High mortality among patients with positive blood cultures at a Childrens Hospital in Tbilisi, Georgia

Nowadays, despite improvements in diagnosis and treatment, infective endocarditis remains associated with high mortality and severe complications. When assessing the prognosis of patients with endocarditis, three different clinical periods are distinguished: prognostic assessment at admission, early risk reassessment during the first week after the beginning of antibiotics, and short- and long-term prognosis after discharge. The three cornerstones for assessing patients’ prognosis can be obtained from clinical findings, echocardiography, and blood cultures. Analytic parameters such as thrombocytopenia may also help to stratify risk.

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Dissemination of extensively drug-resistant and KPC-2 producing Klebsiella pneumoniae isolated from bloodstream infections

The Journal of Infection in Developing Countries ◽

10.3855/jidc.6679 ◽

2015 ◽

Vol 9 (09) ◽

pp. 1016-1021 ◽

Cited By ~ 8

Author(s):

Feng Zhao ◽

Jun Zhang ◽

Ying Fu ◽

Zhi Ruan ◽

Xinyou Xie

Keyword(s):

Klebsiella Pneumoniae ◽

High Mortality ◽

Antimicrobial Agents ◽

Bacterial Species ◽

Bloodstream Infections ◽

Blood Cultures ◽

Drug Resistant ◽

Extended Spectrum Beta Lactamase ◽

Resistant Genes ◽

Extensively Drug Resistant

Introduction: Bloodstream infections (BSIs) are serious diseases associated with high mortality, especially when caused by extensively drug-resistant (XDR) Klebsiella pneumoniae. The prevalence and pandemic strains of extended-spectrum beta-lactamase (ESBL)-producing K. pneumoniae isolated from blood cultures of patients with BSIs were determined at Sir Run Run Shaw Hospital, China. Methodology: A total of 24 XDR K. pneumoniae were isolated from blood cultures, and the clinical data of the patients were analyzed retrospectively. Bacterial species identification and antimicrobial susceptibility testing were performed using VITEK2 and E-test methods, respectively. Common ESBL-resistant genes were amplified and sequenced after the validation of a modified Hodge test. Strain homology was also analyzed by pulsed-field gel electrophoresis (PFGE). Results: All of the isolates were resistant to 10 antimicrobial agents. Several strains showed partial sensitivity to aminoglycosides, but all showed sensitivity to polymyxin and tigecycline. All strains were Klebsiella pneumoniae carbapenemase (KPC-2) producing, and carried two or three ESBL-resistant genes, which belonged to 13 PFGE clones (A–M). The overall mortality rate in patients was as high as 29.2%. Conclusions: KPC-2-producing K. pneumoniae BSIs are associated with high mortality rates. Our observations suggest that KPC-2 and ESBL-producing K. pneumoniae might be responsible for the clonal dissemination of extensively drug-resistant isolates in our hospital.

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An Unusual Presentation From a Sporadic Partially Acid-Fast Aerobic Actinomycete Resistant to Common Antibiotics

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/2324709619899598 ◽

2020 ◽

Vol 8 ◽

pp. 232470961989959

Author(s):

Sreedhar Adapa ◽

Srikanth Naramala ◽

Vijay Gayam ◽

Rajan Kapoor ◽

Mina Raju ◽

...

Keyword(s):

High Mortality ◽

Opportunistic Infections ◽

Slow Growth ◽

Blood Cultures ◽

Unusual Presentation ◽

Organ Involvement ◽

Aggressive Therapy ◽

Nocardia Farcinica ◽

Immunosuppressed Patients ◽

Identification Techniques

Nocardia causes rare opportunistic infections, that can be challenging to diagnose because of atypical features on conventional microbiological identification techniques. Immunosuppressed patients are more susceptible to infections from Nocardia and are associated with multi-organ involvement. We report a case of a 63-year-old male who developed peritonitis from Nocardia farcinica that rarely causes infections in humans. The nonspecific symptoms, negative blood cultures, and slow growth can make diagnosis difficult. Despite aggressive therapy, the virulence and inherent resistance to the antibiotics can result in high mortality from Nocardia farcinica infections.

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1038. Edwardsiella tarda Bacteremia: Epidemiology, Clinical Features, and Outcomes

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.875 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S310-S310

Author(s):

Shinya Kamiyama ◽

Akira Kuriyama ◽

Toru Hashimoto

Keyword(s):

Clinical Features ◽

High Mortality ◽

Clinical Epidemiology ◽

Gastrointestinal Disease ◽

Case Series ◽

Clinical Information ◽

Blood Cultures ◽

Edwardsiella Tarda ◽

Bacterial Peritonitis ◽

Clinical Diagnoses

Abstract Background Edwardsiella tarda is primarily associated with gastrointestinal disease, but an increasing number of cases with extraintestinal disease have been reported. Additionally, E. tarda bacteremia (ETB) may be associated with high mortality; however, little is known about its clinical epidemiology. Methods We collected all clinical information of ETB patients identified between January 2005 and December 2016 from their electronic medical records. We described the epidemiology, clinical features, and 30- and 90-day mortality of these patients. Results A total of 182,668 sets of blood cultures were obtained during the study period, of which 40 sets (0.02%) taken from 26 patients were E. tarda positive. Twenty-six patients (13 men and 13 women) with a median age of 75 years were diagnosed with ETB. Clinical diagnoses by infection site included cholangitis (n = 9), liver abscess (n = 6), enterocolitis (n = 4), cholecystitis (n = 3), and spontaneous bacterial peritonitis, mycotic aneurysm, necrotizing fasciitis, empyema, osteomyelitis, and secondary peritonitis (n = 1 each). The overall 30-day and 90-day mortality rates of ETB in our cohort was 11.5% (3/26) and 26.9% (7/26), respectively. There was no seasonal variation in the incidence of E. tarda infection. All E. tarda strains isolated from blood cultures were susceptible to all tested antibiotics. Additionally, hepatobiliary infection was more frequently seen in ETB compared with non-bacteremic E. tarda infections. Conclusion This study is the largest case series on ETB to date. We found that ETB is a rare entity that is not associated with high mortality. Hepatobiliary infection is the most common clinical manifestation. Disclosures All authors: No reported disclosures.

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Prognosis and complications

ESC CardioMed ◽

10.1093/med/9780198784906.003.0391_update_001 ◽

2018 ◽

pp. 1715-1720

Author(s):

Isidre Vilacosta ◽

Carmen Olmos

Keyword(s):

Infective Endocarditis ◽

High Mortality ◽

Clinical Findings ◽

Blood Cultures ◽

Diagnosis And Treatment ◽

Prognostic Assessment ◽

Early Risk ◽

Short And Long Term ◽

Long Term Prognosis

Nowadays, despite improvements in diagnosis and treatment, infective endocarditis remains associated with high mortality and severe complications. When assessing the prognosis of patients with endocarditis, three different clinical periods are distinguished: prognostic assessment at admission, early risk reassessment during the first week after the beginning of antibiotics, and short- and long-term prognosis after discharge. The three cornerstones for assessing patients’ prognosis can be obtained from clinical findings, echocardiography, and blood cultures. Analytic parameters such as thrombocytopenia may also help to stratify risk.

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Rapid demonstration of septic or infectious arthritis due to Gram-negative bacteria

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100123830 ◽

1992 ◽

Vol 50 (1) ◽

pp. 686-687

Author(s):

Jacob S. Hanker ◽

Paul R. Gross ◽

Beverly L. Giammara

Keyword(s):

Chronic Arthritis ◽

Blood Cultures ◽

Gram Negative Bacteria ◽

Infectious Arthritis ◽

Bacterial Arthritis ◽

Gram Positive ◽

Gram Negative ◽

Gram Positive Bacteria

Blood cultures are positive in approximately only 50 per cent of the patients with nongonococcal bacterial infectious arthritis and about 20 per cent of those with gonococcal arthritis. But the concept that gram-negative bacteria could be involved even in chronic arthritis is well-supported. Gram stains are more definitive in staphylococcal arthritis caused by gram-positive bacteria than in bacterial arthritis due to gram-negative bacteria. In the latter situation where gram-negative bacilli are the problem, Gram stains are helpful for 50% of the patients; they are only helpful for 25% of the patients, however, where gram-negative gonococci are the problem. In arthritis due to gram-positive Staphylococci. Gramstained smears are positive for 75% of the patients.

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