scholarly journals 1269. Infection, Clinical Syndromes and Antimicrobial Resistance by Aeromonas species: 13-Year Experience with an Emerging Pathogen at a Tertiary Care Center

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S723-S723
Author(s):  
Roberto Pineda-Reyes ◽  
Joseph Orndorff ◽  
David Reynoso
Keyword(s):  
Soft Tissue ◽  
Antimicrobial Resistance ◽  
Human Populations ◽  
Wound Infections ◽  
Soft Tissue Infections ◽  
Emerging Pathogens ◽  
Water Exposure ◽  
Clinical Syndromes ◽  
Populations At Risk ◽  
Traumatic Wound

Abstract Background Aeromonas spp. are emerging pathogens that cause a wide breadth of clinical syndromes, ranging from acute gastroenteritis to skin and soft tissue infections, sepsis, and “flesh-eating” necrotizing fasciitis. Aeromonads have been associated with natural disasters and have predominance in estuarine ecosystems, generating a negative impact on the fishing industry and aquaculture, as well as morbidity and mortality in human populations at risk. Antimicrobial resistance patterns differ by geographic locations worldwide, and studies to guide the therapy in the era of multidrug resistance are lacking in the US. Methods A retrospective case series was designed to chart review all adult subjects who had culture proven Aeromonas spp. infections during the period 2008-2020. Demographic data, water exposure, clinical syndromes on presentation, origin (community-acquired vs. nosocomial) and severity of infection, antibiograms, empirical antibiotics, time-to-appropriate therapy, and treatment outcomes were collected. Results Eighty-two subjects were included in the analysis. Demographic and clinical data is summarized in Table 1. Near 20% individuals had water exposure, including 53% of those with traumatic wound infections. Skin and soft tissue infection (including traumatic and surgical wound infections) was the most frequent clinical syndrome (51.2%). Sepsis was present on admission in 33% inpatients. Appropriate antibiotics were instituted in a median of 2 days (IQR=1-5), and the most prescribed empiric agents were piperacillin-tazobactam (48%) and meropenem (13.3%). Most isolates were susceptible to cefepime (70/71, 98.6%), levofloxacin (72/78, 92.3%) and TMP-SMX (69/78, 88.5%). Resistance to meropenem was reported in 18/31 isolates (58.1%) after 2015. Treatment failure was identified in 32.3% cases. Most cases (55%) were encountered during the months of spring and summer, which have warmer temperatures and seasonal heavy rains. Tropical storms caused significant flooding in the Galveston Bay area and Southeast Texas during the summer of 2015, which interestingly coincides with the high number of cases. However, following Hurricane Ike in 2008 or Hurricane Harvey in 2017, the number of cases did not significantly increase. Conclusion Aeromonads are emerging pathogens that cause mainly intraabdominal and skin and soft tissue infections. Their incidence is seasonal (55% cases in spring and summer) and it is associated with water exposure in more than half of those with traumatic wound infections. In subjects with specific risk factors, the use of carbapenem-sparing strategies, such as 3rd or 4th generation cephalosporins, fluoroquinolones or TMP-SMX, may improve outcomes. Disclosures All Authors: No reported disclosures

scholarly journals A resistant culture - ?superbugs? in Australian hospitals

2007 ◽  
Vol 28 (4) ◽  
pp. 184
Author(s):  
G L Gilbert
Keyword(s):  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Antimicrobial Resistance ◽  
Phage Type ◽  
Aureus Strain ◽  
Wound Infections ◽  
Soft Tissue Infections ◽  
Surgical Wound ◽  
Alfred Hospital ◽  
General Community

Antimicrobial resistance is not new in Australian hospitals. In 1946, shortly after penicillin became available for treatment of civilians, a penicillin resistant Staphylococcus aureus strain caused ~50% of staphylococcal surgical wound infections at the Royal Prince Alfred Hospital (RPAH), in Sydney. During the 1950s, another virulent penicillin resistant S. aureus strain (phage type 80/81) emerged in neonatal units in Sydney and spread to other hospitals in Australia and overseas, to the families of affected infants and to the general community, causing serious soft tissue infections, osteomyelitis, pneumonia and septicaemia.

Causative agents and antimicrobial resistance patterns of human skin and soft tissue infections in Bagamoyo, Tanzania

Acta Tropica ◽  
2018 ◽  
Vol 186 ◽  
pp. 102-106 ◽  
Author(s):  
Theckla Kazimoto ◽  
Salim Abdulla ◽  
Leah Bategereza ◽  
Omar Juma ◽  
Francis Mhimbira ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Antimicrobial Resistance ◽  
Human Skin ◽  
Soft Tissue Infections ◽  
Resistance Patterns ◽  
Causative Agents

scholarly journals Clinafloxacin versus Piperacillin-Tazobactam in Treatment of Patients with Severe Skin and Soft Tissue Infections

2001 ◽  
Vol 45 (2) ◽  
pp. 525-531 ◽  
Author(s):  
G. Siami ◽  
N. Christou ◽  
I. Eiseman ◽  
K. J. Tack
Keyword(s):  
Soft Tissue ◽  
Adverse Events ◽  
Clinical Cure ◽  
Wound Infections ◽  
Soft Tissue Infections ◽  
Pathogenic Species ◽  
Treatment Groups ◽  
Diabetic Foot Infections ◽  
Cure Rates ◽  
To Receive

ABSTRACT Patients (n = 409) with severe skin and soft tissue infections (SSTIs) were randomized to receive clinafloxacin or piperacillin-tazobactam (plus optional vancomycin for methicillin-resistant cocci), administered intravenously, with the option to switch to oral medication. Most patients had cellulitis, wound infections, or diabetic foot infections. Staphylococcus aureus, Enterococcus faecalis, and Pseudomonas aeruginosa were the most common baseline pathogens. Fewer baseline pathogens were resistant to clinafloxacin (1.8%) than to piperacillin-tazobactam (6.2%) (P = 0.001). The clinafloxacin and piperacillin-tazobactam groups did not differ significantly in clinical cure rates (68.8 and 65.2%, respectively) or microbiologic eradication rates (61.5 and 57.2%). Clinafloxacin yielded higher eradication rates for all three of the most common pathogenic species, although no differences were statistically significant. Within the power of this study, the overall frequency of adverse events was similar (P = 0.577) in the two treatment groups. Drug-associated adverse events (P = 0.050) and treatment discontinuations (P = 0.052) were marginally more frequent in the clinafloxacin group, primarily due to phototoxicity in outpatients receiving clinafloxacin. Although most cases of phototoxicity were mild to moderate, four cases were reported as severe. In summary, clinafloxacin monotherapy was equivalent in effectiveness to therapy with piperacillin-tazobactam plus optional vancomycin in the treatment of hospitalized patients with severe SSTIs.

Clinical Syndromes in Infectious Diseases

2012 ◽  
Author(s):  
Robert Orenstein
Keyword(s):  
Urinary Tract ◽  
Infective Endocarditis ◽  
Soft Tissue ◽  
Infectious Diseases ◽  
Sexually Transmitted Infections ◽  
Soft Tissue Infections ◽  
Gastrointestinal Infections ◽  
Sexually Transmitted ◽  
Clinical Syndromes ◽  
Tract Infections

This chapter approaches the field of infectious diseases from 3 perspectives. This second part covers clinical syndromes associated with various infections, such as infective endocarditis, meningitis, sexually transmitted infections, urinary tract infections, gastrointestinal infections, and soft-tissue infections. Symptoms, diagnosis, and treatment of these conditions are reviewed.

The Need to Develop New Antimicrobial Molecules, as Revealed by in vitro Assessment of Drug Resistance in Staphylococcal Skin Infections Treated with Autologous Bacterial Vaccine

2020 ◽  
Vol 71 (8) ◽  
pp. 292-303
Author(s):  
Madalina Preda ◽  
Alina-Alexandra Serbanescu ◽  
Mara Madalina Mihai ◽  
Gabriela-Loredana Popa ◽  
Loredana Cornelia Sabina Manolescu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Antimicrobial Resistance ◽  
Soft Tissues ◽  
The Body ◽  
Laboratory Research ◽  
Soft Tissue Infections ◽  
Resistance Profile ◽  
Bacterial Vaccine ◽  
Staphylococcus Spp

Staphylococcus spp. is a facultative pathogen, which can be found in the commensal microbiota of humans, most often in moist skinfolds and mucous membranes. This microorganism has the ability to cause various infections, in almost every organ of the body, with an increased frequency in the skin and soft tissues, being involved in pathologies like acne, folliculitis, furunculosis, hidradenitis suppurativa, cellulitis, abscesses, but also in secondary infections in diseases with an altered cutaneous barrier. The prolonged evolution of these diseases and severe outcome can be influenced by various factors, most importantly being the antimicrobial resistance. We have evaluated the antimicrobial susceptibility profiles, according to the Comite de l` Antibiogramme de la Societe Francaise de Microbiologie recommendations, for strains of Staphylococcus spp. isolated from acne or different types of skin and soft tissue infections in patients recommended to receive autologous bacterial vaccine. Most frequent identified species was Staphylococcus epidermidis, followed by Staphylococcus aureus. The antimicrobial resistance was higher for antibiotics usually used in the treatment of skin and soft tissue infections, with interesting differences of the resistance profile for the strains isolated from patients before receiving autologous bacterial vaccine compared with the ones from individuals already treated. Another important finding was represented by the differences in the resistance profile according to the age group of the patients. The results of this study underline the importance of antimicrobial resistance surveillance in finding new molecules and alternative therapies, the necessity of a personalized approach in medical acts and of a continuous connection between clinic and laboratory research.

scholarly journals Clonal Lineages, Antimicrobial Resistance, and PVL Carriage of Staphylococcus aureus Associated to Skin and Soft-Tissue Infections from Ambulatory Patients in Portugal

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 345
Author(s):  
Carolina Ferreira ◽  
Sofia Santos Costa ◽  
Maria Serrano ◽  
Ketlyn Oliveira ◽  
Graça Trigueiro ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Antimicrobial Resistance ◽  
Target Genes ◽  
Multidrug Resistant ◽  
Hospital Environment ◽  
Soft Tissue Infections ◽  
High Genetic Diversity ◽  
Ambulatory Patients ◽  
Encoding Genes

Staphylococcus aureus (S. aureus) is a leading cause of skin and soft-tissue infections (SSTIs) in the community. In this study, we characterized a collection of 34 S. aureus from SSTIs in ambulatory patients in Portugal and analyzed the presence of Panton–Valentine leucocidin (PVL)-encoding genes and antibiotic-resistance profile, which was correlated with genetic determinants, plasmid carriage, and clonal lineage. Nearly half of the isolates (15, 44.1%) were methicillin-resistant Staphylococcus aureus (MRSA) and/or multidrug resistant (MDR). We also detected resistance to penicillin (33/34, 97.1%), fluoroquinolones (17/34, 50.0%), macrolides and lincosamides (15/34, 44.1%), aminoglycosides (6/34, 17.6%), and fusidic acid (2/34, 5.9%), associated with several combinations of resistance determinants (blaZ, erm(A), erm(C), msr(A), mph(C), aacA-aphD, aadD, aph(3′)-IIIa, fusC), or mutations in target genes (fusA, grlA/gyrA). The collection presented a high genetic diversity (Simpson’s index of 0.92) with prevalence of clonal lineages CC5, CC22, and CC8, which included the MRSA and also most MDR isolates (CC5 and CC22). PVL-encoding genes were found in seven isolates (20.6%), three methicillin-susceptible Staphylococcus aureus (MSSA) (ST152-agrI and ST30-agrIII), and four MRSA (ST8-agrI). Plasmid profiling revealed seventeen distinct plasmid profiles. This work highlights the high frequency of antimicrobial resistance and PVL carriage in SSTIs-related S. aureus outside of the hospital environment.

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