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Insa Joost, Johannes Steinfurt, Philipp T Meyer, Winfried V Kern, Siegbert Rieg
BACKGROUND: Ustekinumab (Stelara®), a human monoclonal antibody targeting the p40-subunit of interleukin (IL)-12 and IL-23, is indicated for moderate to severe plaque psoriasis and psoriatic arthritis. In large multicenter, prospective trials assessing efficacy and safety of ustekinumab increased rates of severe infections have not been observed so far. CASE PRESENTATION: Here, we report the case of a 64-year old woman presenting with chills, pain and swelling of her right foot with dark maculae at the sole, and elevated inflammatory markers...
October 20, 2016: BMC Infectious Diseases
Wei Yee Wan, Ahsan Mughal, Kelly Ward
Psoas abscess is commonly regarded as an unusual cause for back pains and usually associated with significant risk factors or co-morbidities. We describe the clinical presentation and findings of a young male Caucasian with bilateral psoas abscesses caused by an unusual organism, Janibacter terrae (an environmental organism) not previously described in literature and the challenges faced in managing this infection. There are very few case reports of this organism causing opportunistic infections, all reported bacteraemia mainly in patients with significant co-morbidities...
October 19, 2016: Acta Clinica Belgica
Jeremy D Brown, Scott Chapman, Patricia E Ferguson
OBJECTIVE: The objective of the present study is to determine whether a predictive rule could safely reduce the number of negative blood cultures collected in an Australian ED and to assess the clinical impact of positive results from blood cultures taken in the ED. METHODS: All positive blood cultures taken in the ED at a single facility were retrospectively identified for the calendar year 2012. Clinically significant bacteraemia episodes were assessed against a predictive rule using major and minor clinical and laboratory criteria gathered from medical records and pathology databases, and compared with a randomly generated sample of ED patient episode with negative blood cultures...
October 18, 2016: Emergency Medicine Australasia: EMA
Pankaj Aggarwal, Pravin Saxena, Anil Bhan
Coronary artery stent infection has been reported with both bare metal stent and drug eluting stent and can present as mycotic coronary artery aneurysm, pseudoaneurysm, myocardial abscess, pericarditis or exudative effusion. Infection at the site of coronary stent implantation is rare and is believed to result typically from either direct stent contamination at the time of delivery or transient bacteraemia from access site. Introduction of drug-eluting stent (DES) has led to a marked reduction in the problem of in-stent restenosis across all patient subsets and lesions complexities...
September 2016: Indian Heart Journal
Huimin Lin, Samuel T H Chew
An 85-year-old female with chronic kidney disease and newly acquired seizures on oral phenytoin received intravenous ertapenem 500 mg once daily for a urinary tract infection and bacteraemia involving extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli. After three ertapenem doses, she developed seizures which self-aborted. Corrected phenytoin level was sub-therapeutic initially, but became therapeutic following a phenytoin dose increase. On Day 14 of ertapenem, the patient suffered another episode of seizure...
December 2015: Drug Saf Case Rep
Reuben Olaniyi, Clarissa Pozzi, Luca Grimaldi, Fabio Bagnoli
Skin and soft tissue infections (SSTIs) are among the most common infections worldwide. They range in severity from minor, self-limiting, superficial infections to life-threatening diseases requiring all the resources of modern medicine. Community (CA) and healthcare (HA) acquired SSTIs are most commonly caused by Staphylococcus aureus . They have variable presentations ranging from impetigo and folliculitis to surgical site infections (SSIs). Superficial SSTIs may lead to even more invasive infections such as bacteraemia and osteomyelitis...
October 16, 2016: Current Topics in Microbiology and Immunology
Joshua Freeman, Louise Dawson, Deborah Jowitt, Margo White, Hayley Callard, Christine Sieczkowski, Ron Kuriyan, Sally Roberts
AIM: To detail the progress made by Hand Hygiene New Zealand (HHNZ) since 2011 and also describe the challenges experienced along the way and the factors required for delivery of a successful hand hygiene programme at a national level. METHOD: HHNZ is a multimodal culture-change programme based on the WHO '5 moments for hand hygiene' approach. The key components of the programme include clinical leadership, auditing of hand hygiene compliance with thrice yearly reporting of improvement in hand hygiene practice, biannual reporting of the outcome marker, healthcare-associated Staphylococcus aureus bacteraemia (HA-SAB), effective communication with key stakeholders and the use of the front-line ownership (FLO) principles for quality improvement...
October 14, 2016: New Zealand Medical Journal
Gokce Dundar, Gokhan Gokce, Kaan Gokcen, Esat Korgali, Aydemir Asdemir, Kenan Kaygusuz
PURPOSE: Pediatric stone disease is an important clinical problem in pediatric urology practice. We aimed to compare mini-percutaneous nephrolithotomy (miniperc) and micro-percutaneous nephrolithotomy (microperc) in pediatric patients who underwent unsuccesful SWL procedure. MATERIALS AND METHODS: A number of 43 pediatric patients, aged 17 years or younger, were treated with miniperc or microperc procedures due to renal calculi by a single surgeon. In group 1, there were 27 patients who underwent miniperc procedure...
October 10, 2016: Urology Journal
Jeffrey L Carson, Simon J Stanworth, Nareg Roubinian, Dean A Fergusson, Darrell Triulzi, Carolyn Doree, Paul C Hebert
BACKGROUND: There is considerable uncertainty regarding the optimal haemoglobin threshold for the use of red blood cell (RBC) transfusions in anaemic patients. Blood is a scarce resource, and in some countries, transfusions are less safe than others because of a lack of testing for viral pathogens. Therefore, reducing the number and volume of transfusions would benefit patients. OBJECTIVES: The aim of this review was to compare 30-day mortality and other clinical outcomes in participants randomized to restrictive versus liberal red blood cell (RBC) transfusion thresholds (triggers) for all conditions...
October 12, 2016: Cochrane Database of Systematic Reviews
Angela França, Begoña Pérez-Cabezas, Alexandra Correia, Gerald B Pier, Nuno Cerca, Manuel Vilanova
Staphylococcus epidermidis biofilm formation on indwelling medical devices is frequently associated with the development of chronic infections. Nevertheless, it has been suggested that cells released from these biofilms may induce severe acute infections with bacteraemia as one of its major associated clinical manifestations. However, how biofilm-released cells interact with the host remains unclear. Here, using a murine model of hematogenously disseminated infection, we characterized the interaction of cells released from S...
2016: Frontiers in Microbiology
K-H Song, S-I Jung, S Lee, S Park, S M Kiem, S H Lee, Y G Kwak, Y K Kim, H-C Jang, Y-S Kim, H-I Kim, C J Kim, K-H Park, N J Kim, M-D Oh, H B Kim
Cefazolin treatment failure has been observed in high-inoculum infections caused by methicillin-susceptible Staphylococcus aureus (MSSA) with a cefazolin inoculum effect (CIE). However, data on the characteristics and risk factors for the acquisition of CIE-positive MSSA infection are scarce. CIE positivity was measured as an MIC ≥ 16 μg/ml with a high inoculum (∼5 × 10(7) CFU/ml). The blaZ gene type was assessed through sequence analysis. The clinical characteristics and risk factors for the acquisition of CIE-positive MSSA infection were assessed...
October 6, 2016: European Journal of Clinical Microbiology & Infectious Diseases
Steffen Bank, Anders Jensen, Hanne Merete Nielsen, Lena Hagelskjaer Kristensen, Marianne Voldstedlund, Jørgen Prag
Fusobacterium necrophorum findings in Denmark and estimation of the incidence of F. necrophorum bacteraemia was described using data from the nationwide Danish microbiology database (MiBa). All microbiological reports on any Fusobacterium species in Denmark were extracted for a period of 5 years from 2010 to 2014 from MiBa and from the local department of clinical microbiology. The overall incidence of F. necrophorum bacteraemia from 2010 to 2014 was 2.8 cases per million/year vs 9.4 in the age group 15-24 years...
October 5, 2016: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
F Jasmijn Smits, Herman Frima, Christoph Schaeffeler, Christoph Sommer
Septic arthritis of the pubic symphysis is a potentially severe disease. Athletes are at risk of this form of spontaneous arthritis, as inflammation of the pubic bone due to muscular stress is relatively common. Oedema due to inflammation might predispose to infection through bacteraemia or local bacterial translocation. Suspicion should be raised when an athlete complains of groin pain and has signs of infection (i.e., fever, elevated white blood cell count, and elevated C-reactive protein). Diagnosis is made by imaging showing signs of inflammation combined with positive (blood) cultures...
2016: Case Reports in Surgery
Antoni Payeras, Maria Peñaranda, Antonio Iñigo, Margarita Garau, José Luis Pérez, Carmen Gallegos, Melchor Riera
OBJECTIVES: To study the characteristics and outcomes of pneumococcal infections in patients aged ≥65 years since the authorization of the 13-valent pneumococcal conjugate vaccine (PCV-13) in Spain. METHODS: All pneumococcal pneumonias, empyemas or primary bacteraemias treated at two hospitals in Majorca from 2010 to 2015 were included. Clinical variables, serotypes, and antibiotic susceptibility were collected. RESULTS: Two hundred and forty-nine pneumonias, 11 primary bacteraemias, and 2 empyemas in 243 patients were studied; 181 (69...
August 11, 2016: Infectious Diseases
Rohit S Loomba, Andrew N Pelech, Robert H Anderson
BACKGROUND: "Heterotaxy syndrome", best segregated as isomerism, is characterised by laterality defects of the thoraco-abdominal organs, causing functional impairment. In particular, the spleen is frequently affected, increasing susceptibility to bacteraemia. This study explored factors that may increase the risk of bacteraemia in patients with isomerism. METHODS: We identified patients with CHD and isomerism. Review of outpatient, inpatient, and surgical records was conducted to collect data and determine trends in the cohort...
September 29, 2016: Cardiology in the Young
Evelina Tacconelli, Federico Foschi
No abstract text is available yet for this article.
September 22, 2016: Clinical Microbiology and Infection
Shamima Akhter, Tahmeed Ahmed, Shafiqul Alam Sarker, Monira Sarmin, Abu S M S B Shahid, K M Shahunja, Shoeb Bin Islam, Lubaba Shahrin, Tahmina Alam, Nur Haque Alam, Mohammod Jobayer Chisti
Although Klebsiella bacteremia in children is perceived to be associated with fatal consequences, data are scarce on those children presenting with diarrhea. We evaluated the factors associated with Klebsiella bacteremia in such children. In this retrospective chart analysis, data of all diarrheal children was retrieved from electronic medical record system (named as SHEBA) of Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), from January 1, 2010, to December 31, 2012, who had their blood culture done...
2016: International Journal of Pediatrics
Marilena Tsala, Sophia Vourli, George L Daikos, Athanassios Tsakris, Loukia Zerva, Johan W Mouton, Joseph Meletiadis
OBJECTIVES: In the absence of other therapeutic options, tigecycline is used to treat bloodstream infections and pneumonia caused by carbapenemase-producing Klebsiella pneumoniae (CP-Kp). In this study, the standard and high tigecycline dosing regimens were simulated and tested against different inocula of CP-Kp isolates in an in vitro pharmacokinetic (PK)/pharmacodynamic (PD) model. METHODS: Four susceptible isolates (EUCAST MICs of 0.125-1 mg/L) and two intermediately susceptible CP-Kp clinical isolates (MICs of 2 mg/L) were tested at three different inocula (10(7), 10(5) and 10(3) cfu/mL), simulating tigecycline serum and lung fCmax concentrations of 0...
September 19, 2016: Journal of Antimicrobial Chemotherapy
Gulhadiye Avcu, Mehmet Arda Kilinc, Cenk Eraslan, Bulent Karapinar, Fadil Vardar
Mild encephalopathy with a reversible splenial lesion (MERS) is a clinico-radiological syndrome that can be related to infectious and non-infectious conditions. Patients present with mild neurological symptoms, and magnetic resonance imaging typically demonstrate a reversible lesion with transiently reduced diffusion in the splenium of the corpus callosum. Here, we describe MERS in a 10-year-old boy who presented with fever and consciousness and who completely recovered within a few days. Streptococcus pneumoniae was the causative agent...
September 15, 2016: Journal of Infection and Public Health
Deogratias Munube, Elly Katabira, Grace Ndeezi, Moses Joloba, Samden Lhatoo, Martha Sajatovic, James K Tumwine
BACKGROUND: Stroke is a major complication of sickle cell anaemia (SCA). It occurs commonly in childhood with about 10 % of children with sickle cell anaemia getting affected by this complication. In Uganda, there is paucity of data on the prevalence of stroke in children admitted in a tertiary institution. We determined the prevalence of stroke amongst children with SCA admitted to Mulago National Referral Hospital in Uganda and described the ir co-morbidities. METHODS: We conducted a retrospective record review of children with SCA admitted from August 2012 to August 2014 to the Paediatric Haematology Ward of Mulago Hospital in Kampala, Uganda...
2016: BMC Neurology
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