scholarly journals Acinetobacter endocarditis: a rare nosocomial infection of native heart valves

2021 ◽  
Author(s):  
Shervin Shokouhi ◽  
Ghodsieh Kamrani ◽  
Iman Ghasemzadeh ◽  
Mana Baziboroun
Keyword(s):  
Heart Valves ◽  
Bacterial Pathogen ◽  
Surgical Excision ◽  
Drug Resistant ◽  
Hospital Acquired Infections ◽  
First Case ◽  
Life Saving ◽  
Life Threatening ◽  
Hospital Acquired ◽  
Timely Treatment

Acinetobacter baumannii is an opportunistic bacterial pathogen predominantly associated with hospital-acquired infections. Here we present a case of infective endocarditis of native Mitral and Aorta valves caused by A. baumannii in a 73-year-old man. He underwent surgical excision and Pathologic specimen showed A. baumannii growth after 48 hours that was exten- sively drug-resistant (XDR). He was treated with colistin and tigecycline. Finally, he discharged with no important compli- cation. To our best knowledge, it is the first case of Acinetobacter endocarditis has ever been reported in Iran. Although XDR A. baumannii is a life-threatening pathogen, proper and timely treatment can be life-saving.

scholarly journals Molecular Epidemiology of Multi-Drug Resistant Pseudomonas aeruginosa Isolates from Hospitalized Patients in Greece

2020 ◽  
Vol 8 (11) ◽  
pp. 1652
Author(s):  
Olga Pappa ◽  
Anastasia Maria Kefala ◽  
Kyriaki Tryfinopoulou ◽  
Marios Dimitriou ◽  
Kostas Kostoulas ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Molecular Epidemiology ◽  
Financial Resources ◽  
Drug Resistant ◽  
Hospital Acquired Infections ◽  
Antimicrobial Sensitivity ◽  
Tertiary Hospitals ◽  
Hospital Acquired ◽  
First Time ◽  
Hospital Transmission

Resistant Pseudomonas aeruginosa isolates are one of the major causes of both hospital-acquired infections (HAIs) and community-acquired infections (CAIs). However, management of P. aeruginosa infections is difficult as the bacterium is inherently resistant to many antibiotics. In this study, a collection of 75 P. aeruginosa clinical isolates from two tertiary hospitals from Athens and Alexnadroupolis in Greece was studied to assess antimicrobial sensitivity and molecular epidemiology. All P. aeruginosa isolates were tested for susceptibility to 11 commonly used antibiotics, and the newly introduced Double Locus Sequence Typing (DLST) scheme was implemented to elucidate the predominant clones. The tested P. aeruginosa isolates presented various resistant phenotypes, with Verona Integron-Mediated Metallo-β-lactamase (VIM-2) mechanisms being the majority, and a new phenotype, FEPR-CAZS, being reported for the first time in Greek isolates. DLST revealed two predominant types, 32-39 and 8-37, and provided evidence for intra-hospital transmission of the 32-39 clone in one of the hospitals. The results indicate that DLST can be a valuable tool when local outbreaks demand immediate tracking investigation with limited time and financial resources.

scholarly journals Microbial Environmental Pollution in ICUs: Results, Trends, and Suggestions from a Long-Lasting Surveillance

Atmosphere ◽  
2021 ◽  
Vol 12 (9) ◽  
pp. 1174
Author(s):  
Daniela D’Alessandro ◽  
Massimo Fabiani ◽  
Letizia Appolloni
Keyword(s):  
Underlying Disease ◽  
Hospital Acquired Infections ◽  
Hospital Environments ◽  
Life Threatening ◽  
Surgical Icus ◽  
Microbial Strains ◽  
Opportunistic Pathogenic ◽  
Hospital Acquired ◽  
Microbiological Surveillance

Intensive care units (ICUs) are special areas in hospitals for patients with severe and life-threatening diseases. ICUs are of several categories, such as neonatal ICUs, cardiac ICUs, neurological ICUs, surgical ICUs, etc. The ICUs’ patients may show a high susceptibility for hospital-acquired infections (HAIs) depending on underlying disease, duration of stay and treatment. ICUs are considered potential reservoirs for (opportunistic) pathogenic microbial strains and the risk of acquiring infection in these hospital environments is higher than in others. Several studies show the role of inanimate surface and equipment contamination in the transmission of pathogens to ICU patients. The aim of this study is to describe the results of 124 sampling campaigns performed during 12 years of microbiological surveillance of five ICUs of different categories, for an overall number of 714 samples (232 from air and 482 from surface), to analyze their trends and to elaborate suggestions to improve ICUs’ environmental quality and patients’ safety.

scholarly journals Detection of carbapenemase production in Enterobacteriaceae and Pseudomonas species by carbapenemase Nordmann–Poirel test

2019 ◽  
Vol 11 (02) ◽  
pp. 107-110 ◽  
Author(s):  
Morubagal R. Rao ◽  
Pooja Chandrashaker ◽  
Rashmi P. Mahale ◽  
Sowmya G. Shivappa ◽  
Ranjitha S. Gowda ◽  
...  
Keyword(s):  
Cost Effective ◽  
Multidrug Resistant ◽  
Cross Resistance ◽  
Gram Negative Bacteria ◽  
Beta Lactam ◽  
Hospital Acquired Infections ◽  
Beta Lactam Antibiotics ◽  
Pseudomonas Species ◽  
Life Threatening ◽  
Hospital Acquired

Abstract PURPOSE: Multidrug-resistant organisms causing community-acquired and hospital-acquired infections are increasing at a dangerous rate. Carbapenemase-producing Enterobacteriaceae and Pseudomonas species are an important source of concern since these organisms are not only resistant to beta-lactam antibiotics but also show cross-resistance to other groups of antibiotics. In the present study, rapid detection of these carbapenemase-producing Enterobacteriaceae and Pseudomonas species by carbapenemase Nordmann–Poirel (Carba NP) test was evaluated by comparing with modified Hodge test (MHT). MATERIALS AND METHODS: Imipenem-resistant Enterobacteriaceae and Pseudomonas species isolated from various samples such as pus, blood, sputum, urine, and endotracheal aspirates were processed for carbapenemase detection by MHT and Carba NP test. Kappa analysis was done to evaluate the percentage agreement between the two tests. RESULTS: Seventy imipenem-resistant Enterobacteriaceae and Pseudomonas isolates were analyzed in the present study for carbapenemase production. 63.41% ofEnterobacteriaceae and 34.48% of Pseudomonas species were carbapenemase producers considering both the methods. By MHT, 36 (51.42%) isolates and, by Carba NP test, 35 (50%) isolates were positive for carbapenemase production out of the 70 isolates. CONCLUSION: Carba NP test when compared to MHT is a simple, rapid, cost-effective biochemical test which can be used in all laboratories in the identification of life-threatening carbapenemase-producing Gram-negative bacteria.

scholarly journals Successful treatment of acute promyelocytic leukemia in a patient with prosthetic heart valves: a case report and review of the literature

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Shirin Haghighat ◽  
Alireza Rezvani ◽  
Maral Mokhtari
Keyword(s):  
Case Report ◽  
Acute Promyelocytic Leukemia ◽  
Heart Valves ◽  
Chemotherapeutic Agents ◽  
Promyelocytic Leukemia ◽  
Prosthetic Heart Valves ◽  
Bleeding Events ◽  
First Case ◽  
Valve Thrombosis ◽  
Life Threatening

Abstract Background Although life-threatening hemorrhage is a usual manifestation of acute promyelocytic leukemia (APL), thrombotic events seem to be more common in APL compared to other subtypes of acute leukemia. The treatment and prophylaxis of thrombosis are controversial due to the high risk of bleeding caused by disseminated intravascular coagulation (DIC) and thrombocytopenia. To the best of our knowledge we report the first case of APL in a patient with prosthetic heart valves successfully treated with a combination of all-trans-retinoic acid (ATRA) and arsenic trioxide (ATO). We hope this case report helps clinicians to manage different spectra of coagulopathy in APL successfully. Case presentation A 38-year-old Asian man presented with diagnosis of APL confirmed by bone marrow biopsy. He was on warfarin due to prosthetic mitral and aortic valves. He was at risk of both hemorrhagic events due to DIC and life-threatening valve thrombosis. Our management regimen included unfractionated heparin adjusted according to the platelet count to prevent both valve thrombosis and bleeding events. The patient tolerated treatment well without any hemorrhagic or thrombotic events, and complete molecular remission was achieved by ATRA and ATO without the need for chemotherapeutic agents. Conclusion Although this case is exceptional, a precise evaluation may be needed to select the appropriate dose and type of anticoagulant to treat a patient with APL.

scholarly journals In vitro and in vivo activity of GT-1, a novel siderophore cephalosporin, and GT-055, a broad-spectrum β-lactamase inhibitor, against biothreat and ESKAPE pathogens

2021 ◽  
Author(s):  
Stephanie A. Halasohoris ◽  
Jennifer M. Scarff ◽  
Lisa M. Pysz ◽  
Sanae Lembirik ◽  
Margaret M. Lemmon ◽  
...  
Keyword(s):  
Broad Spectrum ◽  
Drug Resistant ◽  
Hospital Acquired Infections ◽  
Broad Array ◽  
Eskape Pathogens ◽  
Hospital Acquired ◽  
Difficult Issue ◽  
Lactamase Inhibitor

AbstractAntimicrobial-resistance (AMR) has become an increasingly difficult issue to overcome for bacteria associated with both community- and hospital-acquired infections as well as potential biodefense threats. The need to identify new therapeutics of novel classes and/or with unique mechanisms is critical to combatting AMR in the coming years. GT-1 (LCB10-0200), a siderophore-linked cephalosporin, is one such novel option and is formulated to be used either alone or in combination with a novel broad-spectrum β-lactamase inhibitor, GT-055 (LCB18-055). This study assessed the in vitro and in vivo efficacy of GT-1 and GT-055 against a broad array of multi-drug resistant and biothreat pathogens. Here, we demonstrated sub-4 µg ml−1 efficacy against a number of pathogens in vitro. We further determined that in mice infected via aerosol route with Yersinia pestis, efficacy of GT-1/GT-055 treatment is at least equivalent to the comparator antibiotic, ciprofloxacin.

Perioperative Adrenal Crisis

2017 ◽  
Author(s):  
Jing Tao ◽  
Jeffrey J. Schwartz
Keyword(s):  
Adrenal Insufficiency ◽  
Adrenal Crisis ◽  
Life Saving ◽  
Distributive Shock ◽  
Threatening Condition ◽  
Life Threatening ◽  
High Doses ◽  
Patient At Risk ◽  
Stress Dose ◽  
Timely Treatment

Perioperative adrenal insufficiency (AI) (adrenal crisis) is an uncommon life-threatening condition manifested by distributive shock that is poorly responsive to the administration of fluids and vasopressors. Timely treatment with high doses of glucocorticoids can be life saving. The difficulty is in recognizing the patient at risk, suspecting the diagnosis, and distinguishing it from other forms of shock. The incidence of adrenal crisis is rare, in large part, due to the liberal use of perioperative “stress dose” steroids in patients already receiving steroids. In this chapter we review the pathophysiology involved in both primary and secondary AI, and provide step-by-step treatment recommendations for patients as risk for this condition.

scholarly journals Structure of ATP synthase from ESKAPE pathogen Acinetobacter baumannii

2021 ◽  
Author(s):  
Julius K Demmer ◽  
Ben P Phillips ◽  
O Lisa Uhrig ◽  
Alain Filloux ◽  
Luke P Allsopp ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Atp Synthase ◽  
Drug Resistant ◽  
Conformational States ◽  
F1fo Atp Synthase ◽  
Antibiotic Development ◽  
Hospital Acquired Infections ◽  
Novel Therapeutics ◽  
Hospital Acquired

Acinetobacter baumannii is a clinically relevant pathogen which causes multi-drug resistant, hospital-acquired infections and is a top priority target for antibiotic development. Cryo-EM structures of the A. baumannii F1Fo-ATP synthase in three conformational states reveal unique features, which represent attractive sites for the development of novel therapeutics.

scholarly journals MRSA Community-acquired Pneumonia: Non COVID-19 Related Bilateral Ground-glass Opacities

2021 ◽  
Vol 2 (2) ◽  
pp. 77-79
Author(s):  
Nasam Alfraji
Keyword(s):  
Unusual Case ◽  
Hospital Setting ◽  
Community Acquired Pneumonia ◽  
Ground Glass ◽  
Drug Resistant ◽  
Poor Clinical Outcome ◽  
Hospital Acquired Infections ◽  
Keywords Mrsa ◽  
High Index Of Suspicion ◽  
Hospital Acquired

Methicillin-resistant staph aureus (MRSA) has been known to cause severe hospital-acquired infections with its multi-drug resistant nature. MRSA Infections could quickly escalate into severe sepsis resulting in death, if not recognized and treated abruptly. This pathogen uncommonly causes Community-Acquired Pneumonia (CAP), which can lead to under treatment due to delayed coverage with anti-MRSA antibiotics resulting in poor clinical outcome. We herein describe an unusual case of MRSA CAP during COVID-19 pandemic in an 80-year-old male who was unresponsive and found to be in septic shock, intubated outside the hospital setting, and then brought to intensive care unit for further management. Laboratory and radiographic studies revealed MRSA in sputum culture and extensive bilateral consolidation with bilateral ground glass opacities and pleural effusions on imaging. Our patient was successfully treated with linezolid and extubated within 48 hours with a favorable outcome. High index of suspicion and a timely coverage with anti-MRSA antibiotics would reduce mortality and lead to a better outcome in otherwise fatal infection. Keywords: MRSA; Community-acquired pneumonia; Respiratory failure; Critical care; Case report

Characterization of 2 Klebsiella pneumoniae carbapenemase–producing Enterobacterales isolated from canine rectal swabs

2021 ◽  
pp. 104063872110655
Author(s):  
Stephen D. Cole ◽  
Shelley C. Rankin
Keyword(s):  
Klebsiella Pneumoniae ◽  
Companion Animals ◽  
E Coli ◽  
Hospital Acquired Infections ◽  
Klebsiella Pneumoniae Carbapenemase ◽  
Rectal Swabs ◽  
Life Threatening ◽  
Hospital Acquired ◽  
Yorkshire Terrier

Globally, carbapenemase-producing Enterobacterales (CPE) cause life-threatening, hospital-acquired infections in people, and have been reported recently among veterinary patients. Organisms that produce a Klebsiella pneumoniae carbapenemase (KPC) are one of the most common CPE isolated from people but have been reported only rarely in animals. We characterized 2 KPC-producing Enterobacterales isolated from companion animal rectal swabs during the response to an outbreak caused by a strain of blaNDM-5 Escherichia coli. Both isolates were characterized by whole-genome sequencing (WGS) and analysis. The first isolate (case A) was from an immunosuppressed 6-y-old Yorkshire Terrier and was identified as E. coli (ST372) with a blaKPC-18 gene and an IncFII plasmid. The second isolate (case B) was from a 3-y-old Labrador Retriever with acute diarrhea and was identified as Citrobacter koseri with a blaKPC-2 gene, multiple plasmids (ColRNAI, pKPC-CAV1193), and a putative enterotoxin gene ( senB). Further research is needed to determine what role animals might play in the epidemiology of CPE in communities. It is imperative that all CPE isolated from companion animals be fully characterized by WGS and the associated case examined. All veterinary isolates should be sequenced and shared for surveillance, monitoring, and investigation purposes.

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