EPIDEMIOLOGY, MICROBIOLOGY AND CLINICAL CHARACTERISTICS OF COMMUNITY-ACQUIRED STAPHYLOCOCCUS AUREUS ACUTE OSTEOMYELITIS(AO) AND SEPTIC ARTHRITIS(SA) IN COSTA RICAN INFANTS <3 MONTHS:OCTOBER 2013-SEPTEMBER 2016

Bacterial keratitis is a devastating condition that can rapidly progress to serious complications if not treated promptly. Certain causative microorganisms such as Staphylococcus aureus and Pseudomonas aeruginosa are notorious for their resistance to antibiotics. Resistant bacterial keratitis results in poorer outcomes such as scarring and the need for surgical intervention. Thorough understanding of the causative pathogen and its virulence factors is vital for the discovery of novel treatments to avoid further antibiotic resistance. While much has been previously reported on P. aeruginosa, S. aureus has been less extensively studied. This review aims to give a brief overview of S. aureus epidemiology, pathophysiology and clinical characteristics as well as summarise the current evidence for potential novel therapies.

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329. Performance of Next Generation Sequencing in Isolating a Pathogen in Pediatric Osteoarticular Infections

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.525 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S236-S237

Author(s):

Nanda Ramchandar ◽

Jessica Burns ◽

Andrew Pennock ◽

Christopher R Cannavino ◽

Lauge Farnaes

Keyword(s):

Next Generation Sequencing ◽

Septic Arthritis ◽

Standard Care ◽

Pediatric Population ◽

Single Site ◽

Acute Osteomyelitis ◽

Next Generation ◽

Pathogenic Organism ◽

Osteoarticular Infections ◽

Generation Sequencing

Abstract Background Osteoarticular infections are often encountered in the pediatric population. Therapy is guided by isolation of a putative organism, however, operative cultures are often negative. Next generation sequencing (NGS) allows for more sensitive sampling of body compartments generally considered sterile. We sought to evaluate the utility of NGS in comparison to culture in detecting a pathogenic organism in acute osteomyelitis and septic arthritis in children. Methods This was a single-site study to evaluate the utility of NGS in comparison to culture in detecting a pathogenic organism in acute osteomyelitis and septic arthritis in children. Eligible patients were all patients with osteomyelitis or septic arthritis admitted to Rady Children’s Hospital from July 2019 through July 2020. We excluded any patients with bone or joint surgery within 30 days prior to admission. Operative samples were chosen at the surgeon’s discretion (joint aspirate, synovium, or bone) based on operative findings. We compared NGS testing to standard care culture from the same site. Results We enrolled 41 subjects. NGS of the operative samples identified a pathogen in 26 (63.4%) patients versus 18 (43.9%) by culture. Operative culture missed the diagnosis in 10 cases, though PCR identified the organism in 6 of those cases (5 were cases in which Kingella kingae was identified). In 4 subjects, NGS identified a putative organism where standard care testing (either PCR or culture) was negative. NGS was falsely positive in 1 subject and falsely negative for one other subject. Sensitivity was 96.3% (CI 95%, 81.0–99.9%) and Specificity was 92.9% (CI 95%, 66.1–99.8) for NGS versus 64.3% (CI 95%, 44.1–81.4) and 84.6% (CI 95%, 54.6–99.9%) for culture respectively. Conclusion In this single site prospective study of pediatric osteoarticular infections, we demonstrate improved sensitivity and specificity of NGS testing when compared to standard culture. Disclosures All Authors: No reported disclosures

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Infective endocarditis caused by HACEK group bacteria—a registry-based comparative study

European Journal of Clinical Microbiology & Infectious Diseases ◽

10.1007/s10096-021-04240-3 ◽

2021 ◽

Author(s):

Anna Bläckberg ◽

Christian Morenius ◽

Lars Olaison ◽

Andreas Berge ◽

Magnus Rasmussen

Keyword(s):

Staphylococcus Aureus ◽

Infective Endocarditis ◽

Mortality Rate ◽

Haemophilus Influenzae ◽

Comparative Study ◽

Clinical Characteristics ◽

Prosthetic Valve ◽

Prosthetic Valve Endocarditis ◽

Common Cause ◽

Prosthetic Valves

AbstractInfective endocarditis (IE) caused by bacteria within Haemophilus (excluding Haemophilus influenzae), Aggregatibacter, Cardiobacterium, Eikenella and Kingella (HACEK) is rare. This study aimed to describe clinical features of IE caused by HACEK genera in comparison with IE due to other pathogens. Cases of IE due to HACEK were identified through the Swedish Registry of Infective Endocarditis (SRIE). Clinical characteristics of IE cases caused by HACEK were compared with cases of IE due to other pathogens reported to the same registry. Ninety-six patients with IE caused by HACEK were identified, and this corresponds to 1.8% of all IE cases. Eighty-three cases were definite endocarditis, and the mortality rate was 2%. The median age was 63 years, which was lower compared to patients with IE caused by other pathogens (66, 70 and 73 years respectively, p ≤ 0.01). Patients with IE caused by Haemophilus were younger compared to patients with IE due to Aggregatibacter (47 vs 67 years, p ≤ 0.001). Patients with IE due to HACEK exhibited longer duration from onset of symptoms to hospitalization and had more prosthetic valve endocarditis compared to patients with IE due to Staphylococcus aureus (10 vs 2 days, p ≤ 0.001, and 35 vs 14%, p ≤ 0.001). This is, to date, the largest study on IE due to HACEK. Aggregatibacter was the most common cause of IE within the group. The condition has a subacute onset and often strikes in patients with prosthetic valves, and the mortality rate is relatively low.

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855. Significance of Invasive Infections due to Methicillin Sensitive Staphylococcus aureus in the neonatal population

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1044 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S468-S468

Author(s):

Mariawy Riollano ◽

Deena Altman ◽

shanna kowalsky ◽

Stephanie Pan

Keyword(s):

Staphylococcus Aureus ◽

Clinical Characteristics ◽

Invasive Disease ◽

Control Measures ◽

Invasive Infection ◽

Single Center ◽

Infection Control Measures ◽

Invasive Infections ◽

Mrsa Colonization ◽

Neonatal Population

Abstract Background Staphylococcus aureus is a well-known cause of hospital acquired infections. Methicillin resistant staphylococcus aureus (MRSA) colonization is a recognized risk factor for invasive infections. The neonatal population in the intensive care unit (NICU) is particularly vulnerable to these types of infections, resulting in high mortality and morbidity. However, only scant data is available to establish the risk for invasive disease in patients with Methicillin sensitive staphylococcus aureus (MSSA). As a result, surveillance and prevention strategies are only address for MRSA colonization. Here, we describe the clinical characteristics of S. aureus colonized patients identified in late 2018 during transmission events in a single center NICU. As a result of the targeted surveillance investigation for MRSA infection control measures, S. aureus colonization was stratified, and we were able to compare the differences in invasive disease between MRSA and MSSA. Methods This is a retrospective chart review of the 47 colonized patients identified during October 2018- January 2019 SA transmission events in single center NICU. Risk factors, clinical characteristics, and the hospital course of these cases, including the proportion of invasive illness were reviewed. Results We found that most clinical characteristic, risk factors, and hospital course were the same between MRSA and MSSA colonized infants (p values > 0.05). Additionally, there was no difference in the proportion of invasive infection between MRSA and MSSA colonized patients (p value > 0.05). The type of invasive infections identified were SSTI, bacteremia, and osteomyelitis. Conclusion The proportion of invasive infection was the same in MSSA and MRSA colonized patients. This data provides us with supportive material for future recommendations of infection control measures for MSSA colonized patients. Disclosures All Authors: No reported disclosures

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