scholarly journals 1354. Nocardia bejingensis: A Novel Isolate Affecting Immunocompromised Patients in the United States

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S490-S490
Author(s):  
Shylah M Moore-Pardo ◽  
Johonna Asquith ◽  
Sadaf Aslam ◽  
Cynthia Mayer ◽  
John Greene ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Antibiotic Susceptibility ◽  
Case Series ◽  
The United States ◽  
Solid Organ ◽  
Nocardia Species ◽  
Antibiotic Susceptibility Patterns ◽  
Immunocompromised Hosts ◽  
Susceptibility Patterns

Abstract Background Nocardia species can cause localized or disseminated disease in humans. Infection results from direct inoculation or inhalation. In recent years, several new species have been identified via molecular methods. Further speciation is crucial as each organism has its own spectrum of disease and unique antibiotic susceptibility patterns. Immunosuppression, alcoholism, and certain lung diseases are well-established risk factors for nocardiosis. In fact, cases have incremented in association with increasing population of immunocompromised hosts as well as improved methods for detection and identification. Thus, Nocardia species may be considered opportunistic pathogens. Nocardia bejingensis was first isolated in 2001 by Wang et al from sewage soil in China. The first human infections were reported in Asia. Subsequently, cases were reported in Europe and a few cases have been described in the United States but it has been infrequently cited in the literature. Thus, not much is known about its spectrum of disease. Methods The primary objective of this study was to determine the risk factors and clinical manifestations of Nocardia bejingensis infection via retrospective chart review of 6 cases identified in Tampa General Hospital and Moffitt Cancer Center within a 5-year period. We aimed to evaluate the treatment used and the antibiotic susceptibility patterns of the isolates. Results All patients were immunocompromised (1/3 HIV/AIDS, 1/3 hematologic malignancy, 1/3 solid-organ transplant). Most were male (67%) and mean age of 48. The majority had lung involvement (67%). Thecal sac infection and femur osteomyelitis (OM) were atypical manifestations. Localized disease predominated. Combination therapy was preferred. Trimethoprim-sulfamethoxazole (TMP-SMX), Ceftriaxone, and carbapenems were mostly used. All isolates were susceptible to TMP-SMX. See Table 1. Conclusion This case series depicts clinical features, risk factors, and epidemiology of Nocardia bejingensis infections. Our observations suggest that it is a novel pathogen in the United States, affecting mainly immunocompromised hosts. Early detection, appropriate antibiotics, and surgery were keys in successful management. However, further studies are needed to further elucidate its pathogenesis. Disclosures All authors: No reported disclosures.

scholarly journals Escherichia coli Antibiotic Susceptibility Patterns for Infants Admitted to NICUs Across the United States from 2009 to 2017

2020 ◽  
Vol 41 (S1) ◽  
pp. s34-s35
Author(s):  
Dustin Flannery ◽  
Ibukun Akinboyo ◽  
Sagori Mukhopadhyay ◽  
Alison Tribble ◽  
Lihai Song ◽  
...  
Keyword(s):  
United States ◽  
Escherichia Coli ◽  
Antibiotic Susceptibility ◽  
Antibiotic Prescription ◽  
The United States ◽  
E Coli ◽  
Empiric Antibiotic ◽  
Antibiotic Susceptibility Patterns ◽  
Susceptibility Patterns ◽  
Over Time

Background:Escherichia coli (E. coli) is a leading cause of infections among term and preterm newborn infants. Continued surveillance of neonatal E. coli antibiotic susceptibility patterns is important to optimize empiric antibiotic prescription for infants at risk for infection, in light of evolving reports of multidrug-resistant gram-negative bacteria in all settings. Our objective was to determine E. coli epidemiology and antibiotic susceptibility patterns among a large sample of infants admitted to neonatal intensive care units (NICUs) across the United States from 2009 to 2017. Methods: Retrospective observational study using the Premier Database, including infants born from 2009 to 2017 and admitted to academic or community NICUs contributing microbiology data during the study period. We analyzed antibiotic susceptibilities for E. coli isolated from blood, cerebrospinal fluid, and urine. We focused on clinically relevant and priority susceptibility categories: (1) ampicillin nonsusceptible; (2) aminoglycoside nonsusceptible; (3) carbapenem nonsusceptible; and (4) extended-spectrum β-lactamase (ESBL; phenotypic definition). We determined the proportion of infants with nonsusceptible organisms in each category by year and tested for changes over time. Lastly, we assessed susceptibility patterns by specimen source, birthweight, and timing of infection. Results: Of the 117,484 included infants, 733 (0.6%) had at least 1 E. coli episode, of which 721 (98.4%) had available susceptibility results, from 69 centers. Patient and center characteristics of infants with E. coli are shown in Table 1. Most organisms were tested against ampicillin (99.9%), gentamicin (99.6%), and ceftriaxone (91.5%). Figure 1 shows nonsusceptibility rates for the categories of interest. Overall, ampicillin nonsusceptibility ranged from 63.3% to 68.6% per year (mean, 66.8%±1.5%); aminoglycoside nonsusceptibility ranged from 10.7% to 23.2% (mean, 16.8%±4.5%); carbapenem nonsusceptibility was 0% for all years; and ESBL ranged from 1.2% to 11.3% (mean, 5.1%±3.4%). We detected no statistically significant trends for any of the categories of interest over time (all P > .05), and susceptibility trends were consistent when repeated by specimen source, birthweight, and timing of infection. Conclusions: We found stable, yet concerning, patterns of E. coli antibiotic nonsusceptibility among infants admitted to NICUs across the United States from 2009 to 2017. Rates of ampicillin nonsusceptibility and aminoglycoside nonsusceptibility were higher than previous reports. ESBL E. coli rates were low but present among neonatal patients. No carbapenem nonsusceptible E. coli was identified. These findings can inform empiric antibiotic prescription for infants admitted to NICUs across the United States.Funding: NoneDisclosures: None

scholarly journals Frequency and antibiotic susceptibility patterns of urinary pathogens in male outpatients in Argentina

2014 ◽  
Vol 8 (06) ◽  
pp. 699-704 ◽  
Author(s):  
Hugo E Villar ◽  
Mónica B Jugo ◽  
Alejandro Macan ◽  
Matias Visser ◽  
Mariana Hidalgo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adult Male ◽  
Antimicrobial Susceptibility ◽  
Antibiotic Susceptibility ◽  
Urine Samples ◽  
Diffusion Method ◽  
Bacterial Strains ◽  
Gram Negative ◽  
Antibiotic Susceptibility Patterns ◽  
Susceptibility Patterns

Introduction: Knowledge of the etiology and antimicrobial susceptibility patterns of uropathogens is important for determining the best treatment option. This study aimed to determine the distribution and antibiotic susceptibility patterns of bacterial strains isolated from adult male outpatients. Methodology: Between November 2012 and April 2013, 3,105 community urine samples were analyzed from adult male patients who attended the Laboratorio Hidalgo, Buenos Aires, Argentina. Antimicrobial susceptibility testing was performed by the Kirby-Bauer disc diffusion method. Isolates resistant to third generation cephalosporin were tested for extended-spectrum beta-lactamase (ESBL) production using the double-disk synergy test. Results: Of the 3,105 urine samples analyzed, 791 (25.5%) had significant bacteriuria. The frequency of positive urine cultures increased significantly with patient age. Escherichia coli was isolated most frequently (47.3%), followed by Enterococcus faecalis (13.6%), and Klebsiella pneumoniae (11.9%). Gram-negative organisms represented 78.8% of urinary pathogens. The highest activities against Gram-negative bacteria were found with imipenem (99.0%), amikacin (98.1%), ertapenem (94.2%), fosfomycin (90.7%), and piperacillin-tazobactam (90.1%). The frequencies of ESBLs among E. coli, K. pneumoniae, and P. mirabilis were 15.2 %, 22.3%, and 8%, respectively. Fosfomycin, piperacillin-tazobactam, and nitrofurantoin were most effective against Gram-positive organisms. Conclusions: Fosfomycin may be an excellent option for cystitis treatment in patients without risk factors, whereas piperacillin-tazobactam is preferred for the treatment of parenchymatous UTIs, complicated UTIs, and UTIs associated with risk factors. To ensure the optimal selection of antibiotics, physicians should have access to up-to-date information about the local prevalence of antimicrobial resistance.

scholarly journals Staphylococcus aureus nasal carriage in the community: a survey from central Italy

2002 ◽  
Vol 129 (2) ◽  
pp. 417-420 ◽  
Author(s):  
G. ZANELLI ◽  
A. SANSONI ◽  
A. ZANCHI ◽  
S. CRESTI ◽  
S. POLLINI ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Central Italy ◽  
Rare Event ◽  
Nasal Carriage ◽  
High Rate ◽  
Methicillin Resistant ◽  
Antibiotic Susceptibility Patterns ◽  
Susceptibility Patterns

Recently, concern has increased regarding the spread of methicillin-resistant Staphylococcus aureus (MRSA) in the community. We studied 812 subjects from central Italy to establish the rates of nasal carriage of S. aureus, and antibiotic susceptibility patterns, in the community. The prevalence of S. aureus nasal carriage was 30.5%. Only one subject, with predisposing risk factors for acquisition, was identified as carrier of MRSA (prevalence of 0.12%). The presence of MRSA in the community of our area still appears to be a rare event. Among methicillin-susceptible S. aureus (MSSA) isolates, a surprisingly high rate (18%) of resistance to rifampin was observed.

scholarly journals Myroides injenensis Bacteremia and Severe Cellulitis

2019 ◽  
Vol 6 (7) ◽  
Author(s):  
Stephanie LaVergne ◽  
Thaidra Gaufin ◽  
Douglas Richman
Keyword(s):  
Antibiotic Susceptibility ◽  
Antibiotic Susceptibility Patterns ◽  
Immunocompromised Hosts ◽  
Susceptibility Patterns

Abstract Myroides spp. are environmental bacterial organisms that rarely cause disease in humans. Myroides spp. infections are infrequently reported in the literature, and Myroides injenensis infections are quite uncommon. Myroides spp. usually infect immunocompromised hosts and can have highly resistant antibiotic susceptibility patterns. Here we report a case of Myroides injenensis bacteremia and severe cellulitis in a patient with cirrhosis and review the literature of other Myroides spp. infections.

scholarly journals THU0426 CLINICAL CHARACTERISTIC OF INFECTIOUS ULCERATION OVER TOPHI

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 451.2-452
Author(s):  
Z. Huang ◽  
T. LI ◽  
X. Liu
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Antibiotic Susceptibility ◽  
Clinical Characteristics ◽  
Albumin Level ◽  
Gram Positive ◽  
Gram Negative ◽  
Antibiotic Susceptibility Patterns ◽  
Susceptibility Patterns

Background:Infection in ulceration over tophi is the leading cause of sepsis in patients with gout, which is the main indication for surgery. Additionally, patients with infection will significantly prolonged wound closure time compared with those without infection. Investigation of infection in ulceration over tophi will improve our understanding of this critical issue.Objectives:To describe the microbiological profile in ulceration over tophi, antibiotic susceptibility patterns of causative agents, and to study the prediction of infection in ulceration over tophi among patients with gout.Methods:Patients with ulceration over tophi were prospectively enrolled. The clinical characteristics were recorded and microbiological specimens were taken on admission. Specimens were cultured for aerobic and anaerobic bacteria, and antibiotic susceptibility testing was performed for the culture isolates. Patients were divided into 2 groups according to having infectious ulceration or not and the potential risk factors for infectious ulceration over tophi were examined using univariate and multivariate logistic regression analyses.Results:A total of 82 patients were included for analysis. 46 pathogens were isolated from 39 (47.6%) patients, among which the top 3 wereStaphylococcus aureus(43.5%),Pseudomonas aeruginosa(17.4%) andEnterococcus faecalis(13.0%). Overall, the Gram-positive bacilli were more sensitive to gentamicin (81.5%), amikacin (88.9%), trimethoprim/sulfamethoxazole (92.6%), nitrofurantoin (96.3%), linezolid (100.0%), teicoplanin (100.0%) and vancomycin (100.0%) whereas penicillin, oxacillin and ampicillin were 66.7% to 77.8% resistant. The Gram-negative bacilli were more sensitive to amikacin (84.2%), cefoperazone/sulbactam (84.2%) and meropenem (89.5%) whereas ampicillin, amoxicillin/clavulanate, cefotaxime, cefazolin, piperacillin, trimethoprim/sulfamethoxazole and tetracycline were 68.4% to 100% resistant. Patients with infection had a higher rate of smoking history and type 2 diabetes, with higher levels of erythrocyte sedimentation rate, C-reactive protein and leucocyte, and lower level of albumin. In stepwise logistic regression analysis, type 2 diabetes (adjusted OR 5.064; 95% CI = 1.430 to 17.928) and albumin level (adjusted OR 0.855; 95% CI = 0.782 to 0.935) were independent predictors of infection in ulceration over tophi.Conclusion:Infection is common in ulceration over tophi. Different antibiotic susceptibility patterns were observed in Gram-positive bacilli and Gram-negative bacilli. Type 2 diabetes and low albumin level were associated with an increased risk of infection in ulceration over tophi. The data in this study will be beneficial for tailoring infection control measures in a way that improves outcomes of ulceration over tophi.References:[1]Huang Z, Liu X, Liu Y, et al. Clinical characteristics and risk factors of ulceration over tophi in patients with gout.International journal of rheumatic diseases2019;22:1052-7.[2]Xu J, Zhu Z, Zhang W. Clinical characteristics of infectious ulceration over tophi in patients with gout.The Journal of international medical research2018;46:2258-64.Table 1.Bacteria isolated from initial ulceration specimens taken on the first admission.BacteriaNumber* (n = 46)Proportion (%)Gram-positive bacilli2758.7 Staphylococcus aureus2043.5 Enterococcus faecalis613.0 Streptococcus mutans12.2Gram-negative bacilli1941.3 Pseudomonas aeruginosa817.4 Klebsiella pneumonia48.7 Enterobacter cloacae36.5 Escherichia coli24.3 Acinetobacter baumannii24.3* Number of ulcerationDisclosure of Interests: :None declared

Sign in / Sign up

Export Citation Format

Share Document