ABSTRACT
Human infections caused by Streptococcus lactarius have not been previously reported. In the present report, we describe a lactational mastitis caused by this organism. The infection occurred in a 28-year-old breast-feeding female, with a 10-days history of moderate pain on the right breast. The patient was cured after antibiotic treatment with levofloxacin for 21 days. Our case shows that S. lactarius should be considered as a cause of lactational mastitis. The introduction of molecular microbiology techniques can be extremely useful for knowing the implication of streptococci in lactational mastitis.
Subject(s)
Mastitis/etiology , Mastitis/pathology , Streptococcal Infections/diagnosis , Streptococcal Infections/pathology , Streptococcus/classification , Streptococcus/isolation & purification , Adult , Anti-Bacterial Agents/therapeutic use , Female , Humans , Levofloxacin/therapeutic use , Mastitis/drug therapy , Mastitis/microbiology , Molecular Diagnostic Techniques , Streptococcal Infections/drug therapy , Streptococcal Infections/microbiology , Treatment OutcomeABSTRACT
Urinary tract infection (UTI) due to Achromobacter xylosoxidans is rare. The aims were to know the frequency and clinical characteristics of this infection in our area. We performed a retrospective analysis of 9 patients with UTI caused by this organism diagnosed over a period of 13 y. The mean age was 63.1 y. All patients had underlying diseases or urological abnormalities. The most frequent underlying diseases were solid or hematological malignancies (3 cases). Seven patients (77.7%) had urological abnormalities. Eight patients had symptoms of cystitis and 1 remained asymptomatic. Seven patients had community acquired UTIs. Clinical outcome was favourable in 5 patients after antibiotic treatment and recurrence occurred in 3 patients who had urological abnormalities. All isolates were susceptible to imipenem and piperacillin-tazobactam, 88.8% were susceptible to ceftazidime and 77.7% were susceptible to trimethoprim-sulfamethoxazole. High frequencies of resistance to ampicillin (100%), amoxicillin/clavulanic acid (78%), cefuroxime (100%), cefotaxime (67%), norfloxacin (89%), ciprofloxacin (78%), nitrofurantoin (89%) and gentamicin (67%) were observed. UTI due to A. xylosoxidans was predominantly observed in elderly patients with predisposing factors, especially urological abnormalities, malignancies and immunosuppression. Treatment can be difficult due to the high level of antibiotic resistance. Trimethoprim-sulfamethoxazole may be useful for treatment, particularly in outpatients with community acquired infections.
