scholarly journals Providencia rettgeri infection complicating cranial surgery: illustrative cases

2021 ◽  
Vol 2 (8) ◽  
Author(s):  
Shabal Sapkota ◽  
Mitesh Karn ◽  
Sanjib Mani Regmi ◽  
Sushma Thapa ◽  
Farhan Uddin Miya ◽  
...  

BACKGROUND Providencia rettgeri is a rare cause of nosocomial infection in humans. These organisms are capable of biofilm production and are intrinsically resistant to commonly used antibiotics, leading to high rates of morbidity and mortality. P. rettgeri may very rarely cause postneurosurgical infection. OBSERVATIONS In this report, the authors describe two patients in whom P. rettgeri infection complicated the postoperative course. Both the patients underwent craniotomy at approximately the same time under similar environments. The organism isolated was resistant to most of the commonly used antibiotics, and therapy tailored to the results of susceptibility testing led to resolution of infection in both cases. LESSONS P. rettgeri is a rare cause of postneurosurgical nosocomial infection. Timely identification and early tailoring of antibiotic therapy based on susceptibility testing is the key to treatment. Every effort should be made to identify the source of infection and rectify it so that mortality, morbidity, and financial burden are reduced. Contact isolation and use of sterile gloves after each patient contact are effective in preventing its spread, as in most cases of nosocomial infection.

The Analyst ◽  
2021 ◽  
Author(s):  
Pengfei Zhang ◽  
Aniruddha Kaushik ◽  
Kathleen E Mach ◽  
Kuangwen Hsieh ◽  
Joseph C. Liao ◽  
...  

The development of accelerated methods for pathogen identification (ID) and antimicrobial susceptibility testing (AST) for infectious diseases is necessary to facilitate evidence-based antibiotic therapy and reduce clinical overreliance on broad-spectrum...


PEDIATRICS ◽  
1984 ◽  
Vol 74 (6) ◽  
pp. 1131-1132
Author(s):  
WILLIAM FELDMAN

To the Editor.— I am concerned about the conclusions in the paper on treatment of occult bacteremia.1 Carroll at al recommend "expectant antibiotic therapy for children who have no obvious source of infection and who have the clinical characteristics associated with occult bacteremia." As a relatively large percentage of infants aged 6 to 24 months have high fevers at one time or another, the implications of this approach were it to be widely implemented would be great.


1980 ◽  
Vol 1 (06) ◽  
pp. 391-400 ◽  
Author(s):  
Donald A. Goldmann ◽  
Ann B. Macone

This article details the appropriate microbiologic support that is critical to the successful investigation of nosocomial infection problems. The infection control team must have ready access to microbiologic data, and the laboratory should retain epidemiologically relevant bacterial isolates. Investigation of epidemics is facilitated by precise identification of bacteria and careful antibiotic susceptibility testing. In some situations, biotyping, serotyping, phage typing, bacteriocin typing, and other specialized techniques may be required. Plasmid analysis may be useful in the investigation of nosocomial infection problems caused by antibiotic-resistant bacteria.


Author(s):  
Jamsheera Cp ◽  
Ethel Suman

Objective: The present study aimed at finding the resistance pattern of Pseudomonas aeruginosa and other Pseudomonas species isolated from various clinical specimens in the laboratory.Methods: A total of 150 isolates of different species of Pseudomonas obtained from various clinical specimens processed at the Microbiology laboratory of Kasturba Medical College, Manipal Academy of Higher Education, were taken for this study. Antibiotic susceptibility testing was performed by Kirby-Bauer disc diffusion method and interpreted according to the CLSI guidelines. Biofilm assay was performed by modified O’Toole and Kolter method. The results were analyzed using SPSS 17.0 and Student’s unpaired t-test, Kruskal–Wallis, Mann–Whitney, ANOVA, and Chi-square test. p<0.05 was considered statistically significant.Results: Increased resistance was observed by P. aeruginosa to cefotaxime, cotrimoxazole, levofloxacin, ofloxacin, and ticarcillin clavulanate. There was also a good correlation between antibiotic resistance to aztreonam, netilmicin, and ceftazidime and biofilm production. Results of the present study, therefore, demonstrated the occurrence of resistance to various antipseudomonal agents among the biofilm-producing P. aeruginosa isolates.Conclusion: The present study may help in assessing the seriousness of drug resistance caused by biofilm formation in P. aeruginosa and devise strategies through antibiotic policies to minimize such problems.


2014 ◽  
Vol 8 (09) ◽  
pp. 1216-1221 ◽  
Author(s):  
Chao Zhang ◽  
Bing Chen ◽  
Yongquan Gu ◽  
Tao Luo ◽  
Shengjia Yang ◽  
...  

Tuberculous pseudoaneurysm of the aorta is rare and exposes patients to a very high risk of unpredictable rupture. To our best knowledge, only 32 cases have been reported related to all arterial systems from 1993 to 2013 in the literature. We report a 44-year-old male who presented with an aortic pseudoaneurysm and tuberculosis of the kidney and vertebrae. He underwent endovascular repair and antibiotic therapy for tuberculosis, combined with a bare stent implanted to seal endoleaks after endograft stenting. The postoperative course was uneventful and the patient recovered and lived well afterwards. Epidemiology, pathogenesis, presentation, management, and mortality of this entity were reviewed and discussed.


2020 ◽  
Vol 64 (9) ◽  
Author(s):  
Sahil Sheth ◽  
Michael Miller ◽  
Angela Beth Prouse ◽  
Scott Baker

ABSTRACT Bloodstream infections (BSI) are associated with increased morbidity and mortality, especially when caused by Gram-negative or fungal pathogens. The objective of this study was to assess the impact of fast identification-antimicrobial susceptibility testing (ID/AST) with the Accelerate Pheno system (AXDX) from May 2018 to December 2018 on antibiotic therapy and patient outcomes. A pre-post quasiexperimental study of 200 patients (100 pre-AXDX implementation and 100 post-AXDX implementation) was conducted. The primary endpoints measured were time to first antibiotic intervention, time to most targeted antibiotic therapy, and 14-day hospital mortality. Secondary endpoints included hospital and intensive care unit (ICU) length of stay (LOS), antibiotic intensity score at 96 h, and 30-day readmission rates. Of 100 patients with Gram-negative bacteremia or candidemia in each cohort, 84 in the preimplementation group and 89 in the AXDX group met all inclusion criteria. The AXDX group had a decreased time to first antibiotic intervention (26.3 versus 8.0, P = 0.003), hours to most targeted therapy (14.4 versus 9, P = 0.03), hospital LOS (6 versus 8, P = 0.002), and average antibiotic intensity score at 96 h (16 versus 12, P = 0.002). Both groups had a comparable 14-day mortality (0% versus 3.6%, P = 0.11). In this analysis of patients with Gram-negative bacteremia or candidemia, fast ID/AST implementation was associated with decreased hospital LOS, decreased use of broad-spectrum antibiotics, shortened time to targeted therapy, and an improved utilization of antibiotics within the first 96 h of therapy.


Author(s):  
Latika . ◽  
Smiti Nanda ◽  
Pushpa Dahiya ◽  
Sushila Chaudhary

Background: Hospital acquired infections (HAIs) are the major causes of morbidity and mortality, functional disability and financial burden among the patients admitted in hospitals. The nosocomial infection has thrown a big challenge to the health sector in both the developing and developed countries; therefore, it is important to put in place surveillance system for monitoring its incidence rate and planning early interventions for its prevention. The aim and objective of the study was to study the socio demographic profile of the patients who underwent Obstetrical and Gynecological surgeries and to identify the risk factors and causative organisms associated with the post-operative nosocomial infection and pattern of antibiotics sensitivity.Methods: It was a record based retrospective study carried out in a tertiary care referral institute. The case files of all post-operative patients from January 2015 to July 2015 were retrieved from the Medical Record department and an extensive analysis was carried out.Results: It was found that majority of the patients (75%) with nosocomial infection were in the age group of 20-35 years and all were married. Most of them (72%) were from the rural background. It was observed that around 9% patients reported nosocomial infection after emergency laparotomy procedure as compared to 8% of patients after elective procedure.Conclusions: In this study it was found that surgical site infection (SSI) was most common nosocomial infection followed by Urinary tract infection. The majority of surgical site infections can be prevented by the preoperative, intraoperative and postoperative phases of care.


2008 ◽  
Vol 29 (11) ◽  
pp. 1091-1093 ◽  
Author(s):  
Alexandre Brûlet ◽  
Marie-Christine Nicolle ◽  
Marine Giard ◽  
Franck-Emmanuel Nicolini ◽  
Mauricette Michallet ◽  
...  

A fatal nosocomial infection withLegionella pneumophilaserogroup 5 occurred in a patient with leukemia. Isolates recovered from both the potable water supply and the patient showed an identical genomic profile. With no other exposure identified, the water from the washbasin was evidently the source of infection.


2008 ◽  
Vol 24 (6) ◽  
pp. E13 ◽  
Author(s):  
Xavier G. Kocherry ◽  
Thimappa Hegde ◽  
Kolluri V. R. Sastry ◽  
Aaron Mohanty

Object Intracranial abscesses located deep in the cerebral parenchyma and in eloquent regions are often difficult to manage surgically. The authors have attempted to analyze the efficacy of stereotactic aspiration in the management of these abscesses. Methods Cases involving 22 patients (including 9 children) with deep-seated and/or eloquent-region intracranial abscesses who underwent CT- or MR imaging–guided stereotactic aspiration between January 1995 and July 2001 were analyzed. Results A definite source of infection could be identified only in 9 of the cases. In 18 patients, the abscess was deep seated, whereas in the rest it was located in the eloquent cortex. Five patients had abscesses located in multiple sites. In 17 patients only 1 aspiration was required; in 5 others subsequent procedures were required. In the initial postaspiration CT, minor hemorrhage was noted in 3 patients not requiring further intervention. Antibiotics were administered for a period varying from 4 to 8 weeks following aspiration. An early recurrence (within 2 weeks of initial aspiration) was evident in 5 patients. All recurrent abscesses were reaspirated. In 2 patients new abscesses developed while the patients were still receiving antibiotic therapy. There were no late recurrences. In 1 patient ventriculitis developed, with subsequent hydrocephalus requiring a shunt insertion. Follow-up CT scans showed complete resolution of the abscess in all patients. There were no deaths. Conclusions Stereotactic aspiration is a useful management option for abscesses located in eloquent or inaccessible regions. Repeated aspiration should be considered in patients in whom the initial aspiration proves ineffective or partially effective. Complete resolution may require repeated stereotactic aspirations and continued antibiotic therapy.


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