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1.
Medicine (Baltimore) ; 100(25): e26387, 2021 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-34160417

RESUMO

RATIONALE: Group B Streptococcus (GBS) remains a principal pathogen causing neonatal sepsis and meningitis, particularly in premature infants with relatively insufficient immunity. Recurrence may occur uncommonly, largely associated with subclinical mucosal persistence or repetitive exposure to exogenous sources. White matter injury (WMI) including cystic periventricular leukomalacia (PVL) has been associated with intrauterine infection/inflammation, and neonatal infection as a more significant predictor including postnatal sepsis and recurrent infection, even without microbial neuroinvasion. Furthermore, clinical and experimental evidence of WMI by some bacteria other than GBS without central nervous system invasion has been reported. However, there is little evidence of WMI associated with neonatal GBS sepsis in the absence of meningitis in the literature. PATIENT CONCERNS: A newborn at 30+4 weeks' gestation with low birthweight presented with 2 episodes (with a 13-day interval with no antibiotic therapy) of neonatal sepsis culture-proven for GBS with early-onset presentation after clinical chorioamnionitis via vertical GBS transmission and the associated conditions including prematurity-related neonatal immunodeficiency and persistent mucosal GBS carriage after the first antibiotic treatment. The perinatal GBS infection was complicated by progressive WMI presenting with ventriculomegaly and cystic PVL without a definite evidence of meningitis, intraventricular hemorrhage, and documented cerebral hypoxia or hypoperfusion conditions including septic shock. DIAGNOSES: Recurrent group B streptococcal sepsis and cystic PVL with ventriculomegaly. INTERVENTIONS: Two episodes of GBS sepsis were treated with 15-day parenteral antibiotic therapy, respectively. OUTCOMES: Resolution of the recurrent GBS sepsis without further relapses, however, complicated by WMI and subsequent about 6 months delay in motor development at 12 months' corrected age. LESSONS: This case suggests WMI associated with GBS bacteremia without central nervous system entry by viable GBS and also shows that in premature infants, intrauterine GBS infection with no interventions may lead to extensive and persistent GBS colonization, early-onset and recurrent GBS disease, and WMI. Postnatal as well as intrauterine infection/inflammation controls with maternal prophylaxis may be pivotal for prevention and limiting the magnitude of neurologic injury.


Assuntos
Leucomalácia Periventricular/microbiologia , Sepse Neonatal/microbiologia , Complicações Infecciosas na Gravidez/microbiologia , Infecções Estreptocócicas/complicações , Streptococcus agalactiae/isolamento & purificação , Administração Intravenosa , Antibacterianos/administração & dosagem , Corioamnionite/diagnóstico , Corioamnionite/microbiologia , Deficiências do Desenvolvimento/diagnóstico , Deficiências do Desenvolvimento/microbiologia , Quimioterapia Combinada/métodos , Feminino , Humanos , Hidrocefalia/diagnóstico , Hidrocefalia/microbiologia , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Prematuro , Transmissão Vertical de Doenças Infecciosas , Leucomalácia Periventricular/diagnóstico , Leucomalácia Periventricular/patologia , Imageamento por Ressonância Magnética , Masculino , Idade Materna , Sepse Neonatal/diagnóstico , Sepse Neonatal/terapia , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Recidiva , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/transmissão , Substância Branca/diagnóstico por imagem , Substância Branca/microbiologia , Substância Branca/patologia , Adulto Jovem
2.
BMJ Case Rep ; 14(6)2021 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-34116990

RESUMO

Brainstem abscess is an uncommon occurrence in itself and an abscess in the medulla oblongata is even rarer. Although these abscesses have established association with head and neck infections, we report the first known case of medullary abscess that was found to be strongly associated with dental procedure. Important point to note is that a simple procedure like tooth extraction can predispose spread of infective seeding to distant sites. High clinical index of suspicion and early diagnosis are essential, as if left untreated, the brainstem abscess is almost always fatal otherwise.


Assuntos
Abscesso Encefálico , Infecções Estreptocócicas , Abscesso Encefálico/diagnóstico por imagem , Abscesso Encefálico/etiologia , Humanos , Bulbo/diagnóstico por imagem , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus intermedius , Extração Dentária/efeitos adversos
3.
BMC Infect Dis ; 21(1): 531, 2021 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-34090359

RESUMO

BACKGROUND: Group B Streptococcus (GBS) is an important cause of invasive infection in neonates and infants. Cerebrospinal fluid (CSF) findings and culture may not show evidence of infection early in GBS meningitis. Next-generation sequencing (NGS) has the potential to detect microbial genetic material in patients with infectious diseases. We report two cases of infantile sepsis of GBS meningitis with negative results for CSF culture tests, but positive results for NGS analysis. CASE PRESENTATION: Patient 1 was a 22-day-old male infant diagnosed with sepsis and meningitis. His CSF findings showed pleocytosis, decreased glucose, and increased protein levels. However, CSF and blood culture results at admission were negative. He received a total of 3 weeks of treatment with ampicillin and cefotaxime, and showed clinical improvement. GBS was detected through NGS analysis of CSF collected at admission. Patient 2 was a 51-day-old male infant with sepsis. CSF findings on admission were normal, and blood and CSF cultures were also negative. Intravenous ampicillin and cefotaxime treatment were initiated. Treatment was de-escalated to ampicillin alone because Enterococcus faecalis was cultured from urine. He was discharged after a total of 1 week of antibiotic treatment. Six days after discharge, he was re-hospitalized for sepsis. Blood and CSF cultures were negative, and E. faecalis was again cultured from urine. He received a total of 3 weeks of ampicillin treatment for enterococcal-induced nephritis and did not relapse thereafter. NGS pathogen searches were retrospectively performed on both blood and CSF collected at the first and second admission. GBS was detected in the CSF collected at the first admission, but no significant pathogen was detected in the other samples. Inadequate treatment for GBS meningitis at the first admission may have caused the recurrence of the disease. CONCLUSION: Infantile sepsis may present bacterial meningitis that is not diagnosed by either culture testing or CSF findings. NGS analysis for CSF may be useful for confirming the diagnosis of bacterial meningitis.


Assuntos
Antibacterianos/uso terapêutico , Meningites Bacterianas/diagnóstico , Meningites Bacterianas/tratamento farmacológico , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Ampicilina/uso terapêutico , Cefotaxima/uso terapêutico , Líquido Cefalorraquidiano/microbiologia , Enterococcus faecalis/efeitos dos fármacos , Enterococcus faecalis/isolamento & purificação , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Lactente , Recém-Nascido , Masculino , Meningites Bacterianas/microbiologia , Estudos Retrospectivos , Sepse/diagnóstico , Sepse/tratamento farmacológico , Sepse/microbiologia , Streptococcus agalactiae/efeitos dos fármacos , Streptococcus agalactiae/genética , Streptococcus agalactiae/isolamento & purificação , Urina/microbiologia
4.
J Coll Physicians Surg Pak ; 30(6): 732-734, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34102792

RESUMO

Acute rhabdomyolysis and elevated transaminases during streptococcal pharyngitis are rare presentations. The proposed pathophysiological mechanisms include direct bacterial invasion and toxin generation. Physicians should be aware of the association between these infections and the above-mentioned complications to facilitate optimal treatment of these patients. We present the case of a 18-years-old gentleman with ß-haemolytic streptococcal pharyngitis complicated by rhabdomyolysis and elevated liver function tests. Such high levels of creatine phosphokinase of 111856 IU/L and elevated liver function tests with aspartate aminotransferase (AST) of 1862 U/L and alanine aminotransferase (ALT) of 1003 U/L in streptococcal pharyngitis is rare to find in the literature. He was treated with aggressive intravenous hydration, antibiotics and hemodialysis. Key Words: Rhabdomyolysis, ß-haemolytic Streptococci, Creatine phosphokinase, Liver function tests.


Assuntos
Faringite , Infecções Estreptocócicas , Adolescente , Antibacterianos/uso terapêutico , Humanos , Masculino , Faringe , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus pyogenes
5.
Ugeskr Laeger ; 183(24)2021 06 14.
Artigo em Dinamarquês | MEDLINE | ID: mdl-34120687

RESUMO

Group B streptococcus (GBS) is a group of naturally occurring bacteria that colonises the anogenital region of every third pregnant woman. From the anogenital region they can colonise the urine and cause bacteriuria. It is well documented that treatment of GBS-bacteriuria with more than 104 colony forming units per millilitre (CFU/ml) reduces the risk of maternal and neonatal morbidity. There is, however, no clear evidence as summarised in this review that GBS-bacteriuria more than 104 CFU/ml increases the risk of maternal and neonatal morbidity which is why no treatment is warranted.


Assuntos
Bacteriúria , Complicações Infecciosas na Gravidez , Infecções Estreptocócicas , Bacteriúria/diagnóstico , Bacteriúria/tratamento farmacológico , Feminino , Humanos , Recém-Nascido , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Gestantes , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus agalactiae
6.
J Dairy Sci ; 104(8): 9115-9129, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33934869

RESUMO

This study aimed to evaluate the diagnostic performance (specificity, Sp; sensitivity, Se; accuracy; positive predictive value; negative predictive value; and Cohen's kappa coefficient, κ, of agreement) of chromogenic culture media for rapid identification of microorganisms isolated from cows with clinical (CM) and subclinical mastitis (SCM). For this, 2 experiments were carried out: evaluation of (1) biplate, and (2) triplate of chromogenic culture media for rapid identification of mastitis-causing microorganisms. For the evaluation of diagnostic performance, identification of microorganisms by MALDI-TOF mass spectrometry was considered the standard methodology. In experiment 1, 476 milk samples collected from cows with CM and 660 from cows with SCM were evaluated by inoculation in 2 selective chromogenic culture media (CHROMagar) for gram-positive bacteria and another for gram-negative bacteria. In experiment 2, 476 milk samples from cows with CM and 500 from cows with SCM were evaluated by inoculation in triplate chromogenic culture media (Smartcolor2, Onfarm), selective for Streptococcus and Strep-like organisms, Staphylococcus, and gram-negative bacteria. In experiment 1 for the CM samples, the use of biplates with gram-positive and gram-negative culture media showed Se that ranged from 0.56 (0.32-0.81; Staphylococcus aureus) to 0.90 (0.80-0.99 Streptococcus uberis), Sp varied from 0.94 (0.92-0.96; Strep. uberis) to 1.00 (Prototheca spp. or yeast), and κ ranged from 0.47 (0.26-0.67; Staph. aureus) to 0.84 (0.78-0.9; Escherichia coli). The Se of biplates for SCM samples ranged from 0.50 (0.15-0.85; E. coli) to 0.94 (0.87-1.00; Staph. aureus), Sp varied from 0.95 (0.93-0.97; Strep. uberis) to 0.99 (0.98-1.00; Staph. aureus and Strep. Agalactiae or dysgalactiae), and κ ranged from 0.18 (0.00-0.40; Escherichia coli) to 0.88 (0.80-0.95; Staph. aureus). In experiment 2, the Se of the triplate chromogenic media in CM samples ranged from 0.09 (0.00-0.26; Serratia spp.) to 0.94 (0.85-1.00; Klebsiella spp. and Enterobacter spp.), Sp varied from 0.94 (0.92-0.96; Strep. agalactiae and Strep. dysgalactiae) to 1.00 (Serratia spp.) and κ ranged from 0.07 (0.00-0.24; Serratia spp.) to 0.85 (0.75-0.94; Klebsiella spp. and Enterobacter spp.). For SCM samples, the use of the triplate with the chromogenic culture media showed Se that varied from 0.25 (0.10-0.40; Lactococcus spp.) to 1.00 (Strep. Agalactiae or dysgalactiae), Sp ranged from 0.92 (0.90-0.94; Strep. Agalactiae and Strep. dysgalactiae) to 0.99 (0.98-1.00; Klebsiella spp. and Enterobacter spp.), and κ varied from 0.28 (0.00-0.72; E. coli) to 0.72 (0.60-0.82; Staph. aureus). Our results suggest that the diagnostic accuracy of the biplate and triplate of chromogenic culture media varies according to pathogen, and the results of chromogenic culture media may be useful for rapid decision-making on mastitis treatment protocols of the main mastitis-causing microorganisms, but their use for implementation of mastitis control measures will depend on each farm specific needs.


Assuntos
Doenças dos Bovinos , Mastite Bovina , Mastite , Infecções Estreptocócicas , Animais , Bovinos , Meios de Cultura , Escherichia coli , Feminino , Mastite/veterinária , Mastite Bovina/diagnóstico , Leite , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/veterinária , Streptococcus
7.
BMC Infect Dis ; 21(1): 492, 2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34044786

RESUMO

BACKGROUND: Group B streptococcus (GBS) is the leading cause of early-onset neonatal sepsis. However, GBS was infrequently reported in the developing world in contrast to western countries. This study assessed the prevalence of GBS colonization among pregnant women in Jiangsu, East China, and revealed the difference of GBS infection between culture and PCR. METHODS: A total of 16,184 pregnant women at 34 to 37 weeks' gestation aged 16-47 years were recruited from Nanjing Kingmed Center for Clinical Laboratory. Nine thousand twenty-two pregnant women received GBS screening by PCR detection only. Seven thousand one hundred sixty-two pregnant women received GBS screening by bacterial culture and GBS-positive samples were tested for antibiotic resistance. RESULTS: The overall GBS positive rate was 8.7% by PCR and 3.5% by culture. Colonization rate was highest in the "25-29 years" age group. The 249 GBS-positive samples which detected by culture were all sensitive to penicillin. The prevalence of resistance to erythromycin, clindamycin, and levofloxacin was 77.5, 68.3, and 52.2%, respectively. CONCLUSIONS: This study revealed the data on the prevalence of GBS colonization in pregnant women at 34 to 37 weeks' gestation in Jiangsu, East China. It compared the difference of the sensitivity to detect GBS between PCR and culture. PCR was expected to become a quick method in pregnancy women conventional detection of GBS infection.


Assuntos
Complicações Infecciosas na Gravidez/epidemiologia , Infecções Estreptocócicas/epidemiologia , Streptococcus agalactiae/isolamento & purificação , Adolescente , Adulto , Antibacterianos/uso terapêutico , China/epidemiologia , Clindamicina/uso terapêutico , Farmacorresistência Bacteriana , Eritromicina/uso terapêutico , Feminino , Humanos , Recém-Nascido , Levofloxacino/uso terapêutico , Pessoa de Meia-Idade , Sepse Neonatal/epidemiologia , Penicilinas/uso terapêutico , Reação em Cadeia da Polimerase , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/microbiologia , Gestantes , Prevalência , Estudos Retrospectivos , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus agalactiae/genética , Vagina/microbiologia , Adulto Jovem
8.
J Med Case Rep ; 15(1): 240, 2021 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-33992114

RESUMO

BACKGROUND: Streptococcus pseudoporcinus (S. pseudoporcinus) was first identified in 2006. It cross-reacts with Lancefield group B antigen agglutination reagents and has been misidentified as S. agalactiae. Sites of S. pseudoporcinus isolation include the female genitourinary tract, urine, wounds, and dairy products. The prevalence of vaginal colonization is reportedly between 1 and 5.4%. Two uneventful cases of soft tissue infection caused by S. pseudoporcinus were reported in the past. However, since late 2019, six cases of invasive S. pseudoporcinus infections have emerged in the literature, one of which was fatal. CASE PRESENTATION: We describe a fatal case of a Caucasian male with spontaneous bacterial peritonitis associated with bacteremia due to a multidrug-resistant S. pseudoporcinus strain in a patient with decompensated liver cirrhosis. Despite the patient's good general condition and stable blood test results when he had visited the outpatient clinic for large-volume paracentesis a few days before admission, this time he presented to the emergency department with a rapidly worsening clinical condition and with laboratory features consistent with multiple-organ dysfunction syndrome, and succumbed within a short period. CONCLUSIONS: Contrary to what was thought until recently, multidrug-resistant S. pseudoporcinus may cause invasive, disseminated, fatal disease in humans. According to current limited data, vancomycin, linezolid, daptomycin, levofloxacin, clindamycin, and tetracycline seem to be the most effective antimicrobial agents against multidrug-resistant strains, and should be the empirical choice in cases of disseminated S. pseudoporcinus infection until laboratory antimicrobial susceptibility results are available. Improvements and new approaches for bacterial identification in routine clinical microbiology laboratories may reveal the real spectrum of S. pseudoporcinus infections in humans, which is currently believed to be underestimated. SS. pseudoporcinus could emerge as a serious medical problem in the near future, similar to other ß-hemolytic streptococci.


Assuntos
Infecções Estreptocócicas , Antibacterianos/uso terapêutico , Clindamicina , Feminino , Humanos , Cirrose Hepática/complicações , Masculino , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus
9.
BMJ Case Rep ; 14(4)2021 Apr 07.
Artigo em Inglês | MEDLINE | ID: covidwho-1172742

RESUMO

Necrotising myositis is a rare complication of Group A Streptococcus infection requiring early and aggressive surgical management to prevent mortality. However, early diagnosis is difficult due to non-specific initial presentation and a low index of clinical suspicion given the paucity of cases. We highlight these challenges and present a case of a 22-year-old woman presenting with cough, fever and severe limb pain refractory to analgesia during the COVID-19 pandemic. We outline potential confounding factors that can delay intervention and offer diagnostic tools that can aid clinical diagnosis of necrotising myositis. In reporting this case, we hope to raise awareness among clinicians to avoid these pitfalls.


Assuntos
Fasciite Necrosante/diagnóstico , Pneumonia Bacteriana/diagnóstico , Infecções Estreptocócicas/diagnóstico , COVID-19 , Extremidades/patologia , Fasciite Necrosante/terapia , Feminino , Humanos , Pneumonia Bacteriana/terapia , Infecções Estreptocócicas/terapia , Streptococcus pyogenes , Adulto Jovem
10.
J Paediatr Child Health ; 57(6): 797-802, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33876472

RESUMO

Rheumatic heart disease (RHD) is a large, preventable, global public health burden. In New Zealand (NZ), acute rheumatic fever (ARF) and RHD rates are highest for Maori and Pacific children. This structured review explores the evidence for primary prevention interventions to diagnose and effectively treat group A Streptococcus (GAS) pharyngitis and skin infections to reduce rates of ARF and RHD. Medline, EMBASE and Scopus databases were searched as well as other electronic publications. Included were 50 publications from 1980 onwards. This review has identified that there is little available evidence for effective primary prevention strategies to reduce ARF rates in NZ. However, two primary intervention strategies that should be considered by communities at high-risk of ARF are: the use of school-based clinics to identify and treat GAS pharyngitis and GAS skin infections; and intramuscular benzathine penicillin G with lignocaine analgesia in children who present with a GAS positive throat.


Assuntos
Faringite , Febre Reumática , Cardiopatia Reumática , Infecções Estreptocócicas , Criança , Humanos , Nova Zelândia , Faringite/tratamento farmacológico , Febre Reumática/tratamento farmacológico , Febre Reumática/prevenção & controle , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/prevenção & controle , Streptococcus pyogenes
11.
BMJ Case Rep ; 14(4)2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33837023

RESUMO

A 57-year-old immunocompetent male patient presented himself to our emergency department with lumbar pain for 10 days, after a lumbar torsion. He was neurologically intact, but showed signs of systemic inflammatory syndrome. A lumbar MRI found a spinal epidural abscess from L3-L4 to L5-S1 levels. The patient was operated early before occurrence of neurological deficit. The abscess cultures found a Streptococcus mitis infection. The patient made a good recovery after surgical decompression, washout with samples taken for cultures and targeted antibiotic therapy for 6 weeks.


Assuntos
Abscesso Epidural , Dor Lombar , Infecções Estreptocócicas , Abscesso Epidural/diagnóstico por imagem , Abscesso Epidural/tratamento farmacológico , Humanos , Vértebras Lombares , Masculino , Pessoa de Meia-Idade , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus mitis
12.
BMJ Case Rep ; 14(4)2021 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-33858899

RESUMO

We herein report three cases of group A Streptococcus (GAS) infection in a family. Patient 1, a 50-year-old woman, was transferred to our hospital in shock with acute respiratory distress syndrome, swelling in the right neck and erythemata on both lower extremities. She required intubation because of laryngeal oedema. At the same time, patient 2, a 48-year-old man, was admitted because of septic shock, pneumonia and a pulmonary abscess. Five days later, patient 3, a 91-year-old woman, visited our clinic with bloody stool. All three patients were cured by antibiotics, and GAS was detected by specimen cultures. During these patients' clinical course, an 84-year-old woman was found dead at home after having been diagnosed with type A influenza. All four patients lived in the same apartment. The GAS genotypes detected in the first three patients were identical. When treating patients with GAS, appropriate management of close contacts is mandatory.


Assuntos
Influenza Humana , Pneumonia , Choque Séptico , Infecções Estreptocócicas , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus pyogenes
13.
Molecules ; 26(7)2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33915741

RESUMO

As an important zoonotic pathogen, Streptococcus suis (S. suis) can cause a variety of diseases both in human and animals, especially Streptococcal toxic shock-like syndrome (STSLS), which commonly appears in severe S. suis infection. STSLS is often accompanied by excessive production of inflammatory cytokines, which is the main cause of host death. Therefore, it is urgent to find a new strategy to relieve the damage caused by STSLS. In this study, we found, for the first time, that apigenin, as a flavonoid compound, could combine with ampicillin to treat severe S. suis infection. Studies found that apigenin did not affect the growth of S. suis and the secretion of suilysin (SLY), but it could significantly inhibit the hemolytic activity of SLY by directly binding to SLY and destroying its secondary structure. In cell assays, apigenin was found to have no significant toxic effects on effective concentrations, and have a good protective effect on S. suis-infected cells. More importantly, compared with the survival rate of S. suis-infected mice treated with only ampicillin, the survival rate of apigenin combined with an ampicillin-treated group significantly increased to 80%. In conclusion, all results indicate that apigenin in combination with conventional antibiotics can be a potential strategy for treating severe S. suis infection.


Assuntos
Ampicilina/farmacologia , Antibacterianos/farmacologia , Apigenina/farmacologia , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/microbiologia , Streptococcus suis/efeitos dos fármacos , Ampicilina/química , Ampicilina/uso terapêutico , Animais , Antibacterianos/química , Apigenina/química , Apigenina/uso terapêutico , Sítios de Ligação , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Citocinas/metabolismo , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Quimioterapia Combinada , Eritrócitos/efeitos dos fármacos , Proteínas Hemolisinas/antagonistas & inibidores , Proteínas Hemolisinas/química , Interações Hospedeiro-Patógeno , Humanos , Mediadores da Inflamação/metabolismo , Camundongos , Testes de Sensibilidade Microbiana , Modelos Moleculares , Conformação Molecular , Estrutura Molecular , Ligação Proteica , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/metabolismo , Relação Estrutura-Atividade , Resultado do Tratamento
14.
BMJ Case Rep ; 14(4)2021 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-33827871

RESUMO

Necrotising myositis is a rare complication of Group A Streptococcus infection requiring early and aggressive surgical management to prevent mortality. However, early diagnosis is difficult due to non-specific initial presentation and a low index of clinical suspicion given the paucity of cases. We highlight these challenges and present a case of a 22-year-old woman presenting with cough, fever and severe limb pain refractory to analgesia during the COVID-19 pandemic. We outline potential confounding factors that can delay intervention and offer diagnostic tools that can aid clinical diagnosis of necrotising myositis. In reporting this case, we hope to raise awareness among clinicians to avoid these pitfalls.


Assuntos
Fasciite Necrosante/diagnóstico , Pneumonia Bacteriana/diagnóstico , Infecções Estreptocócicas/diagnóstico , COVID-19 , Extremidades/patologia , Fasciite Necrosante/terapia , Feminino , Humanos , Pneumonia Bacteriana/terapia , Infecções Estreptocócicas/terapia , Streptococcus pyogenes , Adulto Jovem
16.
BMC Pregnancy Childbirth ; 21(1): 250, 2021 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-33765949

RESUMO

BACKGROUND: Chorioamnionitis may cause serious perinatal and neonatal adverse outcomes, and group B streptococcus (GBS) is one of the most common bacteria isolated from human chorioamnionitis. The present study analyzed the impact of GBS infection and histological chorioamnionitis (HCA) on pregnancy outcomes and the diagnostic value of various biomarkers. METHODS: Pregnant women were grouped according to GBS infection and HCA detection. Perinatal and neonatal adverse outcomes were recorded with a follow-up period of 6 weeks. The white blood cell count (WBC), neutrophil ratio, and C-reactive protein (CRP) level from peripheral blood and soluble intercellular adhesion molecule-1 (sICAM-1), interleukin 8 (IL-8), and tumor necrosis factor α (TNF-α) levels from cord blood were assessed. RESULTS: A total of 371 pregnant women were included. Pregnant women with GBS infection or HCA had a higher risk of pathological jaundice and premature rupture of membranes and higher levels of sICAM-1, IL-8, and TNF-α in umbilical cord blood. Univariate and multivariate regression analysis revealed that sICMA-1, IL-8, TNF-α, WBC, and CRP were significantly related to an increased HCA risk. For all included pregnant women, TNF-α had the largest receiver operating characteristic (ROC) area (area: 0.841; 95% CI: 0.778-0.904) of the biomarkers analyzed. TNF-α still had the largest area under the ROC curve (area: 0.898; 95% CI: 0.814-0.982) for non-GBS-infected pregnant women, who also exhibited a higher neutrophil ratio (area: 0.815; 95% CI: 0.645-0.985) and WBC (area: 0.849; 95% CI: 0.72-0.978), but all biomarkers had lower value in the diagnosis of HCA in GBS-infected pregnant women. CONCLUSION: GBS infection and HCA correlated with several perinatal and neonatal adverse outcomes. TNF-α in cord blood and WBCs in peripheral blood had diagnostic value for HCA in non-GBS-infected pregnant women but not GBS-infected pregnant women.


Assuntos
Corioamnionite/diagnóstico , Complicações Infecciosas na Gravidez/diagnóstico , Nascimento Prematuro/epidemiologia , Infecções Estreptocócicas/diagnóstico , Streptococcus agalactiae/isolamento & purificação , Adulto , Biomarcadores/sangue , Estudos de Casos e Controles , Corioamnionite/sangue , Corioamnionite/microbiologia , Corioamnionite/patologia , Feminino , Sangue Fetal/química , Seguimentos , Humanos , Recém-Nascido , Contagem de Leucócitos , Placenta/patologia , Gravidez , Complicações Infecciosas na Gravidez/sangue , Complicações Infecciosas na Gravidez/microbiologia , Complicações Infecciosas na Gravidez/patologia , Resultado da Gravidez , Curva ROC , Medição de Risco/métodos , Infecções Estreptocócicas/sangue , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/patologia , Fator de Necrose Tumoral alfa/sangue , Cordão Umbilical/patologia , Adulto Jovem
17.
Tidsskr Nor Laegeforen ; 141(4)2021 03 09.
Artigo em Norueguês | MEDLINE | ID: mdl-33685097

RESUMO

BACKGROUND: Zoonoses are important to consider when humans become ill after being in contact with animals. In such cases thorough patient history is crucial, especially when infections have an unclear cause. We present a patient with infection-associated glomerulonephritis, where a horse was the probable source of infection. CASE PRESENTATION: A young woman was admitted to the district general hospital in Vestfold, Norway, with infection and acute kidney failure. Renal biopsy suggested glomerulonephritis, and nasopharyngeal culture taken at admission detected Streptococcus equi. It emerged that the patient had daily contact with horses. INTERPRETATION: As Streptococcus equi is not part of normal human flora and the clinical signs were compatible with infection-associated glomerulonephritis, it was considered a probable causal link between the microbial finding and diagnosis. The source of infection was one of the horses.


Assuntos
Glomerulonefrite , Infecções Estreptocócicas , Streptococcus equi , Animais , Glomerulonefrite/veterinária , Cavalos , Humanos , Noruega , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Zoonoses
18.
Clin Lab ; 67(3)2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33739051

RESUMO

BACKGROUND: To explore the comprehensive treatment of group A streptococcus haemolyticus complicated with streptococcal toxic shock syndrome (STSS) in surgery. METHODS: Six patients with Type II necrotizing fasciitis complicated with STSS were enrolled from September 2018 to October 2019 in the Burn Department at Quanzhou First Hospital. The patients were treated with early incision and reduction of tension, anti-shock, anti-infection, primary debridement and vacuum suction, maintenance of organ function, and adjustment of internal environment, secondary autologous skin graft, and early rehabilitation. RESULTS: Five patients were healed, while one elderly patient refused treatment. CONCLUSIONS: We should be alert to necrotizing fasciitis caused by group A hemolytic streptococcus (GAS) infection and effectively avoid the occurrence of STSS. By making an incision to reduce tension, adopting the principle of anti-infection, and actively anti-shock, maintaining the function of internal organs and the stability of internal environment, debridement and vacuum suction in early and effective stage, followed by selfskin graft to seal the wound and early rehabilitation the treatment of Type II NF and STSS can be effectively improved.


Assuntos
Fasciite Necrosante , Choque Séptico , Infecções Estreptocócicas , Idoso , Fasciite Necrosante/complicações , Fasciite Necrosante/diagnóstico , Fasciite Necrosante/terapia , Humanos , Choque Séptico/diagnóstico , Choque Séptico/terapia , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/terapia , Streptococcus pyogenes
19.
J Obstet Gynaecol Res ; 47(6): 2238-2241, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33754408

RESUMO

Streptococcus agalactiae, also known as group B Streptococcus, is a species of bacteria occasionally detected in the vagina and/or rectum of pregnant women. This report describes the case of a 33-year-old woman who developed infective endocarditis on puerperal day 17, owing to group B Streptococcus, and required lifesaving surgery. The patient was rushed to our hospital with chief complaints of fever and fatigue. After hospitalization, antibiotics were administered; however, the symptoms did not improve. Following a detailed examination, vegetation was found in the heart, suggestive of infective endocarditis. Surgical removal of the vegetation improved the patient's condition. The development of group B Streptococcus infection and infective endocarditis in a pregnant woman with no risk factors is rare. This case confirms that this patient's life was saved by a timely diagnosis and appropriate therapeutic intervention.


Assuntos
Endocardite Bacteriana , Endocardite , Infecções Estreptocócicas , Adulto , Antibacterianos/uso terapêutico , Endocardite/diagnóstico , Endocardite Bacteriana/diagnóstico , Endocardite Bacteriana/cirurgia , Feminino , Humanos , Gravidez , Infecções Estreptocócicas/diagnóstico , Streptococcus agalactiae
20.
J Vet Intern Med ; 35(3): 1597-1603, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33728675

RESUMO

BACKGROUND: Rapid point-of-care (POC) detection of Streptococcus equi subsp. equi (S. equi) would theoretically reduce the spread of strangles by identifying index and carrier horses. HYPOTHESIS: That the eqbE isothermal amplification (LAMP) assay, and the same eqbE LAMP assay tested in a microfluidic device format, are comparable to a triplex real-time quantitative polymerase chain reaction (qPCR) assay that is commonly used in diagnostic labs. SAMPLES: Sixty-eight guttural pouch lavage (GPL) specimens from horses recovering from strangles. METHODS: Guttural pouch lavage specimens were tested for S. equi retrospectively using the benchtop eqbE LAMP, the eqbE LAMP microfluidic device, and compared to the triplex qPCR, that detects 2 S. equi-specific genes, eqbE and SEQ2190, as the reference standard using the receiver operating characteristic area under the curve (ROC). RESULTS: The 27/68 specimens were positive by benchtop eqbE LAMP, 31/64 by eqbE LAMP microfluidic device, and 12/67 by triplex qPCR. Using the triplex PCR as the reference, the benchtop eqbE LAMP showed excellent discrimination (ROC Area = 0.813, 95% confidence interval [CI] = 0.711-0.915) as did the LAMP microfluidic device (ROC Area = 0.811, 95% CI = 0.529-0.782). There was no significant difference between the benchtop LAMP and LAMP microfluidic device (ROC Area 0.813 ± 0.055 vs 0.811 ± 0.034, P = .97). CONCLUSIONS: The eqbE LAMP microfluidic device detected S. equi in GPL specimens from convalescent horses. This assay shows potential for development as a POC device for rapid, sensitive, accurate, and cost-efficient detection of S. equi.


Assuntos
Doenças dos Cavalos , Ácidos Nucleicos , Infecções Estreptocócicas , Streptococcus equi , Domínio AAA , Animais , Doenças dos Cavalos/diagnóstico , Cavalos , Dispositivos Lab-On-A-Chip , Técnicas de Diagnóstico Molecular , Técnicas de Amplificação de Ácido Nucleico , Estudos Retrospectivos , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/veterinária , Streptococcus , Streptococcus equi/genética , Irrigação Terapêutica/veterinária
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