Pseudomonas aeruginosa Otitis Externa in an Infant Associated With a Contaminated Infant Bath Sponge

Pseudomonas is a Gram-negative bacterium frequently recovered from environmental sources, particularly an aquatic environment. Epidemics of skin rash,1 otitis externa,2 isolated cases of urinary tract infections,3 and pneumonia4 have been associated with whirlpools contaminated by Pseudomonas aeruginosa. This report describes P aeruginosa otitis externa in an infant associated with a contaminated infant bath sponge. CASE REPORT K.E., a 3-month-old, first born, healthy girl was seen for drainage from the left ear. She was listless and febrile and had a moderate amount of whitish drainage from the left ear canal. There was no discharge from the right ear canal, but on examination there was right otitis media.

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Ceftazidime/Avibactam: Who Says You Can’t Teach an Old Drug New Tricks?

Journal of Pharmacy & Pharmaceutical Sciences ◽

10.18433/j3x31r ◽

2016 ◽

Vol 19 (4) ◽

pp. 448 ◽

Cited By ~ 4

Author(s):

Katie E. Barber ◽

Jessica K. Ortwine ◽

Ronda L Akins

Keyword(s):

Pseudomonas Aeruginosa ◽

Urinary Tract ◽

Urinary Tract Infections ◽

The United States ◽

Phase Iii ◽

In Vitro Susceptibility ◽

Gram Negative ◽

Tract Infections ◽

Abdominal Infections

Purpose: Gram-negative resistance continues to rise with treatment options becoming more limited. Ceftazidime/avibactam was recently approved in the United States and Europe, which combines an established third-generation cephalosporin with a new, unique, non-β-lactam β-lactamase inhibitor. This review conducts a thorough examination of structure, pharmacology, spectrum of activity, pharmacokinetics/pharmacodynamics, in vitro and clinical efficacy and safety/tolerability of ceftazidime/avibactam, as well as detailed future directions for the agent. Methods: Pubmed and clinicaltrials.gov searches, as well as abstracts from the 2015 Interscience Conference on Antimicrobial Agents and Chemotherapy/International Society of Chemotherapy (ICAAC/ICC) and ID Week meetings and the 2016 American Society of Microbiology Microbe meeting, were conducted from January 2004 – September 2016. Relevant search terms included ceftazidime, ceftazidime/avibactam, avibactam, NXL104 and AVE1330A. The US package insert for ceftazidime/avibactam (02/2015) and European public assessment report (06/2016) were also reviewed. Results: In vitro susceptibility for ceftazidime/avibactam displayed potent activity against many Enterobacteriaceae including extended-spectrum-β-lactamase (ESBL) and carbapenemase-producing strains, as well as Pseudomonas aeruginosa. Phase II clinical trials utilized for approval demonstrated comparable safety and efficacy to imipenem/cilistatin for treatment of complicated urinary tract infections (70.4% vs. 71.4%) and combined with metronidazole compared to meropenem in complicated intra-abdominal infections (91.2% vs 93.4%). Phase III data displayed non-inferior efficacy of ceftazidime/avibactam compared to doripenem for complicated urinary tract infections (70.2% vs 66.2%) and combined with metronidazole compared to meropenem in complicated intra-abdominal infections (82.5% vs 84.9%), as well as comparable safety. Ceftazidime/avibactam was well-tolerated but does require renal adjustments. Additionally, 3 case series and a single case report have demonstrated the potential for ceftazidime/avibactam against multidrug resistant organisms for compassionate use or failure after previous therapy. Conclusion: By adding avibactam to ceftazidime, clinicians’ antimicrobial armamentarium is expanded, potentially increasing the ability to combat multi-drug resistant gram-negative pathogens, particularly ESBL and carbapenemase-producing organisms, as well as Pseudomonas aeruginosa. This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.

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Cedecea lapagei An Extremely Rare Uropathogen: A Case Report and Review of the Literature

10.21203/rs.3.rs-181472/v1 ◽

2021 ◽

Author(s):

Abdikarim Hussein Mohamed ◽

Hussein Ali Mohamud

Keyword(s):

Renal Failure ◽

Case Report ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Beta Lactam ◽

Gram Negative ◽

Beta Lactamases ◽

Extended Spectrum ◽

Extended Spectrum Beta Lactamases ◽

Tract Infections

Abstract Background: Gram-negative enterobacteria are the most common cause of urinary tract infections. Cedecea is a new separate genus in the family enterobacteriaceae, and it is a very rare pathogen that was primarily found in the respiratory tract. Cedecea lapagei is a very rare pathogen of urinary tract infections. To the best of our knowledge, this is the first case report in the world reported in English literature. Case presentation: A 55 years old man with chronic renal failure, poorly controlled diabetes mellitus, and hypertension presented with acute exacerbations of renal failure and irritative voiding symptoms. After stabilization and empirical antibiotic therapy with Ceftriaxone, the patient’s condition was not improved and deteriorated progressively. After the request of urine culture, the culture was isolated, an extremely rare uropathogen recently recognized by the Centers for Disease Control and Prevention (CDC); the Cedecea lapagei. Cedecea lapagei identification had been done using Eosin methylene blue agar (EMB). Gram-negative lipase positive bacteria with bacillus in shape, motile in nature that is non-spore-forming, and non-encapsulated enterobacteria with the final result of >100,000 colony-forming units per ml of Cedecea lapagei were isolated. Mueller-Hinton agar had been used to perform antimicrobial sensitivity and resistance. The pathogen was extensively resistant to the extended-spectrum beta-lactamases antibiotics and extended-spectrum beta-lactam inhibitors while carbapenems, fluoroquinolones, aminoglycosides, and Trimethoprim-sulfamethoxazole showed a higher sensitivity rate. Conclusion: The treatment of Cedecea lapagei infections represents a challenging issue due to its multi-drug resistant and extensive drug resistance patterns to a variety of antimicrobial classes, such as extended-spectrum beta-lactamases, cephalosporins, and beta-lactam inhibitors. Antimicrobial treatment should be aligned with the culture findings once available.

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Multicentre clinical trial to evaluate microbial spectrum in acute diffuse otitis externa in the residents of Ukraine

OTORHINOLARYNGOLOGY 2-3(2) 2019 - OTORHINOLARYNGOLOGY ◽

10.37219/2528-8253-2021-5-55 ◽

2021 ◽

pp. 55-61

Author(s):

Vasyl I. Popovych

Keyword(s):

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Otitis Externa ◽

Healthy Population ◽

External Ear ◽

Ear Canal ◽

Microbial Composition ◽

Gram Negative ◽

External Ear Canal ◽

Microbial Spectrum

Introduction: Acute diffuse otitis externa is a spread skin inflammation of the external ear canal of the bacterial origin. It is reported at an incidence of up to 10% among healthy population of all age groups. Treatment is known to be based on the empirical approach for prescribing topical antibacterials. Therefore studying the bacterial spectrum of otitis externa causative agents is of great value in terms of relevant antimicrobial therapy. Aim: The objective of the study was to evaluate microbial spectrum in diffuse otitis externa in patients – residents of Ukraine. Materials and methods: Four hundred and ninety-three out-patients diagnosed with acute diffuse otitis externa were enrolled. Microbial composition of the external ear canal microflora was tested and aetiologically relevant titres of colony-forming units (CFU) were determined. Criteria for evaluation: titres of 104 to 106 CFU and >106 CFU were considered aetiologically relevant. titres of <104 CFU were considered aetiologically nonrelevant. Results and discussion: In the majority of cases of acute diffuse otitis externa, infection with Staphylococcus aureus in aetiologically relevant titres is reported in 53.2% and Pseudomonas aeruginosa in 23.6%. Cases of multimicrobial infection predominantly involving Gram-negative flora were also reported in 27.9%; each of them results in no more than 2 to 3% of otitis externa. Titres of Candida spp. (3.2%) and Staphylococcus epidermidis (2.6%) were measured as aetiologically non-relevant. Conclusion: common microbial pathogens in acute diffuse otitis externa in patients of the Ukrainian population are Staphylococcus aureus and Pseudomonas aeruginosa. Multimicrobial associations predominantly involving Gram-negative flora, which do not exceed 2 to 3% of cases. Fungal infections are a rare cause of otitis externa.

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Carbapenemase-Producing Raoultella Planticola: A Rare Cause of Pneumonia and Bacteremia

Diseases ◽

10.3390/diseases6040094 ◽

2018 ◽

Vol 6 (4) ◽

pp. 94 ◽

Cited By ~ 1

Author(s):

Jose Gonzales Zamora ◽

Monica Corzo-Pedroza ◽

Maria Romero Alvarez ◽

Octavio Martinez

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Nosocomial Pneumonia ◽

Aquatic Environments ◽

Human Pathogen ◽

Negative Bacterium ◽

Pathogenic Potential ◽

Gram Negative ◽

Raoultella Planticola ◽

Tract Infections

Raoultella planticola is a gram-negative bacterium of the Enterobacteriaceae family that is usually found in soil, plant and aquatic environments. It is an uncommon human pathogen and has been associated with cases of bacteremia, pneumonia, urinary tract infections, among others. Here, we present the case of an 85-year-old female that developed nosocomial pneumonia and bacteremia caused by Raoultella planticola. Pertinent microbiological studies detected carbapenemase production codified by the blaKPC gene. The patient was successfully treated with ceftazidime/avibactam and polymyxin. Our case illustrates the pathogenic potential of this organism and highlights the importance of phenotypic and genotypic assays for the appropriate identification of carbapenemase production.

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Complete Genome Sequence of Klebsiella pneumoniae Carbapenemase-Producing K. pneumoniae Siphophage Sushi

Genome Announcements ◽

10.1128/genomea.00994-15 ◽

2015 ◽

Vol 3 (5) ◽

Cited By ~ 3

Author(s):

Dat T. Nguyen ◽

Lauren E. Lessor ◽

Jesse L. Cahill ◽

Eric S. Rasche ◽

Gabriel F. Kuty Everett

Keyword(s):

Urinary Tract ◽

Klebsiella Pneumoniae ◽

Genome Sequence ◽

Complete Genome Sequence ◽

Complete Genome ◽

Negative Bacterium ◽

Gram Negative ◽

Klebsiella Pneumoniae Carbapenemase ◽

The Family ◽

Tract Infections

Klebsiella pneumoniae is a Gram-negative bacterium in the family Enterobacteriaceae . It is associated with numerous nosocomial infections, including respiratory and urinary tract infections in humans. The following reports the complete genome sequence of K. pneumoniae carbapenemase-producing K. pneumoniae T1-like siphophage Sushi and describes its major features.

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Rapid diagnosis of Pseudomonas aeruginosa urinary tract infections by radioimmunoassay

Journal of Clinical Microbiology ◽

10.1128/jcm.9.2.253-258.1979 ◽

1979 ◽

Vol 9 (2) ◽

pp. 253-258

Author(s):

R B Kohler ◽

L J Wheat ◽

A White

Keyword(s):

Pseudomonas Aeruginosa ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Solid Phase ◽

Bacterial Species ◽

Phase Growth ◽

Gram Negative ◽

Solid Phase Radioimmunoassay ◽

Tract Infections ◽

Urine Specimens

A solid-phase radioimmunoassay designed to detect serotype 6 Pseudomonas aeruginosa antigens was evaluated for its ability to rapidly diagnose urinary tract infections. Twelve P. aeruginosa serotypes were easily differentiated in the assay from eight other gram-negative bacterial species. During log-phase growth, the assay detected antigens in culture when approximately 10(6) or more serotype 6 P. aeruginosa organisms were present. Both cell-associated and solubilized antigens were detected. The assay detected antigens in 13 of 17 urine specimens which grew greater than 10(5) P. aeruginosa, 3 of 38 which grew other gram-negative rods, and none of 83 with no growth. Two of the three positive specimens from the other gram-negative rod group probably also contained P. aeruginosa. No preincubation of the urine specimens was required, and results were available within 2.5 h. The assay represents an improvement over other procedures for rapidly diagnosing urinary tract infections in that it allows diagnosis by species and should be adaptable to semiautomation.

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Pseudomonas aeruginosa

Oxford Textbook of Medicine ◽

10.1093/med/9780198746690.003.0112 ◽

2020 ◽

pp. 1041-1044

Author(s):

G.C.K.W. Koh ◽

Sharon J. Peacock

Keyword(s):

Pseudomonas Aeruginosa ◽

Urinary Tract ◽

Opportunistic Pathogen ◽

Selective Advantage ◽

Innocent Bystander ◽

Negative Bacterium ◽

Gram Negative ◽

Skin Ulcers ◽

Wide Range ◽

Pathogen Diagnosis

Pseudomonas aeruginosa is a highly versatile environmental Gram-negative bacterium that can be isolated from a wide range of habitats, including soil, marshes, and the ocean, as well as from plant and animal tissues. It is resistant to many disinfectants and antibiotics, giving it a selective advantage in hospitals. It rarely causes infection in the healthy host but is a major opportunistic pathogen. Diagnosis is usually straightforward when the organism is cultured from samples collected from normally sterile sites, but is often challenging when infection is suspected in non-sterile sites such as a catheterized urinary tract, burns, or skin ulcers, because P. aeruginosa may be either a pathogen or an innocent bystander. Treatment can be challenging as P. aeruginosa is intrinsically resistant to a broad range of antimicrobials.

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Antimicrobial Activities of Ceftazidime-Avibactam and Comparator Agents against Gram-Negative Organisms Isolated from Patients with Urinary Tract Infections in U.S. Medical Centers, 2012 to 2014

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00405-16 ◽

2016 ◽

Vol 60 (7) ◽

pp. 4355-4360 ◽

Cited By ~ 17

Author(s):

Helio S. Sader ◽

Mariana Castanheira ◽

Robert K. Flamm ◽

Ronald N. Jones

Keyword(s):

Pseudomonas Aeruginosa ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Antimicrobial Activities ◽

Broth Microdilution ◽

Gram Negative ◽

Content Type ◽

Medical Centers ◽

Gram Negative Organisms ◽

Tract Infections

ABSTRACTA total of 7,272 unique patient clinical isolates were collected from 71 U.S. medical centers from patients with urinary tract infections in 2012 to 2014 and tested for susceptibility to ceftazidime-avibactam and comparators by broth microdilution methods. Ceftazidime-avibactam inhibited >99.9% of allEnterobacteriaceaeat the susceptible breakpoint of ≤8 μg/ml (there were only three nonsusceptible strains). Ceftazidime-avibactam was also active againstPseudomonas aeruginosaisolates (MIC50, 2 μg/ml; MIC90, 4 μg/ml; 97.7% susceptible), including many isolates not susceptible to meropenem, ceftazidime, and/or piperacillin-tazobactam.

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