scholarly journals Bihemispheric Cortical Infarcts in an Adult Secondary to Escherichia coli K1 Meningitis

2021 ◽  
pp. 572-577
Author(s):  
Bhanu Gogia ◽  
Angela L. Young ◽  
Barbara J. O’Brien ◽  
Pablo C. Okhuysen ◽  
Vinodh A. Kumar
Keyword(s):  
Escherichia Coli ◽  
Cerebral Ischemia ◽  
Early Diagnosis ◽  
Antibiotic Treatment ◽  
Pediatric Population ◽  
Neurological Complications ◽  
Diagnosis And Treatment ◽  
E Coli ◽  
Systemic Antibiotic ◽  
Systemic Antibiotic Treatment

Cerebral ischemia is a known complication of meningitis. Most <i>Escherichia coli</i> meningitis-induced infarcts have been reported in the neonatal and pediatric population. To the best of our knowledge, there have been no previous reports describing bilateral cortical infarcts in an adult secondary to a K1 strain of <i>E. coli</i> meningitis, and herein we report a case in a 25-year-old female. The challenge in treating this patient was determining the duration of systemic antibiotic treatment and whether or not to use steroids. This study demonstrates the necessity of early diagnosis and treatment of <i>E. coli</i> meningitis to prevent neurological complications, including stroke.

scholarly journals 1671. Diagnosis and management of Escherichia coli bacteriuria at a Veterans Affairs hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S821-S821
Author(s):  
Niyati H Shah ◽  
Brooke K Decker ◽  
Brooke K Decker ◽  
Gaetan Sgro ◽  
Monique Y Boudreaux-Kelly ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Treatment ◽  
High Yield ◽  
Comorbid Conditions ◽  
Provider Education ◽  
Transmitted Infection ◽  
Physician Practices ◽  
E Coli ◽  
Diagnosis And Management ◽  
Tract Infections

Abstract Background The IDSA recommends against screening for and treating ASB in all patients except for those pregnant or undergoing urologic procedures. Nevertheless, antibiotic treatment of ASB is widespread. We conducted a retrospective analysis of physician practices in diagnosis and management of Escherichia coli (E. coli) ASB in a male Veteran population, and compared outcomes in ASB patients treated or not treated with antibiotics. Methods Patients with an E. coli positive urine culture during an ED visit or inpatient admission from 01/2017 to 12/2017 were screened. Patients admitted to the intensive care unit or diagnosed with a sexually transmitted infection, pyelonephritis, prostatitis, or epididymitis/orchitis were excluded. A total of 163 patients were included. Demographics, clinical comorbidities and severity of illness, and outcomes were compared in ASB patients managed with or without antibiotics. ANOVA and Chi-square or Fisher’s exact tests were utilized for comparing measurements. Results ASB was present in 92/163 patients. The majority (74%) of these patients were given antibiotics. Regardless of qSOFA score or alternate infection, there were no significant differences in outcomes between ASB patients treated or not treated with antibiotics: 3-month mortality (15% vs 21%; p = 0.53), emergence of newly resistant bacterial pathogens (7% vs 13%; p = 0.43), recurrent urinary tract infections (61% vs 50%; p = 0.72), clearance of urinary pathogens (75% vs 58%; p = 0.45), length of hospital stay (7 vs 6 days, p = 0.67). Factors that were predictive of physician treatment of ASB included patient comorbid conditions such as benign prostatic hyperplasia, pyuria, and the absence of hematuria. The incidence of adverse events with antibiotic treatment of ASB was low. Conclusion The rate of antibiotic treatment of E. coli ASB in male veterans is high. Outcomes do not differ among ASB patients managed with or without antibiotics. Future studies examining outcomes in patients prescribed antibiotics for multiple episodes of ASB may yield differences, particularly in emergence of resistant pathogens. Focusing on patients with comorbid conditions who are not critically ill would be a high yield target for provider education to reduce ASB treatment. Disclosures All Authors: No reported disclosures

Investigation of High-Risk ST131 Clone in Extended Spectrum β-Lactamase–Producing Escherichia coli Isolates in Children

2021 ◽  
Author(s):  
Mehmet E. Bulut ◽  
Gülen Hürkal ◽  
Nazan Dalgıç
Keyword(s):  
Escherichia Coli ◽  
High Risk ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Maldi Tof Ms ◽  
E Coli ◽  
Maldi Tof ◽  
Extended Spectrum ◽  
St131 Clone ◽  
Tof Ms

Abstract Objective Antimicrobial resistance poses a serious threat to children's health. In recent years, high-risk Escherichia coli ST131 has become an important target for global surveillance studies. The E.coli ST131 clone is associated with extended spectrum β-lactamase (ESBL) production, as well as multidrug resistance and treatment failure. Studies on this clone in the pediatric age group are limited. We aim to investigate the rate of high-risk E. coli ST131 clone in ESBL-positive E. coli isolates obtained from pediatric patients. Methods A total of 292 ESBL-positive E. coli isolates from clinical samples of pediatric patients was included in the study. MALDI-TOF MS system was used for bacterial identification. Susceptibility tests were performed using BD Phoenix automated system. ST131 detection was done by MALDI-TOF-MS. Fisher's exact test was used to compare the groups (significance <0.05). Results A total of 292 isolates was analyzed. The high-risk ST131 clone was detected in 117 (40%) of the 292 ESBL-positive isolates. ST131 rates were found to be significantly higher in children under the age of 5 years compared with children over the age of 5 years (49.3 vs. 31.1%, p = 0.0019). Ciprofloxacin resistance was higher in ST131 isolates (45.6 vs. 31.7%; p < 0.05). Conclusion The rate of the ST131 clone was found to be high in the pediatric population. The significantly high rate of resistance to ciprofloxacin, which is not commonly used in the pediatric population, in ST131 isolates reveals the importance of the spread of high-risk clones for the development of resistance.

scholarly journals Reactive arthritis and other musculoskeletal symptoms associated with acquisition of diarrhoeagenic Escherichia coli (DEC)

2020 ◽  
Vol 79 (5) ◽  
pp. 605-611
Author(s):  
Riitta Tuompo ◽  
Tinja Lääveri ◽  
Timo Hannu ◽  
Sari H Pakkanen ◽  
Juha Kirveskari ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Multivariate Analysis ◽  
Antibiotic Treatment ◽  
Reactive Arthritis ◽  
Musculoskeletal Symptoms ◽  
E Coli ◽  
Increased Risk ◽  
Stool Samples ◽  
Study Participants

ObjectivesUsing a prospective research design, we evaluated the association between acquisition of diarrhoeagenic Escherichia coli (DEC) and development of reactive arthritis (ReA) and other reactive musculoskeletal (MSK) symptoms among international travellers.MethodsA total of 526 study participants were asked to provide pretravel and post-travel stool samples and fill in questionnaires (pretravel, post-travel and 3-week follow-up). A multiplex quantitative PCR assay was deployed to detect five DEC comprising enteroaggregative E. coli, enteropathogenic E. coli, enterotoxigenic E. coli, enterohaemorrhagic E. coli and enteroinvasive E. coli and Salmonella, Shigella, Campylobacter, Yersinia, and Vibrio cholerae. Multivariate analysis was employed to identify factors predisposing to MSK symptoms. New post-travel MSK symptoms reported by participants with DEC were assessed by phone interviews and, if needed, clinically confirmed.ResultsFrom among the total of 224 volunteers who returned all questionnaires and stool specimens, 38 (17.0%) reported MSK symptoms. Multivariate analysis revealed that acquisition of DEC was associated with MSK symptoms (OR 3.9; 95% CI 1.2 to 13.3). Of the 151 with only-DEC, four (2.6%) had ReA, two (1.3%) reactive tendinitis and three (2.0%) reactive arthralgia. ReA was mostly mild, and all patients with ReA were negative for human leucocyte antigen B27. Antibiotic treatment of travellers’ diarrhoea did not prevent development of MSK symptoms.ConclusionA total of 17% of volunteers reported post-travel MSK symptoms. DEC acquisition was associated with an increased risk of developing them, yet the ReA incidence remained low and the clinical picture mild. Antibiotic treatment did not protect against development of MSK symptoms.

scholarly journals Effects of Therapeutic Ceftiofur Administration to Dairy Cattle on Escherichia coli Dynamics in the Intestinal Tract

2008 ◽  
Vol 74 (22) ◽  
pp. 6956-6962 ◽  
Author(s):  
Randall S. Singer ◽  
Sheila K. Patterson ◽  
Richard L. Wallace
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Treatment ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Causal Link ◽  
Susceptible Population ◽  
E Coli ◽  
Genetic Groups ◽  
Susceptibility Profiles ◽  
Cessation Of Treatment

ABSTRACT The goal of this study was to follow ceftiofur-treated and untreated cattle in a normally functioning dairy to examine enteric Escherichia coli for changes in antibiotic resistance profiles and genetic diversity. Prior to treatment, all of the bacteria cultured from the cows were susceptible to ceftiofur. Ceftiofur-resistant E. coli was only isolated from treated cows during and immediately following the cessation of treatment, and the 12 bla CMY-2-positive isolates clustered into two genetic groups. E. coli bacterial counts dropped significantly in the treated animals (P < 0.027), reflecting a disappearance of the antibiotic-susceptible strains. The resistant bacterial population, however, did not increase in quantity within the treated cows; levels stayed low and were overtaken by a returning susceptible population. There was no difference in the genetic diversities of the E. coli between the treated and untreated cows prior to ceftiofur administration or after the susceptible population of E. coli returned in the treated cows. A cluster analysis of antibiotic susceptibility profiles resulted in six clusters, two of which were multidrug resistant and were comprised solely of isolates from the treated cows immediately following treatment. The antibiotic treatment provided a window to detect the presence of ceftiofur-resistant E. coli but did not appear to cause its emergence or result in its amplification. The finding of resistant isolates following antibiotic treatment is not sufficient to estimate the strength of selection pressure nor is it sufficient to demonstrate a causal link between antibiotic use and the emergence or amplification of resistance.

scholarly journals Association of Systemic Antibiotic Treatment of Acne With Skin Microbiota Characteristics

2019 ◽  
Vol 155 (4) ◽  
pp. 425 ◽  
Author(s):  
Anna L. Chien ◽  
Jerry Tsai ◽  
Sherry Leung ◽  
Emmanuel F. Mongodin ◽  
Amanda M. Nelson ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Skin Microbiota ◽  
Systemic Antibiotic ◽  
Systemic Antibiotic Treatment
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