RESUMO
To increase the knowledge about S. capitis in the neonatal setting, we conducted a nationwide 3-month survey in 38 neonatal intensive care units (NICUs) covering 56.6% of French NICU beds. We demonstrated 14.2% of S. capitis BSI (S.capBSI) among nosocomial BSIs. S.capBSI incidence rate was 0.59 per 1000 patient-days. A total of 55.0% of the S.capBSIs were late onset catheter-related BSIs. The S. capitis strains infected preterm babies (median gestational age 26 weeks, median birth weight 855 g). They were resistant to methicillin and aminoglycosides and belonged to the NRCS-A clone. Evolution was favorable in all but one case, following vancomycin treatment.
Assuntos
Sepse/epidemiologia , Infecções Estafilocócicas/epidemiologia , Staphylococcus capitis/isolamento & purificação , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Infecções Relacionadas a Cateter/tratamento farmacológico , Infecções Relacionadas a Cateter/epidemiologia , Infecções Relacionadas a Cateter/etiologia , Farmacorresistência Bacteriana Múltipla , Feminino , França/epidemiologia , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal , Masculino , Sepse/tratamento farmacológico , Sepse/etiologia , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/etiologia , Staphylococcus capitis/efeitos dos fármacosRESUMO
BACKGROUND: The use of a catheter for hemodialysis is associated with a 5-fold increased risk of septicemia. Early detection of catheter-related bloodstrean infection (CRBSI) may decrease morbidity and mortality, but the benefits of systematic blood cultures have not been demonstrated. MATERIALS AND METHODS: We retrospectively studied the blood culture results of patients who had been dialyzed with a tunneled jugular catheter for more than 1 month in a dialysis unit from January to December 2015. Systematic monthly catheter blood cultures were taken from the heparin lock solutions in the arterial and venous branches, at the beginning or end of the session. CRBSI was assessed using patient symptoms (fever, chills, hemodynamic instability) and positive catheter blood cultures. RESULTS: 75 patients were included. We analyzed the results of 577 systematic catheter blood cultures. 27 (5%) were positive, including 23 from patients who did not develop CRBSI in the following month. For the latter, there was a predominance of coagulase-negative staphylococci. Only four patients with positive catheter blood cultures went on to develop CRBSI in the following month. The sensitivity and specificity of these monthly blood cultures to detect CRBSI in the following month were 0.44 and 0.95, respectively. The positive and negative predictive values of the test were 0.14 and 0.99, respectively. CONCLUSION: In this study, systematic catheter blood cultures did not predict the occurrence of CRBSI. The sensitivity of these tests could be improved by increasing the sampling frequency. A cost-benefit analysis of such measures should be performed.
Assuntos
Bacteriemia/diagnóstico , Hemocultura/métodos , Infecções Relacionadas a Cateter/diagnóstico , Diálise Renal/efeitos adversos , Idoso , Diagnóstico Precoce , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
STUDY OBJECTIVE: To compare the antimicrobial susceptibility testing (AST) performance of positive blood cultures (PBC) VITEK®2 off-label use (D0) and traditional VITEK®2 workflow using isolated colonies after overnight (D1). METHODS: Patient samples with monomicrobial Gram-negative rod or Gram-positive cocci in clusters bacteremia were tested on D0 and compared to D1 AST results in 7 laboratories in France. RESULTS: Overall, categorical and essential agreement rates were 98.4% and 96.7%, respectively. Very major discrepancy and major discrepancy rates for Enterobacterales and Staphylococci satisfied the NF EN ISO 20776-2 (2007) criteria for sepsis-relevant drugs. Very major discrepancies were >3% for amoxicillin-clavulanate (4.9%, 6/122), piperacillin-tazobactam (7.5%, 4/53) and meropenem (33%,1/3) for Enterobacterales and gentamicin for Staphylococci (4.6%, 4/87). CONCLUSION: Direct AST from PBC broths by VITEK®2 for Enterobacterales and Staphylococci is reliable and fast and may positively influence antimicrobial stewardship.
Assuntos
Bacteriemia , Gammaproteobacteria , Infecções por Bactérias Gram-Negativas , Humanos , Hemocultura/métodos , Antibacterianos/farmacologia , Testes de Sensibilidade Microbiana , Bactérias Gram-Negativas , Bacteriemia/diagnóstico , StaphylococcusRESUMO
Campylobacter coli is a rare cause of bacteremia. We report here the first case of C.coli spondylodiscitis complicated by an aortic aneurysm. Outcome was favourable with surgery and antibiotic therapy.
Assuntos
Aneurisma da Aorta Abdominal/microbiologia , Bacteriemia/complicações , Infecções por Campylobacter/complicações , Campylobacter coli , Discite/microbiologia , Idoso , Antibacterianos/uso terapêutico , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/tratamento farmacológico , Infecções por Campylobacter/diagnóstico , Infecções por Campylobacter/tratamento farmacológico , Cefotaxima/uso terapêutico , Ciprofloxacina/uso terapêutico , Discite/diagnóstico por imagem , Discite/cirurgia , Quimioterapia Combinada , Gentamicinas/uso terapêutico , Humanos , Masculino , RadiografiaRESUMO
INTRODUCTION: In Europe, the number of cases of Campylobacter enteritis and their quinolone resistance is increasing. The aims of this work were to evaluate: (1) the hospital epidemiology of bacterial enteritis between 2010 and 2015. (2) The proportion of Campylobacter and Salmonella enteritis. (3) Resistance to quinolones in adult and paediatric populations. (4) To investigate possible regional epidemiological and bacteriological disparities. PATIENTS AND METHODS: This is a multicentric study carried out in 21 general hospitals (CHG) representing 14 French regions with a prospective collection of the results of coprocultures from 2010 to 2015 in adult and paediatric populations (children < 15 years old not exposed to quinolones). The epidemiological and bacteriological data were collected from software laboratory for positive stool cultures for Campylobacter and Salmonella. The results were compared year by year and by a period of 2 years. RESULTS: In adults, Campylobacter enteritis was each year significantly more frequent than Salmonella (P < 0.001), with a significant increase from 2010 to 2015 (P < 0.05). In children, there was also a significant and stable predominance of Campylobacter enteritis over the study period (P = 0.002). The quinolone resistance of Campylobacter was greater than 50% on the whole territory, with no North-South difference over the three periods studied. It increased significantly from 2012 to 2015 in adults (48% to 55%, P < 0.05) and in children (54% to 61%, P = 0.04). CONCLUSION: Our results confirm the increase in the prevalence of Campylobacter enteritis compared to Salmonella between 2010 and 2015. The quinolone resistance of Campylobacter is greater than 50% on the whole territory, stable between 2010 and 2015 in adults and significantly increased in children.
Assuntos
Infecções por Campylobacter/epidemiologia , Enterite/epidemiologia , Enterite/microbiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Farmacorresistência Bacteriana , França/epidemiologia , Hospitais Gerais , Humanos , Incidência , Pessoa de Meia-Idade , Estudos Retrospectivos , Infecções por Salmonella/epidemiologia , Estações do Ano , Adulto JovemAssuntos
Antibacterianos/farmacologia , Enterobacter cloacae/genética , RNA Ribossômico 16S/genética , beta-Lactamases/genética , Adulto , Amicacina/farmacologia , Amicacina/uso terapêutico , Antibacterianos/uso terapêutico , Carbapenêmicos/farmacologia , Carbapenêmicos/uso terapêutico , Enterobacter cloacae/efeitos dos fármacos , Enterobacter cloacae/isolamento & purificação , Infecções por Enterobacteriaceae/tratamento farmacológico , Infecções por Enterobacteriaceae/microbiologia , França , Humanos , Masculino , Testes de Sensibilidade Microbiana , Ácido Penicilânico/análogos & derivados , Ácido Penicilânico/farmacologia , Ácido Penicilânico/uso terapêutico , Piperacilina/farmacologia , Piperacilina/uso terapêutico , Pneumonia Associada à Ventilação Mecânica/tratamento farmacológico , Pneumonia Associada à Ventilação Mecânica/microbiologia , Análise de Sequência de DNA , Tazobactam , Resistência beta-Lactâmica , beta-Lactamases/metabolismoRESUMO
Twelve clonally related and multidrug-resistant Acinetobacter baumannii isolates were recovered during a 4-month period from 12 patients hospitalized at the Valenciennes Hospital in France. Antibiograms determined by the double-disk diffusion technique on cloxacillin-containing plates detected a clavulanic acid-inhibited extended-spectrum beta-lactamase (ESBL). PCR and sequencing identified the gene encoding the Ambler class A ESBL VEB-1. This gene was located on the chromosome and was part of a class 1 integron identical to that previously identified in Pseudomonas aeruginosa isolates from Thailand. Additionally, seven clonally related bla(VEB-1)-positive A. baumannii strains were identified in the immediate environment of the hospitalized patients. This is the first report of the ESBL VEB-1 in Acinetobacter spp. and the first description of VEB-1-producing strains as a source of an outbreak occurring outside Southeast Asia. This report underlines the difficulty of the identification of ESBLs in A. baumannii.