RESUMO
A case of bacteremia caused by Pantoea agglomerans (P. agglomerans) and Enterococcus faecalis in a male patient with colon cancer is reported. He was successfully treated with vancomycin and meropenem. The clinical isolate was identified as P. agglomerans by 16S rRNA gene sequencing.
Assuntos
Bacteriemia/microbiologia , Neoplasias do Colo/complicações , Enterococcus faecalis/isolamento & purificação , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Pantoea/isolamento & purificação , Idoso , Antibacterianos/uso terapêutico , Bacteriemia/complicações , Bacteriemia/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/complicações , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Positivas/complicações , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Humanos , Masculino , Meropeném , Tienamicinas/uso terapêutico , Vancomicina/uso terapêuticoRESUMO
A case of central venous catheter-related bacteraemia due to Roseomonas mucosa in a neutropenic patient with acute myelogenous leukaemia is reported. The patient was successfully treated with amikacin and piperacillin-tazobactam. The clinical isolate was identified as R. mucosa by 16S rRNA gene sequencing.
Assuntos
Bacteriemia/etiologia , Cateterismo Venoso Central/efeitos adversos , Leucemia Mieloide/complicações , Methylobacteriaceae/isolamento & purificação , Neutropenia/complicações , Doença Aguda , Adulto , Amicacina/uso terapêutico , Antibacterianos/uso terapêutico , Antimetabólitos Antineoplásicos/administração & dosagem , Antimetabólitos Antineoplásicos/uso terapêutico , Antineoplásicos/administração & dosagem , Antineoplásicos/uso terapêutico , Bacteriemia/tratamento farmacológico , Sequência de Bases , Citarabina/administração & dosagem , Citarabina/uso terapêutico , Humanos , Leucemia Mieloide/tratamento farmacológico , Masculino , Methylobacteriaceae/classificação , Methylobacteriaceae/genética , Dados de Sequência Molecular , Ácido Penicilânico/análogos & derivados , Ácido Penicilânico/uso terapêutico , Filogenia , Piperacilina/uso terapêutico , Combinação Piperacilina e Tazobactam , RNA Bacteriano , RNA Ribossômico 16S/genética , Vidarabina/análogos & derivados , Vidarabina/uso terapêuticoRESUMO
PURPOSE: To present the clinical course and laboratory results of leukemic patients with candidemia and to comment on the incidence and clinical findings of mycoses in this particular patient population. PATIENTS AND METHODS: From 2002 to 2005 in the Department of Hematology of our institution 53 leukemic patients with clinical signs of infection and severe neutropenia after intensive chemotherapy presented 127 febrile episodes during which blood cultures were taken, both from central venous catheters and from peripheral veins with a sterile method as described elsewhere. RESULTS: 4/53 (7.5%) of neutropenic patients presented disseminated candidiasis with positive blood cultures with different species of Candida (C) according to the EORTC criteria. Two patients had strains susceptible to all or most antifungal agents, 1 had dose-dependent sensitivity and 1 had C. krusei resistant to all agents. Two patients died probably because of disseminated candidiasis, 1 survived and 1 died of unrelated cause. CONCLUSION: Fungal infections are not uncommon in patients with hematological malignancies, but they are rarely microbiologically documented. A fast and reliable means of diagnosis of invasive fungal infections is urgently needed.
Assuntos
Candidíase/etiologia , Fungemia/etiologia , Leucemia Mieloide/microbiologia , Doença Aguda , Idoso , Candida/isolamento & purificação , Candidíase/sangue , Candidíase/tratamento farmacológico , Candidíase/microbiologia , Feminino , Fungemia/microbiologia , Humanos , Leucemia Mieloide/sangue , Masculino , Pessoa de Meia-Idade , Neutropenia/microbiologiaRESUMO
Blastoschizomyces capitatus (formerly known as Geotrichum capitatum and Trichosporon capitatum) is a rare, yet an emerging, cause of invasive infections in immunosuppressed patients. Profound and prolonged neutropenia is the crucial predisposing factor for this yeast infection. Blastoschizomyces capitatus was isolated from peripheral blood cultures of a profoundly neutropenic patient with acute myeloid leukemia (M2 FAB). Despite administration of antifungal chemotherapy with liposomal amphotericin B at 4.5 mg kg(-1) daily, the patient succumbed 4 days after initiation of treatment. Infections attributed to B. capitatus have generally a poor prognosis, although the yeast shows in vitro susceptibility to antifungal agents. Low flucytosine, caspofungin acetate, voriconazole and amphotericin B minimum inhibitory concentration values were also recorded with our isolate. The clinical relevance of the in vitro susceptibility testing against the isolate and the current antifungal chemotherapy regimens against B. capitatus systemic infections are discussed.
