RESUMO
Retrospective antibiotic surveillance data of selected invasive pathogens isolated from blood and cerebrospinal fluid at public sector hospitals in South Africa in 2007 are presented. Antimicrobial susceptibilities were determined according to the 2007 Clinical and Laboratory Standards Institute criteria. Klebsiella pneumoniae remains a highly resistant pathogen; with approximately half of all strains producing extended-spectrum beta-lactamases. All laboratories reported considerable resistance among Acinetobacter spp. Approximately 50-60of Staphylococcus aureus isolates from blood were resistant to cloxacillin. Among Streptococcus pneumoniae isolates from blood and cerebrospinal intermediate resistance to penicillin. Resistance to ceftriaxone in S. pneumoniae was rare
Assuntos
Anti-Infecciosos , Resistência a Medicamentos , Enterobacteriaceae , Hospitais , Staphylococcus aureusRESUMO
Chromobacterium violaceum sepsis is extremely rare and usually fatal. A very few cases of C. violaceum infection have been reported from Africa, but never from South Africa. As far as could be ascertained, this infection has never been reported in a patient with leukaemia. We describe what we believe to be the first such case of C. violaceum sepsis, in a 16-year-old female patient with acute biphenotypic leukaemia, which developed during the neutropenic phase after intensive chemotherapy. The infection was due to a non-pigmented strain of C. violaceum and was associated with a co-infection with Candida parapsilosis; both were successfully treated using broad-spectrum antibiotics, antifungals and removal of a Hickman line.
Assuntos
Antibacterianos/uso terapêutico , Chromobacterium/isolamento & purificação , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Sepse/tratamento farmacológico , Adolescente , Antifúngicos/farmacologia , Candidíase/complicações , Candidíase/tratamento farmacológico , Feminino , Infecções por Bactérias Gram-Negativas/epidemiologia , Infecções por Bactérias Gram-Negativas/microbiologia , Humanos , Leucemia/complicações , Neutropenia/complicações , Sepse/microbiologia , África do Sul/epidemiologia , Resultado do TratamentoRESUMO
In order to determine the incidence and the causative agents of fungaemia, a survey was undertaken of blood culture specimens received from the Bloemfontein academic hospitals. Over a period of 1 year, 5,017 successive blood cultures were examined; 1,030 (20.5%) had growth of which 106 (2.1%) yielded yeasts. Candida albicans (42%), C. tropicalis (26%) and C. parapsilosis (20%) were the species most frequently isolated. Fungaemia occurred most often after broad-spectrum antimicrobial therapy and abdominal disorders.
Assuntos
Sangue/microbiologia , Infecção Hospitalar/epidemiologia , Micoses/epidemiologia , Leveduras/isolamento & purificação , Candida/isolamento & purificação , Geotrichum/isolamento & purificação , Humanos , Micoses/etiologia , Pichia/isolamento & purificação , África do Sul/epidemiologiaRESUMO
A wet preparation method, modified serum test and a modified disc diffusion method were evaluated in order to identify yeasts more rapidly during fungaemia. A total of 2,932 blood cultures were processed, of which 54 (1.8%) yielded yeasts. By using these methods, Candida albicans was identified within 3 hours, after yeast growth in the blood culture was confirmed by Gram stain. The wet preparation examinations were accurate in 60% of cases and the serum test in 95% of cases. After growth was detected, yeast species other than C. albicans were identified within 24 hours using the modified disc diffusion method. C. albicans (50%), C. tropicalis (22%) and C. parapsilosis (22%) were the species most frequently isolated. Fungaemia occurred most often after antimicrobial therapy and abdominal conditions.