Actinotignum schaalii infection: Challenges in diagnosis and treatment.

Actinotignum schaalii affects elderly people and is associated with individuals with urological-related predispositions, but can be found in a variety of locations, such as cutaneous, intraabdominal, genitourinary and surgical infections. Disseminated infections occur less frequently and are by and large related to urinary tract colonisation. This pathogen is often neglected due to growth requirements, especially in urinary tract infections. We present 107 Actinotignum schaalii isolated from genitourinary samples (80.4%), from skin and soft tissue infections (13.1%), from bone and deep tissue infection (4.7%) and from blood cultures (1.9%). The automated system Alfred 60/AST was paramount for the isolation of 77.6% of the UTI. All the isolates tested were susceptible to penicillin, ampicillin, linezolid, vancomycin, teicoplanin, rifampicin and tetracycline. In conclusion, we present a large series of Actinotignum schaalii infections. This pathogen is hard to isolate, and is resistant to commonly used empirical antimicrobials.

Capnophilic Enterobacteriaceae.

Bacteria use bicarbonate as substrate for crucial metabolic reactions. We report the first case of bacteremia by capnophilic E. coli without the YadF gene (also known as CynT2 or Can2) that needs high concentrations of CO2 to non-enzymatically produce bicarbonate. This lack may also apply to previously reported capnophilic Enterobacteriaceae.

Cócteles e imperios en la era de la navegación a vela / Coctails and empires in the wind mailing times

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In vitro activity of linezolid in combination with doxycycline, fosfomycin, levofloxacin, rifampicin and vancomycin against methicillin-susceptible Staphylococcus aureus.

The objective of this paper was to investigate the in vitro effects of linezolid combined with five antistaphylococcal antibiotics--doxycycline, fosfomycin, levofloxacin, rifampicin and vancomycin--upon methicillin-susceptible Staphylococcus aureus (MSSA). Five MSSA isolates from clinical specimens of human infections--hf008, hf095, hf295, hf602 and hf946--were used in this study. The checkerboard method was used to assess synergism between linezolid and the five antibiotics, and time-kill curves were carried out with the most active combinations. Indifference was the most common result achieved by the checkerboard method when linezolid was combined with rifampicin, vancomycin or doxycycline. The combination with levofloxacin yielded antagonism for two of the five isolates. However, four isolates showed synergy for the combination of linezolid plus fosfomycin with a fractional inhibitory concentration index (FICI) > or = 0.5. Neither linezolid nor fosfomycin alone inhibited growth at 1/4x minimum inhibitory concentration (MIC); but the combination of both drugs at 1/4 the respective MIC showed a synergistic bacteriostatic effect, a 2-3 log(10) decrease with respect to the most active antibiotic alone. In summary, the combination of subinhibitory.

In vitro activity of linezolid in combination with doxycycline, fosfomycin, levofloxacin, rifampicin and vancomycin against methicillin-susceptible Staphylococcus aureus

El objetivo de este estudio fue investigar los efectos in vitro de linezolid en combinación con cinco antimicrobianos antiestafilocócicos (doxiciclina,fosfomicina, levofloxacino, rifampicina y vancomicina) en cepas de Staphylococcus aureus sensibles a meticilina (SASM). Se utilizaroncinco cepas de SASM (hf008, hf095, hf295, hf602 y hf946) aisladas de muestras procedentes de infecciones humanas. Se utilizó el métododel damero para evaluar la sinergia entre linezolid y los cinco antimicrobianos, y se trazaron curvas de tiempo-muerte con las combinacionesmás activas. El resultado más habitual para las combinaciones de linezolid con rifampicina, vancomicina y doxiciclina fue indiferencia.La combinación con levofloxacino produjo antagonismo en dos de las cinco cepas. Sin embargo, frente a cuatro cepas se observó sinergiacon la combinación de linezolid y fosfomicina, con un índice de concentración inhibitoria fraccionada (ICIF) >0,5. Ni linezolid ni fosfomicinaen solitario inhibieron el crecimiento a 1/4x CMI, pero la combinación de ambos fármacos a 1/4 de la CMI respectiva mostró un efecto bacteriostáticosinérgico, un descenso de 2-3 log10 respecto al antimicrobiano más activo en solitario. En resumen, la combinación de linezolid yfosfomicina a concentraciones subinhibitorias se mostró sinérgica, ejerciendo un efecto bacteriostático

The objective of this paper was to investigate the in vitro effects of linezolid combined with five antistaphylococcal antibiotics – doxycycline,fosfomycin, levofloxacin, rifampicin and vancomycin – upon methicillin-susceptible Staphylococcus aureus (MSSA). Five MSSA isolates fromclinical specimens of human infections – hf008, hf095, hf295, hf602 and hf946 – were used in this study. The checkerboard method wasused to assess synergism between linezolid and the five antibiotics, and time-kill curves were carried out with the most active combinations.Indifference was the most common result achieved by the checkerboard method when linezolid was combined with rifampicin, vancomycinor doxycycline. The combination with levofloxacin yielded antagonism for two of the five isolates. However, four isolates showed synergyfor the combination of linezolid plus fosfomycin with a fractional inhibitory concentration index (FICI) >0.5. Neither linezolid nor fosfomycinalone inhibited growth at 1/4x minimum inhibitory concentration (MIC); but the combination of both drugs at 1/4 the respective MICshowed a synergistic bacteriostatic effect, a 2–3 log10 decrease with respect to the most active antibiotic alone. In summary, the combinationof subinhibitory concentrations of linezolid and fosfomycin presented synergism, exerting a bacteriostatic effect