1559. Methicillin Susceptible Staphylococcus aureus Is The Predominant Organism In Septic Bursitis With The Majority Involving The Olecranon Bursa: A Study Of 61 Cases

Background Bursae are fluid filled structures between mobile parts of the musculoskeletal system to reduce friction between surfaces by lubrication. The most frequently infected are the olecranon and prepatellar bursae. In reported studies there is male preponderance, a relationship to occupational or recreational activities, a mean age of about 50 years and the most frequent organism being Staphylococcus aureus. The frequency of methicillin resistance is not well documented. Methods We analyzed approximately 7000 Staphylococcus aureus isolates reported by the laboratory over a 3-year period in 10 of our network hospitals, 9 in Eastern Pennsylvania and one in adjacent Warren County, New Jersey and found 61 cases of S. aureus septic bursitis. Results Only 13/61 (21.3%) were caused by methicillin resistant S. aureus (MRSA), 8 olecranon (61.5%), 4 prepatellar (30.8%) and one subacromial (7.7%). Only one in MRSA group (olecranon bursitis) was female. The mean age of MRSA cases was 58.5. Methicillin susceptible S. aureus (MSSA) predominated with 34/48 (70.8%) olecranon bursitis (28M/6F), 11/48 (22.9%) prepatellar bursitis (10M/1F) and 3/48 (6.3%) sub acromial bursitis (1M/2F) with a mean age of 61.9. Overall (MRSA +MSSA), 51/61 (83.6%) were male and 10/61 (16.4%) were female. The olecranon bursa was involved in 42/61 (68.9%), prepatellar bursa 15/54 (24.6%) and subacromial bursa 4/54 (6.6%). The mean age for the entire group was 61.2 with the youngest 23 and the oldest 93. The occupational history was recorded only in a few patients e.g. roofer, floor worker, construction worker. Three in the MSSA group had bacteremia (2 subacromial bursitis and 1 olecranon bursitis). There was 1 death from gram negative sepsis which was unrelated. The majority were successfully treated with a combination of drainage and antibiotics. Conclusion In summary, our study shows a predominance of olecranon bursitis, with a higher incidence in males and majority caused by MSSA. The mean age around 61 was higher than the mean age in prior reports around 50 years. Elbows and knees accounted for 57/61 (93%) cases of septic bursitis. Avoidance of activities involving friction or repeated trauma to elbows and knees should help prevention of septic bursitis. As far as we are aware, this is the largest series of septic bursitis reported. Disclosures All Authors: No reported disclosures

Characterization of novelChrysosporium morrisgordoniisp. nov., from bat white-nose syndrome (WNS) affected mines, northeastern United States

Psychrotolerant hyphomycetes including unrecognized taxon are commonly found in bat hibernation sites in Upstate New York. During a mycobiome survey, a new fungal species,Chrysosporium morrisgordoniisp. nov., was isolated from bat White-nose syndrome (WNS) afflicted Graphite mine in Warren County, New York. This taxon was distinguished by its ability to grow at low temperature spectra from 6°C to 25°C. Conidia were tuberculate and thick-walled, globose to subglobose, unicellular, 3.5-4.6 µm ×3.5-4.6 µm, sessile or borne on narrow stalks. The stalks occurred at right angles to the hypha. Intercalary aleuroconidia were also observed; the hyphae were septate, hyaline, smooth-walled, 1-3 µm wide, straight or branched. The ITS1-5.8S-ITS2 sequence ofC. morrisgordoniidiffered from the closest match toC. speluncarumby 37 nucleotides (94% identity); the Neighbor-joining phylogenetic tree confirmed thatC. morrisgordoniiwas placed in a well-supported monophyletic group withC. speluncarum. LSU and ITS phylogenetic trees further indicated thatC. morrisgordonii, C. speluncarum, Renispora flavissima, Neogymnomyces virgineus and Gymnoascus demonbreuniiformed a distinct group in theOnygenales.

The Death of the Rebel Press

Kentucky’s Union occupiers suppressed the state’s secessionist papers as treasonous. A few editors were arrested, but most were soon released. Walter Haldeman employed an elaborate ruse to flee to the Confederates at Bowling Green after federal authorities shut down his Louisville Courier. He resurrected the Courier in the Warren County seat but later retreated from Kentucky with the rebel army. The paper reappeared now and again in Confederate territory. Editor Thomas Bell Monroe suspended the Kentucky Statesman, joined the rebel army, and was fatally wounded at Shiloh. The Paducah Herald and Hickman Courier also ceased when their editors donned rebel gray. The Frankfort Yeoman and other papers toned down their secessionism, but the Yeoman’s presses were ultimately stopped too. Other rebel papers faded away and remained silent for the war’s duration.