Computed tomography scan features of multidrug-resistant TB and extensively drug-resistant TB

2021 ◽  
Vol 9 (5) ◽  
pp. 21
Author(s):  
Payam Mehrian ◽  
Poopak Farnia ◽  
Dina Jalalvand ◽  
MostafaRezaei Chamani ◽  
Mahmood Bakhtiyari
Keyword(s):  
Computed Tomography ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
Computed Tomography Scan ◽  
Extensively Drug Resistant ◽  
Tomography Scan

scholarly journals 1597. Ceftolozane-Tazobactam and Meropenem Synergy Testing Against Multi-Drug and Extensively-Drug Resistant Pseudomonas aeruginosa

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S794-S795
Author(s):  
Mary Francine P Chua ◽  
Syeda Sara Nida ◽  
Jerry Lawhorn ◽  
Janak Koirala
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Synergistic Effect ◽  
Inhibitory Concentration ◽  
Multidrug Resistant ◽  
Additive Effect ◽  
Teaching Hospitals ◽  
Drug Resistant ◽  
Extensively Drug Resistant ◽  
Synergy Testing ◽  
Concentration Indices

Abstract Background Multidrug-resistant (MDR) and extensively drug-resistant (XDR) Pseudomonas aeruginosa (PA) have limited therapeutic options for treatment. Ceftolozane/tazobactam is a newer anti-pseudomonal drug effective against resistant PA infections, however resistance against this drug has now also developed and is increasing. In this study, we explored the combination of ceftolozane/tazobactam (CT) and meropenem (MP) as a possible effective regimen against MDR and XDR PA. Methods We obtained 33 non-duplicate isolates of MDR and XDR PA grown from blood, urine and respiratory samples collected from patients admitted between 2015 and 2019 at our two affiliate teaching hospitals. MDR PA was defined as resistance to 3 or more classes of anti-pseudomonal antibiotics, and XDR PA as resistance to all but two or less classes of anti-pseudomonal antibiotics. Antimicrobial preparations of both MP and CT were made according to manufacturer instructions. Susceptibility testing was performed using the checkerboard method in accordance to CLSI guidelines (CLSI M100, 2017). The ATCC 27853 strain of PA used as control. Synergy, additive effect, indifference and antagonism were defined as FIC (fractional inhibitory concentration) indices of ≤0.5, >0.5 to <1, >1 to <4, and >4, respectively. Results Thirteen (39%) of 33 PA isolates were classified as XDR, while 20 (61%) PA isolates were MDR. All isolates were resistant to MP (MIC50 >32 ug/mL), while only 2 (6%) isolates were susceptible to CT (MIC50 64 ug/mL). A synergistic effect was seen in 9 (27.3%) of PA isolates (FIC index range 0.28 to 0.5)— 2 of which were XDR PA, and 7 were MDR PA. An additive effect was seen in 12 (36.4%), with indifference seen in 12 (36.4%) of isolates. In this study, no antagonism was seen when CT and MP were combined. Conclusion When used in combination, CT and MP can exert a synergistic effect against MDR and XDR PA. Additive effect and indifference can also be seen when both antibiotics were used. Moreover, there was no antagonism seen when both antibiotics were combined. This study shows that the use of CT and MP in combination may be an option against XDR and MDR PA infections. Disclosures All Authors: No reported disclosures

scholarly journals Multiple Tracheal Diverticula in a COVID-19 Positive Patient

2021 ◽  
pp. 014556132110346
Author(s):  
Konstantinos Garefis ◽  
Konstantinos Tarazis ◽  
Konstantinos Gkiouzelis ◽  
Anastasia Kipriotou ◽  
Iordanis Konstantinidis ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Incidental Finding ◽  
Positive Patient ◽  
Computed Tomography Scan ◽  
Tracheal Diverticulum ◽  
Tomography Scan ◽  
Paratracheal Air Cyst

A tracheal diverticulum is a type of paratracheal air cyst and is usually an incidental finding after a computed tomography scan of the neck and thorax. With an incidence between 1% and 4% in adults, tracheal diverticula are rare entities that can be symptomatic in certain cases. We present a case of a COVID-19 positive patient who presented to our hospital and was diagnosed with multiple tracheal diverticula during his hospitalization.

scholarly journals Pulmonary coinfection of Mycobacterium tuberculosis and Tropheryma whipplei: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Binghua Zhu ◽  
Jing Tang ◽  
Rong Fang ◽  
Xuejie Fei ◽  
Qing Wang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Mycobacterium Tuberculosis ◽  
Next Generation Sequencing ◽  
Tropheryma Whipplei ◽  
Diagnostic Methods ◽  
Next Generation ◽  
Computed Tomography Scan ◽  
Chest Computed Tomography ◽  
Tomography Scan ◽  
Generation Sequencing

Abstract Background We diagnosed a clinical case of pulmonary infection involving Mycobacterium tuberculosis and Tropheryma whipplei in a patient with acute respiratory distress syndrome. The diagnosis was assisted by metagenomic next-generation sequencing of bronchoalveolar lavage fluid. Case presentation A 44-year-old Han Chinese inmate was transferred to the emergency department because of dry cough, chest tightness, and shortness of breath. The patient’s body temperature rose to 39.3 °C following empirical cephalosporin treatment for 1 week. The blood CD4+/CD8+ ratio was 0.7, suggesting immunodeficiency. Routine microbiological tests were performed, and tuberculosis interferon gamma release assays were positive. Mycobacterium tuberculosis polymerase chain reaction was also positive. Chest computed tomography scan revealed miliary nodules and ground-glass opacifications, which were in accordance with tuberculosis. To fully examine the etiology, we performed routine laboratory tests and metagenomic sequencing, the results of which indicated the presence of Mycobacterium tuberculosis and Tropheryma whipplei. We administered anti-tuberculosis regimen in combination with trimethoprim/sulfamethoxazole. The patient recovered, with chest computed tomography scan showing absorption of lesions. Conclusions Compared with traditional diagnostic methods such as culture and serology, metagenomic next-generation sequencing has the advantage of detecting a wide array of microorganisms in a single test and therefore can be used for clinical diagnosis of rare pathogens and microbial coinfections. It is particularly useful for immunocompromised patients as they are more prone to infection by opportunistic microorganisms.

Numerical assessment of natural respiration and particles deposition in the computed tomography scan airway with a glomus tumour

2021 ◽  
pp. 095440892110240
Author(s):  
Digamber Singh
Keyword(s):  
Computed Tomography ◽  
Respiratory Tract ◽  
Particle Deposition ◽  
Flow Characteristics ◽  
Glomus Tumour ◽  
Computed Tomography Scan ◽  
Human Respiratory Tract ◽  
Airflow Pattern ◽  
Human Airways ◽  
Tomography Scan

The human respiratory tract has a complex airflow pattern. If any obstruction is present in the airways, it will change the airflow pattern and deposit particles inside the airways. This is the concern of breath quality (inspired air), and it is decreasing due to the unplanned production of material goods. This is a primary cause of respiratory illness (asthma, cancer, etc.). Therefore, it is important to identify the flow characteristics in the human airways and airways with a glomus tumour with particle deposition. A numerical diagnosis is presented with an asymmetric unsteady-state light breathing condition (10 l/min). An in vitro human respiratory tract model has been reconstructed using computed tomography scan techniques and an artificial glomus tumour developed 2 cm above a carina on the posterior wall of the trachea. The transient flow characteristics are numerically simulated with a realizable (low Reynolds number) k–ɛ turbulence model. The flow disturbance is captured around the tumour, which influenced the upstream and downstream of the flow. The flow velocity pattern, wall shear stress and probable area of inflammation (hotspot) due to suspended particle deposition are determined, which may assist doctors more effectively in aerosol therapy and prosthetics of human airways illness.

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