The epidemiology of central venous catheter-related bloodstream infection in our renal units is changing

2021 ◽  
pp. 112972982199022
Author(s):  
Salvatore Mandolfo ◽  
Adriano Anesi ◽  
Vanina Rognoni
Keyword(s):  
Burkholderia Cepacia ◽  
Present Report ◽  
Statistical Significance ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Renal Unit ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Over Time

Recent reports have shown an increase in the rate of Gram-negative bacteremia in several settings, including catheter-related bloodstream infections (CRBSI). To analyze if the epidemiology of CRBSI is also changing in hemodialysis patients, we revisited the etiology of CRBSIs in our renal unit over 8 years. During the observed periods, 149 episodes of CRBSIs were reported and the CRBSI incidence rate, ranged between 0.67 and 0.82 episodes/1000 tCVC days. Of these 149 episodes, 84 (56.3%) were due to Gram-positive bacteria, 62 (41.6%) to Gram-negative bacteria, and 3 (2.1%) to polymicrobial flora, no episodes of fungi were found. There was a trend, but not statistically significative, increase over time in the number of Gram-negative CRBSIs among the total CRBSIs, rising from 37.8% in the first period to 41.2% in the second period and to 44.3% in the last period, with a parallel decrease in the percentage of Gram-positive CRBSIs (from 59.5% to 56.9% and subsequently to 54.1%). Between Gram-negative, we reported an intensification of CRBSI due to Enterobacterales, particularly Escherichia coli. Among the Gram-negative, we have isolated germs rarely reported in the literature, such as Burkholderia cepacia, Pantoea agglomerans, and Rhizobium radiobacter. Regarding Gram-positive bacteria, a triplicate incidence of Staphylococcus aureus was reported with MRSA accounting for 42% in the third period. Among the Gram-positive bacteria, we reported two episodes of Kocuria kristinae and two of Bacillus spp. Our data demonstrated that the epidemiology of CRBSI in the same center, will change over time and Gram-negative strains are an increasing cause of CRBSI. The limitation of the present report is that statistical significance has not been reached, probably due to the limited number of CRBSI. New bacteria, both Gram-negative and Gram-positive, are emerging. Collaboration with the Microbiology Department appears essential to an appropriate diagnosis.

scholarly journals Microbiological Isolates and Antibiotic Susceptibilities in Cases of Posttraumatic Endophthalmitis: A 15-Year Review

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Chunhong Liu ◽  
Jian Ji ◽  
Zhujian Wang ◽  
Huiwen Chen ◽  
Wenjun Cao ◽  
...  
Keyword(s):  
Antibiotic Sensitivity ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Fungal Isolates ◽  
Antibiotic Susceptibilities ◽  
Chi Squared ◽  
Posttraumatic Endophthalmitis ◽  
Over Time

Purpose. The objective of this study was to evaluate the microbiological spectrum and antibiotic susceptibilities of isolates in posttraumatic endophthalmitis over a 15-year period. Methods. A retrospective study of 3,163 posttraumatic endophthalmitis cases was conducted between July 2004 and July 2019. The outcome measures included the microbiological spectrum and antibiotic susceptibilities. Chi-squared tests were conducted to detect trends in changes in antibiotic sensitivity over the 15-year period. P values of <0.05 were considered statistically significant. Results. Of the 3,163 cases of posttraumatic endophthalmitis, 1,003 culture-positive isolates were identified. Among these, there were 848 (84.5%) Gram-positive isolates, 109 (10.9%) Gram-negative isolates, and 46 (4.6%) fungal isolates. The most common isolates were Staphylococcal species. There was a significant increase in the percentage of fungal isolates over the 15-year period (P=0.02). Gram-positive organisms showed the greatest level of susceptibility to vancomycin (99.6%). The susceptibilities of the 109 Gram-negative isolated organisms were as follows: levofloxacin (95.8%), meropenem (95.7%), ciprofloxacin (93.5%), tobramycin (90.8%), imipenem (88.9%), trimethoprim-sulfamethoxazole (TMP-SMX) (87.7%), ertapenem (80%), and ceftazidime (79.1%). The susceptibility of Gram-positive organisms to several antibiotics, including levofloxacin (P=0.004), ciprofloxacin (P<0.001), and chloramphenicol (P=0.001) decreased over time, whereas the susceptibility to TMP-SMX increased over time (P<0.001). The susceptibility of Gram-negative bacilli to ceftazidime decreased over time (P=0.03). Conclusions. Over the 15-year study period, most isolates were Gram-positive cocci, especially coagulase-negative staphylococci (CNS). Vancomycin seemed to be the most effective antibiotic for Gram-positive bacteria. Gram-negative bacteria appeared to be most susceptible to fluoroquinolones. A number of antibiotics showed an increasing trend of microbial resistance.

scholarly journals The diagnostic ability of procalcitonin to differentiate Gram-negative bacteria from Gram-positive bacteria and fungal bloodstream infections in critically ill patients

2019 ◽  
Vol 17 ◽  
pp. 205873921984146
Author(s):  
Di Wang ◽  
Xiaogen Tao ◽  
Wei Guo ◽  
Haihua Liu ◽  
Shaohui Cheng ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Operating Characteristic ◽  
Bloodstream Infections ◽  
Gram Negative Bacteria ◽  
Diagnostic Ability ◽  
Gram Positive ◽  
Gram Negative ◽  
Receiver Operating Characteristic Curves ◽  
Gram Positive Bacteria

Bloodstream infection (BSI) is a severe infectious complication in critically ill patients. This study was aimed to investigate the diagnostic accuracy of procalcitonin (PCT) to differentiate Gram-negative bacteria (Gram-neg) from Gram-positive bacteria (Gram-pos) and fungal BSI. PCT and other inflammation markers of monomicrobial BSI patients were retrospectively collected and compared between patients with Gram-neg, Gram-pos, or fungal BSI. The differential diagnosis performance of PCT was evaluated by receiver operating characteristic curves (ROC). The area under curve (AUC) of PCT for differentiating Gram-neg BSI from Gram-pos BSI was 0.95 with an optimal cut-off value of 4.15 ng/mL, a sensitivity of 82.05%, and a specificity of 96.15%. AUC of PCT for differentiating Gram-neg BSI from fungal BSI was 0.92 with an optimal cut-off value of 3.13 ng/mL, a sensitivity of 84.62%, and a specificity of 88.89%. Serum PCT concentration can be used to differentiate Gram-neg from Gram-pos and fungal BSI.

scholarly journals Epidemiology and mortality in bacterial bloodstream infections in patients with hematologic malignancies

2019 ◽  
Vol 13 (08) ◽  
pp. 727-735
Author(s):  
Duygu Mert ◽  
Sabahat Ceken ◽  
Gulsen Iskender ◽  
Dicle Iskender ◽  
Alparslan Merdin ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Mortality Rate ◽  
Hematological Malignancies ◽  
Methicillin Resistance ◽  
Bloodstream Infections ◽  
Hematologic Malignancies ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria

Introduction: Patients with hematological malignancies, who are in the high risk group for infectious complications and bacterial bloodstream infections. The aim of the study evaluated epidemiology and mortality in bacterial bloodstream infections in patients with hematologic malignancies. In addition to determine the risk factors, changes in the distribution and frequency of isolated bacterias. Methodology: In this retrospective study. There were investigated data from 266 patients with hematological malignancies and bacterial bloodstream infections who were hospitalized between the dates 01/01/2012 and 12/31/2017. Results: There were 305 blood and catheter cultures in febrile neutropenia attacks in total. In these total attacks, primary bloodstream infections were 166 and catheter-related bloodstream infections were 139. In blood cultures; Escherichia coli and Klebsiella pneumoniae bacteria were detected in 58,0% and 22,9% of the samples, respectively. 52,4% of the cultured Gram-negative bacterias were extended spectrum beta-lactamase (ESBL). Carbapenemase positive culture rate was 17,2% in Gram-negative bacteria cultures. Staphylococcus epidermidis was found in 38,4% of the Gram-positive bacteria cultures. In Gram-positive bacteria; methicillin resistance were detected in 82,2% of the samples. There was a statistically significant relationship between bloodstream infection and disease status. 60 patients with primary bloodstream infections were newly diagnosed. Conclusions: In patients with hematological malignancies, certain factors in the bloodstream infections increase the mortality rate. With the correction of these factors, the mortality rate in these patients can be reduced. The classification of such risk factors may be an important strategy to improve clinical decision making in high-risk patients, such as patients with hematological malignancies.

Catheter-related bloodstream infections: predictive factors for Gram-negative bacteria aetiology and 30 day mortality in a multicentre prospective cohort

2020 ◽  
Vol 75 (10) ◽  
pp. 3056-3061
Author(s):  
Federica Calò ◽  
Pilar Retamar ◽  
Pedro María Martínez Pérez-Crespo ◽  
Joaquín Lanz-García ◽  
Adrian Sousa ◽  
...  
Keyword(s):  
Septic Shock ◽  
Protective Factors ◽  
Empirical Therapy ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Empirical Treatment ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
National Cohort

Abstract Background Catheter-related bloodstream infections (CRBSIs) increase morbidity and mortality, prolong hospitalization and generate considerable medical costs. Recent guidelines for CRBSI recommend empirical therapy against Gram-positive bacteria (GPB) and restrict coverage for Gram-negative bacteria (GNB) only to specific circumstances. Objectives To investigate predictors of GNB aetiology in CRBSI and to assess the predictors of outcome in patients with CRBSI. Methods Patients with CRBSI were selected from the PROBAC cohort, a prospective, observational, multicentre national cohort study including patients with bloodstream infections consecutively admitted to 26 Spanish hospitals in a 6 month period (October 2016–March 2017). Outcome variables were GNB aetiology and 30 day mortality. Adjusted analyses were performed by logistic regression. Results Six hundred and thirty-one episodes of CRBSI were included in the study. Risk factors independently related to GNB aetiology were central venous catheter (CVC) [OR 1.60 (95% CI: 1.05–2.44), P = 0.028], sepsis/septic shock [OR: 1.76 (95% CI: 1.11–2.80), P = 0.016], antibiotic therapy in the previous 30 days [OR: 1.56 (95% CI: 1.02–2.36), P = 0.037], neutropenia &lt;500/μL [OR: 2.01 (95% CI: 1.04–3.87), P = 0.037] and peripheral vascular disease [OR: 2.04 (95% CI: 1.13–3.68), P = 0.018]. GNB were not associated with increased mortality in adjusted analysis, while removal of catheter [OR: 0.24 (95% CI: 0.09–0.61), P = 0.002] and adequate empirical treatment [OR: 0.37 (95% CI: 0.18–0.77), P = 0.008] were strong protective factors. Conclusions Our study reinforces the recommendation that empirical coverage should cover GNB in patients presenting with sepsis/septic shock and in neutropenic patients. Catheter removal and adequate empirical treatment were both protective factors against mortality in patients with CRBSI.

Microanatomy of the Periplasm of Bacillus Licheniformis

1971 ◽  
Vol 29 ◽  
pp. 262-263
Author(s):  
B.K. Ghosh
Keyword(s):  
Cell Wall ◽  
Plasma Membrane ◽  
Bacillus Licheniformis ◽  
External Environment ◽  
Permeability Barrier ◽  
Periplasmic Space ◽  
Modified Technique ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria

Periplasm of bacteria is the space outside the permeability barrier of plasma membrane but enclosed by the cell wall. The contents of this special milieu exterior could be regulated by the plasma membrane from the internal, and by the cell wall from the external environment of the cell. Unlike the gram-negative organism, the presence of this space in gram-positive bacteria is still controversial because it cannot be clearly demonstrated. We have shown the importance of some periplasmic bodies in the secretion of penicillinase from Bacillus licheniformis.In negatively stained specimens prepared by a modified technique (Figs. 1 and 2), periplasmic space (PS) contained two kinds of structures: (i) fibrils (F, 100 Å) running perpendicular to the cell wall from the protoplast and (ii) an array of vesicles of various sizes (V), which seem to have evaginated from the protoplast.

Rapid demonstration of septic or infectious arthritis due to Gram-negative bacteria

1992 ◽  
Vol 50 (1) ◽  
pp. 686-687
Author(s):  
Jacob S. Hanker ◽  
Paul R. Gross ◽  
Beverly L. Giammara
Keyword(s):  
Chronic Arthritis ◽  
Blood Cultures ◽  
Gram Negative Bacteria ◽  
Infectious Arthritis ◽  
Bacterial Arthritis ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria

Blood cultures are positive in approximately only 50 per cent of the patients with nongonococcal bacterial infectious arthritis and about 20 per cent of those with gonococcal arthritis. But the concept that gram-negative bacteria could be involved even in chronic arthritis is well-supported. Gram stains are more definitive in staphylococcal arthritis caused by gram-positive bacteria than in bacterial arthritis due to gram-negative bacteria. In the latter situation where gram-negative bacilli are the problem, Gram stains are helpful for 50% of the patients; they are only helpful for 25% of the patients, however, where gram-negative gonococci are the problem. In arthritis due to gram-positive Staphylococci. Gramstained smears are positive for 75% of the patients.

Antibacterial activity of magnesium oxide nanoparticles prepared by Calcination method

2019 ◽  
Vol 10 (03) ◽  
Author(s):  
Elaf Ayad Kadhem ◽  
Miaad Hamzah Zghair ◽  
Sarah , Hussam H. Tizkam, Shoeb Alahmad Salih Mahdi ◽  
Hussam H. Tizkam ◽  
Shoeb Alahmad
Keyword(s):  
Antibacterial Activity ◽  
Magnesium Oxide ◽  
Diffusion Method ◽  
Oxide Nanoparticles ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Magnesium Oxide Nanoparticles ◽  
Agar Disc

magnesium oxide nanoparticles (MgO NPs) were prepared by simple wet chemical method using different calcination temperatures. The prepared NPs were characterized by Electrostatic Discharge (ESD), Scanning Electron Microscope (SEM) and X-ray Diffraction (XRD). It demonstrates sharp intensive peak with the increase of crystallinty and increase of the size with varying morphologies with respect to increase of calcination temperature. Antibacterial studies were done on gram negative bacteria (E.coli) and gram positive bacteria (S.aureus) by agar disc diffusion method. The zones of inhibitions were found larger for gram positive bacteria than gram negative bacteria, this mean, antibacterial MgO NPs activity more active on gram positive bacteria than gram negative bacteria because of the structural differences. It was found that antibacterial activity of MgO NPs was found it has directly proportional with their concentration.

BAKTERI PADA KARANG SCLERACTINIA DI KAWASAN PERAIRAN BUNAKEN, MOROTAI DAN RAJA AMPAT

2020 ◽  
Vol 8 (1) ◽  
pp. 122
Author(s):  
Eghbert Eghbert Elvan Eghbert Elvan Ampou ◽  
Iis Iis Triyulianti ◽  
Nuryani Widagti ◽  
Suciadi Catur Nugroho ◽  
Yuli Pancawati
Keyword(s):  
Scleractinian Coral ◽  
Gram Negative Bacteria ◽  
Hard Coral ◽  
Field Sampling ◽  
Bacterial Isolation ◽  
Gram Positive ◽  
Coral Mucus ◽  
Gram Negative ◽  
Gram Positive Bacteria

Research on hard coral (Scleractinian coral) contaminated with bacteria is still not much done, especially in Indonesian waters. This study took samples of coral mucus in 2010 at 3 (three) different locations, namely Bunaken (May); Morotai (September) and Raja Ampat (November), which focused on the analysis of Research on hard coral (Scleractinian coral) contaminated with bacteria is still not much done, especially in Indonesian waters. This study took samples of coral mucus in 2010 at 3 (three) different locations, namely Bunaken (May); Morotai (September) and Raja Ampat (November), which focused on the analysis of gram-positive and gram-negative bacteria. The method used for field sampling is time swim, which is by diving at a depth of 5-10 meters for ± 30 minutes and randomly taking samples of coral mucus using siring or by taking directly on corals (reef branching). Mucus samples were analyzed by bacterial isolation in the laboratory. The result shows that there were differences between gram-positive and gram-negative bacteria in the three research sites and that gram-positive bacteria were higher or dominant. Further research that can identify the bacteria species and explain its relationship to the ecosystem is highly recommended.Keywords: Bacteria, Scleractinian coral, gram-positive and -negative, Bunaken, Morotai, Raja Ampat  AbstrakPenelitian tentang karang keras (Scleractinian coral) yang terkontaminasi bakteri masih belum banyak dilakukan, terutama di perairan Indonesia. Penelitian ini mengambil sampel mucus karang pada tahun 2010 di 3 (tiga) lokasi berbeda, yakni Bunaken (Mei); Morotai (September) dan Raja Ampat (November), yang difokuskan pada analisis bakteri gram postif dan gram negatif. Metode yang digunakan untuk pengambilan sampel di lapangan adalah time swim, yaitu dengan penyelaman pada kedalaman 5-10 meter selama ±30 menit dan mengambil sampel mucus karang secara acak menggunakan siring atau dengan mengambil langsung pada karang (fraksi cabang). Sampel mucus dianalisis dengan cara isolasi bakteri di laboratorium. Hasil analisis menunjukkan bahwa ada perbedaan antara bakteri gram positif dan gram negative di tiga lokasi survei dan bakteri gram positif lebih tinggi atau dominan. Penelitian lebih lanjut yang dapat menentukan jenis bakteri serta menjelaskan hubungannya dengan ekosistem sangat disarankan untuk dilakukan.Kata Kunci : Bakteri, Scleractinian coral, gram positif dan negatif, Bunaken, Morotai, Raja Ampat

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