scholarly journals 1520. Streptococcus anginosus Group Organisms Are an Increasing Cause of Complicated Sinusitis and Otitis Media in Children

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S553-S553
Author(s):  
Jonathan C McNeil ◽  
James Dunn ◽  
Sheldon L Kaplan ◽  
Jesus G Vallejo
Keyword(s):  
Otitis Media ◽  
Hospital Admissions ◽  
Disease Rate ◽  
Clinical Microbiology Laboratory ◽  
Multicenter Studies ◽  
Streptococcus Anginosus ◽  
Invasive Infections ◽  
Dural Enhancement ◽  
Case Rate ◽  
Brain Parenchymal

Abstract Background The Streptococcus anginosus group (SAG), including S. anginosus, S. intermedius and S. constellatus, are common flora of the oral cavity, respiratory tree and gastrointestinal tract. However, these organisms have the potential to cause serious invasive infections and are notably pyogenic. We observed an apparent increase in the frequency of intraorbital and intracranial infections resulting from SAG at Texas Children’s Hospital (TCH). We undertook a retrospective review to describe the frequency and clinical features of these infections. Methods We reviewed the database of the clinical microbiology laboratory at TCH from 2011 to 2018 for SAG-positive cultures. For purposes of this study, cases included were those associated with 1) either otitis media or sinusitis and 2) Pott’s Puffy Tumor, orbital abscesses, epidural abscesses, subdural empyema, brain parenchymal abscesses, dural enhancement by imaging or mastoiditis. Similar methods were used for SAG identification throughout the study period. The number of cases per year was used along with annual hospital admissions data to estimate case rate; case rate trends were examined using linear regression. Results 950 cultures positive for SAG were identified by the clinical lab; 95 cases met inclusion criteria. The median age of patients was 11.4 years. Specific diagnoses are presented in Figure 1. S. intermedius was most commonly isolated (81.1%) followed by S. constellatus (12.6%) and S. anginosus (7.4%); 50.5% of cases were polymicrobial. Among polymicrobial cases, S. aureus was most frequently isolated (25%). All patients underwent surgical intervention and 20.5% underwent ≥2 procedures (Figure 2). 16.8% were associated with intracranial thromboses and 4.2% with CNS infarcts; 8.4% of patients experienced persistent neurologic deficits. All isolates were susceptible to penicillin. We observed an increase in the annual disease rate during the study (Figure 3, P = 0.01). Conclusion Complications of otitis media and sinusitis due to SAG are associated with substantial morbidity. These infections are becomingly increasingly common at our center although the precise reason for this temporal trend is unclear. Multicenter studies are needed to validate these epidemiologic findings. Disclosures All authors: No reported disclosures.

scholarly journals Trends in molecular characteristics and antimicrobial resistance of group B streptococci: a multicenter study in Serbia, 2015–2020

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Dusan Kekic ◽  
Ina Gajic ◽  
Natasa Opavski ◽  
Milan Kojic ◽  
Goran Vukotic ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Neonatal Morbidity ◽  
Disease Rate ◽  
Molecular Characteristics ◽  
Group B Streptococci ◽  
Live Births ◽  
Invasive Infections ◽  
Group B

AbstractGroup B Streptococcus (GBS) is a major cause of neonatal morbidity and mortality. Serbia has not fully implemented preventive measures against GBS neonatal diseases. Therefore, we aimed to assess the maternal GBS colonisation and invasive neonatal disease rate, to reveal the trends of antimicrobial resistance and serotype distribution of GBS from various patient groups. Randomly selected non-invasive (n = 991) and all invasive GBS (n = 80) collected throughout Serbia from 2015 to 2020 were tested for antimicrobial susceptibility, capsular typing, and hvgA detection. Overall, 877/5621 (15.6%) pregnant women were colonised with GBS. Invasive GBS infections incidence in infants (0.18/1000 live births) showed a decreasing trend (0.3 to 0.1/1000 live births). Type III was overrepresented in infants with invasive infections (n = 35, 58.3%), whereas type V predominated among colonised adults (n = 224, 25.5%) and those with noninvasive (n = 37, 32.5%) and invasive infections (n = 8, 40%). The hypervirulent clone III/ST17 was highly associated with invasive infections (n = 28, 35%), particularly late-onset disease (n = 9, 47.4%), showing an increase from 12.3 to 14.8%. The GBS resistance to erythromycin and clindamycin was 26.7% and 22.1%, respectively, with an upward trend. The emergence of the hypervirulent clone III/ST17 and the escalation in GBS resistance highlight an urgent need for continuous monitoring of GBS infections.

scholarly journals Automatic Alerts for Methicillin-Resistant Staphylococcus aureus Surveillance and Control: Role of a Hospital Information System

1996 ◽  
Vol 17 (8) ◽  
pp. 496-502 ◽  
Author(s):  
Didier Pittet ◽  
Edith Safran ◽  
Stephan Harbarth ◽  
François Borst ◽  
Pascale Copin ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Information System ◽  
Infection Control ◽  
Hospital Information System ◽  
Hospital Admissions ◽  
Control Measures ◽  
Clinical Microbiology Laboratory ◽  
Infection Control Program ◽  
Methicillin Resistant

AbstractBackground: Methicillin-resistant Staphylococcus aureus (MRSA) is an escalating problem in hospitals worldwide. The hospital reservoir for MRSA includes recognized and unrecognized colonized or infected patients, as well as previously colonized or infected patients readmitted to the hospital. Early and appropriate infection control measures (ICM) are key elements to reduce MRSA transmission and to control the hospital reservoir.Objective: To describe the role of an expert system applied to the control of MRSA at a large medical center (1,600 beds) with high endemic rates.Methods: The University Hospital of Geneva has an extended hospital information system (HIS), DIOGENE, structured with an open distributed architecture. It includes administrative, medical, nursing, and laboratory applications with their relational databases. Among available patient databases, clinical microbiology laboratory and admission-discharge-transfer (ADT) databases are used to generate computer alerts. A laboratory alert (lab alert) is printed daily in the Infection Control Program (ICP) offices, listing all patients with cultures positive for MRSA detected within the preceding 24 hours. Patients might be either newly detected patients colonized or infected with MRSA, or previously recognized MRSA patients having surveillance cultures. The ICP nurses subsequently go to the ward or call the ward personnel to implement ICM. A second alert, the “readmission alert,” detects readmission to the hospital of any patient previously colonized or infected with MRSA by periodic queries (q 1 min) to the ADT database. The readmission alert is printed in the ICP offices, but also forwarded with added guidelines to the emergency room.Results: During the first 12 months of application (July 1994 to June 1995), the lab alert detected an average of 4.6 isolates per day, corresponding to 314 hospital admissions (248 patients); the use of this alert saved time for the ICP nurses by improving work organization. There were 438 readmission alerts (1.2 alerts per day) over the study period; of 347 patients screened immediately upon readmission, 114 (33%) were positive for MRSA carriage. Delayed recognition of readmitted MRSA carriers decreased significantly after the implementation of this alert; the proportion of MRSA patients recognized at the time of admission to the hospital increased from 13% in 1993 to 40% in 1995 (P<.001).Conclusions: Hospital information system-based alerts can play an important role in the surveillance and early prevention of MRSA transmission, and it can help to recognize patterns of colonization and transmission.

scholarly journals The microbiology of the acute dental abscess

2009 ◽  
Vol 58 (2) ◽  
pp. 155-162 ◽  
Author(s):  
D. Robertson ◽  
A. J. Smith
Keyword(s):  
Hospital Admissions ◽  
Odontogenic Infections ◽  
Culture Techniques ◽  
Streptococcus Anginosus ◽  
Dental Abscess ◽  
Relevant Today ◽  
Causative Agents ◽  
Severe Infections ◽  
Viridans Group Streptococci ◽  
Insight Into

The acute dental abscess is frequently underestimated in terms of its morbidity and mortality. The risk of potential serious consequences arising from the spread of a dental abscess is still relevant today with many hospital admissions for dental sepsis. The acute dental abscess is usually polymicrobial comprising facultative anaerobes, such as viridans group streptococci and the Streptococcus anginosus group, with predominantly strict anaerobes, such as anaerobic cocci, Prevotella and Fusobacterium species. The use of non-culture techniques has expanded our insight into the microbial diversity of the causative agents, identifying such organisms as Treponema species and anaerobic Gram-positive rods such as Bulleidia extructa, Cryptobacterium curtum and Mogibacterium timidum. Despite some reports of increasing antimicrobial resistance in isolates from acute dental infection, the vast majority of localized dental abscesses respond to surgical treatment, with antimicrobials limited to spreading and severe infections. The microbiology and treatment of the acute localized abscess and severe spreading odontogenic infections are reviewed.

Complications of Otitis Media and Sinusitis Caused by Streptococcus anginosus Group Organisms in Children

2020 ◽  
Vol 39 (2) ◽  
pp. 108-113
Author(s):  
J. Chase McNeil ◽  
James J. Dunn ◽  
Sheldon L. Kaplan ◽  
Jesus G. Vallejo
Keyword(s):  
Otitis Media ◽  
Streptococcus Anginosus

scholarly journals Trends in adult otitis media incidence - a 20-year national observational study

2021 ◽  
Author(s):  
Marie Gisselsson-Solen
Keyword(s):  
Otitis Media ◽  
Watchful Waiting ◽  
Hospital Admissions ◽  
Acute Otitis Media ◽  
Pneumococcal Vaccination ◽  
National Database ◽  
Common Disease ◽  
Outpatient Visits ◽  
Hospitalised Patients ◽  
Number Of Patients

Objective: Otitis media (OM) is a common disease in childhood, but much less prevalent in adults, where it, however, tends to have a less benign course. The incidence of OM in children has decreased in recent years, which might be partly explained by the introduction of watchful waiting strategies, and by the introduction of conjugate pneumococcal vaccination (PCV) in children. Adult OM has been sparsely studied, and it is not known whether a herd immunity effect has been achieved after the introduction of PCV. Watchful waiting is usually not considered in adult OM patients. The purpose of this study was to use a national database to investigate the incidence of adult OM in Sweden during the last 20 years. Design: The yearly number of patients aged 20 and over, admitted to hospital with OM was obtained through a national database from 2000 to 2019. The corresponding numbers for outpatients were obtained between 2005 and 2019. Main outcome measures: incidence of acute otitis media in adults in in- and outpatient care. Results: Incidence rates decreased steadily during the study period. Comparing data on hospitalised patients from 2016-2019 to 2005-2008 (PCV was introduced in 2009), the incidence rate ratio was 0.49 (95% CI 0.45-0.53); p<0.0001. The corresponding figures for outpatients were 0.62 (95% CI 0.61-0.63); p<0.0001. The decrease in hospital admissions was most pronounced among younger patients, whereas the opposite was true for outpatient visits. Conclusions: There has been a continuous decrease in incidence of adult patients admitted to hospital with OM in Sweden during the last twenty years. Outpatient visits for OM have declined since 2009.

scholarly journals Characterization of Streptococcus pneumoniae strains causing invasive infections using whole-genome sequencing

2020 ◽  
Vol 97 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Konstantin O. Mironov ◽  
Vitaly I. Korchagin ◽  
Yuliya V. Mikhailova ◽  
Yurii G. Yanushevich ◽  
Andrey A. Shelenkov ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Pneumococcal Infection ◽  
Whole Genome ◽  
Multicenter Studies ◽  
Serotype 1 ◽  
Invasive Infections ◽  
Sequence Types

Purpose: antigenic and genetic characterization of Streptococcus pneumoniae strains isolated from patients with invasive forms of pneumococcal infection using whole-genome sequencing.Materials and Methods. The study was performed on 46 S. pneumoniae strains isolated during the PEHASus multicenter studies in 2015-2018. Sequencing was performed using Illumina protocols and equipment. The SPAdes, SeroBA, PneumoCaT software were used for data processing, as well as BIGSdb software (PubMLST.org).Results and Discussion. Whole-genome sequences of strains were obtained; the information was entered into the PubMLST database (id: 51080-51125). Ten (21%) strains were found to have serotype 3. Five (11%) strains belonged to serotype 19F and five to serogroup 6; two of them belonged to serotype 6A; one strain had 6B and 1 had 6BE serotype; 1 strain showed discordant result (6A or 6BE). Serotype 15B was identified in 3 (6.5%) strains. Serotypes 7F, 8, 9V, 14, 22F, 23F and 28A were identified in two strains each; serotypes 1, 4, 9N, 10C, 12F, 18C, 35F, 37 and 38 were found once. The proportion of strains with serotypes included in PCV13 and PPV23 vaccines was 65% and 80%, respectively. 36 sequence types were found in strains; out of them, 6 sequence types were found for the first time. A dominant sequence type or clone complexes could not be identified using multilocus sequence typing except for serotype 3 strains. The inability to identify clonal complexes is in congruence with the previously obtained data on the absence of S. pneumoniae clones associated with pneumococcal meningitis in Russia.Conclusion. The information about serotypes of S. pneumoniae causing invasive infections together with epidemiologic data about strain sources and vaccination allows us to evaluate the effectiveness of pneumococcal vaccines and provide information for improving the PCR-based routine serotyping.

scholarly journals Decline in Pneumonia and Acute Otitis Media after the Introduction of Childhood Pneumococcal Vaccination in Liguria, Italy

2008 ◽  
Vol 36 (6) ◽  
pp. 1255-1260 ◽  
Author(s):  
F Ansaldi ◽  
L Sticchi ◽  
P Durando ◽  
R Carloni ◽  
P Oreste ◽  
...  
Keyword(s):  
Otitis Media ◽  
Conjugate Vaccine ◽  
Pneumococcal Pneumonia ◽  
Hospital Admissions ◽  
Acute Otitis Media ◽  
Pneumococcal Vaccination ◽  
Birth Cohorts ◽  
Admission Rates ◽  
Immunization Programme ◽  
Before And After

The effect of the pneumococcal conjugate vaccine immunization programme on pneumococcal-associated or potentially pneumococcal-associated hospital admissions in the Italian region of Liguria was assessed. Hospital admission rates were compared in subjects belonging to birth cohorts before and after the introduction of widespread immunization for 0 − 2-year old children with a seven-valent conjugate vaccine (PCV7). Significant reductions in hospitalization rates for all-cause and pneumococcal pneumonia and for acute otitis media were observed in subjects born after widespread uptake of the vaccine. The preventive fraction (a measure of vaccine effectiveness) ranged from 15.2% for all-cause pneumonia to 70.5% for pneumococcal pneumonia. This study contributes to the growing body of information that supports the beneficial effect of PCV7 vaccination.

scholarly journals 1681. Assessment of the Impact of Infectious Events in a Cohort of Pediatric Leukemia Patients in the Dominican Republic

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S615-S616
Author(s):  
Julianne E Burns ◽  
Dominga Reyes Pérez ◽  
Yimei Li ◽  
Wendy Gómez García ◽  
F Jay Garcia ◽  
...  
Keyword(s):  
Dominican Republic ◽  
Poisson Regression ◽  
Hospital Admissions ◽  
Lymphoblastic Leukemia ◽  
Invasive Infection ◽  
Pediatric Leukemia ◽  
Middle Income ◽  
Effective Interventions ◽  
Invasive Infections ◽  
The Impact

Abstract Background Infections are a leading cause of morbidity and mortality in children with cancer. Although data are limited, the impact of infection in this population appears to be amplified in low- and middle-income countries. Defining the epidemiology of infection in a specific region is paramount to developing effective interventions. This study aims to define the epidemiology of and outcomes from infection in children with leukemia in the Dominican Republic. Methods A retrospective cohort was assembled of children newly diagnosed with leukemia between July 1, 2015 and June 30, 2017 at Hospital Infantil Dr. Robert Reid Cabral in Santo Domingo. Patients were identified from the Pediatric Oncology Network Database and hospital admissions from the Oncology admissions logbook. Medical records and microbiology results were reviewed to identify all inpatient invasive infections. Distance from a child’s home to the hospital was determined using ArcGIS 10.5.1. Infection rates were described in discrete time periods after diagnosis and risk factors for invasive infection were explored using Poisson regression. Results The cohort included 68 patients; 54 (79.4%) with acute lymphoblastic leukemia and 14 (20.6%) with acute myeloblastic leukemia. The cohort was 48.5% female, had a median age at diagnosis of 7.3 years (range 1.1–16.6), and a median weight-for-age of 45.5 percentile (range 0–99.9). There were 1.2 invasive infections per 100 days at risk in the first 60 days after diagnosis, 0.8 from > 60–100 days, and 0.4 from > 100–180 days. Gastroenteritis, skin/soft-tissue infection, and pneumonia were most frequent, with bacteremia most common in the first 60 days. In a multivariate Poisson regression model, age ≥10 years (IRR 0.49, 95% CI 0.28–0.85) and distance from the hospital >100 km (IRR 0.34, 95% CI 0.14 – 0.81) were each protective against infection in the first 180 days after diagnosis. During the 2-year period, 8 of 22 (36%) patient deaths were related to infection. Conclusion Invasive infections were common and a prominent source of death in this cohort. Interventions aimed at reducing infection should target the first 60 days after diagnosis. Decreased infection incidence among children of older age and farther distance from the hospital were unexpected and warrant further investigation. Disclosures All authors: No reported disclosures.

Clostridium difficile Infections in Veterans Health Administration Acute Care Facilities

2014 ◽  
Vol 35 (8) ◽  
pp. 1037-1042 ◽  
Author(s):  
Martin E. Evans ◽  
Loretta A. Simbartl ◽  
Stephen M. Kralovic ◽  
Rajiv Jain ◽  
Gary A. Roselle
Keyword(s):  
Clostridium Difficile ◽  
Acute Care ◽  
Hospital Admissions ◽  
Healthcare Facility ◽  
Resistant Organism ◽  
Veterans Health ◽  
Health Administration ◽  
Case Rate ◽  
Community Onset ◽  
Admission Prevalence

ObjectiveAn initiative was implemented in July 2012 to decrease Clostridium difficile infections (CDIs) in Veterans Affairs (VA) acute care medical centers nationwide. This is a report of national baseline CDI data collected from the 21 months before implementation of the initiative.MethodsPersonnel at each of 132 data-reporting sites entered monthly retrospective CDI case data from October 2010 through June 2012 into a central database using case definitions similar to those of the National Healthcare Safety Network multidrug-resistant organism/CDI module.ResultsThere were 958,387 hospital admissions, 5,286,841 patient-days, and 9,642 CDI cases reported during the 21-month analysis period. The pooled CDI admission prevalence rate (including recurrent cases) was 0.66 cases per 100 admissions. The nonduplicate/nonrecurrent community-onset not-healthcare-facility-associated (CO-notHCFA) case rate was 0.35 cases per 100 admissions, and the community-onset healthcare facility–associated (CO-HCFA) case rate was 0.14 cases per 100 admissions. Hospital-onset healthcare facility–associated (HO-HCFA), clinically confirmed HO-HCFA (CC-HO-HCFA), and CO-HCFA rates were 9.32, 8.40, and 2.56 cases per 10,000 patient-days, respectively. There were significant decreases in admission prevalence (P = .0006, Poisson regression), HO-HCFA (P = .003), and CC-HO-HCFA (P = .004) rates after adjusting for type of diagnostic test. CO-HCFA and CO-notHCFA rates per 100 admissions also trended downward (P = .07 and .10, respectively).ConclusionsVA acute care medical facility CDI rates were higher than those reported in other healthcare systems, but unlike rates in other venues, they were decreasing or trending downward. Despite these downward trends, there is still a substantial burden of CDI in the system supporting the need for efforts to decrease rates further.

Otologic Facial Palsy: Etiology, Onset, and Symptom Duration

2002 ◽  
Vol 111 (7) ◽  
pp. 598-602 ◽  
Author(s):  
Ellen Kvestad ◽  
Kari J. Kværner ◽  
Iain W. S. Mair
Keyword(s):  
Otitis Media ◽  
Facial Palsy ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
University Hospital ◽  
Symptom Duration ◽  
Acute Mastoiditis ◽  
Retrospective Case ◽  
Multicenter Studies ◽  
Case Record

To estimate the occurrence of otogenic facial palsy, we performed a retrospective case record study of all patients hospitalized for otogenic facial palsy in the period 1989 to 1999 at Ullevål University Hospital, which is the only referral hospital for patients with otologic sequelae in Oslo. The facial palsy was a complication of acute otitis media in 10 patients (56%), of acute mastoiditis in 3 patients (17%), of secretory otitis media in 3 patients (17%), and of chronic otitis media in 2 patients (11%). In half of the patients, complete facial palsy was found at the time of diagnosis. Sixteen patients (89%) reported a gradual onset of the facial palsy. The mean duration of otologic symptoms before the onset of facial palsy was 3 days (range, 1 to 9 days), and the median time to remission was 9 weeks (range, 2 to 96 weeks). Total remission was achieved in all patients who received follow-up. Although most patients recover within a few weeks, some patients have long-lasting facial palsy. Multicenter studies are needed to increase the sample size and to identify predictors of facial palsy duration.

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