scholarly journals Staphylococcus aureus is a major pathogen in severe acute bacterial rhinosinusitis

2014 ◽  
Vol 52 (1) ◽  
pp. 48-52
Author(s):  
A. Byrjalsen ◽  
T. Ovesen ◽  
T. Kjaergaard
Keyword(s):  
Staphylococcus Aureus ◽  
Group A Streptococcus ◽  
Tertiary Hospital ◽  
University Hospital ◽  
Bacterial Strains ◽  
Acute Rhinosinusitis ◽  
Intracranial Complications ◽  
Group A ◽  
Acute Bacterial Rhinosinusitis ◽  
Orbital Complications

Purpose: The purpose of this study was to investigate the epidemiology and microbiology of severe acute bacterial rhinosinusitis in patients admitted to a Danish tertiary hospital. Methods: A retrospective study was performed including all cases of acute rhinosinusitis admitted to the ENT-department of Aarhus University Hospital, in the period 2001 to 2011. Results: In total, 143 cases of acute rhinosinusitis were identified of which 51% were children. The most prevalent bacterial strains were Staphylococcus aureus followed by group A streptococcus, Haemophilus influenzae and Streptococcus pneumonia. Morexella catarrhalis was only rarely cultured. Anerobes were not assessed routinely. Of all patients, 47.8% presented with orbital complications and 2.1% developed intracranial complications. Patients infected with group A streptococcus had significantly higher leukocyte and neutrophil counts than other patients. All cultured S. aureus were resistant to penicillin, but sensitive to methicillin. Conclusion: Our results imply that S. aureus and group A streptococcus are important pathogens in severe and complex cases of ABRS, in addition to the accepted pathogens S. pneumoniae and H. influenzae. On the contrary M. catarrhalis appears less significant. These findings have important implications regarding the selection of relevant treatment strategy in secondary care, which may currently be underestimating the role of S. aureus.

scholarly journals A clinical case of rhinogenous orbit phlegmon in a four months old infant

2019 ◽  
Vol 18 (1) ◽  
pp. 92-97
Author(s):  
S. I. Alekseenko ◽  
◽  
M. V. Molchanova ◽  
S. A. Artyushkin ◽  
N. A. Malinovskaya ◽  
...  
Keyword(s):  
Inflammatory Process ◽  
Clinical Case ◽  
Interdisciplinary Approach ◽  
Acute Rhinosinusitis ◽  
Intracranial Complications ◽  
Acute Bacterial Rhinosinusitis ◽  
Nose And Paranasal Sinuses ◽  
Orbital Complications ◽  
Early Surgical Treatment ◽  
Scientific Achievements

In spite of scientific achievements in diagnostics and treatment of the diseases of nose and paranasal sinuses in children, this problem remains important. Acute bacterial rhinosinusitis occupies one of the leading positions among ENT diseases in terms of seeking medical care, and often results in the development of orbital and intracranial complications. Rhinogenic orbital complications in children occur more frequently than in adults, where 10–22% are purulent-septic orbital processes with a possible outcome of blindness. The article presents a clinical case of acute purulent rhinosinusitis complicated with a right orbit phlegmon in a four months old infant. Timely diagnosis, early surgical treatment made it possible to stop the inflammatory process, to avoid the development of more severe complications. The specific features of diagnostics and treatment of acute rhinosinusitis in infants, occurring with orbital complications, predetermines the need for an interdisciplinary approach of doctors of different specialties.

Paediatric empyema: worsening disease severity and challenges identifying patients at increased risk of repeat intervention

2020 ◽  
Vol 105 (9) ◽  
pp. 886-890 ◽  
Author(s):  
Stuart Haggie ◽  
Hasantha Gunasekera ◽  
Chetan Pandit ◽  
Hiran Selvadurai ◽  
Paul Robinson ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Initial Treatment ◽  
Group A Streptococcus ◽  
Thoracoscopic Surgery ◽  
Tertiary Hospital ◽  
Fibrinolytic Therapy ◽  
Younger Age ◽  
Increased Risk ◽  
Group A ◽  
Single Intervention

ObjectiveEmpyema is the most common complication of pneumonia. Primary interventions include chest drainage and fibrinolytic therapy (CDF) or video-assisted thoracoscopic surgery (VATS). We describe disease trends, clinical outcomes and factors associated with reintervention.Design/setting/patientsRetrospective cohort of paediatric empyema cases requiring drainage or surgical intervention, 2011–2018, admitted to a large Australian tertiary children’s hospital.ResultsDuring the study, the incidence of empyema increased from 1.7/1000 to 7.1/1000 admissions (p<0.001). We describe 192 cases (174 CDF and 18 VATS), median age 3.0 years (IQR 1–5), mean fever duration prior to intervention 6.2 days (SD ±3.3 days) and 50 (26%) cases admitted to PICU. PICU admission increased during the study from 18% to 34% (p<0.001). Bacteraemia occurred in 23/192 (12%) cases. A pathogen was detected in 131/192 (68%); Streptococcus pneumoniae 75/192 (39%), S. aureus 25/192 (13%) and group A streptococcus 13/192 (7%). Reintervention occurred in 49/174 (28%) and 1/18 (6%) following primary CDF and VATS. Comparing repeat intervention with single intervention cases, a continued fever postintervention increased the likelihood for a repeat intervention (OR 1.3 per day febrile; 95% CI 1.2 to 1.4, p<0.0001). Younger age, prolonged fever preintervention and previous antibiotic treatment were not associated with initial treatment failure (all p>0.05).ConclusionWe report increasing incidence and severity of empyema in a large tertiary hospital. One in four patients required a repeat intervention after CDF. Neither clinical variables at presentation nor early investigations were able to predict initial treatment failure.

scholarly journals Natural Disruption of Two Regulatory Networks in Serotype M3 Group A Streptococcus Isolates Contributes to the Virulence Factor Profile of This Hypervirulent Serotype

2014 ◽  
Vol 82 (5) ◽  
pp. 1744-1754 ◽  
Author(s):  
Tram N. Cao ◽  
Zhuyun Liu ◽  
Tran H. Cao ◽  
Kathryn J. Pflughoeft ◽  
Jeanette Treviño ◽  
...  
Keyword(s):  
Virulence Factor ◽  
Regulatory Networks ◽  
Molecular Mechanisms ◽  
Group A Streptococcus ◽  
Regulatory System ◽  
Mrna Levels ◽  
Bacterial Strains ◽  
Content Type ◽  
Small Regulatory Rna ◽  
Group A

ABSTRACTDespite the public health challenges associated with the emergence of new pathogenic bacterial strains and/or serotypes, there is a dearth of information regarding the molecular mechanisms that drive this variation. Here, we began to address the mechanisms behind serotype-specific variation between serotype M1 and M3 strains of the human pathogenStreptococcus pyogenes(the group AStreptococcus[GAS]). Spatially diverse contemporary clinical serotype M3 isolates were discovered to contain identical inactivating mutations within genes encoding two regulatory systems that control the expression of important virulence factors, including the thrombolytic agent streptokinase, the protease inhibitor-binding protein-G-related α2-macroglobulin-binding (GRAB) protein, and the antiphagocytic hyaluronic acid capsule. Subsequent analysis of a larger collection of isolates determined that M3 GAS, since at least the 1920s, has harbored a 4-bp deletion in thefasCgene of thefasBCAXregulatory system and an inactivating polymorphism in therivRregulator-encoding gene. ThefasCandrivRmutations in M3 isolates directly affect the virulence factor profile of M3 GAS, as evident by a reduction in streptokinase expression and an enhancement of GRAB expression. Complementation of thefasCmutation in M3 GAS significantly enhanced levels of the small regulatory RNA FasX, which in turn enhanced streptokinase expression. Complementation of therivRmutation in M3 GAS restored the regulation ofgrabmRNA abundance but did not alter capsule mRNA levels. While important, thefasCandrivRmutations do not provide a full explanation for why serotype M3 strains are associated with unusually severe invasive infections; thus, further investigation is warranted.

Comparative study of the efficacy of topical steroid and antibiotic combination therapy versus oral antibiotic alone when treating acute rhinosinusitis

2015 ◽  
Vol 129 (5) ◽  
pp. 462-467 ◽  
Author(s):  
D M El-Hennawi ◽  
M R Ahmed ◽  
A M Farid ◽  
A M Al Murtadah
Keyword(s):  
Symptom Relief ◽  
Topical Steroid ◽  
Control Group ◽  
Nasal Discharge ◽  
Oral Antibiotic ◽  
Topical Antibiotic ◽  
Acute Rhinosinusitis ◽  
Group A ◽  
Acute Bacterial Rhinosinusitis ◽  
Group B

AbstractBackground:Acute rhinosinusitis arises as a consequence of viral rhinitis, and bacterial infection can subsequently occur. Intranasal antibiotics as an adjunct to corticosteroids usually demonstrate the greatest symptom relief.Aim:We wanted to clinically evaluate the effects of a topical antibiotic and steroid combination administered intranasally, versus an oral antibiotic alone when treating acute rhinosinusitis.Method:Forty patients with acute bacterial rhinosinusitis were divided into two groups. Group A received an antibiotic and steroid combination (ofloxacin 0.26 per cent and dexamethasone 0.053 per cent nasal drops) for 10 days, administered intranasally (5 drops in each nostril/8 hours). Group B, the control group, received an oral antibiotic alone (amoxicillin 90 mg/kg).Results:Eight hours after commencing treatment, facial pain was more severe in group B and nasal obstruction was reduced in both groups. Ten days after commencing treatment, anterior nasal discharge was 0.15 per cent in group A and absent in group B.Conclusion:The application of a topical antibiotic and steroid combination into the nasal cavity is an effective way of treating uncomplicated, acute bacterial rhinosinusitis with the theoretical advantages of easy administration, high local drug concentration and minimal systemic adverse effects.

Staphylococcus aureusis the most common identified cause of cellulitis: a systematic review

2009 ◽  
Vol 138 (3) ◽  
pp. 313-317 ◽  
Author(s):  
S. CHIRA ◽  
L. G. MILLER
Keyword(s):  
Systematic Review ◽  
Staphylococcus Aureus ◽  
Group A Streptococcus ◽  
Needle Aspiration ◽  
Punch Biopsy ◽  
Review Of The Literature ◽  
Intact Skin ◽  
Methicillin Resistant ◽  
Therapeutic Implications ◽  
Group A

SUMMARYWe utilized Medline to perform a systematic review of the literature to quantify the aetiology of cellulitis with intact skin. Of 808 patients with cellulitis, 127–129 (15·7–16·0%) patients had positive needle aspiration and/or punch biopsy cultures from intact skin. Of the patients with positive cultures, 65 (50·4–51·2%) had cultures positive forStaphylococcus aureus, 35 (27·1–27·6%) for group A streptococcus, and 35–37 (27·1–29·1%) for other pathogens. The most common aetiology of cellulitis with intact skin, when it can be determined, isS. aureus, outnumbering group A streptococcus by a ratio of nearly 2:1. Given the increasing incidence of community-associated methicillin-resistantS. aureusinfections, our findings may have critical therapeutic implications.

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