsequent identification by the MALDI-TOF is the current strategy for detection of L. hongkongensis. Phenotypic susceptibility testing is necessary to guide the treatment choice. Few resistance genes have been described in L. hongkongensis. CONCLUSION: L. hongkongensis should be considered a potential cause of acute and prolonged diarrhoea. Clinicians must be aware of the test methods in the local clinical microbiology laboratory, since L. hongkongensis is difficult to detect and easily overlooked.
Assuntos
Diarreia/microbiologia , Microbiologia de Alimentos , Infecções por Neisseriaceae , Neisseriaceae/fisiologia , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Dinamarca , Diarreia/etiologia , Farmacorresistência Bacteriana , Fezes/microbiologia , Feminino , Genoma Bacteriano/genética , Humanos , Testes de Sensibilidade Microbiana , Neisseriaceae/efeitos dos fármacos , Infecções por Neisseriaceae/complicações , Infecções por Neisseriaceae/tratamento farmacológico , Infecções por Neisseriaceae/epidemiologia , Infecções por Neisseriaceae/patologia , RNA Ribossômico 16S/genética , Fatores de Risco , Transplantados , Adulto JovemRESUMO
Management of bone and joint infections in children associates early appropriate antibiotic therapy against Staphylococcus aureus and Kingella kingae and, if necessary, surgical drainage of abscess or septic arthritis. In 2007, the Paediatric Infectious Diseases Group of the French Society of Paediatrics (GPIP) proposed guidelines for antibiotherapy in acute and non-complicated cases, with an intravenous therapy during 4 to 7 days followed by oral therapy during 3 weeks.
Assuntos
Antibacterianos/uso terapêutico , Artrite Infecciosa/tratamento farmacológico , Kingella kingae , Infecções por Neisseriaceae/tratamento farmacológico , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus aureus , Artrite Infecciosa/microbiologia , Artrite Infecciosa/cirurgia , Criança , Humanos , Kingella kingae/isolamento & purificação , Testes de Sensibilidade Microbiana , Infecções por Neisseriaceae/complicações , Infecções por Neisseriaceae/cirurgia , Osteomielite/tratamento farmacológico , Guias de Prática Clínica como Assunto , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/cirurgia , Staphylococcus aureus/isolamento & purificação , Resultado do TratamentoRESUMO
The efficacy of mexlocillin-amikacin combination as empirical therapy for febrile neutropenic patients was studied in 30 children (21 males, 9 females) with various oncologic diseases aged 1-15 years (mean age 7.3 +/- 4.4) in the Istanbul Medical School, Oncologic Disease Research and Treatment Center, and Department of Pediatric Hematology-Oncology between January 1 and May 31, 1988. The response rate was 76.6%. Profound persistent granulocytopenia (fewer than 100 ml) was present in 70% of the patients. In 63.3% of patients, the infections were microbiologically documented (60%) Gram(+) and 40% Gram(-). The combination was well tolerated with hepatic and/or renal disturbances in 8 cases (26.6%). We conclude that mezlocillin-amikacin is an effective empirical combination in the initial treatment of infections in febrile neutropenic children with various oncologic diseases.