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1.
Medicine (Baltimore) ; 99(2): e18504, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914021

RESUMEN

We aimed to evaluate the clinical significance of bacterial coexistence and the coinfection dynamics between bacteria and respiratory viruses among young children. We retrospectively analyzed clinical data from children aged < 5 years hospitalized with a community-acquired single respiratory viral infection of influenza, adenovirus, or RSV during 2 recent consecutive influenza seasons. Remnant respiratory specimens were used for bacterial PCR targeting Moraxella catarrhalis, Haemophilus influenzae, Streptococcus pneumoniae, and Staphylococcus aureus.A total of 102 children were included; median age was 0.8 years and 44.1% had underlying comorbidities. Overall, 6.8% (7/102) of cases were classified as severe diseases requiring intensive care unit admission and/or mechanical ventilation and ranged from 8.8% for a patient with RSV and 7.6% for those with adenovirus to 0% for those with influenza viruses. The overall viral-bacterial codetection rate was 59.8% (61/102); M catarrhalis was the most frequent (33.3%), followed by H influenzae (31.4%). Influenza cases showed higher bacterial codetection rates (80.0%; 8/10) compared with those with adenoviruses (69.2%; 9/13) and RSV (55.7%; 44/79). S pneumoniae and H influenzae codetections were associated with reduced severity (aOR, 0.24; 95% CI, 0.07-0.89), and reduced risk of wheezing (aOR, 0.36; 95% CI, 0.13-0.98), respectively.We observed the interactions between respiratory viruses and bacteria and the clinical significance of viral-bacterial coexistence in upper airway on disease severity. Future study will be necessary to elucidate the active interactions between different viruses and bacteria and give clues to risk stratified strategy in the management of respiratory infections among young children.


Asunto(s)
Adenoviridae/aislamiento & purificación , Haemophilus influenzae/aislamiento & purificación , Infecciones del Sistema Respiratorio/microbiología , Infecciones del Sistema Respiratorio/virología , Infecciones por Adenoviridae/diagnóstico , Infecciones por Adenoviridae/virología , Bacterias/genética , Preescolar , Coinfección/microbiología , Coinfección/virología , Infecciones Comunitarias Adquiridas/diagnóstico , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/virología , Femenino , Hospitalización , Humanos , Lactante , Recién Nacido , Gripe Humana/diagnóstico , Gripe Humana/virología , Masculino , Prevalencia , Ruidos Respiratorios/diagnóstico , Ruidos Respiratorios/etiología , Infecciones por Virus Sincitial Respiratorio/diagnóstico , Infecciones por Virus Sincitial Respiratorio/virología , Virus Sincitiales Respiratorios/genética , Infecciones del Sistema Respiratorio/diagnóstico , Infecciones del Sistema Respiratorio/epidemiología , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Staphylococcus aureus/aislamiento & purificación , Streptococcus pneumoniae/aislamiento & purificación , Virus/genética
2.
Ann Otol Rhinol Laryngol ; 129(1): 5-11, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31390881

RESUMEN

OBJECTIVES: Intranasal septal splints are often used in nasal septal surgeries. Routine use of postoperative antibiotics is an accepted practice, although data regarding its efficacy in preventing postsurgical complications are limited. This study aimed to examine bacterial colonization on septal splints following prophylactic antibiotic therapy and the association with postoperative infections. METHODS: Fifty-five patients underwent septoplasty by a single surgeon between March 2015 and April 2016. All had intranasal septal splints and were given antibiotic prophylaxis for 7 days until removal of splints. Nasal cultures were taken before surgery, and septal splints were examined for bacterial colonization following their removal. RESULTS: Thirty-six patients (65%) had positive nasal culture prior to surgery. The most common isolates were Staphylococcus aureus (30%) and Enterobacteriaceae species (66%). All these patients had postoperative bacterial colonization on septal splints. In 15 patients with negative preoperative cultures, bacteria were isolated postoperatively. An increased resistance profile was documented postoperatively in 9 patients (16%), including two with multidrug resistance. In two of these patients preoperative wild-type strains acquired antibiotic resistance postoperatively. No adverse drug reactions to antibiotics were reported. CONCLUSIONS: Increased bacterial growth and emergence of resistant strains were observed on intranasal septal splints despite prophylactic antibiotic treatment. Nonetheless, this did not translate into clinical infection. Thus, considering antibiotics overuse and increasing bacterial resistance, further research is needed to determine the role of antibiotic prophylaxis in the setting of intranasal splints.


Asunto(s)
Antibacterianos/uso terapéutico , Profilaxis Antibiótica , Cavidad Nasal/microbiología , Tabique Nasal/cirugía , Procedimientos Quírurgicos Nasales/métodos , Férulas (Fijadores)/microbiología , Infección de la Herida Quirúrgica/prevención & control , Adolescente , Adulto , Anciano , Combinación Amoxicilina-Clavulanato de Potasio/uso terapéutico , Cefalexina/uso terapéutico , Técnicas de Cultivo , Farmacorresistencia Bacteriana , Farmacorresistencia Bacteriana Múltiple , Enterobacteriaceae/aislamiento & purificación , Infecciones por Enterobacteriaceae/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infecciones Estafilocócicas/epidemiología , Staphylococcus aureus/aislamiento & purificación , Infección de la Herida Quirúrgica/epidemiología , Adulto Joven
3.
Talanta ; 206: 120233, 2020 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-31514847

RESUMEN

The possibility of achieving bacterial discrimination using a miniaturized aspiration ion mobility spectrometer model ChemPro-100i (Environics Oy) has been tested by interrogating the headspace air samples above in vitro bacterial cultures of three species - Escherichia coli, Bacillus subtilis and Staphylococcus aureus, respectively. The ChemPro-100i highly integrated seven sensor array, composed of one a-IMS cell, three MOS (metal oxide sensors), one FET (field effect transistor) sensor and two SC (semiconductor) sensors, provided enough analytical information to discriminate between the three bacterial species. Statistical data processing using either principal component analysis (PCA) or partial least squares discriminant analysis (PLS-DA) was accomplished. We concluded that although the data from the aspiration-type ion mobility sensor, with its 16 ion detectors, is absolutely sufficient to discriminate between various bacteria using their volatile compounds' chemical profile, the other six sensors deliver additional, valuable information.


Asunto(s)
Bacillus subtilis/aislamiento & purificación , Técnicas de Tipificación Bacteriana/métodos , Escherichia coli/aislamiento & purificación , Espectrometría de Movilidad Iónica/métodos , Staphylococcus aureus/aislamiento & purificación , Análisis Discriminante , Análisis de los Mínimos Cuadrados , Análisis de Componente Principal , Compuestos Orgánicos Volátiles/análisis
4.
BMC Infect Dis ; 19(1): 1023, 2019 Dec 02.
Artículo en Inglés | MEDLINE | ID: mdl-31791276

RESUMEN

BACKGROUND: Staphylococcus aureus carriage is a known risk factor for staphylococcal disease. However, the carriage rates vary by country, demographic group and profession. This study aimed to determine the S. aureus carriage rate in children in Eastern Uganda, and identify S. aureus lineages that cause infection in Uganda. METHODS: Nasopharyngeal samples from 742 healthy children less than 5 years residing in the Iganga/Mayuge Health and Demographic Surveillance Site in Eastern Uganda were processed for isolation of S. aureus. Antibiotic susceptibility testing based on minimum inhibitory concentrations (MICs) was determined by the BD Phoenix™ system. Genotyping was performed by spa and SCCmec typing. RESULTS: The processed samples yielded 144 S. aureus isolates (one per child) therefore, the S. aureus carriage rate in children was 19.4% (144/742). Thirty one percent (45/144) of the isolates were methicillin resistant (MRSA) yielding a carriage rate of 6.1% (45/742). All isolates were susceptible to rifampicin, vancomycin and linezolid. Moreover, all MRSA were susceptible to vancomycin, linezolid and clindamycin. Compared to methicillin susceptible S. aureus (MSSA) isolates (68.8%, 99/144), MRSA isolates were more resistant to non-beta-lactam antimicrobials -trimethoprim/sulfamethoxazole 73.3% (33/45) vs. 27.3% (27/99) [p < 0.0001]; erythromycin 75.6% (34/45) vs. 24.2% (24/99) [p < 0.0001]; chloramphenicol 60% (27/45) vs. 19.2% (19/99) [p < 0.0001]; gentamicin 55.6% (25/45) vs. 25.3% (25/99) [p = 0.0004]; and ciprofloxacin 35.6% (16/45) vs. 2% (2/99) [p < 0.0001]. Furthermore, 42 MRSA (93.3%) were multidrug resistant (MDR) and one exhibited high-level resistance to mupirocin. Overall, 61 MSSA (61.6%) were MDR, including three mupirocin and clindamycin resistant isolates. Seven spa types were detected among MRSA, of which t037 and t064 were predominant and associated with SCCmec types I and IV, respectively. Fourteen spa types were detected in MSSA which consisted mainly of t645 and t4353. CONCLUSIONS: S. aureus carriage rate in healthy children in Eastern Uganda is high and comparable to rates for hospitalized patients in Kampala. The detection of mupirocin resistance is worrying as it could rapidly increase if mupirocin is administered in a low-income setting. S. aureus strains of spa types t064, t037 (MRSA) and t645, t4353 (MSSA) are prevalent and could be responsible for majority of staphylococcal infections in Uganda.


Asunto(s)
Antígenos Bacterianos/análisis , Portador Sano/epidemiología , Farmacorresistencia Bacteriana , Nariz/microbiología , Faringe/microbiología , Infecciones Estafilocócicas/epidemiología , Staphylococcus aureus/aislamiento & purificación , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Antígenos Bacterianos/clasificación , Antígenos Bacterianos/genética , Portador Sano/microbiología , Preescolar , Estudios Transversales , Farmacorresistencia Bacteriana/genética , Femenino , Técnicas de Genotipaje/métodos , Humanos , Lactante , Recién Nacido , Masculino , Staphylococcus aureus Resistente a Meticilina/genética , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Pruebas de Sensibilidad Microbiana , Tipificación Molecular/métodos , Mupirocina/farmacología , Mupirocina/uso terapéutico , Mucosa Nasal/microbiología , Vigilancia de la Población/métodos , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus/clasificación , Staphylococcus aureus/genética , Uganda/epidemiología
5.
Lakartidningen ; 1162019 Nov 29.
Artículo en Sueco | MEDLINE | ID: mdl-31794049

RESUMEN

Neonatal suppurative parotitis is a rare condition characterized by swelling, pain and erythema over the parotid gland. There may be a purulent exsudate from the Stensen duct. The predominant etiology is Staphylococcus aureus but cases with gram negative bacteria and streptococci have been reported. Most cases are managed conservatively with intravenous antibiotic therapy, and early treatment reduces risks of complications like sepsis and intraglandular abscess. We report two cases of neonatal suppurative parotitis; two 14-days-old males, both with one day history of parotid swelling and erythema. In one of them purulent exudate could be extracted from the Stensen duct. One of them had positive blood culture with Staphylococcus aureus. Ultrasound examination showed an enlarged parotid gland but no abscess. Growth of Staphylococcus aureus was found in both cases and the patients responded well to intravenous antibiotic therapy.


Asunto(s)
Parotiditis , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Exudados y Transudados/microbiología , Humanos , Recién Nacido , Masculino , Parotiditis/diagnóstico , Parotiditis/diagnóstico por imagen , Parotiditis/tratamiento farmacológico , Parotiditis/microbiología , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/diagnóstico por imagen , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus/aislamiento & purificación , Ultrasonografía
6.
J Water Health ; 17(6): 930-943, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31850900

RESUMEN

Multi-drug resistance traits of Staphylococcus species especially methicillin-resistant Staphylococcus aureus (MRSA) in the clinical settings are well established. Of environmental concern is hospital effluents discharging into wastewaters. This article investigated the prevalence and detection of antibiotic resistance genes in Staphylococcus species from clinical and environmental sources in Ile-Ife, Nigeria. Standard culture-based and molecular protocols were used. Seventy-six (27 clinical, 14 hospital effluent and 35 environmental) Staphylococcus isolates were recovered: 56.58% were coagulase-negative and 43.42% coagulase-positive (S. aureus). For the clinical isolates, 10, 6, 4, 4 and 1 were isolated from urine, skin, wounds, blood and pus, respectively. Isolates were resistant to methicillin and amoxycillin (91.7%), cloxacillin (88.0%), ciprofloxacin (84.0%), ofloxacin (83.3%), azithromycin (78.0%), ceftazidime (76.0%), gentamycin (75.0%), cefuroxime (75.0%) and erythromycin (72.0%). Nearly, all isolates (90.8%) had multiple antibiotic resistance (MAR) index >0.2. Overall MAR indices for Staphylococcus species isolated from the clinical, hospital effluent and environmental wastewaters were relatively similar (0.482; 0.500; 0.435). mecA, nuc and luk-pvl genes were detected in S. aureus, while mecA was detected in S. arlettae, S. sciuri, S. cohnii, S. epidermidis and S. saprophyticus. This study informs on the potential contamination of environmental waters downstream from hospitals and possible impacts that this could have on human and animal health.


Asunto(s)
Staphylococcus aureus Resistente a Meticilina/genética , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Staphylococcus/efectos de los fármacos , Staphylococcus/genética , Animales , Antibacterianos/uso terapéutico , Resistencia a Múltiples Medicamentos , Microbiología Ambiental , Humanos , Meticilina/uso terapéutico , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Pruebas de Sensibilidad Microbiana , Nigeria , Staphylococcus/clasificación , Staphylococcus/aislamiento & purificación , Staphylococcus aureus/aislamiento & purificación
7.
Pol J Microbiol ; 68(3): 343-351, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31880880

RESUMEN

The aim of the study was to analyze the reasons for removing implants after breast reconstruction in the course of treatment of breast cancer. The study involved 428 patients, who underwent a total of 648 breast reconstruction procedures using artificial implants. 47 out of 648 cases (7.3%) were identified in which the implant had to be removed. Of the 47 cases, 57.4% had undergone deferred reconstruction, and 42.6% immediate reconstruction; 27.7% had undergone pre-operative chemotherapy and radiotherapy, 27.7% pre-operative chemotherapy, and 2.1% pre-operative radiotherapy; 6.4% were diabetic, 4.3% active smokers, and more than 50.0% had BMI greater than 25 kg/m2. In 83.0% of the analyzed cases, the reason for removal of the implant was infection, in 8.5% it was local recurrence of breast cancer, in 4.3% it was damage (leakage) of the implant, and in 2.1% it was post-operative pain. About 87.0% of infections appeared within one year of implantation; however, less than a half developed within 90 days of the reconstructive surgery, and up to 30 days only about 13.0% had appeared. Among the etiological agents of infections were: coagulase-negative Staphylococcus (31.3%), Staphylococcus aureus (18.7%), Enterococcus faecalis (9.4%), Enterobacter cloacae (18.8%), Pseudomonas aeruginosa (12.5%), Acinetobacter lwoffii (3.1%), and other Gram-negative fermenting rods accounted for 6.2%. Infections were the most common reason for removing the implant after breast reconstruction. and occurred most often as late infections (>30 days after surgery). The time of observation for infectious complications should be at least 1 year.The aim of the study was to analyze the reasons for removing implants after breast reconstruction in the course of treatment of breast cancer. The study involved 428 patients, who underwent a total of 648 breast reconstruction procedures using artificial implants. 47 out of 648 cases (7.3%) were identified in which the implant had to be removed. Of the 47 cases, 57.4% had undergone deferred reconstruction, and 42.6% immediate reconstruction; 27.7% had undergone pre-operative chemotherapy and radiotherapy, 27.7% pre-operative chemotherapy, and 2.1% pre-operative radiotherapy; 6.4% were diabetic, 4.3% active smokers, and more than 50.0% had BMI greater than 25 kg/m2. In 83.0% of the analyzed cases, the reason for removal of the implant was infection, in 8.5% it was local recurrence of breast cancer, in 4.3% it was damage (leakage) of the implant, and in 2.1% it was post-operative pain. About 87.0% of infections appeared within one year of implantation; however, less than a half developed within 90 days of the reconstructive surgery, and up to 30 days only about 13.0% had appeared. Among the etiological agents of infections were: coagulase-negative Staphylococcus (31.3%), Staphylococcus aureus (18.7%), Enterococcus faecalis (9.4%), Enterobacter cloacae (18.8%), Pseudomonas aeruginosa (12.5%), Acinetobacter lwoffii (3.1%), and other Gram-negative fermenting rods accounted for 6.2%. Infections were the most common reason for removing the implant after breast reconstruction. and occurred most often as late infections (>30 days after surgery). The time of observation for infectious complications should be at least 1 year.


Asunto(s)
Infecciones Bacterianas/microbiología , Neoplasias de la Mama/cirugía , Infecciones Relacionadas con Prótesis/microbiología , Adulto , Remoción de Dispositivos , Femenino , Humanos , Mamoplastia/efectos adversos , Persona de Mediana Edad , Prótesis e Implantes/efectos adversos , Infecciones Relacionadas con Prótesis/etiología , Pseudomonas aeruginosa/clasificación , Pseudomonas aeruginosa/genética , Pseudomonas aeruginosa/aislamiento & purificación , Estudios Retrospectivos , Staphylococcus/clasificación , Staphylococcus/genética , Staphylococcus/aislamiento & purificación , Staphylococcus aureus/clasificación , Staphylococcus aureus/genética , Staphylococcus aureus/aislamiento & purificación
8.
Pol J Microbiol ; 68(3): 371-376, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31880882

RESUMEN

Elderly people living in nursing homes are a high-risk population for Staphylococcus aureus infection. Multiple comorbidities, a weakened immune system, inadequate hygienic conditions, and crowding might increase the prevalence rates of this opportunistic pathogen. However, the epidemiological aspects, genetic diversity, and transmission of S. aureus in nursing homes are still poorly understood, especially in Poland. This study aimed to determine the genetic relatedness and prevalence of colonization of S. aureus isolated from the anterior nares and the throat of residents and staff in a nursing home located in Lublin, Poland. The study showed a high S. aureus prevalence rate among participants (46.1%), yet there was a low frequency of MRSA strains among residents (1.7%) and staff (0%). The multiple-locus variable-number tandem-repeat fingerprinting (MLVF) analysis demonstrated a high degree of genetic diversity of S. aureus strains colonizing the anterior nares and the throat of the participants. The occurrence of simultaneous colonization with more than one unique S. aureus strain in any one individual as well as the incidence of colonization with the same genetic variant of S. aureus in different individuals was observed. These findings suggest that inter-participant S. aureus transmission might contribute to the development of cross-infections.Elderly people living in nursing homes are a high-risk population for Staphylococcus aureus infection. Multiple comorbidities, a weakened immune system, inadequate hygienic conditions, and crowding might increase the prevalence rates of this opportunistic pathogen. However, the epidemiological aspects, genetic diversity, and transmission of S. aureus in nursing homes are still poorly understood, especially in Poland. This study aimed to determine the genetic relatedness and prevalence of colonization of S. aureus isolated from the anterior nares and the throat of residents and staff in a nursing home located in Lublin, Poland. The study showed a high S. aureus prevalence rate among participants (46.1%), yet there was a low frequency of MRSA strains among residents (1.7%) and staff (0%). The multiple-locus variable-number tandem-repeat fingerprinting (MLVF) analysis demonstrated a high degree of genetic diversity of S. aureus strains colonizing the anterior nares and the throat of the participants. The occurrence of simultaneous colonization with more than one unique S. aureus strain in any one individual as well as the incidence of colonization with the same genetic variant of S. aureus in different individuals was observed. These findings suggest that inter-participant S. aureus transmission might contribute to the development of cross-infections.


Asunto(s)
Infección Hospitalaria/microbiología , Sistema Respiratorio/microbiología , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus/genética , Adulto , Anciano , Anciano de 80 o más Años , Infección Hospitalaria/epidemiología , Femenino , Variación Genética , Personal de Salud/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Casas de Salud/estadística & datos numéricos , Filogenia , Polonia/epidemiología , Infecciones Estafilocócicas/epidemiología , Staphylococcus aureus/clasificación , Staphylococcus aureus/aislamiento & purificación
9.
Int. microbiol ; 22(4): 411-417, dic. 2019. graf, tab
Artículo en Inglés | IBECS | ID: ibc-185059

RESUMEN

Glycopeptides, particularly the cell wall-acting antibiotic vancomycin, are the safest cure for methicillin-resistant Staphylococcus aureus. The aim of this study was to evaluate nonsusceptibility of clinical isolates of S. aureus to vancomycin and investigate mutations in vraSR, a cell wall synthesis regulator gene, in vancomycin-resistant strains. Susceptibility of 110 clinical strains of S. aureus to methicillin and vancomycin were determined using disc diffusion method and determination of minimum inhibitory concentration, respectively. Presence of mecA and vanA genes was determined by PCR. Determination of spa types and mutations of the vraSR gene in vancomycin nonsusceptible isolates were assessed by PCR-sequencing analyses. In total, 47 isolates (42.73%) were recognized as MRSA, three (2.73%) strains were resistant to vancomycin, and eight (7.27%) strains were vancomycin intermediates. The MIC of vancomycin was 4-64 μg/ml in these isolates. All vancomycin nonsusceptible S. aureus strains were mecA positive and one isolate was positive for the vanA gene. Spa type t030 was found as the most common type. In vraSR sequence analysis, all 11 vancomycin nonsusceptible isolates had the D59E mutation in the vraR and E45G in vraS genes. R117H, R121S, and R121I are the other identified missense mutations in the vraR gene. The identification of a high percentage of MRSA and presence of VRSA and VISA isolates is a serious warning about the treatment of future MRSA infections and reveals the need for new and effective therapeutic agents


No disponible


Asunto(s)
Enterococos Resistentes a la Vancomicina/efectos de los fármacos , Enterococos Resistentes a la Vancomicina/aislamiento & purificación , Staphylococcus aureus/aislamiento & purificación , Infecciones Estafilocócicas/microbiología , Vancomicina/farmacología , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/metabolismo , Irán , Resistencia a la Meticilina/efectos de los fármacos , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Infecciones Estafilocócicas/tratamiento farmacológico
10.
Int. microbiol ; 22(4): 451-459, dic. 2019. graf, tab
Artículo en Inglés | IBECS | ID: ibc-185063

RESUMEN

An endophytic actinomycete strain SKH1-2 isolated from Musa (ABB) cv. 'Kluai Sao Kratuep Ho' collected in Suphan Buri province (14° 54′ 22.5″ N/100° 04′ 50″ E), Thailand, was identified as Streptomyces pseudovenezuelae based on phenotypic and chemotaxonomic characteristics, and 16S rRNA sequence analyses. A chemical investigation led to the isolation of two polyketide molecules from the n-butanol crude extract of the strain SKH1-2 culture broth. The compounds were purified using various chromatographic techniques and identified using spectroscopic methods compared with earlier published data. Compound 1, chartreusin, is known as an anti-Gram (+) bacterial compound and was active against Bacillus subtilis ATCC 6633, Kocuria rhizophila ATCC 9341 and Staphylococcus aureus ATCC 6538p with MIC values of 3.1, 1.6 and 12.5 μg/mL, respectively. Compound 2, lumichrome, did not show activity against all tested microbes. To our knowledge, this is the first report of chartreusin and lumichrome isolated from S. pseudovenezuelae. Taken together, it could be proved that Thai plant species are valuable reservoirs of interesting endophytic actinomycetes producing several interesting biologically active compounds


No disponible


Asunto(s)
Policétidos/aislamiento & purificación , Streptomyces/aislamiento & purificación , ARN Ribosómico 16S/aislamiento & purificación , Staphylococcus aureus/aislamiento & purificación , Streptomyces/clasificación , Musa/química , Musa/microbiología , ARN Ribosómico 16S/química , Análisis Espectral
11.
Tex Heart Inst J ; 46(3): 215-218, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31708707

RESUMEN

Infected cardiac myxomas are rare and can have disastrous sequelae; urgent surgical resection is typically indicated. We report the case of a 43-year-old user of intravenous heroin who presented with weakness and dyspnea. He was diagnosed with infective endocarditis of a myxoma attached to the left ventricular lateral wall. The patient underwent successful surgical resection of the myxoma and then completed 4 weeks of antibiotic therapy. In addition to discussing this patient's case, we briefly review the relevant medical literature, in which we found only 4 previous reports of left ventricular myxoma associated with infective endocarditis.


Asunto(s)
Endocarditis Bacteriana/etiología , Neoplasias Cardíacas/complicaciones , Dependencia de Heroína/complicaciones , Mixoma/complicaciones , Infecciones Estafilocócicas/etiología , Adulto , Procedimientos Quirúrgicos Cardíacos/métodos , Ecocardiografía Transesofágica , Endocarditis Bacteriana/diagnóstico , Endocarditis Bacteriana/microbiología , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/cirugía , Ventrículos Cardíacos , Humanos , Imagen por Resonancia Cinemagnética , Masculino , Mixoma/diagnóstico , Mixoma/cirugía , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus/aislamiento & purificación
12.
Klin Lab Diagn ; 64(10): 627-631, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31742957

RESUMEN

Relevance of microbiological monitoring in chronic osteomyelitis of the tibia developed during treatment of fractures with a plate is associated with a noticeable increase of various kinds of the microflora. A microbiological study was conducted of pathological material taken from wounds, fistulas and from the focus of inflammation in 49 patients with chronic tibial osteomyelitis, developed during treatment of fractures with a plate. The patients underwent sequestrectomy of the tibia and subsequent application of bilocal consecutive compression-distraction osteosynthesis or monolocal compression osteosynthesis. Microbiological study of smears taken before the reconstructive treatment from fistulas and wounds of patients showed that in monoculture there were 30 strains, the remaining 30 - as a part of 14 two - and three-component associations. The frequency of S. aureus strains was 55.3%, followed by coagulase-negative staphylococcus - 13.6% and representatives of the family Enterobacteriacae - 10.2%. There were methicillin-resistant strains of S. aureus in 11.8%, strains of coagulase-negative staphylococcus (MRCoNS) - 6.8%. Recurrence of the disease was observed in 7 patients. The microflora of the discharge from the fistula was represented by monocultures of S. aureus and associations of bacteria in which one of the components was methicillin-resistant strains of S. aureus. We observed differences in the contents of the microflora before reconstructive treatment of patients and in recurrence of infection. In case of recurrence of infection, the qualitative contents of the microflora changed: in 2 patients in the association of microorganisms and in 3 - in monocultures, S. aureus strains acquired resistance to ß-lactam antibiotics, new associations appeared, which were not present in primary cultures before reconstructive treatment. The study showed that the spectrum of micro-organisms in chronic osteomyelitis of the tibia, developed after osteosynthesis with a plate, varied and is subject to change and that dictates the need for microbiological monitoring to detect the etiological structure of pathogens, monitoring of antibiotic resistance of the isolated strains and rational approach to treatment of patients.


Asunto(s)
Fístula/microbiología , Osteomielitis/microbiología , Herida Quirúrgica/microbiología , Antibacterianos , Enterobacteriaceae/aislamiento & purificación , Humanos , Osteomielitis/cirugía , Staphylococcus aureus/aislamiento & purificación , Tibia/patología
13.
Medicine (Baltimore) ; 98(45): e17852, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31702645

RESUMEN

RATIONALE: Fusidic acid (FA) is an active agent against gram-positive bacteria such as Staphylococcus, it is generally well tolerated and the major adverse effects are mild gastrointestinal discomfort, diarrhea, and headache. However, some rare side effects such as granulocytopenia and thrombocytopenia have also been reported. Here we report a case of FA-induced hepatotoxicity and hematologic toxicity. PATIENT CONCERNS: A 54-year-old woman with hepatitis B cirrhosis was referred to us because of fever, Staphylococcus aureus was identified in the twice blood culture, and intravenous FA was given (0.5 g, q8 hours). Twelve days after FA therapy, she developed nausea and jaundice. Meanwhile, complete blood cell count showed neutropenia (white blood cell count of 1360/µL, neutrophil of 619/µL) and aggravated thrombocytopenia (platelet count of 18,000/µL). Adverse drug reaction was suspected, and FA was stopped immediately, after 1 day of discontinuation of FA, nose bleeding occurred and the platelet count declined further and reached the lowest value of 4000/µL. DIAGNOSES: Hepatotoxicity and hematologic complications induced by FA were diagnosed. INTERVENTIONS AND OUTCOMES: The FA was stopped immediately, and concentrated platelet transfusion was used. Five days after withdrawal of FA, jaundice resolved and the hematologic index returned to the level before the medication. LESSONS: Hematologic adverse effect accompanying with hepatotoxicity may be induced by FA. Though the risk is rather low, it should not be overlooked.


Asunto(s)
Ácido Fusídico/administración & dosificación , Ictericia/inducido químicamente , Neutropenia/inducido químicamente , Infecciones Estafilocócicas/tratamiento farmacológico , Administración Intravenosa , Femenino , Ácido Fusídico/efectos adversos , Hepatitis B/complicaciones , Humanos , Cirrosis Hepática/virología , Persona de Mediana Edad , Neutropenia/terapia , Transfusión de Plaquetas , Infecciones Estafilocócicas/diagnóstico , Staphylococcus aureus/aislamiento & purificación , Resultado del Tratamiento
14.
BMC Infect Dis ; 19(1): 850, 2019 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-31615449

RESUMEN

BACKGROUND: To determine, from October 2010 to October 2018, the epidemiology of Deep Neck Infections (DNIs), regarding the detection, the identification and the susceptibility to antimicrobials of causative microorganisms, in Thessaly-Central Greece. METHODS: An analysis of data from a prospective database was conducted on 610 consecutive patients with DNIs treated in the Otolaryngology / Head & Neck Surgery Department of University Hospital of Larissa. Demographics, clinical features and microbiological data were analyzed. RESULTS: Among the 610 patients (1,9/1 male to female ratio, mean age: 39,24 ± 17,25) with DNIs, 579 had a single space (94,9%), while the remaining 31 had a multi-space (5,1%) DNI. The most common areas affected were the peritonsillar space (84,6%) followed by the submandibular space (6,5%). Clinical samples were obtained from 462 patients, and were tested by culture and by the application of 16S rRNA PCR. Two hundred fifty-five samples (55,2%) gave positive cultures, in which Streptococcus pyogenes and Staphylococcus aureus were predominant. The application of the 16S rRNA PCR revealed that 183 samples (39,6%) were positive for bacterial DNA; 22 of them, culture negative, were found to be positive for anaerobic (Fusobacterium necrophorum, Actinomyces israellii etc) and for fastidious microorganisms (Brucella mellitensis, Mycobacterium avium). CONCLUSION: DNIs represent a medical and surgical emergency and evidence-guided empirical treatment with intravenous infusion of antibiotics at the time of diagnosis is mandatory, highlighting the importance of epidemiological studies regarding the causative microorganisms. Although, in our study, the predominant pathogens were S. pyogenes and S. aureus, the combination of culture and molecular assay revealed that anaerobic bacteria play also a significant role in the pathogenesis of DNIs. Based on the local epidemiology, we propose as empirical therapy the intravenous use of a beta-lactam /beta-lactamase inhibitor; metronidazole or clindamycin can be added only in specific cases such as in immunocompromised patients.


Asunto(s)
Antiinfecciosos/farmacología , Bacteriemia/diagnóstico , Bacterias/efectos de los fármacos , Cuello/microbiología , Absceso/diagnóstico , Absceso/microbiología , Adulto , Bacteriemia/epidemiología , Bacteriemia/microbiología , Bacterias/aislamiento & purificación , Femenino , Grecia/epidemiología , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , ARN Ribosómico 16S/metabolismo , Estudios Retrospectivos , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/genética , Staphylococcus aureus/aislamiento & purificación , Streptococcus pyogenes/efectos de los fármacos , Streptococcus pyogenes/genética , Streptococcus pyogenes/aislamiento & purificación
15.
BMC Infect Dis ; 19(1): 841, 2019 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-31615450

RESUMEN

BACKGROUND: The purposes of this study were to determine the incidence of central and peripheral venous catheter-related bacteraemias, the relationship between the suspected and final confirmed bacteraemia origins, and the differences in microbiological, epidemiological, clinical, and analytical characteristics between the groups, including evolution to death. METHODS: This was a 7-year descriptive retrospective populational study of all bloodstream infections, comparing central (CB) and peripheral (PB) venous catheter-related bacteraemias in patients older than 15 years. RESULTS: In all, 285 catheter-related bacteraemia patients, 220 with CBs (77.19%) and 65 with PBs (22.81%), were analysed among 1866 cases with bloodstream infections. The cumulative incidence per 1000 patients-day of hospital stay was 0.36 for CB and 0.106 for PB. In terms of the suspected origin, there was less accuracy in diagnosing catheter-related bloodstream infections (68. 2%) than those of other origins (78. 4%), p <  0.001. The accuracy was greater for PB (75%) than for CB (66. 2%), Coagulase-negative staphylococci were the most frequent microorganisms in both groups but occurred 1.57 times more frequently in CB (64.1%/40.6%) (p = 0.004), while Staphylococcus aureus (23. 4%/9.5%) (p = 0.02) and Enterobacteriae species (15.6%/6. 3%) (p = 0.003) were 2.5 times more frequent in PB. The CB patients stayed at the hospital for an average of 7.44 days longer than did the PB patients; more CB patients had active neoplasia (70. 4%/32.8%), more had surgery in the previous week (29. 2%/8. 3%), and fewer received adequate empirical treatment (53.9%/ 62.5%). Catheter was not removed in 8. 2% of CB and 3.7% of PB. On the other hand, the CB and PB patients had similar Pitt scores at blood extraction (median 0.89 versus 0.84 points, respectively; p = 0.8) and similar survival rates at hospital discharge (91.1% versus 90. 2%; p = 0.81). CONCLUSIONS: Central catheters were more frequent sources of bacteraemias than were peripheral catheters. There were important differences in the microbiological aetiology as well. PB patients received correct empirical antibiotic treatment more frequently and had a higher initial rate of correct determination of the suspected source of bacteraemia. Differences in the microbiological aetiology and empirical antibiotic treatment received, and probably catheter removal and time to catheter removal could explain why CB and PB patients had similar survival rates .


Asunto(s)
Bacteriemia/diagnóstico , Infecciones Relacionadas con Catéteres/diagnóstico , Cateterismo Venoso Central/métodos , Cateterismo Periférico/métodos , Bacteriemia/microbiología , Bacteriemia/mortalidad , Infecciones Relacionadas con Catéteres/microbiología , Catéteres de Permanencia/microbiología , Enterobacteriaceae/aislamiento & purificación , Humanos , Tiempo de Internación , Estudios Retrospectivos , Staphylococcus aureus/aislamiento & purificación , Tasa de Supervivencia
16.
BMC Infect Dis ; 19(1): 873, 2019 Oct 22.
Artículo en Inglés | MEDLINE | ID: mdl-31640587

RESUMEN

BACKGROUND: There have been no reports regarding the molecular characteristics, virulence features, and antibiotic resistance profiles of Staphylococcus aureus (S. aureus) from Hainan, the southernmost province of China. METHODS: Two hundred twenty-seven S. aureus isolates, consisting of 76 methicillin-resistant S. aureus (MRSA) and 151 methicillin-susceptible S. aureus (MSSA), were collected in 2013-2014 and 2018-2019 in Hainan, and investigated for their molecular characteristics, virulence genes, antibiotic resistance profiles and main antibiotic resistance genes. RESULTS: Forty sequence types (STs) including three new STs (ST5489, ST5492 and ST5493), and 79 Staphylococcal protein A (spa) types were identified based on multilocus sequence typing (MLST) and spa typing, respectively. ST398 (14.1%, 32/227) was found to be the most prevalent, and the prevalence of ST398-MSSA increased significantly from 2013 to 2014 (5.5%, 5/91) to 2018-2019 (18.4%, 25/136). Seventy-six MRSA isolates were subject to staphylococcus chromosomal cassette mec (SCCmec) typing. SCCmec-IVa was the predominant SCCmec type, and specifically, ST45-SCCmec IVa, an infrequent type in mainland China, was predominant in S. aureus from Hainan. The antibiotic resistance profiles and antibiotic resistance genes of S. aureus show distinctive features in Hainan. The resistant rates of the MRSA isolates to a variety of antibiotics were significantly higher than those of the MSSA isolates. The predominant erythromycin and tetracycline resistance genes were ermC (90.1%, 100/111) and tetK (91.8%, 78/85), respectively. Eleven virulence genes, including the Panton-Valentine leukocidin (pvl) and eta, were determined, and the frequency of eta and pvl were found to be 57.3 and 47.6%. Such high prevalence has never been seen in mainland China before. CONCLUSION: S. aureus isolates in Hainan have unique molecular characteristics, virulence gene and antibiotic resistance profiles, and main antibiotic resistance genes which may be associated with the special geographical location of Hainan and local trends in antibiotic use.


Asunto(s)
Farmacorresistencia Bacteriana/genética , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus/genética , Staphylococcus aureus/patogenicidad , Factores de Virulencia/genética , Antibacterianos/farmacología , Proteínas Bacterianas/genética , Toxinas Bacterianas/genética , China , Farmacorresistencia Bacteriana/efectos de los fármacos , Exotoxinas/genética , Humanos , Leucocidinas/genética , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Staphylococcus aureus Resistente a Meticilina/genética , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Staphylococcus aureus Resistente a Meticilina/patogenicidad , Pruebas de Sensibilidad Microbiana , Tipificación de Secuencias Multilocus , Infecciones Estafilocócicas/tratamiento farmacológico , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/aislamiento & purificación , Virulencia/genética
17.
BMC Infect Dis ; 19(1): 905, 2019 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-31660864

RESUMEN

BACKGROUND: Antibiotic resistance is rising at disturbing rates and contributes to the deaths of millions of people yearly. Antibiotic resistant infections disproportionately affect those with immunocompromising conditions, chronic colonization, and frequent antibiotic use such as transplant patients or those with cystic fibrosis. However, clinicians lack the diagnostic tools to confidently diagnose and treat infections, leading to widespread use of empiric broad spectrum antimicrobials, often for prolonged duration. CASE PRESENTATION: A 22 year-old Caucasian female with cystic fibrosis received a bilateral orthotopic lung transplantation 5 months prior to the index hospitalization. She underwent routine surveillance bronchoscopy and was admitted for post-procedure fever. A clear cause of infection was not identified by routine methods. Imaging and bronchoscopic lung biopsy did not identify an infectious agent or rejection. She was treated with a prolonged course of antimicrobials targeting known colonizing organisms from prior bronchoalveolar lavage cultures (Pseudomonas, Staphylococcus aureus, and Aspergillus). However, we identified Stenotrophomonas maltophilia in two independent whole blood samples using direct-pathogen sequencing, which was not identified by other methods. CONCLUSIONS: This case represents a common clinical conundrum: identification of infection in a high-risk, complex patient. Here, direct-pathogen sequencing identified a pathogen that would not otherwise have been identified by common techniques. Had results been clinically available, treatment could have been customized, avoiding a prolonged course of broad spectrum antimicrobials that would only exacerbate resistance. Direct-pathogen sequencing is poised to fill a diagnostic gap for pathogen identification, allowing early identification and customization of treatment in a culture-independent, pathogen-agnostic manner.


Asunto(s)
Broncoscopía/efectos adversos , Fiebre/etiología , Infecciones por Bacterias Gramnegativas/diagnóstico , Infecciones por Bacterias Gramnegativas/etiología , Secuenciación de Nucleótidos de Alto Rendimiento , Análisis de Secuencia de ARN , Stenotrophomonas maltophilia/genética , Antibacterianos/uso terapéutico , Lavado Broncoalveolar , Toma de Decisiones Clínicas , Fibrosis Quística/cirugía , Farmacorresistencia Bacteriana , Femenino , Fiebre/tratamiento farmacológico , Humanos , Trasplante de Pulmón , Pseudomonas/aislamiento & purificación , Staphylococcus aureus/aislamiento & purificación , Resultado del Tratamiento , Adulto Joven
18.
Medicine (Baltimore) ; 98(42): e17347, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31626092

RESUMEN

RATIONALE: Non-significant residual shunt is a relatively common complication after device closure of perimembranous ventricular septal defects (Pm-VSD). Lifelong antibiotic prophylaxis has been recommended in guidelines to avoid infectious endocarditis (IE) if residual shunt remains. Clinicians, however, rarely follow it in their practice and regular follow-up was the most common option since post-procedure IE after transcatheter closure of PmVSD is rarely reported. We firstly described a case of IE after transcatheter closure of PmVSD with modified symmetrical double-disk device with a residual shunt, highlighting the need for reassessing the prognostic implications of post-procedure non-significant residual shunt and the most appropriate treatment strategy. PATIENT CONCERNS: A 3-year old female received transcatheter closure of PmVSD sized 5.0 mm on left ventricular angiography with an 8-mm modified symmetric double-disk occluder (SHAMA) owing to a history of recurrent lower respiratory tract infections. Post-procedure echocardiography documented a non-significant residual shunt, but no additional interventions were performed. Two months post procedure, the child was re-admitted into our department with a complaint of persistent fever up to 41°C for 11 days and nonresponse to 1-week course of amoxicillin. DIAGNOSES: The diagnosis of post procedure IE was established since a vegetation (13 × 9 mm) was found to be attached to the tricuspid valve and the occluder, and Staphylococcus aureus was isolated from all three-blood cultures. INTERVENTIONS: After 6 weeks of vancomycin treatment, the vegetation disappeared with no sign of valvular dysfunction. Three weeks after discharge, a second device was implanted to abolish persistent residual flow. OUTCOMES: Unfortunately, the child was ultimately transferred to surgical department due to severe hemolysis after the second device implantation. The occluders were removed and the VSD was closed with a pericardial patch. Tricuspid valvuloplasty was also performed and the following course was uneventful. LESSONS: For non-significant residual shunt after device closure of PmVSD, implantation of a second device or surgical repair may be a better and more satisfactory alternative compared with lifelong antibiotic prophylaxis or no interventions, since associated IE can indeed occur despite its rarity and the risk of antibiotic-associated adverse events may outweigh the benefits.


Asunto(s)
Cateterismo Cardíaco/efectos adversos , Endocarditis Bacteriana/etiología , Defectos del Tabique Interventricular/cirugía , Dispositivo Oclusor Septal/efectos adversos , Profilaxis Antibiótica/efectos adversos , Preescolar , Endocarditis Bacteriana/terapia , Femenino , Humanos , Reoperación/métodos , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/etiología , Staphylococcus aureus/aislamiento & purificación , Válvula Tricúspide/diagnóstico por imagen , Válvula Tricúspide/patología
20.
Georgian Med News ; (292-293): 113-117, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31560675

RESUMEN

The development of atopic dermatitis (AD) is often associated with the presence of pathogenic microflora in the skin's biotope against the background of acute immunological disorders of the microorganism. In this case, the leading role is played by Staphylococcus aureus, which is seeded in 80-95% of patients diagnosed with AD. The clinical significance of the pathogen is determined by its ability to actively survive in the biotope, aided by a wide range of pathogenicity factors of this microorganism. Goal of research - to study the activity levels of pathogenicity factors and the persistence of staphylococci clinical autostrains isolated from different topodems of the skin of patients diagnosed with AD. The object of study was 101 laboratory strain of the skin's staphylococci of 50 patients diagnosed with AD and 39 control strains isolated from 20 generally healthy individuals. Isolation of microorganisms and bacteriological studies of their pathogenic characteristics were carried out using the methods of classical bacteriology. It was revealed that the qualitative and quantitative characteristics of the antilysocyme activity (ALA), the anti-interferon activity (AIA) and the adhesive properties of the strains isolated from the affected skin areas were significantly higher than that of the cultures isolated from the intact areas. The data obtained indicate the ability of these pathogens to adversely affect the course of the pathological process in the skin.


Asunto(s)
Dermatitis Atópica/diagnóstico , Eccema/diagnóstico , Piel/microbiología , Staphylococcus aureus/aislamiento & purificación , Staphylococcus aureus/patogenicidad , Estudios de Casos y Controles , Dermatitis Atópica/microbiología , Eccema/microbiología , Humanos , Piel/patología , Infecciones Estafilocócicas/diagnóstico
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