Tracheocarotid artery fistula infected with methicillinresistant Staphylococcus aureus

1999 ◽  
Vol 113 (7) ◽  
pp. 689-691 ◽  
Author(s):  
M. F. Tungekar
Keyword(s):  
Staphylococcus Aureus ◽  
Blood Vessel ◽  
Rare Complication ◽  
Methicillin Resistant ◽  
Major Blood Vessel ◽  
Life Threatening

AbstractMassive life-threatening haemorrhage from a fistula between the trachea and a major blood vessel of the neck is a rare complication of the tracheostomy procedure, well-recognized by anaesthetists and otolaryngologists. Although the lesion is likely to be encountered at autopsy, it is not described in histopathological literature. The possible causes are discussed together with the macroscopic and microscopic appearances of the lesion. Suitable procedures for its identification and for obtaining appropriate histopathological blocks are suggested. Presence of methicillin-resistant Staphylococcus aureus (MRSA) has not been documented before and might have contributed to the genesis of the fistula in this case.

scholarly journals Blurred molecular epidemiological lines between the two dominant methicillin-resistant Staphylococcus aureus clones

2018 ◽  
Author(s):  
Amy C. Dupper ◽  
Mitchell J. Sullivan ◽  
Kieran I. Chacko ◽  
Aaron Mishkin ◽  
Brianne Ciferri ◽  
...  
Keyword(s):  
New York ◽  
Staphylococcus Aureus ◽  
Medical Center ◽  
Data Extraction ◽  
Age Groups ◽  
Bloodstream Infections ◽  
Methicillin Resistant ◽  
Peripheral Intravenous Catheter ◽  
Life Threatening ◽  
Healthcare Associated

AbstractBackgroundMethicillin-resistant Staphylococcus aureus (MRSA) causes life-threatening infections in both community and hospital settings and is a leading cause of healthcare-associated infections (HAIs). We sought to describe the molecular epidemiological landscape of patients with MRSA bloodstream infections (BSIs) at an urban medical center by evaluating the clinical characteristics associated with the two dominant endemic clones.MethodsComprehensive clinical data extraction from the electronic health records of 227 hospitalized patients ≥18 years old with MRSA BSI over a 33-month period in New York City were collected. The descriptive epidemiology and mortality associated with the two dominant clones was compared using logistic regression.ResultsMolecular analysis revealed that 91% of all single-patient MRSA BSIs were due to two equally represented genotypes, clonal complex (CC) 5 (N=117) and CC8 (N=110). MRSA BSIs were associated with a 90-day mortality of 27%. CC8 caused disease more frequently in younger age groups (56 ± 17 vs 67 ± 17 years old; p<0.001) and in non-White race (OR=3.45 95% CI [1.51-7.87]; p=0.003), with few other major distinguishing features. Morbidity and mortality also did not differ significantly between the two clones. CC8 caused BSIs more frequently in the setting of peripheral intravenous catheters (OR=5.96; 95% CI [1.51-23.50]; p=0.01).ConclusionThe clinical features distinguishing dominant MRSA clones continue to converge. The association of CC8 with peripheral intravenous catheter infections underscores the importance of classical community clones causing hospital-onset infections. Ongoing monitoring and analysis of the dynamic epidemiology of this endemic pathogen is crucial to inform management to prevent disease.

scholarly journals Human urine alters methicillin-resistant Staphylococcus aureus virulence and transcriptome

2021 ◽  
Author(s):  
Santosh Paudel ◽  
Kamal Bagale ◽  
Swapnil Patel ◽  
Nicholas J. Kooyers ◽  
Ritwij Kulkarni
Keyword(s):  
Gene Expression ◽  
Staphylococcus Aureus ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Human Urine ◽  
Molecular Mechanisms ◽  
Methicillin Resistant ◽  
Life Threatening ◽  
Tract Infections

Gram-positive methicillin-resistant Staphylococcus aureus (MRSA) is an emerging cause of hospital-associated urinary tract infections (UTI), especially in catheterized individuals. Despite being rare, MRSA UTI are prone to potentially life-threatening exacerbations such as bacteremia that can be refractory to routine antibiotic therapy. To delineate the molecular mechanisms governing MRSA urinary pathogenesis, we exposed three S. aureus clinical isolates, including two MRSA strains to human urine for 2h and analyzed virulence characteristics and changes in gene expression. The in vitro virulence assays showed that human urine rapidly alters adherence to human bladder epithelial cells and fibronectin, hemolysis of sheep RBCs, and surface hydrophobicity in a staphylococcal strain-specific manner. In addition, RNA-Seq analysis of uropathogenic strain MRSA-1369 revealed that 2h-long exposure to human urine alters MRSA transcriptome, by modifying expression of genes encoding enzymes catalyzing metabolic pathways, virulence factors, and transcriptional regulators. In summary, our results provide important insights into how human urine specifically and rapidly alters MRSA physiology and facilitates MRSA survival in the nutrient-limiting and hostile urinary microenvironment. Importance: Methicillin-resistant Staphylococcus aureus (MRSA) is an uncommon cause of urinary tract infections (UTI) in the general population. However, it is important to understand MRSA pathophysiology in the urinary tract because isolation of MRSA in urine samples often precedes potentially life-threatening MRSA bacteremia. In this report, we describe how exposure to human urine alters MRSA global gene expression and virulence. We hypothesize that these alterations may aid MRSA in acclimating to the nutrient-limiting, immunologically hostile conditions within the urinary tract leading to MRSA-UTI.

Hypertensive emergency and seizures during haemodialysis

2021 ◽  
Vol 14 (9) ◽  
pp. e242471
Author(s):  
Shraddha Murali ◽  
Srinivas Vinayak Shenoy ◽  
Ravindra Attur Prabhu ◽  
Shankar Prasad Nagaraju
Keyword(s):  
Chronic Kidney Disease ◽  
Staphylococcus Aureus ◽  
Kidney Disease ◽  
Brain Abscess ◽  
Bacterial Infections ◽  
Methicillin Resistant ◽  
Atypical Clinical Presentation ◽  
Life Threatening ◽  
Traditional Risk Factors ◽  
Infected Material

Intracranial abscesses are uncommon, serious and life-threatening infections. A brain abscess is caused by inflammation and collection of infected material, coming from local or remote infectious sources. Patients with chronic kidney disease on dialysis are prone to invasive bacterial infections like methicillin-resistant Staphylococcus aureus (MRSA) especially in the presence of central venous catheters or arteriovenous grafts. However, intracranial abscess formation due to MRSA is rare. Here, we present a case of MRSA brain abscess with an atypical clinical presentation in the absence of traditional risk factors.Intracranial abscesses are uncommon, serious, and life-threatening infections. A Brain abscess is caused by inflammation and collection of infected material, coming from local or remote infectious sources. Patients with chronic kidney disease on dialysis are prone to invasive bacterial infections like methicillin-resistant staphylococcus aureus (MRSA) especially in the presence of central venous catheters or arterio-venous grafts. However intracranial abscess formation due to MRSA is rare. Here we present a case of MRSA brain abscess with an atypical clinical presentation in the absence of traditional risk factors. A 46-year-old male with chronic kidney disease (CKD) secondary to chronic glomerulonephritis, on haemodialysis for 4 years through a left brachio-cephalic AVF developed an episode of generalised tonic-clonic seizures lasting 2 min during his scheduled dialysis session. He reported no complaints before entry to the dialysis. On clinical examination, he was drowsy with the absence of any focal motor deficits. His blood pressure was recorded to be 200/120 mm Hg. He was managed in the intensive care unit with mechanical ventilation, intravenous nitroglycerine for blood pressure control, levetiracetam for seizures and empirical vancomycin. Radiological evaluation showed a brain abscess in the midline involving bosth basi-frontal lobes. After medical optimization, the abscess was drained surgically, and the pus cultured. As culture grew Methicillin Resistant Staphylococcus aureus, he was treated with intravenous vancomycin for 6 weeks. On follow up, the abscess had resolved and the patient recovered without any neurological deficits.

Methicillin-Resistant Staphylococcus aureus: An Emerging Pathogen in Small Animals

2005 ◽  
Vol 41 (3) ◽  
pp. 150-157 ◽  
Author(s):  
J. Scott Weese
Keyword(s):  
Staphylococcus Aureus ◽  
Disease Surveillance ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Diagnostic Testing ◽  
Small Animals ◽  
Emerging Pathogen ◽  
Methicillin Resistant ◽  
Mild Disease ◽  
Life Threatening ◽  
The Impact

Methicillin-resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen in humans and is increasingly implicated in community-associated infections in people. In household pets, MRSA infections are uncommon but are on the rise, possibly because of the increased prevalence of human MRSA in the community. Clinical MRSA infections in some animals can be life threatening and difficult to treat; however, other animals may develop mild disease or only become colonized. Veterinarians should be aware of the concerns regarding MRSA and should develop an understanding of appropriate disease surveillance, diagnostic testing, and infection control in order to lessen the impact of MRSA on small animals.

scholarly journals Phenotypic and Genotypic Characteristics of Methicillin-Resistant Staphylococcus aureus (MRSA) Related to Persistent Endovascular Infection

Antibiotics ◽  
2019 ◽  
Vol 8 (2) ◽  
pp. 71 ◽  
Author(s):  
Liang Li ◽  
Michael R. Yeaman ◽  
Arnold S. Bayer ◽  
Yan Q. Xiong
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Specific Mechanism ◽  
Host Defense Peptides ◽  
Methicillin Resistant ◽  
Preventative Measures ◽  
Life Threatening ◽  
Genotypic Characteristics

Persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia (PB) represents an important subset of S. aureus infection and correlates with poor clinical outcomes. MRSA isolates from patients with PB differ significantly from those of resolving bacteremia (RB) with regard to several in vitro phenotypic and genotypic profiles. For instance, PB strains exhibit less susceptibility to cationic host defense peptides and vancomycin (VAN) killing under in vivo-like conditions, greater damage to endothelial cells, thicker biofilm formation, altered growth rates, early activation of many global virulence regulons (e.g., sigB, sarA, sae and agr) and higher expression of purine biosynthesis genes (e.g., purF) than RB strains. Importantly, PB strains are significantly more resistant to VAN treatment in experimental infective endocarditis as compared to RB strains, despite similar VAN minimum inhibitory concentrations (MICs) in vitro. Here, we review relevant phenotypic and genotypic characteristics related to the PB outcome. These and future insights may improve our understanding of the specific mechanism(s) contributing to the PB outcome, and aid in the development of novel therapeutic and preventative measures against this life-threatening infection.

Life-threatening infection due to community-acquired methicillin-resistant Staphylococcus aureus: case report and review

2009 ◽  
Vol 169 (1) ◽  
pp. 47-53 ◽  
Author(s):  
Kalomoira Kefala-Agoropoulou ◽  
Efthimia Protonotariou ◽  
Danai Vitti ◽  
Sofia Sarafidou ◽  
Athanasia Anastasiou ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Case Report ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistant ◽  
Life Threatening

scholarly journals Hemothorax due to Ruptured Mycotic Aneurysm of Intercostal Arteries Associated with Infective Endocarditis

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Eddie Y. Liu ◽  
Jennifer Crawford ◽  
Haissam Haddad
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Drug Use ◽  
Mycotic Aneurysm ◽  
Rare Complication ◽  
Intravenous Drug ◽  
Intravenous Drug Use ◽  
Methicillin Resistant

We present a case of hemothorax due to ruptured mycotic aneurysm in three intercostal arteries in a 40-year-old male with methicillin-resistant Staphylococcus aureus infective endocarditis (IE) due to intravenous drug use. Microcoil embolization and thoracotomy successfully achieved hemostasis. Mycotic aneurysm is a rare complication of IE and is usually found in the intracranial vessels. Ruptured mycotic aneurysm in the intercostal arteries can be associated with IE and can present as acute hemothorax.

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