scholarly journals Fatal pulmonary infection by trimethoprim-sulfamethoxazole resistant Nocardia otitidiscaviarum: report of two cases and review

2020 ◽  
Vol 14 (02) ◽  
pp. 214-222
Author(s):  
Rushika Saksena ◽  
Dabet Rynga ◽  
Santosh Rajan ◽  
Rajni Gaind ◽  
Reetika Dawar ◽  
...  
Keyword(s):  
Pulmonary Infection ◽  
Species Level ◽  
Shortness Of Breath ◽  
Microbiology Laboratory ◽  
Antimicrobial Susceptibility Pattern ◽  
Improve Treatment ◽  
Amoxicillin Clavulanic Acid ◽  
Biochemical Identification ◽  
Nocardia Otitidiscaviarum ◽  
Human Infections

Introduction: Nocardia otitidiscaviarum is a rare cause of human infections, mostly causing cutaneous and lymphocutaneous infections of mild severity. We report two cases of fatal pulmonary infection caused by Nocardia otitidiscaviarum in elderly patients. Methodology: Case 1: A 70-year old woman presented with fever and cough with expectoration for a month. On physical examination, she had tachypnea and inspiratory crepitations in bilateral basal regions. Case 2: A 74-year old man presented with productive cough with foul smelling expectoration, fever and shortness of breath for one week. On examination, he had tachypnea, bilateral wheezing and inspiratory crepitations. In both cases, sputum was sent to microbiology laboratory. On direct microscopy Gram-positive, finely branching filaments were observed which were acid fast with 1% sulphuric acid. Chalky white opaque wrinkled colonies with musty basement type odour were seen on blood agar. Both patients were treated empirically with trimethoprim-sulfamethoxazole for Nocardia infection after notification of microscopy findings however both expired on Day 2 and Day 5 of admission, respectively. Both isolates were susceptible to amikacin, linezolid, ciprofloxacin and gentamicin. They were resistant to trimethoprim-sulfamethoxazole, ampicillin, amoxicillin-clavulanic acid, erythromycin, and imipenem. Based on biochemical identification and antimicrobial susceptibility pattern, the organism was identified as Nocardia otitidiscaviarum. The identification was confirmed using MALDI-TOF (Vitek MS, Biomerieux, France). Conclusion: Our report highlights the importance of early identification of Nocardia to species level to improve treatment outcomes especially in critically ill patients. Mass spectrometry can become an integral part of diagnostic algorithms for nocardiosis.

Abstract 378: Diagnosing Pneumonia After Cardiac Arrest

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Alexandra Weissman ◽  
Jacob S Puyana ◽  
David Spencer ◽  
Melissa Repine ◽  
Jon C Rittenberger ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Chest Radiography ◽  
Innate Immune System ◽  
Pulmonary Infection ◽  
Innate Immune ◽  
Microbiology Laboratory ◽  
Blood Cell Count ◽  
Interleukin 17A ◽  
Post Cardiac Arrest Syndrome ◽  
Pneumonia Diagnosis

Introduction: Post cardiac arrest syndrome, therapeutic hypothermia, and CPR confound the clinical diagnosis of pneumonia. Accurate pneumonia diagnosis is required to improve targeted antibiotic allocation and prevent sequelae of untargeted antibiotic therapy. Hypothesis: We can rigorously define pneumonia after cardiac arrest (CA) using accepted clinical parameters adapted from existing guidelines and innate immune system biomarkers Interleukin-17A (IL-17A), integrin α9β1, and CD11b specific to the response to pulmonary infection. Methods: A prospective cohort of consecutive OHCA patients surviving at least 72 hours from arrival was enrolled. IL-17A, integrin α9β1, and CD11b were measured daily at 4 timepoints from time 0 (arrival) through 72 hours. Chest radiography, pulmonary microbiology, temperature, and white blood cell count were recorded concurrently from the medical record. Pneumonia was defined narrowly (pna_narrow) by the presence of at least 2 of the following criteria in the initial 72 hours of presentation: fever ≥38°C; persistent infiltrate on chest radiography; positive sputum or bronchoalveolar lavage per the hospital microbiology laboratory. Broad criteria (pna_broad) also incorporated persistent leukocytosis ≥15,000 or leukopenia <3,000. Results: Of the 56 subjects with all data, 23% (13 of 56) met pna_narrow criteria while 43% (24 of 56) met pna_broad criteria. Positive clinical pulmonary microbiology was present in 62% (8 of 13) subjects meeting pna_narrow and 46% (11 of 24) subjects meeting pna_broad criteria. Antibiotics were given to 65% (28 of 43) subjects without pna_narrow and 63% (20 of 32) without pna_broad. Overall, 70% (39 of 56) subjects received antibiotics regardless of pneumonia status. Integrin α9β1 at Time 28 hours and Time 72 hours was associated with pna_narrow (p = 0.010, p = 0.049). CD11b at Time 0 and 72 hours was associated with pna_narrow (p = 0.03, p = 0.049). IL-17 at Time 28 and Time 72 was associated with pna_narrow (p = 0.04, p = 0.01). Conclusions: Pneumonia was rigorously defined in 23 to 43% of our sample, yet 70% of subjects received antibiotics. More rigorous definitions for pneumonia after CA, combined with pulmonary infection biomarkers, could be used to improve diagnosis and antibiotic allocation.

scholarly journals Achromobacter Xylosoxidans Bloodstream Infection in Elderly Patient with Hepatocellular Carcinoma: Case Report and Review of Literature

2015 ◽  
Vol 7 (02) ◽  
pp. 124-127 ◽  
Author(s):  
Kausalya Raghuraman ◽  
Nishat H Ahmed ◽  
Frincy K Baruah ◽  
Rajesh K Grover
Keyword(s):  
Hepatocellular Carcinoma ◽  
Clavulanic Acid ◽  
Bloodstream Infection ◽  
Acid Treatment ◽  
Achromobacter Xylosoxidans ◽  
Review Of Literature ◽  
Gram Negative ◽  
Antimicrobial Susceptibility Pattern ◽  
Amoxicillin Clavulanic Acid

ABSTRACT Achromobacter xylosoxidans is a nonfermentative Gram-negative organism, known to cause opportunistic infection in humans. We report a case of septicemia in a 76-year-old male patient with underlying hepatocellular carcinoma due to A. xylosoxidans, which showed a different antimicrobial susceptibility pattern from what is usually reported. From aerobic blood culture of the patient, A. xylosoxidans was isolated which was found to be sensitive to amoxicillin-clavulanic acid, piperacillin-tazobactam, ceftazidime, cefoperazone-sulbactam, meropenem, minocycline, tigecycline, and trimethoprim/sulfamethoxazole. The patient recovered with amoxicillin-clavulanic acid treatment, which was given empirically to the patient. The present case highlights the possible role of amoxicillin-clavulanic acid for treatment of bloodstream infection with A. xylosoxidans.

scholarly journals Antimicrobial susceptibility and molecular characterization of Salmonella serovar Ndolo isolated from outbreaks in cattle and horses

2018 ◽  
Vol 48 (12) ◽  
Author(s):  
Carolina Pantuzza Ramos ◽  
Rafael Gariglio Clark Xavier ◽  
Carlos Augusto Gomes Leal ◽  
Elias Jorge Facury Filho ◽  
Antonio Ultimo de Carvalho ◽  
...  
Keyword(s):  
Clavulanic Acid ◽  
Antimicrobial Susceptibility ◽  
Virulence Genes ◽  
Susceptibility Testing ◽  
Domestic Animals ◽  
Amoxicillin Clavulanic Acid ◽  
Resistant Strains ◽  
Human Infections ◽  
First Time

ABSTRACT: The present study aimed to describe and characterize, for the first time, two outbreaks of salmonellosis caused by Salmonella Ndolo in foals and calves in Brazil and compare the isolated strains with S. Ndolo previously identified in asymptomatic reptiles. The affected calves and foals presented fever, lethargy, and profuse diarrhea. Isolated strains were subjected to antimicrobial susceptibility testing, characterized according to virulence genes, and fingerprinted by ERIC-PCR. Salmonella Ndolo was identified in fecal samples from two foals and four calves. One isolate from a calf was resistant to amoxicillin/clavulanic acid, trimethoprim/sulfamethoxazole, and florfenicol. Strains from two other calves were resistant to oxytetracycline. All virulence genes tested were present in the isolates, and two major clusters of closely related strains were identified by ERIC-PCR, each per outbreak. This is the first report of Salmonella Ndolo infection in domestic and symptomatic animals. Previously, this serovar had been identified only in human infections. The presence of relevant virulence genes in all Salmonella Ndolo isolates and the detection of antimicrobial multi-resistant strains highlighted the importance of monitoring serovars associated with salmonellosis in domestic animals.

scholarly journals Kodamaea (Pichia) ohmeri fungaemia in a premature neonate

2006 ◽  
Vol 55 (2) ◽  
pp. 237-239 ◽  
Author(s):  
S. J. Taj-Aldeen ◽  
S. H. Doiphode ◽  
X. Y. Han
Keyword(s):  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Gene Sequencing ◽  
Premature Neonate ◽  
Rrna Gene ◽  
Pathogenic Yeast ◽  
First Case ◽  
Biochemical Identification ◽  
Rrna Gene Sequencing ◽  
Human Infections

Kodamaea ohmeri is a yeast that rarely causes human infections. The first case of K. ohmeri fungaemia in a premature neonate is reported; it was successfully treated with liposomal amphotericin B. Biochemical identification of the yeast was performed by Vitek II and API and was confirmed by rRNA gene sequencing. K. ohmeri as a human pathogenic yeast is uncommon to hospitalized neonates and immunocompromised individuals.

scholarly journals Identify and Test the Resistance of Bacteria on Dental Unit Surfaces in Dental Clinic of Dentistry Faculty, Andalas University Padang

2017 ◽  
Vol 1 ◽  
Author(s):  
Alifia Aura Syafira ◽  
Mustafa Noer ◽  
Syafrawati Syafrawati
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Clavulanic Acid ◽  
Bacterial Contamination ◽  
Sampling Method ◽  
Simple Random Sampling ◽  
The Body ◽  
Resistance Test ◽  
Microbiology Laboratory ◽  
Dental Clinic ◽  
Amoxicillin Clavulanic Acid

<p class="AbstractContent"><strong>Objective</strong>: Cross infection is one of the problems in dentistry. It can be caused by dental unit surfaces which act as the mediator for bacteria to enter the body. The aim of this research was to identify and test the resistance of bacteria that found on dental unit surfaces which suspected to be contaminated by patients in Dental Clinic.</p><p class="AbstractContent"><strong>Methods:</strong> Using simple random sampling method, this research observed 15 samples of handle, instruments table and spittoon bowl surfaces. Bacterial contamination identified and tested for its resistance in Microbiology Laboratory of Faculty of Medicine, Andalas University. Amoxicillin, amoxicillin-clavulanic acid combination, chloramphenicol, erythromycin, gentamycin, tetracycline, ciprofloxacin and cefoperazone discs were used for resistance test of bacteria.</p><p class="AbstractContent"><strong>Results</strong>: There were 16 contaminations of bacteria found. 12 of them were gram-positiveBacillus spand remaining four were gram-negative bacilli which are Enterobacteriaceae, Pseudomonas aeruginosa, and two Klebsiella sp. The resistance test showed that Pseudomonas aeruginosa is resistant to amoxicillin, amoxicillin-clavulanic acid combination, chloramphenicol, and erythromycin while both of Klebsiella sp are resistant to amoxicillin, amoxicillin-clavulanic acid combination, chloramphenicol, and erythromycin.</p><p class="AbstractContent"><strong>Conclusion: </strong>Dental unit surfaces are an important vehicle for resistance bacteria to spread.</p>

scholarly journals Prevalence and antimicrobial susceptibility pattern of Staphylococcus Aureus isolated from clinical specimens at the Mater Hospital Nairobi, Kenya.

2020 ◽  
Author(s):  
Christina Okello ◽  
Loice Achieng ◽  
Enoch Omonge ◽  
Frederick Otieno ◽  
Davies Otieno ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Clinical Specimen ◽  
Mater Hospital ◽  
Antimicrobial Susceptibility Pattern ◽  
High Prevalence ◽  
Amoxicillin Clavulanic Acid ◽  
Antibiotic Susceptibility Patterns ◽  
And Gender ◽  
Low Prevalence ◽  
Susceptibility Patterns

Abstract Staphylococcus aureus (S. aureus) is a leading cause of hospital and community acquired infections globally. Methicillin-resistant Staphylococcus aureus (MRSA) prevalence has been reported to be high in various settings and is associated with increased morbidity, mortality and risk of nosocomial outbreaks. Surveillance of prevalence and antibiotic susceptibility patterns is important to ensure appropriate antibiotic prescription. The objective of our study was to establish the prevalence of S. aureus, to identify patterns of susceptibility to commonly used antibiotics and quantify contemporary penicillin resistance among S. aureus. A retrospective study was conducted at the Mater Misericordiae Hospital, Nairobi. The study involved a review of non-duplicate records of specimens analyzed between January 2014 and December 2018.A specimen was categorized as Penicillin susceptible (PSSA) if susceptible to Penicillin and Oxacillin, MSSA if resistant to Penicillin but susceptible to Oxacillin, and MRSA if resistant to Oxacillin. We present proportions of S. aureus that was PSSA, MSSA and MRSA. Multivariate logistic regression was used to determine the association between the presence of S. aureus isolates and the source of the clinical specimen (in vs. outpatient), age and gender. A total of 659 specimens of S. aureus were analyzed in the 5-year period. ​​PSSA was the most prevalent organism seen (60.85%) while MRSA was the least prevalent (0.61 %). Most S. aureus was isolated in pus from wound swabs-644 (73. 3%). A significant increase in susceptibility of S. aureus to Penicillin and Amoxicillin-clavulanic acid was observed during the study period however, sensitivity to Amoxicillin declined. This study demonstrated a high prevalence of Penicillin Sensitive S. aureus and a low prevalence of MRSA.

Pulsed-field gel electrophoresis profiles of aeromonads isolated from healthy and diseasedHelix aspersafrom French snail farms

2005 ◽  
Vol 51 (9) ◽  
pp. 817-820 ◽  
Author(s):  
M B Kiebre-Toe ◽  
A Lacheretz ◽  
L Villard ◽  
Y Richard ◽  
A Kodjo
Keyword(s):  
Gel Electrophoresis ◽  
Geographic Origin ◽  
Pulsed Field Gel Electrophoresis ◽  
Species Level ◽  
Chromosomal Dna ◽  
Epidemiological Evidence ◽  
Pulsed Field ◽  
Aeromonas Caviae ◽  
Biochemical Identification ◽  
Epizootic Disease

The XbaI digestion patterns of chromosomal DNA of 42 aeromonads isolated from French breeding snails during a new epizootic disease, which rapidly progressed to death during the summer of 1994, were analyzed by pulsed-field gel electrophoresis. Biochemical identification to species level was also performed. Interestingly, we found that 76% of the aeromonads isolated from diseased snails clustered into a unique pulsotype (P1) whatever their geographic origin, and were assessed to belong to Aeromonas hydrophila. Other strains belonged to Aeromonas caviae or remained unspecified. Our results provide retrospective supplementary epidemiological evidence for implication of A. hydrophila strains in the snail summer disease.Key words: breeding snails, pulsed-field gel electrophoresis, Aeromonas.

scholarly journals Occurrence and antimicrobial susceptibility of Salmonella isolates recovered from the pig slaughter process in Romania

2015 ◽  
Vol 9 (01) ◽  
pp. 099-104 ◽  
Author(s):  
Adriana Morar ◽  
Claudia Sala ◽  
Kálmán Imre
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Susceptibility ◽  
Multidrug Resistant ◽  
Resistance Pattern ◽  
Pork Products ◽  
Human Salmonellosis ◽  
Production Complex ◽  
Amoxicillin Clavulanic Acid ◽  
Meat Samples ◽  
Human Infections

Introduction: Reported human salmonellosis cases have increased in Romania. Antibiotic susceptibility testing of Salmonella strains isolated from pork and chicken meat indicate a worrying multidrug resistance pattern. This study aimed to investigate the occurrence of Salmonella and to evaluate the antibiotic resistance of Salmonella strains in a pig slaughterhouse-processing complex, which receives animals from 30% of the large industrialized swine farms in Romania. Methodology: A total of 108 samples, including pork (n = 47), packaged pork products (n = 44), scald water sludge (n = 8), and detritus from the hair removal machine of the slaughterhouse (n = 9) were examined for the presence of Salmonella through standard methods. The antibiotic susceptibility of the isolated strains to 17 antibiotics was tested using the Vitek 2 system. Results: Twenty-six (24.1%) samples were found to be Salmonella positive; this included 25.5% of meat samples and 15.9% of packaged products, as well as samples from two different points of the slaughter (41.2%). Resistance was observed against tetracycline (61.5%), ampicillin (50%), piperacillin (50%), trimethoprim-sulfamethoxazole (34.6%), amoxicillin/clavulanic acid (26.9%), nitrofurantion (23.1%), cefazolin (15.4%), piperacillin/tazobactam (7.7%), imipenem (3.8%), ciprofloxacin (3.8%), and norfloxacin (3.8%). No resistance towards cefoxitin, cefotaxime, ceftazidime, cefepime, amikacin, and gentamicin was found. Conclusions: Our study demonstrated the occurrence of multidrug-resistant Salmonella strains in the investigated pork production complex and highlighted it as a potential source of human infections. The results demonstrate the seriousness of antibiotic resistance of Salmonella in Romania, while providing a useful insight for the treatment of human salmonellosis by specialists.

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