scholarly journals Acute Hematogenous Escherichia coli Osteomyelitis of the Fibula in an Adolescent Girl

2020 ◽  
Vol 13 (8) ◽  
Author(s):  
Ninoslav Begovic ◽  
Slavisa M Djuricic ◽  
Lazar Stijak ◽  
Zorica V Vasiljevic
Keyword(s):  
Escherichia Coli ◽  
Causative Agent ◽  
Adolescent Girl ◽  
Antimicrobial Treatment ◽  
Diagnostic Challenge ◽  
Proximal Fibula ◽  
System Defect ◽  
Acute Hematogenous Osteomyelitis ◽  
Empiric Antibiotic ◽  
Empiric Antibiotic Treatment

Introduction: Acute hematogenous osteomyelitis (AHO) usually occurs in the first two decades of life. Evidence shows that 50% of patients with AHO are younger than five years. This infection typically affects the metaphyseal region of long tubular bones, whereas the fibula is rarely involved. Staphylococcus aureus is the causative agent of AHO in the majority of cases, while Escherichia coli is isolated rather uncommonly beyond the neonatal period. Case Presentation: Herein, we describe the case of an adolescent girl who was treated medically and surgically for AHO with an unusual location in the proximal fibula, caused by E. coli. The source of the causative agent remained unknown after the patient had been evaluated for possible urinary tract infection and underlying immune system defect. Conclusions: The fibula is a rare anatomic location for AHO, and such cases may pose a diagnostic challenge. Lack of response to empiric antibiotic treatment in patients with AHO may indicate the involvement of an uncommon pathogen, which is not susceptible to standard empiric antimicrobials aimed to target S. aureus as the most likely pathogen. In such instances, prompt surgical intervention can help determine the causative pathogen and optimize antimicrobial treatment.

Empiric Antibiotic Treatment Reduces Mortality in Severe Sepsis and Septic Shock From the First Hour

2014 ◽  
Vol 42 (8) ◽  
pp. 1749-1755 ◽  
Author(s):  
Ricard Ferrer ◽  
Ignacio Martin-Loeches ◽  
Gary Phillips ◽  
Tiffany M. Osborn ◽  
Sean Townsend ◽  
...  
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Antibiotic Treatment ◽  
Empiric Antibiotic ◽  
Empiric Antibiotic Treatment ◽  
Sepsis And Septic Shock

YhcB coordinates peptidoglycan and LPS biogenesis with phospholipid synthesis during Escherichia coli cell growth.

2021 ◽  
Author(s):  
Emily C A Goodall ◽  
Georgia L Isom ◽  
Jessica L Rooke ◽  
Christopher Icke ◽  
Karthik Pullela ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Genetic Interaction ◽  
Cell Envelope ◽  
Interaction Network ◽  
Antimicrobial Treatment ◽  
Cell Permeability ◽  
Whole Genome ◽  
Confined Space ◽  
Common Strategy ◽  
Conserved Gene

The cell envelope is essential for viability in all kingdoms of life. It retains enzymes and substrates within a confined space while providing a protective barrier to the external environment. Destabilising the envelope of bacterial pathogens is a common strategy employed by antimicrobial treatment. However, even in one of the most well studied organisms, Escherichia coli, there remain gaps in our understanding of how the synthesis of the successive layers of the cell envelope are coordinated during growth and cell division. Here, we used a whole genome phenotypic screen to identify mutants with a defective cell envelope. We report that loss of yhcB, a conserved gene of unknown function, results in loss of envelope stability, increased cell permeability and dysregulated control of cell size. Using whole genome transposon mutagenesis strategies we report the complete genetic interaction network of yhcB, revealing all genes with a synthetic negative and a synthetic positive relationship. These genes include those previously reported to have a role in cell envelope biogenesis. Surprisingly, we identified genes previously annotated as essential that became non-essential in a ΔyhcB background. Subsequent analyses suggest that YhcB sits at the junction of several envelope biosynthetic pathways coordinating the spatiotemporal growth of the cell, highlighting YhcB as an as yet unexplored antimicrobial target.

SEPSIS MARKERS AND SENSITIVITY OF STAPHYLOCOCCUS AUREUS AND ESCHERICHIA COLI ISOLATES IN A GENERAL HOSPITAL SETTING

Vestnik ◽  
2021 ◽  
pp. 68-74
Author(s):  
М.Е. Рамазанов ◽  
В.Н. Сон ◽  
М.Р. Рысулы ◽  
С.Т. Турсуналиев ◽  
Е.Б. Еспенбетов
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Hospital Setting ◽  
Bloodstream Infections ◽  
High Sensitivity ◽  
Clinical Isolates ◽  
Empiric Antibiotic Therapy ◽  
E Coli ◽  
Number Of Patients ◽  
Empiric Antibiotic

Представлены результаты проспективного обследования 80 больных ГКБ №7 с бактериемией с октября 2019 года по февраль 2021 года из различных отделений госпиталя. Производилась оценки показателей маркеров сепсиса - пресепсина, прокальцитонина и С-реактивного белка (СРБ) в крови больных в динамике эмпирической терапии антимикробными препаратами (АМП). Наибольшее число больных с выявленной бактериемией находилось в отделении ОАРИТ - 39 пациентов, у 25 из них был диагностирован сепсис по шкале СЕПСИС III, вызванный известными патогенами Staphylococcus aureus (46,6%) и Escherichia coli (36,6%). Для эмпирического лечения применялись различные антибиотики: ампенициллин, амикацин, меропенем, цефотаксим, метрид, ципрофлоксацин, ципрокс, цефлокс, цефазолин, цефтриаксон, левофлоксацин. Уровни прокальцитонина составляют для больных с клиническими изолятами E. coli 20,8±3,1нг/мл, а для изолятов St. aureus 15,7±1,8 нг/мл. После терапии АМП наблюдается значительное снижение показателей до 1,43±0,6 и 2,3±0,9 нг/мл., что позволяет признать эффективность эмпирической антибиотикотерапии при инфекциях кровотока. Высокая чувствительность клинических изолятов Escherichia coli отмечена к препаратам группы карбапенемов - имипенему и меропенему (90,9%), низкая к эртапенему (72,7%). 100% чувствительность все изоляты показали по отношению к АМП из группы глицилциклинов - тигециклину, который структурно сходен с тетрациклинами. Высокой резистеностью клинические изоляты Staphylococcus aureus обладают к пенициллину (92,9%), липопептиду природного происхождения даптомицину (85,8%) и препарату из группы линкозамидов - клиндамицину (64,3%). The results of a prospective examination of 80 patients with bacteremia from October 2019 to February 2021 from various departments of the hospital are presented. The largest number of patients with detected bacteremia were in the OARIT department - 39 patients, 25 of them were diagnosed with sepsis according to the SEPSIS III scale, caused by known pathogens Staphylococcus aureus (46.6%) and Escherichia coli (36.6%). For empirical treatment, various antibiotics were used: ampenicillin, amikacin, meropenem, cefotaxime, metrid, ciprofloxacin, ciprox, ceflox, cefazolin, ceftriaxone, levofloxacin. Procalcitonin levels for patients with clinical E. coli isolates are 20.8 ± 3.1 ng / ml, and for St. aureus 15.7 ± 1.8 ng / ml. After AMP therapy, there is a significant decrease in indicators to 1.43 ± 0.6 and 2.3 ± 0.9 ng / ml, which makes it possible to recognize the effectiveness of empiric antibiotic therapy for bloodstream infections. High sensitivity of clinical isolates of Escherichia coli was noted to drugs of the carbapenem group - imipenem and meropenem (90.9%), low to ertapenem (72.7%). All isolates showed 100% sensitivity to AMPs from the glycylcycline group - tigecycline, which is structurally similar to tetracyclines. Clinical isolates of Staphylococcus aureus are highly resistant to penicillin (92.9%), natural lipopeptide daptomycin (85.8%), and a drug from the lincosamide group - clindamycin (64.3%).

Two Novel Mutations Associated with Polymyxin-B Resistance in a Pandemic Lineage of Uropathogenic Escherichia coli of the Sequence Type 69

Chemotherapy ◽  
2021 ◽  
pp. 1-7
Author(s):  
Carla Adriana dos Santos ◽  
Rodrigo Tavanelli Hernandes ◽  
Marcos Paulo Vieira Cunha ◽  
Filipe Onishi Nagamori ◽  
Claudia Regina Gonçalves ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Susceptibility Testing ◽  
Polymyxin B ◽  
Antimicrobial Treatment ◽  
Sequence Type ◽  
Broth Microdilution ◽  
Economic Costs ◽  
Novel Mutations ◽  
E Coli ◽  
Total Inhibition

<b><i>Background:</i></b> Uropathogenic <i>Escherichia coli</i> (UPEC) are frequent pathogens worldwide, impacting on the morbidity and economic costs associated with antimicrobial treatment. <b><i>Objectives:</i></b> We report two novel mutations associated with polymyxin-B resistance in an UPEC isolate collected in 2019. <b><i>Methods:</i></b> Isolate was submitted to antimicrobial susceptibility testing including broth microdilution for polymyxin B. Whole genome was sequenced and analyzed. <b><i>Results:</i></b> Polymyxin-B total inhibition occurred at 16 mg/L (resistant). UPEC isolate was assigned to the phylogroup D, serotype O117:H4, and Sequence Type 69. <i>mcr</i> genes were not detected, but two novel mutations in the <i>pmrA/basS</i> (A80S) and <i>pmrB/</i>basR (D149N) genes were identified. <b><i>Conclusions:</i></b> The occurrence of non-<i>mcr</i> polymyxin resistance in <i>E. coli</i> from extraintestinal infections underscores the need of a continuous surveillance of this evolving pathogen.

scholarly journals Antimicrobial Interventions to Reduce Shiga Toxin-Producing Escherichia coli (STEC) Surrogate Populations on Beef Striploins Intended for Blade Tenderization

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
C. L. Thomas ◽  
H. Thippareddi ◽  
M. Rigdon ◽  
S. Kumar ◽  
R. W. McKee ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Sodium Dodecyl ◽  
Antimicrobial Treatment ◽  
Sodium Chlorite ◽  
Beef Industry ◽  
Anterior Portion ◽  
E Coli ◽  
Group Data ◽  
Blade Tenderization ◽  
Antimicrobial Interventions

ObjectivesBlade tenderization (BT) is used in the beef industry to improve tenderness of steaks prepared from subprimals but can translocate surface pathogens to the interior of meat. Application of antimicrobial solutions on the surface of subprimals prior to blade tenderization can reduce the risk of translocation of surface microorganisms. The objectives of this research were: 1) evaluate the efficacy of antimicrobial interventions applied to inoculated (surrogate Escherichia coli) beef striploins prior to blade tenderization; and 2) examine the transfer of E. coli from inoculated striploins to subsequent non-inoculated subprimals.Materials and MethodsThe anterior portion of whole muscle beef striploins (30.48 cm) were inoculated (lean side) across a 10 cm band with an approximately 8.00 log CFU/mL cocktail containing non-pathogenic, rifampicin-resistant surrogate STEC strains (BAA-1427, BAA-1428, BAA-1429, BAA-1430, and BAA-1431). The inoculated striploins were sprayed with (1) levulinic acid (5.0%) + sodium dodecyl sulfate (0.50%) (LVA+SDS), (2) peroxyacetic acid (2000 ppm; PAA; FCN 1666), (3) acidified sodium chlorite (1200 ppm; ASC), or (4) lactic acid (4.5%; LA) by passing through a spray cabinet and blade tenderized, along with an inoculated, non-sprayed control (CON). To evaluate the potential for cross-contamination of subsequent subprimals, an inoculated striploin (for each treatment) was blade tenderized followed by a non-inoculated beef striploin. For each striploin, surface and subsurface samples (2.54 cm wide) were collected from three different locations including the anterior, middle, and posterior end of each striploin. A total of 30 striploins across three replications were randomly assigned to treatment stratification. Sponge samples were also collected from the blade tenderizer (plate of the blade unit and blades) after each treatment group. Data were analyzed using Proc Mixed (SAS Inst., v.9.4; Cary, NC) as a completely randomized split-plot design. Microbial counts for all samples were log transformed and then analyzed for the main effects of antimicrobial treatment, location (anterior to posterior and surface or interior), and their interaction. Differences were considered significant at α ≤ 0.05.ResultsPAA was more effective in reducing E. coli populations (1.80 log CFU/g; P ≤ 0.05) and had lowest recovery of the microorganism from the striploin subsurface compared to other treatments, followed by LVA+SDS (1.00 log CFU/g). E. coli populations gradually decreased (P ≤ 0.05) on the surface and subsurface as sampling moved anterior to posterior. However, E. coli populations were similar (P > 0.05) on the posterior end of inoculated striploins and the anterior end of the subsequent, non-inoculated striploins, indicating transfer of microorganisms from one striploin to the following striploin. E. coli populations of 3.03 log CFU/cm2 and 2.47 log CFU/cm2 were recovered from the plate of the blade unit and the blades of the blade tenderizer. E. coli populations recovered from the plastic plate (3.46 log CFU/cm2) and blades (2.87 log CFU/cm2) of the blade tenderizer were the similar (P > 0.05) for all treatment groups except for PAA (1.41 log CFU/cm2 and 0.97 log CFU/cm2, respectively).ConclusionThese results showed that PAA and LVA+SDS can be used to improve the safety of blade tenderized beef.

scholarly journals Primary Cutaneous Cryptococcosis in an Immunocompetent 6-Year-Old Female

2018 ◽  
Vol 2 (4) ◽  
pp. 240-242
Author(s):  
Mitchell Hobbs ◽  
Joy King ◽  
Rana El Feghaly ◽  
Robert Brodell
Keyword(s):  
Cryptococcus Neoformans ◽  
Skin Lesions ◽  
Immunocompetent Patient ◽  
Immunocompromised Patients ◽  
Oral Fluconazole ◽  
Healthy Female ◽  
Empiric Antibiotic ◽  
Empiric Antibiotic Treatment ◽  
Cutaneous Cryptococcosis ◽  
Superficial Culture

A 6-year-old otherwise healthy female presented to the ED with a right eyebrow lesion for one month.  Previous I&D attempts and empiric antibiotic treatment had failed to improve the lesion.  Following dermatology referral, superficial culture resulted with growth of Cryptococcus neoformans after which completion of oral fluconazole treatment resolved the lesion.  Though Cryptococcus neoformans infections commonly plague immunocompromised patients, primary cutaneous cryptococcosis in the immunocompetent patient is a rare but documented infection with a paucity of reported pediatric cases, and frontline physicians should be aware of such a diagnosis in the setting of persistent skin lesions without response to more commonly utilized therapies.

scholarly journals Urinary Tract Infection Caused By Enterococcus Spp: Risk Factors And Mortality. An Observational Study.

2020 ◽  
Author(s):  
Elisa Alvarez-Artero ◽  
Amaia Campo Nuñez ◽  
Inmaculada Garcia Garcia ◽  
Moises Garcia Bravo ◽  
Olia Cores ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Antimicrobial Treatment ◽  
Empiric Antibiotic Therapy ◽  
Enterococcus Spp ◽  
Empiric Antibiotic ◽  
Patients At Risk ◽  
Severe Comorbidity ◽  
Predictive Risk ◽  
Tract Infections

Abstract Background Urinary tract infections (UTIs) are frequently caused by Enterococcus spp. We aim to define the risk factors involved in UTIs caused by Enterococcus. Determine the overall mortality and predictive risk factors. Methods A retrospective in-patients study was conducted with bacteriemic UTIs caused by Enterococcus spp. We compared bacteriemic UTIs caused by Enterococcus spp. vs. a random sample of 100 in-patients with bacteriemic UTIs caused by others enterobacteria. Results We found 106 in-patients with UTIs caused by Enterococcus spp., 51 of whom had concomitant positive blood cultures. Distribution by species was: 83% E. faecalis and 17% E. faecium, with a Charlson comorbidity index of 5.9 ± 2.9. When we compared bacteriemic UTIs caused by Enterococcus spp. vs. bacteriemic UTIs caused by others enterobacteria we found the following independent predictors of bacteriemic UTI by Enterococcus: male sex with an OR of 6.1 (95%CI 2.3–16.1), uropathy with an OR of 4.1 (1.6–10.1), nosocomial infection with an OR of 3.8 (1.4–10.3), urinary cancer with an OR of 6.4 (1.3–30.3) and previous antimicrobial treatment with an OR of 18 (5.2–62.1). Overall, in-patient mortality was 16.5%, which was associated with a higher Sequential Organ Failure Assessment (SOFA) score (> 4), severe comorbidity such as immunosuppression, malignant hemopathy and nephrostomy, or Enterococcus faecium species and its pattern or resistance to ampicillin or vancomycin (p < 0.05). Appropriate empiric antibiotic therapy was not associated with a better prognosis (p > 0.05). Conclusions Enterococcus spp. is a frequent cause of complicated UTI by a profile of risk factors. High mortality secondary to a severe clinical setting and high comorbidity may be sufficient reasons for implementing empiric treatment of patients at risk, although we did not show a higher survival rate in patients with this treatment strategy.

scholarly journals Lingual schwannoma in an adolescent girl- A diagnostic challenge

2020 ◽  
Vol 9 (3) ◽  
pp. 1775
Author(s):  
Suhael Ahmed ◽  
Omar Al Dayel ◽  
Nafeesa Tabassum ◽  
MaryamH Al Qanabr ◽  
HassanAbu Ali ◽  
...  
Keyword(s):  
Adolescent Girl ◽  
Diagnostic Challenge
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