Fungal Keratitis Due to Beauveria bassiana in a Contact Lenses Wearer and Review of Published Reports.

Fungal keratitis is a severe ocular infection that primarily affects subjects engaged in outdoor activities. Risk factors include allergic conjunctivitis, previous eye surgery, previous treatment with wide-spectrum antimicrobial agents and corticosteroids and using contact lenses. Corneal infection is usually secondary to trauma involving organic material, which is often the only predisposing factor. Early diagnosis based on clinical examination and microbiological investigation (microscopy, cultures and molecular techniques) is crucial to selecting the appropriate antifungal therapy and prevent progression. We report the case of a patient with keratitis due to Beauveria bassiana, an opportunistic and entomopathogenic filamentous fungus that is used as a biological insecticide and which is a rare cause of corneal infection. We review previous cases reports of B. bassiana keratitis published and its main features to compare with our case, a female occasional agriculture worker who had not suffered any trauma involving organic material. The patient received topical and oral antifungal therapy and debridement surgery, with a satisfactory outcome.

[Serotypes and antibiotic resistance patterns in beta-hemolytic Streptococcus agalactiae isolates in colonized mothers and newborns with invasive disease]. / Serotipos y patrones de resistencia antibiótica en aislados betahemolíticos de Streptococcus agalactiae de madres colonizadas y recién nacidos con enfermedad invasiva.

INTRODUCTION: Current preventive measures against neonatal disease caused by Streptococcus agalactiae (GBS) are prenatal screening and intrapartum antibiotic prophylaxis with appropriate antimicrobials. An alternative to this strategy would be the administration of a polysaccharide vaccine as the distribution of capsular serotypes of circulating strains needs to be known. METHODS: A study was made of 188 strains from pregnant women carrying GBS and 24 newborns with neonatal disease. Susceptibility testing was performed with penicillin, erythromycin and clindamycin following CLSI standards, and capsular serotype was determined by two methods: latex agglutination and PCR. RESULTS: Of the 188 strains of S.agalactiae from the pregnant women, there was 80.8% agreement in the results between the two techniques. Resistant to erythromycin and clindamycin was found in 16.5% and 10.1%, respectively. For neonatal strains, 95.8% of the results obtained by the two techniques were identical. The rates of resistance to erythromycin and clindamycin were 8.3% and 4.1%, respectively. In both groups, most frequently isolated serotype was iii, and the most related to antimicrobial resistance serotype was v. CONCLUSION: Epidemiological studies are necessary to continue surveillance of serotypes causing invasive disease and its antibiotic sensitivity patterns using sensitive and specific methods.

Disseminated infection due to Saksenaea vasiformis secondary to cutaneous mucormycosis.

Mucormycosis is an uncommon opportunistic fungal infection caused by Zygomycetes. It usually affects immunocompromised, diabetic and trauma patients with infected wounds. We report a case of disseminated infection secondary to facial cutaneous mucormycosis caused by Saksenaea vasiformis in a diabetic patient who had a farming accident causing him severe head injury. The patient was treated with a combination of surgical debridement and antifungal therapy with liposomal amphotericin B, but he had a slow and fatal outcome. In cases of tissue necrosis following trauma involving wound contact with soil (i.e., potential fungal contamination), testing for the presence of Zygomycetes fungi such as S. vasiformis in both immunocompetent and immunocompromised patients is crucial. The reason is that this infection usually has a rapid progression and may be fatal if appropriate treatment is not administered.

[Bacterial identification from blood cultures by a rapid Matrix-Assisted Laser Desorption-Ionisation Time-of-Flight mass spectrometry technique]. / Identificación bacteriana directamente del hemocultivo mediante una técnica rápida de espectrometría de masas Matrix-Assisted Laser Desorption-Ionisation Time-of-Flight.

INTRODUCTION: Matrix-Assisted Laser Desorption-Ionisation Time-of-Flight (MALDI-TOF) Mass Spectrometry is rapid and accurate for the bacterial identification. METHODS: We have evaluated a less laborious and less time consuming method for microorganism identification directly from positive blood cultures. RESULTS: When we considered the scores ≥1.7 and ≥1.4 for acceptable identification of species and genus, the percentage of identification was 77.5% and 93.9%, respectively. CONCLUSIONS: This method is reliable, rapid and cost-effective for implementation in routine use in clinical microbiology laboratories.

Development of a web application for recording bacterial etiologic agents and their antimicrobial susceptibility to improve the treatment of urinary tract infections and monitor resistance to antibiotics.

OBJECTIVE: We describe the development of a web platform that provides an updated record of the etiology and antimicrobial susceptibility of the different microorganisms responsible for urinary tract infections. METHODS: The MicrobDinamyc system (Francisco Soria Melguizo, SA, Madrid, Spain) is employed for the management of information derived from the urine culture results. The web application database automatically gathers the results of urine cultures conducted in the laboratory. RESULTS: Results. The user can consult the distribution of bacterial etiologies and antimicrobial susceptibilities in the different clinical settings during a specific time window. CONCLUSIONS: Using susceptibility data obtained in previous studies and stored on the web platform, it is possible to deduce the clinical activity of a given antibiotic in a specific setting.

Evolution of the resistance to antibiotics of bacteria involved in urinary tract infections: a 7-year surveillance study.

BACKGROUND: We conducted a retrospective analysis on the identification and antibiogram of all bacteria isolated from urine samples with microbiological confirmation of urinary tract infection (UTI) in a Spanish reference hospital over a 7-year period. METHODS: A retrospective analysis was performed of the identification and antibiogram data. RESULTS: A total of 31,758 uropathogens were isolated. Escherichia coli accounted for the majority (55.2%) of these, followed by Enterococcus faecalis (18.0%) and Klebsiella spp (10.3%). The highest E coli susceptibility rates were to imipenem (93.0%-99.8%), amikacin (97.3%-99.5%), nitrofurantoin (96.7%-98.9%), and fosfomycin (95.3%-100%), and the lowest were to cefuroxime (67.8%-86.4%), ciprofloxacin (61.2%-69.8%), and co-trimoxazole (55.0%-65.5%). We highlight the overall high activity of imipenem, piperacillin-tazobactam, nitrofurantoin, and fosfomycin on isolates versus the low activity of fluoroquinolones, co-trimoxazole, or cephalosporins. The activity of amoxicillin-clavulanic acid and fosfomycin decreased significantly over the 7-year study period. CONCLUSIONS: Imipenem and piperacillin-tazobactam appear to be good options for the empiric treatment of UTI acquired in hospital or requiring hospitalization, whereas nitrofurantoin and fosfomycin can be first-choice antibiotics for the treatment of uncomplicated community-acquired cystitis. However, surveillance studies are required to detect resistance to these antibiotics, given that an increase in uropathogen resistance rates may contraindicate its future use in empiric UTI therapy.

Implementation and monitoring of a quality management system based on the standard UNE-EN-ISO 15189 in a urine culture unit.

OBJECTIVES: To evaluate the implementation of a quality management system based on ISO-15189 in a urine culture unit. DESIGN AND METHODS: The effectiveness of improvement actions was measured by quality indicators. RESULTS: The errors in the pre-analytical phase and the rate of contaminated urine decreased significantly. The traceability, response time and external quality control were fulfilled. CONCLUSIONS: The implementation of ISO-15189 was effective in improving the management of a urine culture unit.