Fatal necrotizing fasciitis following two suicide attempts with petroleum oil injection.

PURPOSES: Necrotizing fasciitis is an aggressively progressing complication of the skin and soft tissue infections. It has dramatic course and often leads to patient's death. METHODS: In our research, we present the casuistic case concerning double suicide attempt with petroleum oil injection, complicated by the necrotizing fasciitis, patient was with deliberately withheld mental disorders. RESULTS: During the first suicide attempt, the oil substance was injected into the left cubital fossa and left toes areas, what lead to amputation of the upper left limb above the cubitial fossa and the left toes. Afterward, patient gradually recovered and survived. Two years later, another suicide attempt took place with the same substance: a 27-year-old man injected the petroleum oil into the right supraclavicular area. That affected a necrosis penetrating into the mediastinum and the patient died. CONCLUSIONS: To our knowledge, such case of the necrotizing fasciitis has not been previously reported. The mechanism of derivatives of oil influence on tissues is not investigated yet; therefore, treatment method is uncertain and sometimes ineffective.

A case of defibrillator-associated infective endocarditis due to Campylobacter fetus.

Campylobacter spp. are Gram-negative, spiral motile bacteria. Infections caused by Campylobacter fetus are frequently of invasive character, but they are very rare. The described case of infection of a cardioverter defibrillator implantation site was effectively cured with antibiotics, but it required removal of the cardioverter defibrillator.

Problems in the diagnosis of profound trichophytosis barbae.

Zoophilic species of human dermatophytoses, such as Trichophyton mentagrophytes are significantly rare. We present a case of a 42-year-old male who for 2 months had been unsuccessfully treated and then referred to hospital with suspected actinomycosis. Lesions on the skin on his neck, submandibular area, cheeks and groins were consistent with extremely painful, merging inflammatory tumours and infiltrations with the presence of numerous pustules in hair follicles that poured purulent contents forming into yellow crusts after compression. The treatment with terbinafine was successful. The final identification of the Trichopyton mentagrophytes var. granulosum strain was performed based on a microscopic assessment of the culture, and the result of species identification was confirmed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis.

[Influence of culture conditions on cell surface hydrophobicity of rods of genus Serratia]. / Wplyw warunków hodowli na hydrofobowe wlasciwosci paleczek z rodzaju Serratia.

The cell surface hydrophobicity (CSH) is a non-specific adhesion factor that is important in the proliferation of microorganisms on solid surfaces. Serratia spp. is a bacterium that has been increasingly implicated as a primary pathogen in numerous human infections, particularly in urinary tract infections. CSH of 60 Serratia spp. strains isolated from clinical materials was evaluated using the ammonium sulfate salt aggregation test. Bacteria were grown for 24 h and 48 h at room temperature (22 degrees C) and 37 degrees C on enrichment broth and agar (Biomed), enrichment agar with 5% human blood and medium composed of agar granulated (Becton Dickinson), neopeptone (Difco) and 1% (v/v) glycerol. CSH was estimated most frequently when the analyzed strains in enrichment broth were cultured. When grown in enrichment broth cells of Serratia spp. at room temperature were more hydrophobic (43% after 24 h and 47% after 48 h) than those at 37 degrees C (30% after 24 h and 33% after 48 h). CSH of the examined Serratia spp. strains were depended on the temperature, time of the culture of bacteria and the kind of media. The influence of the culture conditions on the changes in CSH of the analyzed bacteria may suggest significance of these properties in the pathogenesis of Serratia spp.

[Occurrence of beta-lactamase type ESBL in rods of the Serratia species]. / Wystepowanie beta-laktamaz typu ESBL u paleczek z rodzaju Serratia.

Serratia spp. has been identified as an important opportunistic pathogen agent in nosocomial infections. The aim of the study was the determination of extended spectrum beta-lactamases (ESBL) occurrence among 78 of Serratia spp. strains isolated in 1996-1998 from clinical specimens obtained from patients of State Clinical Hospital in Bydgoszcz. Identification of Serratia spp. strains was performed in automatic ATB system with ID 32GN strips (bioMérieux). The strains with ESBL activity were detected by double-disc method according to Jarlier et al. (10) with small modifications. Clavulanic acid, tazobactam and sulbactam were used as the inhibitors of ESBLs. Drug-susceptibility was determined by disc-diffusion method according to NCCLS standards. Forty-five (57.7%) of the strains were ESBL (+). All of them belonged to S. marcescens species. The majority--91.1% of strains was derived from urine, 3 from wound and 1 from blood. The obtained results indicate the necessity of monitoring of ESBL-producing strains among gram-negative rods from clinical specimen. The aims of such a procedure are to control and to prevent their dissemination within hospital, as well as to avoid therapeutic failures.

[Beta-lactam-resistance patterns of some gram-negative rods]. / Wzory opornosci na antybiotyki beta-laktamowe niektórych paleczek gram-ujemnych.

Antibiotic susceptibility to ampicillin of 290 E. coli, 56 Klebsiella sp. And 167 P.mirabilis strains was evaluated by the disk diffusion method. Data were interpreted according to the NCCLS criteria. 37.9% of E. coli, 85.7% of Klebsiella sp. And 65.9% of P. mirabilis strains were resistant to ampicillin. In all resistant to ampicillin strains were performed resistance patterns to following antibiotics: piperacillin, amoxicillin/clavulanic acid, cefoxitin, cefuroxime, ceftazidime, cefotaxime and imipenem. The strains resistant to ampicillin were divided into four groups depending on resistance patterns.

[Resistance of Haemophilus sp. to antibiotics]. / Opornosc Haemophilus sp. na antybiotyki.

The present study was undertaken to determine the in vitro drug resistance of Haemophilus influenzae (68 isolates) and H. parainfluenzae (17 isolates). The tests susceptibility to Ampicillin, Amoxicilin/Clavulanic Acid, Cefaclor, Cefuroxime, Cotrimoxazole, Aztreonam, Ceftriaxone, Tetracycline, Ciprofloxacin, Rifampicin and Chloramphenicol were performed with a standard disk-diffusion method. The NCCLS methodology and susceptibility interpretative criteria were applied as described by the disk manufacturer. Beta-lactamase production was detected with nitrocefin impregnated disk (Cefinase, BBL Microbiology System). Resistance in nosocomially acquired Haemophilus isolates to several antibiotics was observed. Of the Haemophilus isolates 28.2% were Ampicillin in resistant, all were susceptible to the combination of Amoxicillin/Clavulanic acid. The Ampicillin-resistant strains were beta-lactamase producers. We observed the high resistance (70.1%) to Tetracycline and (28.2%) to SXT (Cotrimoxazole). All isolates of Haemophilus were susceptible to Ciprofloxacin. The low resistance percentages to Rifampin (1.2%), Aztreonam (3.5%) and Chloramphenicol (3.5%) was observed.

[Resistance to antibiotics of Streptococcus pneumoniae strains]. / Opornosc na antybiotyki szczepów Streptococcus pneumoniae.

Streptococcus pneumoniae strains are exhibiting increasing rates of antibiotics resistance. A rapid increase of resistance was seen not only to penicillin but also other antimicrobial agents and therefore this paper describes the study of resistance and multiresistance of pneumococci to 7 antibiotics: penicillin (P), erythromycin (E), clindamycin (CC), tetracycline (T), co-trimoxazole (SXT), cefotaxime (CTX) and vancomycin (Va), using the disk-diffusion technique according to NCCLS procedure. We tested a total of 218 S. pneumoniae strains isolated from various materials: from sputum (54), noses (117), throats (28) and different swabs specimens (19). The overall percentage of resistant isolates to penicillin was 3.7%, to erythromycin--4.1%, to clindamycin--10.6%, to tetracycline--17.4%, to co-trimoxazole--15.6%, to cefotaxime--2.3%. In the sputum was most the monoresistant strains (66.7%). The multiresistance was highest in the penicillin resistant pneumococci. With the exception of vancomycin, the number of resistant strains to non-beta-lactam antibiotics (erythromycin, clindamycin, tetracycline, co-trimoxazole) was higher in penicillin-resistant strains compared with penicillin susceptible isolates. All isolates were susceptible to vancomycin.

Antibiotic-sensitivity of Moraxella catarrhalis isolated from clinical materials in 1997-1998.

Moraxella catarrhalis (M. catarrhalis) may normally be found in the upper respiratory tract. This bacterium, however, may cause infections such as acute otitis media, sinusitis, conjunctivitis, bronchitis chronica, pneumonia, endocarditis, septicaemia and meningitis. Haemophilus influenzae, Streptococcus pneumoniae and M. catarrhalis were the main causative agents responsible for respiratory tract infections. The major resistance problems associated with these species are those which cause resistance to beta-lactams. beta-lactamase was produced by > 80% M. catarrhalis strains. The susceptibility to ampicillin, amoxicillin/clavulanic acid, cefuroxime, erythromycin, ciprofloxacin was tested in 137 M. catarrhalis strains. All the strains resistant to ampicillin produced beta-lactamase and were sensitive to amoxicillin/clavulanic acid. For M. catarrhalis, the most active antimicrobials included cefuroxime (99%), ciprofloxacin (99%) and erythromycin (93%).