Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 32.010
Filtrar
1.
BMJ Case Rep ; 14(2)2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33526521

RESUMO

Vertebral osteomyelitis is an infection of the vertebrae that can lead to spinal degeneration, most commonly caused by Staphylococcus aureus Here, we report an unusual case of pyogenic osteomyelitis caused by Gardnerella vaginalis and Streptococcus parasanguinis in a 61-year-old postmenopausal woman. The patient presented with a 2-week history of worsening lower back pain and fever and a recent episode of cystitis following re-engagement of sexual activity. Imaging revealed a deterioration of vertebrae discs and spinal canal stenosis at the L3-L4 levels with a formation of abscess in the right psoas muscle. Needle aspiration of the abscess identified G. vaginalis and S. parasanguinis and the patient was successfully treated with a 6-week course of ceftriaxone and metronidazole. This case describes an unusual coinfection of two pathogens that normally reside in the urogenital tract and oral cavity, respectively, and highlights the risk posed when these organisms breach the body's normal barriers.


Assuntos
Discite/microbiologia , Gardnerella vaginalis/isolamento & purificação , Vértebras Lombares , Osteomielite/microbiologia , Abscesso do Psoas/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus/isolamento & purificação , Antibacterianos/uso terapêutico , Técnicas de Cultura , Discite/diagnóstico por imagem , Discite/tratamento farmacológico , Discite/fisiopatologia , Feminino , Infecções por Bactérias Gram-Positivas/diagnóstico , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Infecções por Bactérias Gram-Positivas/microbiologia , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Osteomielite/diagnóstico por imagem , Osteomielite/tratamento farmacológico , Osteomielite/fisiopatologia , Pós-Menopausa , Abscesso do Psoas/diagnóstico por imagem , Abscesso do Psoas/tratamento farmacológico , Estenose Espinal/fisiopatologia , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico
2.
BMJ Case Rep ; 14(2)2021 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-33563670

RESUMO

Cerebral vasculitis is a serious complication of bacterial meningitis that can cause significant morbidity and mortality due to stroke. Currently, there are no treatment guidelines or safety and efficacy studies on the management of cerebral vasculitis in this context. Herein, we report a case of a previously well 11-year-old girl who presented with acute otitis media that progressed to mastoiditis and fulminant meningitis. Group A Streptococcus was found in blood and ear-fluid cultures (lumbar puncture was unsuccessful). Her decreased level of consciousness persisted despite appropriate antimicrobial treatment, and repeat MRI revealed extensive large vessel cerebral vasculitis. Based on expert opinion and a presumed inflammatory mechanism, her cerebral vasculitis was treated with 7 days of pulse intravenous methylprednisolone followed by oral prednisone taper. She was also treated with intravenous heparin. Following these therapies, she improved clinically and radiographically with no adverse events. She continues to undergo rehabilitation with improvement.


Assuntos
Antibacterianos/administração & dosagem , Heparina/administração & dosagem , Meningites Bacterianas/diagnóstico , Meningites Bacterianas/tratamento farmacológico , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Vasculite do Sistema Nervoso Central/diagnóstico , Vasculite do Sistema Nervoso Central/tratamento farmacológico , Criança , Diagnóstico Diferencial , Diagnóstico por Imagem , Quimioterapia Combinada , Feminino , Humanos , Meningites Bacterianas/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus pyogenes , Vasculite do Sistema Nervoso Central/microbiologia
3.
mBio ; 12(1)2021 01 05.
Artigo em Inglês | MEDLINE | ID: mdl-33402537

RESUMO

Invasive bacterial infections during pregnancy are a major risk factor for preterm birth, stillbirth, and fetal injury. Group B streptococci (GBS) are Gram-positive bacteria that asymptomatically colonize the lower genital tract but infect the amniotic fluid and induce preterm birth or stillbirth. Experimental models that closely emulate human pregnancy are pivotal for the development of successful strategies to prevent these adverse pregnancy outcomes. Using a unique nonhuman primate model that mimics human pregnancy and informs temporal events surrounding amniotic cavity invasion and preterm labor, we show that the animals inoculated with hyaluronidase (HylB)-expressing GBS consistently exhibited microbial invasion into the amniotic cavity, fetal bacteremia, and preterm labor. Although delayed cytokine responses were observed at the maternal-fetal interface, increased prostaglandin and matrix metalloproteinase levels in these animals likely mediated preterm labor. HylB-proficient GBS dampened reactive oxygen species production and exhibited increased resistance to neutrophils compared to an isogenic mutant. Together, these findings demonstrate how a bacterial enzyme promotes GBS amniotic cavity invasion and preterm labor in a model that closely resembles human pregnancy.IMPORTANCE Group B streptococci (GBS) are bacteria that commonly reside in the female lower genital tract as asymptomatic members of the microbiota. However, during pregnancy, GBS can infect tissues at the maternal-fetal interface, leading to preterm birth, stillbirth, or fetal injury. Understanding how GBS evade host defenses during pregnancy is key to developing improved preventive therapies for these adverse outcomes. In this study, we used a unique nonhuman primate model to show that an enzyme secreted by GBS, hyaluronidase (HylB) promotes bacterial invasion into the amniotic cavity and fetus. Although delayed immune responses were seen at the maternal-fetal interface, animals infected with hyaluronidase-expressing GBS exhibited premature cervical ripening and preterm labor. These observations reveal that HylB is a crucial GBS virulence factor that promotes bacterial invasion and preterm labor in a pregnancy model that closely emulates human pregnancy. Therefore, hyaluronidase inhibitors may be useful in therapeutic strategies against ascending GBS infection.


Assuntos
Hialuronoglucosaminidase/metabolismo , Neutrófilos/imunologia , Trabalho de Parto Prematuro/imunologia , Infecções Estreptocócicas/imunologia , Streptococcus agalactiae/metabolismo , Líquido Amniótico/microbiologia , Animais , Citocinas/metabolismo , Modelos Animais de Doenças , Feminino , Humanos , Hialuronoglucosaminidase/genética , Inflamação , Pulmão/microbiologia , Pulmão/patologia , Macaca nemestrina , Neutrófilos/microbiologia , Gravidez , Nascimento Prematuro , Primatas , Infecções Estreptocócicas/metabolismo , Infecções Estreptocócicas/microbiologia , Streptococcus agalactiae/enzimologia , Streptococcus agalactiae/genética , Streptococcus agalactiae/imunologia
4.
BMC Infect Dis ; 21(1): 125, 2021 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-33509097

RESUMO

BACKGROUND: Streptococcus agalacticae (Group B Streptococcus, GBS) is one of the most important causative agents of serious infections among neonates. This study was carried out to identify antibiotic resistance and virulence genes associated with GBS isolated from pregnant women. METHODS: A total of 43 GBS isolates were obtained from 420 vaginal samples collected from HIV positive and negative women who were 13-35 weeks pregnant attending Antenatal Care at Chitungwiza and Harare Central Hospitals in Zimbabwe. Identification tests of GBS isolates was done using standard bacteriological methods and molecular identification testing. Antibiotic susceptibility testing was done using the modified Kirby-Bauer method and E-test strips. The boiling method was used to extract DNA and Polymerase Chain Reaction (PCR) was used to screen for 13 genes. Data was fed into SPSS 24.0. RESULTS: Nine distinct virulence gene profiles were identified and hly-scpB-bca-rib 37.2% (16/43) was common. The virulence genes identified were namely hly 97.8% (42/43), scpB 90.1% (39/43), bca 86.0% (37/43), rib 69.8% (30/43) and bac 11.6% (5/43). High resistance to tetracycline 97.7% (42/43) was reported followed by 72.1% (31/43) cefazolin, 69.8% (30/43) penicillin G, 58.1% (25/43) ampicillin, 55.8% (24/43) clindamycin, 46.5% (20/43) ceftriaxone, 34.9% (15/43) chloramphenicol, and 30.2% (13/43) for both erythromycin and vancomycin using disk diffusion. Antibiotic resistance genes among the resistant and intermediate-resistant isolates showed high frequencies for tetM 97.6% (41/42) and low frequencies for ermB 34.5% (10/29), ermTR 10.3% (3/29), mefA 3.4% (1/29), tetO 2.4% (1/42) and linB 0% (0/35). The atr housekeeping gene yielded 100% (43/43) positive results, whilst the mobile genetic element IS1548 yielded 9.3% (4/43). CONCLUSION: The study showed high prevalence of hly, scpB, bca and rib virulence genes in S. agalactiae strains isolated from pregnant women. Tetracycline resistance was predominantly caused by the tetM gene, whilst macrolide resistance was predominantly due to the presence of erm methylase, with the ermB gene being more prevalent. Multi-drug resistance coupled with the recovery of resistant isolates to antimicrobial agents such as penicillins indicates the importance of GBS surveillance and susceptibility tests. It was also observed that in vitro phenotypic resistance is not always accurately predicted by resistance genotypes.


Assuntos
Farmacorresistência Bacteriana/genética , Infecções Estreptocócicas/microbiologia , Streptococcus agalactiae/genética , Streptococcus agalactiae/isolamento & purificação , Fatores de Virulência/genética , Adulto , Antibacterianos/farmacologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Feminino , Humanos , Testes de Sensibilidade Microbiana , Gestantes , Prevalência , Infecções Estreptocócicas/epidemiologia , Streptococcus agalactiae/efeitos dos fármacos , Streptococcus agalactiae/patogenicidade , Zimbábue/epidemiologia
5.
BMJ Case Rep ; 14(1)2021 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-33495173

RESUMO

Surgery for prosthetic valve endocarditis in the mitral valve position is still challenging for surgeons. Reconstruction of the mitral annulus is useful for patients with a mitral annulus disputed by infection. Here, we report a redo mitral valve replacement using a collar-reinforced tissue valve, which was inserted into a mitral annulus reconstructed with a bovine patch. Though the preoperative blood culture detected Streptococcus anginosus, the intraoperative culture detected methicillin-resistant coagulase-negative staphylococci (MRCNS). MRCNS is rarely detected because of its indolent nature.


Assuntos
Antibacterianos/uso terapêutico , Endocardite Bacteriana/terapia , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Estenose da Valva Mitral/cirurgia , Infecções Relacionadas à Prótese/terapia , Infecções Estafilocócicas/terapia , Infecções Estreptocócicas/terapia , Idoso , Ampicilina/uso terapêutico , Hemocultura , Daptomicina/uso terapêutico , Desbridamento , Ecocardiografia , Endocardite Bacteriana/complicações , Endocardite Bacteriana/microbiologia , Feminino , Humanos , Embolia Intracraniana/diagnóstico por imagem , Embolia Intracraniana/etiologia , Imagem por Ressonância Magnética , Resistência a Meticilina/fisiologia , Infecções Relacionadas à Prótese/microbiologia , Procedimentos Cirúrgicos Reconstrutivos , Reoperação , Staphylococcus/isolamento & purificação , Staphylococcus/fisiologia , Streptococcus anginosus/isolamento & purificação , Streptococcus anginosus/fisiologia , Sulbactam/uso terapêutico
6.
BMJ Case Rep ; 14(1)2021 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-33495174

RESUMO

Constrictive pericarditis is a relatively uncommon form of cardiac failure and presents due to scarring and consequent loss of the normal elasticity of the pericardial sac. This results in abnormal/limited ventricular filling and symptoms of heart failure. The aetiology is varied, from infective causes to idiopathic causes, or can manifest after cardiothoracic surgery. This case involves a 46-year-old man presenting with acute group A beta haemolytic streptococcus infection, and over the subsequent 6 months develops constrictive pericarditis due to what is believed to be a rheumatic aetiology. The patient subsequently underwent pericardiectomy and had restoration of normal filling dynamics confirmed on follow-up echocardiography. This case provides a subject matter for the review of the features of constrictive pericarditis and its investigation and management. This case is that it highlights the fact that pericarditis is not a benign condition. Emerging evidence suggests that pericarditis is due to a failure in inflammatory regulatory mechanisms, and patients suffering this condition have a preponderance to 'autoinflammation'. Pericarditis should be recognised early and treated fully with anti-inflammatory agents.


Assuntos
Bacteriemia/diagnóstico , Pericardite Constritiva/diagnóstico , Cardiopatia Reumática/diagnóstico , Infecções Estreptocócicas/diagnóstico , Antibacterianos/uso terapêutico , Antiestreptolisina/imunologia , Bacteriemia/complicações , Bacteriemia/tratamento farmacológico , Hemocultura , Proteína C-Reativa/imunologia , Cateterismo Cardíaco , Ceftriaxona/uso terapêutico , Eletrocardiografia , Hospitalização , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Pericardiectomia , Pericardite Constritiva/etiologia , Pericardite Constritiva/fisiopatologia , Pericardite Constritiva/cirurgia , Combinação Piperacilina e Tazobactam/uso terapêutico , Cardiopatia Reumática/etiologia , Cardiopatia Reumática/fisiopatologia , Cardiopatia Reumática/cirurgia , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus pyogenes , Pressão Ventricular
8.
mBio ; 12(1)2021 01 05.
Artigo em Inglês | MEDLINE | ID: mdl-33402539

RESUMO

Bacteriocins are natural antimicrobial peptides produced by bacteria to kill closely related competitors. The opportunistic pathogen Streptococcus gallolyticus subsp. gallolyticus was recently shown to outcompete commensal enterococci of the murine microbiota under tumoral conditions thanks to the production of a two-peptide bacteriocin named gallocin. Here, we identified four genes involved in the regulatory control of gallocin in S. gallolyticus subsp. gallolyticus UCN34 that encode a histidine kinase/response regulator two-component system (BlpH/BlpR), a secreted peptide (GSP [gallocin-stimulating peptide]), and a putative regulator of unknown function (BlpS). While BlpR is a typical 243-amino-acid (aa) response regulator possessing a phospho-receiver domain and a LytTR DNA-binding domain, BlpS is a 108-aa protein containing only a LytTR domain. Our results showed that the secreted peptide GSP activates the dedicated two-component system BlpH/BlpR to induce gallocin transcription. A genome-wide transcriptome analysis indicates that this regulatory system (GSP-BlpH/BlpR) is specific for bacteriocin production. Importantly, as opposed to BlpR, BlpS was shown to repress gallocin gene transcription. A conserved operator DNA sequence of 30 bp was found in all promoter regions regulated by BlpR and BlpS. Electrophoretic mobility shift assays (EMSA) and footprint assays showed direct and specific binding of BlpS and BlpR to various regulated promoter regions in a dose-dependent manner on this conserved sequence. Gallocin expression appears to be tightly controlled in S. gallolyticus subsp. gallolyticus by quorum sensing and antagonistic activity of 2 LytTR-containing proteins. Competition experiments in gut microbiota medium and 5% CO2 to mimic intestinal conditions demonstrate that gallocin is functional under these in vivo-like conditions.IMPORTANCE Streptococcus gallolyticus subsp. gallolyticus, formerly known as Streptococcus bovis biotype I, is an opportunistic pathogen causing septicemia and endocarditis in the elderly often associated with asymptomatic colonic neoplasia. Recent studies indicate that S. gallolyticus subsp. gallolyticus is both a driver and a passenger of colorectal cancer. We previously showed that S. gallolyticus subsp. gallolyticus produces a bacteriocin, termed gallocin, enabling colonization of the colon under tumoral conditions by outcompeting commensal members of the murine microbiota such as Enterococcus faecalis Here, we identified and extensively characterized a four-component system that regulates gallocin production. Gallocin gene transcription is activated by a secreted peptide pheromone (GSP) and a two-component signal transduction system composed of a transmembrane histidine kinase receptor (BlpH) and a cytosolic response regulator (BlpR). Finally, a DNA-binding protein (BlpS) was found to repress gallocin genes transcription, likely by antagonizing BlpR. Understanding gallocin regulation is crucial to prevent S. gallolyticus subsp. gallolyticus colon colonization under tumoral conditions.


Assuntos
Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Bacteriocinas/genética , Regulação Bacteriana da Expressão Gênica , Streptococcus gallolyticus/genética , Streptococcus gallolyticus/metabolismo , Proteínas de Ligação a DNA/metabolismo , Microbioma Gastrointestinal , Perfilação da Expressão Gênica , Genes Bacterianos/genética , Genoma Bacteriano , Histidina Quinase/genética , Histidina Quinase/metabolismo , Percepção de Quorum , Infecções Estreptocócicas/microbiologia , Transcriptoma
9.
BMC Surg ; 21(1): 5, 2021 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-33397326

RESUMO

BACKGROUND: Phlegmonous gastritis (PG) is a rare, suppurative bacterial infection of the gastric wall, which may rapidly evolve into fatal septicemia. The etiology and pathogenesis are poorly understood; however, multiple risk factors have been cited in current literature. Most cases have been diagnosed at autopsy, and occasionally at laparotomy, as the clinical presentation is often variable. CASE PRESENTATION: We report a case of a 67-year-old male presenting with intractable nausea, vomiting, and epigastric pain following an uneventful upper gastrointestinal (GI) endoscopy. Diagnostic workup including contrast tomography (CT) and endoscopic assessment was in keeping with PG. This was subsequently followed by development of abdominal compartment syndrome (ACS) and clinical deterioration necessitating surgical resection of the stomach. CONCLUSION: This case emphasizes the importance of early diagnosis of this potentially fatal infection that can follow endoscopic procedures and illustrates ACS and septic shock as serious complications. There is currently no consensus on the proper management of PG; however, in this case, a combination of surgery and antibiotics provided a favourable outcome. Limited number of cases of PG have been reported in literature, and to our knowledge, this is the first reported case of PG with subsequent ACS as an acute complication.


Assuntos
Endoscopia Gastrointestinal/efeitos adversos , Gastrite/complicações , Hipertensão Intra-Abdominal/etiologia , Idoso , Antibacterianos/uso terapêutico , Diabetes Mellitus Tipo 2 , Gastrite/diagnóstico , Gastrite/tratamento farmacológico , Gastrite/microbiologia , Humanos , Hipertensão Intra-Abdominal/diagnóstico , Masculino , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus/isolamento & purificação , Tomografia Computadorizada por Raios X , Resultado do Tratamento
10.
BMC Infect Dis ; 21(1): 73, 2021 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-33446117

RESUMO

BACKGROUND: In pregnant women Streptococcus agalactiae (GBS) can be transmitted to newborn causing severe infections. It is classified into 10 serotypes (Ia, Ib, II-IX). The severity of neonatal disease is determined by the capsular serotype and virulence factors such as the polysaccharide capsule, encoded by the cps gene, protein C, which includes the Cα surface proteins (bca gene), Rib (rib gene) and Cß (bac gene); the proteins Lmb (lmb gene), FbsB (fbsB gene), FbsA (fbsA gene), the cyl operon encoding a ß-hemolysin (hylB gene), the CAMP factor (cfb gene) and the C5a peptidase (scpB gene). The aim of this work was to determine the degree of GBS colonization in pregnant women, the serotypes distribution and to investigate virulence-associated genes. METHODS: We worked with 3480 samples of vagino-rectal swabs of women with 35-37 weeks of gestation. The identification of the strains was carried out using conventional biochemical tests and group confirmatory serology using a commercial latex particle agglutination kit. Two hundred GBS strains were selected. Their serotype was determined by agglutination tests. The monoplex PCR technique was used to investigate nine virulence-associated genes (cps, bca, rib, bac, lmb, fbsB, fbsA, hylB and scpB). RESULTS: The maternal colonization was 9.09%. The serotypes found were: Ia (33.50%), III (19.00%), Ib (15.50%), II (14.00%), V (7.00%) and IX (5.50%). 5.50% of strains were found to be non-serotypeable (NT). The nine virulence genes investigated were detected simultaneously in 36.50% of the strains. The genes that were most frequently detected were scpB (100.00%), fbsA (100.00%), fbsB (100.00%), cylB (95.00%), lmb (94.00%) and bca (87.50%). We found associations between serotype and genes bac (p = 0.003), cylB (p = 0.02), rib (p = 0.01) and lmb (p < 0.001). CONCLUSIONS: The frequency of vaginal-rectal colonization, serotypes distribution and associated virulence genes, varies widely among geographical areas. Therefore, epidemiological surveillance is necessary to provide data to guide decision-making and planning of prevention and control strategies.


Assuntos
Genes Bacterianos , Idade Gestacional , Sorogrupo , Infecções Estreptocócicas/epidemiologia , Streptococcus agalactiae/isolamento & purificação , Streptococcus agalactiae/patogenicidade , Fatores de Virulência/genética , Adulto , Argentina/epidemiologia , Proteínas de Bactérias/genética , Feminino , Humanos , Reação em Cadeia da Polimerase , Gravidez , Prevalência , Infecções Estreptocócicas/microbiologia , Virulência/genética
11.
Autoimmun Rev ; 20(2): 102740, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33333234

RESUMO

Rheumatic heart disease (RHD) is a serious and long-term consequence of acute rheumatic fever (ARF), an autoimmune sequela of a mucosal infection by Streptococcus pyogenes (Group A Streptococcus, Strep A). The pathogenesis of ARF and RHD is complex and not fully understood but involves host and bacterial factors, molecular mimicry, and aberrant host innate and adaptive immune responses that result in loss of self-tolerance and subsequent cross-reactivity with host tissues. RHD is entirely preventable yet claims an estimated 320 000 lives annually. The major burden of disease is carried by developing nations and Indigenous populations within developed nations, including Australia. This review will focus on the epidemiology, pathogenesis and treatment of ARF and RHD in Australia, where: streptococcal pyoderma, rather than streptococcal pharyngitis, and Group C and Group G Streptococcus, have been implicated as antecedents to ARF; the rates of RHD in remote Indigenous communities are persistently among the highest in the world; government register-based programs coordinate disease screening and delivery of prophylaxis with variable success; and researchers are making significant progress in the development of a broad-spectrum vaccine against Strep A.


Assuntos
Febre Reumática , Cardiopatia Reumática , Infecções Estreptocócicas , Austrália , Humanos , Pesquisa , Febre Reumática/diagnóstico , Febre Reumática/epidemiologia , Febre Reumática/terapia , Cardiopatia Reumática/diagnóstico , Cardiopatia Reumática/epidemiologia , Cardiopatia Reumática/terapia , Infecções Estreptocócicas/epidemiologia , Streptococcus pyogenes
12.
BMJ Case Rep ; 13(12)2020 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-33370943

RESUMO

A previously independent 56-year-old immunocompetent woman presented with septic shock in the setting of periorbital swelling and diffuse infiltrates on chest imaging. Blood cultures were positive for growth of group A Streptococcus (GAS). Broad spectrum antimicrobials were initiated with the inclusion of the antitoxin agent clindamycin. Necrosis of periorbital tissue was noted and surgical consultation was obtained. Débridement of both eyelids with skin grafting was performed. GAS was isolated from wound cultures and also observed on periorbital tissue microscopy. The final diagnosis was bilateral periorbital necrotising fasciitis (PONF) associated with invasive GAS infection. The patient had a prolonged intensive care unit course with input from multiple specialist teams. This case demonstrates the importance of early recognition and treatment of PONF, the profound systemic morbidity caused by these infections, and illustrates successful multidisciplinary teamwork.


Assuntos
Fasciite Necrosante/complicações , Choque Séptico/microbiologia , Infecções Estreptocócicas/complicações , Streptococcus pyogenes/isolamento & purificação , Antibacterianos/uso terapêutico , Desbridamento , Quimioterapia Combinada , Pálpebras/microbiologia , Pálpebras/cirurgia , Fasciite Necrosante/diagnóstico , Fasciite Necrosante/microbiologia , Fasciite Necrosante/terapia , Feminino , Humanos , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Choque Séptico/diagnóstico , Choque Séptico/terapia , Transplante de Pele , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/terapia , Resultado do Tratamento
13.
BMJ Case Rep ; 13(12)2020 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-33370987

RESUMO

Cavernous sinus thrombosis (CST) is a rare and potentially fatal complication of acute sinusitis. Timely diagnosis and management is, therefore, essential in preventing death and neurological disability. Here, we describe the case of a paediatric patient with bilateral CST secondary to acute unilateral pansinusitis that presented with rapidly progressing bilateral periorbital oedema. Initial imaging was negative. This case serves to emphasise the importance of maintaining a high index of suspicion when managing paediatric patients with suspected CST with persistent symptoms. Expeditious investigation and management of our patient in this case resulted in a positive outcome, with resolution of symptoms and no residual neurological deficit.


Assuntos
Trombose do Corpo Cavernoso/diagnóstico , Seio Cavernoso/microbiologia , Cefaleia/etiologia , Sinusite/diagnóstico , Infecções Estreptocócicas/diagnóstico , Administração Intravenosa , Adolescente , Antibacterianos/administração & dosagem , Anticoagulantes/administração & dosagem , Seio Cavernoso/diagnóstico por imagem , Seio Cavernoso/patologia , Seio Cavernoso/cirurgia , Trombose do Corpo Cavernoso/líquido cefalorraquidiano , Trombose do Corpo Cavernoso/tratamento farmacológico , Trombose do Corpo Cavernoso/etiologia , Diagnóstico Diferencial , Quimioterapia Combinada/métodos , Endoscopia , Cefaleia/líquido cefalorraquidiano , Cefaleia/terapia , Humanos , Angiografia por Ressonância Magnética , Masculino , Sinusite/complicações , Sinusite/microbiologia , Sinusite/terapia , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/terapia , Streptococcus intermedius/isolamento & purificação , Tomografia Computadorizada por Raios X , Resultado do Tratamento
14.
Ann Agric Environ Med ; 27(4): 540-543, 2020 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-33356058

RESUMO

INTRODUCTION: The role of fungi in infections in immunocompromised patients is a growing problem in both diagnosis and treatment. Candida species are the most common cause of fungal, endogenous endophthalmitis and infections of the cornea. CASE STUDY: A patient was admitted to hospital due to acute inflammation of the tissue of the left orbit, 1.5 years after the corneal penetrating transplantation of the left eye with intracapsular extraction of lens and simultaneous anterior vitrectomy. The microbiological system identified: Streptococcus pyogenes, Staphylococcus aureus, and Candida glabrata in the patient. CONCLUSIONS: The factors conducive to fungal infections are: patient's old age, immune disorders and diabetes, as well as the presence of a necrotic tissue or a foreign body. All these parameters were met in this case. Only antibiotic therapy and long-term antifungal therapy, together with surgical debridement of the site of the ongoing infection produces clinical effects in such severe cases.


Assuntos
Antifúngicos/uso terapêutico , Candida glabrata/isolamento & purificação , Candidíase/diagnóstico , Desbridamento , Infecções Oculares Fúngicas/diagnóstico , Panoftalmite/diagnóstico , Idoso , Antibacterianos/uso terapêutico , Candidíase/microbiologia , Candidíase/fisiopatologia , Infecções Oculares Fúngicas/microbiologia , Feminino , Humanos , Panoftalmite/microbiologia , Polônia , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/terapia , Staphylococcus aureus/isolamento & purificação , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/terapia , Streptococcus pyogenes/isolamento & purificação , Resultado do Tratamento
15.
Dis Aquat Organ ; 142: 197-201, 2020 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-33331287

RESUMO

Streptococcus iniae causes high mortality in cultured and wild fish stocks globally. Since the first report in captive Amazon river dolphins Inia geoffrensis in 1976, it has emerged in finfish across all continents except Antarctica. In March 2016, an estimated 17000 fish were observed dead and dying along a remote 70 km stretch of the Kimberley coastline north of Broome, Western Australia. Affected species included finfish (lionfish Pterois volitans, angelfish Pomacanthus sp., stripey snapper Lutjanus carponotatus, sand bass Psammoperca waigiensis, yellowtail grunter Amniataba caudavittata, damselfish Pomacentridae sp.), flatback sea turtles Natator depressus, and olive (Aipysurus laevis) and black-ringed (Hydrelaps darwiniensis) sea snakes. Moribund fish collected during the event exhibited exophthalmia and abnormal behaviour, such as spiralling on the surface or within the water column. Subsequent histopathological examination of 2 fish species revealed bacterial septicaemia with chains of Gram-positive cocci seen in multiple organs and within brain tissue. S. iniae was isolated and identified by bacterial culture, species-specific PCR, Matrix-Assisted Laser Desorption Ionisation Time-Of-Flight (MALDI-TOF) and biochemical testing. This is the first report of S. iniae associated with a major multi-species wild marine fish kill in Australia. Extreme weather events in the region including a marked decrease in water temperatures, followed by an extended period of above-average coastal water temperatures, were implicated as stressors potentially contributing to this outbreak.


Assuntos
Doenças dos Peixes , Infecções Estreptocócicas , Animais , Austrália , Doenças dos Peixes/epidemiologia , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/veterinária , Streptococcus iniae , Austrália Ocidental/epidemiologia
16.
BMC Infect Dis ; 20(1): 958, 2020 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-33327946

RESUMO

BACKGROUND: Group B Streptococcus (GBS) is the leading cause of invasive neonatal disease in the industrialized world. We aimed to genomically and phenotypically characterise invasive GBS isolates in Slovenia from 2001 to 2018 and contemporary colonising GBS isolates from screening cultures in 2018. METHODS: GBS isolates from 101 patients (invasive isolates) and 70 pregnant women (colonising isolates) were analysed. Basic clinical characteristics of the patients were collected from medical records. Antimicrobial susceptibility and phenotypic capsular serotype were determined. Whole-genome sequencing was performed to assign multilocus sequence types (STs), clonal complexes (CCs), pathogenicity/virulence factors, including capsular genotypes, and genome-based phylogeny. RESULTS: Among invasive neonatal disease patients, 42.6% (n = 43) were females, 41.5% (n = 39/94) were from preterm deliveries (< 37 weeks gestation), and 41.6% (n = 42) had early-onset disease (EOD). All isolates were susceptible to benzylpenicillin with low minimum inhibitory concentrations (MICs; ≤0.125 mg/L). Overall, 7 serotypes were identified (Ia, Ib, II-V and VIII); serotype III being the most prevalent (59.6%). Twenty-eight MLST STs were detected that clustered into 6 CCs. CC-17 was the most common CC overall (53.2%), as well as among invasive (67.3%) and non-invasive (32.9%) isolates (p < 0.001). CC-17 was more common among patients with late-onset disease (LOD) (81.4%) compared to EOD (47.6%) (p < 0.001). The prevalence of other CCs was 12.9% (CC-23), 11.1% (CC-12), 10.5% (CC-1), 8.2% (CC-19), and 1.8% (CC-498). Of all isolates, 2.3% were singletons. CONCLUSIONS: A high prevalence of hypervirulent CC-17 isolates, with low genomic diversity and characteristic profile of pathogenicity/virulence factors, was detected among invasive neonatal and colonising GBS isolates from pregnant women in Slovenia. This is the first genomic characterisation of GBS isolates in Slovenia and provides valuable microbiological and genomic baseline data regarding the invasive and colonising GBS population nationally. Continuous genomic surveillance of GBS infections is crucial to analyse the impact of IND prevention strategies on the population structure of GBS locally, nationally, and internationally.


Assuntos
Genótipo , Doenças do Recém-Nascido/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Sorogrupo , Infecções Estreptocócicas/epidemiologia , Streptococcus agalactiae/genética , Adulto , Antibacterianos/farmacologia , Feminino , Humanos , Recém-Nascido , Doenças do Recém-Nascido/microbiologia , Masculino , Testes de Sensibilidade Microbiana , Tipagem de Sequências Multilocus , Penicilina G/farmacologia , Filogenia , Polimorfismo de Nucleotídeo Único , Gravidez , Complicações Infecciosas na Gravidez/microbiologia , Prevalência , Estudos Retrospectivos , Eslovênia/epidemiologia , Infecções Estreptocócicas/microbiologia , Streptococcus agalactiae/efeitos dos fármacos , Streptococcus agalactiae/isolamento & purificação , Sequenciamento Completo do Genoma
17.
BMC Infect Dis ; 20(1): 817, 2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-33167878

RESUMO

BACKGROUND: Gastrointestinal (GI) mucormycosis is a rare and often deadly form of mucormycosis. Delayed diagnosis can lead to an increased risk of death. Here, we report a case of GI mucormycosis following streptococcal toxic shock syndrome in a virologically suppressed HIV-infected patient. CASE PRESENTATION: A 25-year-old Thai woman with a well-controlled HIV infection and Grave's disease was admitted to a private hospital with a high-grade fever, vomiting, abdominal pain, and multiple episodes of mucous diarrhea for 3 days. On day 3 of that admission, the patient developed multiorgan failure and multiple hemorrhagic blebs were observed on all extremities. A diagnosis of streptococcal toxic shock was made before referral to Siriraj Hospital - Thailand's largest national tertiary referral center. On day 10 of her admission at our center, she developed feeding intolerance and bloody diarrhea due to bowel ischemia and perforation. Bowel resection was performed, and histopathologic analysis of the resected bowel revealed acute suppurative transmural necrosis and vascular invasion with numerous broad irregular branching non-septate hyphae, both of which are consistent with GI mucormycosis. Peritoneal fluid fungal culture grew a grayish cottony colony of large non-septate hyphae and spherical sporangia containing ovoidal sporangiospores. A complete ITS1-5.8S-ITS2 region DNA sequence analysis revealed 100% homology with Rhizopus microsporus strains in GenBank (GenBank accession numbers KU729104 and AY803934). As a result, she was treated with liposomal amphotericin B. However and in spite of receiving appropriate treatment, our patient developed recurrent massive upper GI bleeding from Dieulafoy's lesion and succumbed to her disease on day 33 of her admission. CONCLUSION: Diagnosis of gastrointestinal mucormycosis can be delayed due to a lack of well-established predisposing factors and non-specific presenting symptoms. Further studies in risk factors for abdominal mucormycosis are needed.


Assuntos
Trato Gastrointestinal/microbiologia , Doença de Graves/complicações , Infecções por HIV/complicações , Mucormicose/complicações , Rhizopus/genética , Choque Séptico/complicações , Infecções Estreptocócicas/complicações , Streptococcus pyogenes/isolamento & purificação , Adulto , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , DNA Fúngico/genética , Evolução Fatal , Feminino , Infecções por HIV/virologia , Humanos , Mucormicose/diagnóstico , Mucormicose/tratamento farmacológico , Mucormicose/microbiologia , Choque Séptico/diagnóstico , Choque Séptico/microbiologia , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/microbiologia , Síndrome , Tailândia
18.
Vestn Otorinolaringol ; 85(5): 57-60, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33140935

RESUMO

Acute respiratory infections (ORI) consistently occupy one of the leading places among infectious and inflammatory diseases in children. Most often, antibacterial drugs are used to stop the inflammatory process in the pharynx. Cationic peptides have an extremely broad antimicrobial spectrum, rendering the effect not only in bacterial infections and mycoses, and protozoans. THE PURPOSE OF THE STUDY: To demonstrate that the test drug is effective and safe for the treatment of acute viral pharyngitis in childhood. MATERIALS AND METHODS: In the period from September 2019 to January 2020, 120 patients aged 6 to 18 years were treated with the drug «Doritricin¼ for viral pharyngitis. RESULTS: According to the research results it can be concluded that «Diretrizes¼ provides fast and high effect in pediatric practice.


Assuntos
Faringite , Infecções Respiratórias , Infecções Estreptocócicas , Adolescente , Antibacterianos/uso terapêutico , Criança , Humanos , Peptídeos , Faringite/tratamento farmacológico , Faringe , Infecções Respiratórias/tratamento farmacológico , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus pyogenes
19.
Vestn Otorinolaringol ; 85(5): 65-70, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33140937

RESUMO

The purpose of the study. To establish the effectiveness of symptom reduction and preventive action of the herbal drug Tonsilgon N (HD) as monotherapy for exacerbations of chronic tonsillitis/pharyngitis in adult patients. MATERIAL AND METHODS: The study included 60 adult male and female patients aged 18 to 60 years with an established diagnosis of acute tonsillopharyngitis. In total, each patient underwent 5 visits. Visit 1 - enrollment in the study and beginning of HD monotherapy, Visit 2 - on Day 7, Visit 3 - on Day 14 and completion of HD monotherapy, Visit 4 - on Day 60 and Visit 5 - on Day 180. The diagnosis of the disease and the examination of the patient was carried out on the basis of anamnesis, general clinical and ENT examination, palpation of regional lymph nodes. The severity of the clinical signs was evaluated on the basis of the symptom score. The general condition of the patient was also evaluated using a visual analogue scale (VAS) and the number of exacerbations of tonsillopharyngitis during the observation period. RESULTS: The number of exacerbations of chronic tonsillitis and episodes of ATP for 6 months after the end of treatment decreased 4.8 times compared to the previous period. During the course of treatment (14 days), complaints of patients with ATP (general health and/or fatigue, pain when swallowing, headache, cough, burning sensation, a lump in the throat, hoarseness, pain and dryness in the throat, difficulty swallowing) had a pronounced tendency to regression. Improvement was also noted on examination and clinical evaluation. According to the results of the analysis of the evaluation of general condition according to the VAS (according to the standard technique in cm), there was a significant improvement both during the treatment period by 2.2 times, and during the observation period (180 days) from the period of Visit 2 to Visit 4 by 31.3 times. CONCLUSION: The use of HD as monotherapy for non-streptococcal ATP has shown its high efficiency. The possibility of using Tonsilgon N was shown as a prophylactic agent that reduces the number of exacerbations of inflammatory diseases in the pharynx during the period after the treatment course.


Assuntos
Faringite , Infecções Estreptocócicas , Tonsilite , Adolescente , Adulto , Feminino , Medicina Herbária , Humanos , Masculino , Pessoa de Meia-Idade , Faringite/diagnóstico , Faringite/tratamento farmacológico , Streptococcus pyogenes , Tonsilite/diagnóstico , Tonsilite/tratamento farmacológico , Adulto Jovem
20.
Medicine (Baltimore) ; 99(44): e22938, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126360

RESUMO

RATIONALE: Sternoclavicular joint septic arthritis is an unusual disease in healthy adults, and Staphylococcus aureus is the most common causative pathogen. The current treatment of choice is surgery with sternoclavicular joint resection and pectoralis flap closure, especially when the disease is complicated by osteomyelitis and abscess. PATIENT CONCERNS: Here, we report a 76-year-old woman without risk factors who visited our hospital for pain and redness, swelling on the left anterior chest wall. DIAGNOSIS: Magnetic resonance imaging showed infectious arthritis in the left SCJ, with multiple abscess pockets at the subcutaneous layer of anterior chest wall communicating with the joint cavity. Streptococcus agalactiae was isolated from blood culture. INTERVENTION: She was treated with 6 weeks of antibiotic therapy. OUTCOMES: After antibiotic treatment, she was successfully treated without recurrence. LESSONS: Besides surgery, medical treatment should also be considered for sternoclavicular joint septic arthritis, depending on patient status and the causative pathogen. Physicians should be aware of this rare disease to facilitate its prompt diagnosis and management.


Assuntos
Antibacterianos/uso terapêutico , Artrite Infecciosa/tratamento farmacológico , Articulação Esternoclavicular , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus agalactiae , Idoso , Artrite Infecciosa/diagnóstico , Artrite Infecciosa/diagnóstico por imagem , Artrite Infecciosa/microbiologia , Feminino , Humanos , Imagem por Ressonância Magnética , Testes de Sensibilidade Microbiana , Articulação Esternoclavicular/microbiologia , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/diagnóstico por imagem , Streptococcus agalactiae/efeitos dos fármacos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA