scholarly journals Cervical melioidosis: an infrequent cause of neck abscess

2020 ◽  
Vol 6 (2) ◽  
pp. 388
Author(s):  
Nurul Alya Binti Azwan ◽  
Ram Kumar Sharma Shanmugam ◽  
Kong Yin Teng
Keyword(s):  
Infectious Disease ◽  
Blood Culture ◽  
Burkholderia Pseudomallei ◽  
Case Series ◽  
Morbidity Rate ◽  
Gram Negative ◽  
Mortality And Morbidity ◽  
Neck Abscess ◽  
Culture And Sensitivity ◽  
Soil And Water

<p class="abstract">Melioidosis remains as one of the rare infectious disease with high mortality and morbidity rate. It is caused by the gram-negative bacilli <em>Burkholderia pseudomallei</em> found in soil and water. We would like to share our experience of four case series that had been collected in Bintulu Hospital, Sarawak over a period of eight months starting from June 2018- January 2019. A total of four patients presented with neck abscess where the pus culture and sensitivity show <em>B. pseudomallei</em> but the blood culture and sensitivity show no culture or growth.</p>

scholarly journals Evaluation of the Performance of Direct Susceptibility Test by VITEK-2 from Positively Flagged Blood Culture Broth for Gram-Negative Bacilli

2021 ◽  
Author(s):  
Kavipriya D. ◽  
Suman Susan Prakash ◽  
Sarumathi Dhandapani ◽  
Deepashree Rajshekar ◽  
Apurba Sankar Sastry
Keyword(s):  
Blood Culture ◽  
Susceptibility Testing ◽  
Blood Stream Infection ◽  
Tertiary Care ◽  
Reference Method ◽  
Culture Broth ◽  
Timely Initiation ◽  
Gram Negative ◽  
Mortality And Morbidity ◽  
Vitek 2

Abstract Background Timely initiation of antimicrobial therapy in patients with blood stream infection is absolutely necessary to reduce mortality and morbidity. Most clinical microbiology laboratories use conventional methods for identification and antimicrobial susceptibility testing (AST) that involve biochemical methods for identification followed by AST by disk diffusion. The aim of the current study is to assess the various errors associated with direct susceptibility testing done from blood culture broth using automated AST system-Vitek-2 compact compared with the reference method of AST done from bacterial colonies. Materials and Methods The study was conducted in a tertiary care public sector 2,200-bedded hospital in South India for a period of 6 months. The study involved positively flagged blood culture bottles that yielded single morphotype of Gram-negative organism by Gram stain. A total of 120 bacterial isolates were collected that consisted of consecutively obtained first 60 isolates of Enterobacteriaceae family (30 Escherichia coli and 30 Klebsiella pneumoniae) and consecutively obtained first 60 nonfermenters (30 Pseudomonas aeruginosa and 30 Acinetobacter baumannii). Vitek-2 AST was done from these 120 blood culture broth, following the protocol by Biomerieux, and results were obtained. Then, Vitek-2 was done from colonies (reference method) using appropriate panel for Enterobacteriaceae and nonfermenters, and results were obtained. Both the results were compared. Results Nonfermenters showed a better categorical agreement of 97.6%, as compared to Enterobacteriaceae, which showed 97%. Among Enterobacteriaceae, both E. coli and K. pneumoniae showed categorical agreement of 97% each. Conclusion The procedure of AST directly from blood culture broth represents a simple and effective technique that can reduce the turnaround time by 24 hours, which in turn benefits the clinician in appropriate utilization of antimicrobials for better patient care.

scholarly journals Osteomyelitis in Immunocompromised children and neonates, a case series

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bryan Foong ◽  
Kenneth Pak Leung Wong ◽  
Carolin Joseph Jeyanthi ◽  
Jiahui Li ◽  
Kevin Boon Leong Lim ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Staphylococcus Aureus ◽  
Palliative Care ◽  
Stenotrophomonas Maltophilia ◽  
Burkholderia Pseudomallei ◽  
Bone Growth ◽  
Case Series ◽  
Immune Recovery ◽  
Prolonged Administration ◽  
Infectious Disease Service

Abstract Background Osteomyelitis in immunocompromised children can present differently from immunocompetent children and can cause devastating sequelae if treated inadequately. We aim to review the aetiology, clinical profile, treatment and outcomes of immunocompromised children with osteomyelitis. Methods Retrospective review of all immunocompromised children aged < 16 years and neonates admitted with osteomyelitis in our hospital between January 2000 and January 2017, and referred to the Paediatric Infectious Disease Service. Results Fourteen patients were identified. There were 10 boys (71%), and the median age at admission was 70.5 months (inter-quartile range: 12.3–135.0 months). Causal organisms included, two were Staphylococcus aureus, two were Mycobacterium bovis (BCG), and one each was Mycobacterium tuberculosis, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Burkholderia pseudomallei and Rhizopus sp. One patient had both Clostridium tertium and Clostridium difficile isolated. Treatment involved appropriate antimicrobials for a duration ranging from 6 weeks to 1 year, and surgery in 11 patients (79%). Wherever possible, the patients received treatment for their underlying immunodeficiency. For outcomes, only three patients (21%) recovered completely. Five patients (36%) had poor bone growth, one patient had recurrent discharge from the bone and one patient had palliative care for underlying osteosarcoma. Conclusions Although uncommon, osteomyelitis in immunocompromised children and neonates can be caused by unusual pathogens, and can occur with devastating effects. Treatment involves prolonged administration of antibiotics and surgery. Immune recovery also seems to be an important factor in bone healing.

scholarly journals Melioidosis: a case series from coastal Karnataka, India

2019 ◽  
Vol 7 (10) ◽  
pp. 3920
Author(s):  
Shabari M. Shenoy ◽  
Ankith Vaidya ◽  
Chethan Subramanya
Keyword(s):  
Infectious Disease ◽  
South India ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Case Series ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Negative ◽  
Coastal City ◽  
Sporadic Cases

Melioidosis is an infectious disease caused by gram negative bacteria B. pseudomallei. The disease is largely under diagnosed globally. Sporadic cases have been reported from India, distributed mostly in the coastal areas. Authors present a series of seven culture proven cases of Melioidosis treated at a tertiary care Hospital in the coastal city of Mangalore in South India.

scholarly journals Fatal acute melioidosis in a tourist returning from Martinique Island, November 2010

2011 ◽  
Vol 16 (1) ◽  
Author(s):  
L Gétaz ◽  
M Abbas ◽  
L Loutan ◽  
J Schrenzel ◽  
A Iten ◽  
...  
Keyword(s):  
Intensive Care ◽  
Blood Culture ◽  
Burkholderia Pseudomallei ◽  
Fatal Case ◽  
Severe Pneumonia ◽  
Intravenous Therapy ◽  
Gram Negative ◽  
High Doses

We report the fatal case of acute melioidosis in a patient returning from Martinique with fever in November 2010. Gram-negative rods were isolated from a blood culture and Burkholderia pseudomallei identified within 24 hours after first medical contact. The patient died two days after admission to hospital despite intravenous therapy with high doses of imipenem/cilastatin and intensive care. Clinicians seeing travellers returning from the subtropics or tropics with severe pneumonia or septicaemia should consider the possibility of acute melioidosis.

scholarly journals Disseminated melioidosis involving skin and joint: a case report

2016 ◽  
Vol 9 (2) ◽  
pp. 55-57 ◽  
Author(s):  
Samira Rahat Afroze ◽  
Muhammad Abdur Rahim ◽  
Lovely Barai ◽  
Khwaja Nazim Uddin
Keyword(s):  
Infectious Disease ◽  
Case Report ◽  
Burkholderia Pseudomallei ◽  
Causative Organism ◽  
Soil And Water

Melioidosis is an infectious disease that can cause serious morbidity and may result in death if not treated early. Its causative organism, Burkholderia pseudomallei is present in soil and water. Here, we report a case of disseminated melioidosis involving skin and joint in a farmer residing in an area where the organism has been found in the soil.Ibrahim Med. Coll. J. 2015; 9(2): 55-57

scholarly journals Bacteriological Profile and Antibiotic Sensitivity of Neonatal Septicemia Admitted in Neonatal Intensive Care Unit (NICU) of Dhaka Shishu Hospital

2020 ◽  
Vol 35 (2) ◽  
pp. 130-134
Author(s):  
Md Mosharaf Hossain ◽  
Mir Mohammad Yusuf ◽  
Md Kamrunzzaman ◽  
Maksudur Rahman ◽  
Md Jahangir Alam
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Antibiotic Sensitivity ◽  
Gram Negative ◽  
Mortality And Morbidity ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis ◽  
Gram Negative Organisms

Background: Septicemia in neonates refers to bacterial infection documented by positive blood culture in the first four weeks of life and is one of the leading causes of neonatal mortality and morbidity. Objective: To isolate and identify the bacterial etiologic agents responsible for neonatal sepsis and to determine the susceptibility pattern of isolates in A NICU of Dhaka Shishu (Children) Hospital. Methods: This is a prospective observational study conducted in the NICU from July 2018 to December 2018. Two hundred ninty blood samples were collected and processed from patients in accordance with standard protocols. Antibiotic susceptibility of the isolates was done. Results: Blood culture reports were positive in 9.31% cases. Among the culture positive cases, there were 65.5% males and 34.5% females. Early onset sepsis was present in 74.8% and late onset sepsis was observed in 25.2% of the cases. Best overall sensitivity among Gram negative (Acinetobacter, Klebsiella, Pseudomonas) isolates was to netilmycin (61%), followed by ceftazidim (57%) and amikacin (56%).Gram positive (Staphylococci, streptococci) isolates had sensitivity of 50% to levofloxacin, 50% to ceftriaxon. Conclusion: Gram negative organisms are the leading cause of neonatal sepsis in this study and most of them are resistant to multiple antibiotics. Therefore the results of this study suggest that, surveillance of antimicrobial resistance in our hospital is necessary. DS (Child) H J 2019; 35(2) : 130-134

scholarly journals Rapid Identification of Burkholderia pseudomallei in Blood Cultures by a Monoclonal Antibody Assay

1999 ◽  
Vol 37 (11) ◽  
pp. 3662-3667 ◽  
Author(s):  
Supinya Pongsunk ◽  
Nittaya Thirawattanasuk ◽  
Nuanchan Piyasangthong ◽  
Pattama Ekpo
Keyword(s):  
Monoclonal Antibody ◽  
Blood Culture ◽  
Culture System ◽  
Burkholderia Pseudomallei ◽  
Bacterial Culture ◽  
Brain Heart Infusion ◽  
Culture Method ◽  
Blood Culture System ◽  
Gram Negative

Burkholderia pseudomallei is the causative agent of melioidosis. In northeast Thailand, this gram-negative bacterium is a major cause of mortality from septicemia. The definitive diagnosis of this disease is made by bacterial culture. In this study, we produced a monoclonal antibody (MAb) specific to the 30-kDa protein of B. pseudomallei by in vivo and in vitro immunization of BALB/c mice with a crude culture filtrate antigen. The MAb could directly agglutinate with all 243 clinical isolates of B. pseudomallei but not with other gram-negative bacteria, except for one strain of Burkholderia mallei. However, the MAb cross-reacted with the gram-positive Bacillus sp. andStreptococcus pyogenes. B. pseudomallei in brain heart infusion broth (BHIB) subcultured from a BacT/Alert automated blood culture system could be identified by simple agglutination with this MAb assay. The sensitivity and specificity of direct agglutination compared to the “gold standard,” the culture method, were 94.12 and 98.25%, respectively. However, the MAb adsorbed to polystyrene beads or latex particles directly identified the bacterium in blood culture specimens and in BHIB subcultured from a BacT/Alert automated blood culture system. The sensitivity of the latex agglutination test was 100% for both blood culture and BHIB specimens. The specificity was 85.96 and 96.49% for the blood culture and BHIB specimens, respectively. The specificity could be increased if the nonspecific materials in the blood culture broths were eradicated by centrifugation at low speeds. Thus, a combination of blood culture and the agglutination method could be used for the rapid diagnosis of melioidosis in the routine bacteriological laboratory. This method could speed up detection of the bacterium in blood culture by at least 2 days, compared to the conventional bacterial culture method. In addition, the MAb is stable at room temperature for 2 weeks and at 4, −20, and −70°C for at least 1 year. The latex reagent was stable for at least 6 months at 4°C.

Drug-Induced Agranulocytosis: A Mini Review

2016 ◽  
Vol 2 (1) ◽  
pp. 57-59
Author(s):  
Pavithra D ◽  
Praveen D ◽  
Vijey Aanandhi M
Keyword(s):  
Bone Marrow ◽  
Complete Blood Count ◽  
Genetic Manipulation ◽  
White Blood Cells ◽  
Deep Infection ◽  
Morbidity Rate ◽  
Drug Induced ◽  
Serious Adverse Event ◽  
Mortality And Morbidity ◽  
The Individual

Agranulocytosis is also known to be granulopenia, causing neutropenia in circulating blood streams .The destruction of white blood cells takes place which leads to increase in the infection rate in an individual where immune system of the individual is suppressed. The symptoms includes fever, sore throat, mouth ulcers. These are commonly seen as adverse effects of a particular drug and are prescribed for the common diagnostic test for regular monitoring of complete blood count in an admitted patient. Drug-induced agranulocytosis remains a serious adverse event due to occurrence of severe sepsis with deep infection leading to pneumonia, septicaemia, and septic shock in two/third of the patient. Antibiotics seem to be the major causative weapon for this disorder. Certain drugs mainly anti-thyroid drugs, ticlopidine hydrochloride, spironolactone, clozapine, antileptic drugs (clozapine), non-steroidal anti-inflammatory agents, dipyrone are the potential causes. Bone marrow insufficiency followed by destruction or limited proliferative bone marrow destruction takes place. Chemotherapy is rarely seen as a causative agent for this disorder. Genetic manipulation may also include as one of the reason. Agranulocytosis can be recovered within two weeks but the mortality and morbidity rate during the acute phase seems to be high, appropriate adjuvant treatment with broad-spectrum antibiotics are prerequisites for the management of complicated neutropenia. Drugs that are treated for this are expected to change as a resistant drug to the patient. The pathogenesis of agranulocytosis is not yet known. A comprehensive literature search has been carried out in PubMed, Google Scholar and articles pertaining to drug-induced agranulocytosis were selected for review.

scholarly journals 649. Clinical Implementation of a Rapid Susceptibility Testing Procedure, Directly From a Positive Blood Culture Using the Vitek®2 System on Gram Negative Rods

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S383-S383
Author(s):  
Charma Henry ◽  
Dustin Evans ◽  
Daniel Navas ◽  
Arleen Barker ◽  
Chonnapat Somyos ◽  
...  
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Susceptibility Testing ◽  
Testing Procedure ◽  
Turnaround Time ◽  
National Average ◽  
Major Error ◽  
Clinical Implementation ◽  
Salmonella Spp ◽  
Gram Negative

Abstract Background The national average of identification and susceptibility for organisms isolated from positive blood culture to final susceptibility based on growth on solid media is 48 hours. The goal of this research was to prove that the Vitek®2 (bioMérieux, Inc.) system can provide an accurate and reliable susceptibility result directly from positive blood culture for Gram negative rods and reduce the turnaround time (TAT) from positive blood culture to the final susceptibility. Methods An FDA-modified validation procedure was performed on positive blood cultures directly from the bottle to the VITEK®2 System for susceptibility testing. The protocol tested and validated an aliquot of 50uL of blood directly from the positive bottle into 10 mL of saline (1:200). The solution was vortexed and 3mL were placed in the VITEK®2 test tube. This protocol was intended only for Gram negative rods using the AST-GN70, AST-GN81 & AST-GN801 cards. This protocol followed the CLSI M52 and M100 guidelines. Results 515 organisms from clinical blood culture samples from July 2018 to October 2019 were evaluated. Organisms included, but were not limited to: E. coli, K. pneumoniae, Enterobacter spp., and P. aeruginosa, Proteus spp., Salmonella spp., Acinetobacter spp., and S. maltophilia. There were 5,201 drug/bug combinations. AdventHealth Orlando achieved an essential agreement of 99.32% (n=5,166), minor error 0.74% (n=39) major error 0.02% (n=1) and very major error 0.49% (n=2). A 100% agreement was achieved on detection of ESBL, CRE, and MDR organisms. Conclusion Rapid direct blood culture protocol using the VITEK®2 System and the AST-GN cards is accurate, reliable and can be performed with less than 1 minute hands-on time. The protocol can be implemented in any laboratory at no additional costs or modification where the current VITEK®2 AST-GN panels are in use. This protocol was clinically implemented at AdventHealth Orlando on July 15, 2019. Compared with the national average of 72 hours, the TAT obtained during this study was 23 hours from positive blood culture to final susceptibility, a significant reduction of 25 hours. The authors encourage bioMérieux Inc. to evaluate and explore the opportunity to expand the use of the VITEK®2 system for this application with the appropriate clinical trial. Disclosures All Authors: No reported disclosures

Meningoencephalomyelitis in domestic cats: 3 cases of Pasteurella multocida infection and literature review

2021 ◽  
pp. 104063872110344
Author(s):  
Bianca S. de Cecco ◽  
Mariano Carossino ◽  
Fabio Del Piero ◽  
Nobuko Wakamatsu ◽  
Maria S. Mitchell ◽  
...  
Keyword(s):  
Pasteurella Multocida ◽  
Case Series ◽  
Infectious Agents ◽  
Domestic Cats ◽  
Neurologic Diseases ◽  
Gram Negative ◽  
The Central Nervous System ◽  
Upper Respiratory ◽  
Portal Of Entry ◽  
Histologic Changes

Neurologic diseases are common in domestic cats, and infectious agents are suspected to be the primary cause in 30–45% of cases. Among infectious etiologies, those of bacterial origin are only sporadically characterized in the literature, with few of these reports correlating gross and histologic findings with confirmatory bacteriologic identification. Here, we describe bacterial meningitis and meningoencephalomyelitis associated with Pasteurella multocida in 3 domestic cats. Purulent exudate expanding the cerebral meninges was grossly evident in 2 of the cases. In all 3 cases, histologic changes included multifocal suppurative-to-necrosuppurative meningitis and/or meningoencephalomyelitis of variable severity. Intralesional colonies of gram-negative, short rod-shaped to coccobacillary bacteria were evident histologically in only 1 case. P. multocida was confirmed by routine bacteriologic culture in all cases. Based on our cases, we hypothesize that the upper respiratory system serves as the main portal of entry for P. multocida, leading to invasion of the central nervous system and possible systemic hematogenous dissemination. A case series of meningoencephalomyelitis associated with P. multocida infection in cats has not been reported previously, to our knowledge. We also review briefly other causes of meningoencephalomyelitis in cats.

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