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gram-negative bacteremia

Alessandro Russo, Simone Giuliano, Giancarlo Ceccarelli, Francesco Alessandri, Alessandra Giordano, Grazia Brunetti, Mario Venditti
Objectives: a significant cause of mortality in intensive care unit (ICU) is represented by multidrug-resistant (MDR) gram-negative bacteria, such as MDR Acinetobacter baumannii (MDR-AB) and Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae (KPC-Kp). Aim of the present study was the comparison of clinical features, therapy and outcome of patients who developed septic shock due to either MDR-AB or KPC-Kp. Methods: were retrospectively analyzed patients admitted to the intensive care unit (ICU) of a teaching hospital, from November 2010 to December 2015, who developed septic shock due to MDR-AB or KPC-Kp infection...
March 19, 2018: Antimicrobial Agents and Chemotherapy
P Ioannou, M Stavroulaki, V Mavrikaki, I Papakitsou, S Panagiotakis
WHAT IS KNOWN AND OBJECTIVE: Hyponatremia is the most common electrolyte disorder. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the main cause of euvolemic hyponatremia and is often associated with medications or underlying diseases. Linezolid is a potent antibiotic against resistant Gram-positive microorganisms that has been associated with mild hyponatremia, yet with a mechanism different from SIADH. CASE SUMMARY: We present the case of a patient who developed severe hyponatremia during treatment with linezolid for an ampicillin-resistant E...
March 14, 2018: Journal of Clinical Pharmacy and Therapeutics
Nicholas Agyepong, Usha Govinden, Alex Owusu-Ofori, Sabiha Yusuf Essack
Background: Multidrug-resistant Gram-negative bacteria have emerged as major clinical and therapeutic dilemma in hospitals in Ghana.To describe the prevalence and profile of infections attributable to multidrug-resistant Gram-negative bacteria among patients at the Komfo Anokye Teaching Hospital in the Ashanti region of Ghana. Methods: Bacterial cultures were randomly selected from the microbiology laboratory from February to August, 2015. Bacterial identification and minimum inhibitory concentrations were conducted using standard microbiological techniques and the Vitek-2 automated system...
2018: Antimicrobial Resistance and Infection Control
Tuna Demirdal, Pinar Sen, Salih Atakan Nemli
Background and Aims: Several biomarkers are used in the diagnosis of bacteremia. Procalcitonin (PCT) is more specific than other biomarkers in differentiating bacterial and nonbacterial inflammation. It was aimed to evaluate the diagnostic and prognostic value of PCT in bacteremic patients in Intensive Care Unit (ICU). Materials and Methods: A total of 156 patients diagnosed with noninfectious systemic inflammatory response syndrome, sepsis, and severe sepsis/septic shock in ICU between December 2014 and July 2015 were evaluated in this prospective cohort study...
February 2018: Indian Journal of Critical Care Medicine
Annie W T Lee, Johnson K S Lam, Ricky K W Lam, Wan H Ng, Ella N L Lee, Vicky T Y Lee, Po P Sze, Rahim Rajwani, Kitty S C Fung, Wing K To, Rodney A Lee, Dominic N C Tsang, Gilman K H Siu
Objective: This study evaluated the capability of a MALDI Biotyper system equipped with the newly introduced MBT STAR-BL module to simultaneously perform species identification and β-lactamase-mediated resistance detection in bacteremia -causing bacteria isolated from cultured isolates and patient-derived blood cultures (BCs). Methods: Two hundred retrospective cultured isolates and 153 prospective BCs containing Gram-negative rods (GNR) were collected and subjected to direct bacterial identification, followed by the measurement of β-lactamase activities against ampicillin, piperacillin, cefotaxime, ceftazidime, and meropenem using the MBT STAR-BL module...
2018: Frontiers in Microbiology
Yoel Gil, Yonit Well-Weiner, Tod Zalut, Reuven Friedmann, Amos M Yinnon, Eli Ben-Chetrit
Blood cultures' contamination (BCC) is associated with unnecessary processing of cultures, higher cost, and occasionally, unjustified antibiotic treatment. We aimed to reduce the rate of BCC by educational intervention. In parallel, we also strove to expand the use of aminoglycosides (AMG) and reduce the utilization of beta-lactam antibiotics. The rate of BCC was assessed prospectively in the study department - the Emergency Department (ED) and in control departments - Medical Departments A, B and Geriatrics...
February 2018: Harefuah
Jason M Pogue, Emily L Heil, Paul Lephart, J Kristie Johnson, Ryan P Mynatt, Hossein Salimnia, Kimberly C Claeys
Rapid diagnostic tests (RDTs) have revolutionized the management of Gram-negative bacteremia by allowing antimicrobial stewardship teams the ability to escalate therapy and improve patient outcomes through timely organism identification and detection of certain resistance determinants. However, given the complex nature of Gram-negative resistance, stewardship teams are left without clear direction for how to respond when resistance determinants are absent as the safety of de-escalation in this setting is unknown...
February 26, 2018: Antimicrobial Agents and Chemotherapy
Gayathri Naganathan, Nalin Kumar Amin
INTRODUCTION: Raoultella Planticola is a gram negative, aerobic, rod bacteria found in water and soil and is rarely reported to cause infections in humans. This case study is the first of its kind in reporting R. planticola appendicitis. PRESENTATION OF CASE: We report a case of a woman presenting with a two-day history of increased weakness, fatigue and anorexia, localized pain to the right lower quadrant, and elevated white blood cell count. CT results demonstrated acute uncomplicated appendicitis which was managed via laparoscopic appendectomy...
February 9, 2018: International Journal of Surgery Case Reports
P Dow, K Kotz, S Gruszka, J Holder, J Fiering
A more effective treatment of bacteremia requires a diagnostic platform that is both sensitive, accurate and rapid. Currently, clinical laboratory techniques require growth of bacteria prior to diagnosis, take days to complete, and leave empiric therapy and broad spectrum antibiotics as the only option at the onset of treatment. In order to bypass this growth requirement, we engineered a system that purifies bacteria from blood to improve performance in a bacteriophage-based luminescence assay. To perform the purification, we used acoustophoresis in plastic microfluidic chips, enabling future development into a low cost point-of-care system...
February 15, 2018: Lab on a Chip
Milena M McLaughlin, Cristina Miglis, Erik Skoglund, Jamie Wagner, Maria R Advincula, Marc H Scheetz
BACKGROUND: Carbapenem MICs are known to predict outcomes for patients with Gram-negative bacteremias. However, limited data exists on how MICs influence such outcomes when organisms are classified as carbapenem resistant. The purpose of this study was to evaluate the effect of increasing imipenem/cilastatin MICs on mortality. METHODS: Patients with an imipenem/cilastatin resistant (i.e. MIC>4mg/L), monomicrobial, Gram-negative bloodstream infection were eligible and assessed for baseline characteristics, organ function, microbiological data, timing and type of therapeutic treatment, and in-hospital mortality...
February 9, 2018: Journal of Global Antimicrobial Resistance
Emine Alp, Tuğba Tok, Leylagül Kaynar, Fatma Cevahir, İsmail Hakkı Akbudak, Kürşat Gündoğan, Mustafa Çetin, Jordi Rello
BACKGROUND: Haematological cancer (HC) patients are increasingly requiring intensive care (ICUs). The aim of this study was to investigate the outcome of HC patients in our ICU and evaluate 5 days-full support as a breakpoint for patients' re-assessment for support. METHODS: Retrospective study enrolling 112 consecutive HC adults, requiring ICU in January-December 2015. Patients' data were collected from medical records and Infection Control Committee surveillance reports...
February 8, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Marco Falcone, Giusy Tiseo, Francesco Dentali, Micaela La Regina, Emanuela Foglia, Maurizia Gambacorta, Elisabetta Garagiola, Giorgio Bonardi, Pierangelo Clerici, Fabrizio Colombo, Alessio Farcomeni, Ercole Concia, Salvatore Corrao, Mauro Campanini, Antonino Mazzone
OBJECTIVE: To develop a risk-scoring tool to predict multidrug-resistant (MDR) etiology in patients with bloodstream infections (BSI) caused by Gram-negative bacilli (GNB). METHODS: A prospective multicenter study analyzed patients with BSI hospitalized in 31 Internal Medicine wards in Italy from March 2012 to December 2012. Patients with BSI caused by MDR-GNB (non-susceptible to at least one agent in three antimicrobial categories) were compared to those with BSI due to susceptible GNB...
February 6, 2018: European Journal of Internal Medicine
Chung-Jong Kim, Jeong-Eun Yi, Yookyung Kim, Hee Jung Choi
RATIONALE: Infective endocarditis (IE) is a life-threatening disease, mostly caused by gram-positive bacteria. Gram-negative bacteria were identified as a causative organism in relatively small number of cases. Although, antibiotic-resistant Escherichia coli is common cause of gram-negative endocarditis, AmpC beta-lactamase (BL)-harboring E coli is very rare cause of IE. Furthermore, emphysematous endocarditis is also a very rare manifestation of E coli infection. PATIENT CONCERNS: We report a case of 80-year-old female patient presenting with dizziness, fever, and altered mental status, who was finally diagnosed with emphysematous endocarditis caused by E coli harboring an AmpC BL gene...
February 2018: Medicine (Baltimore)
Lea Papst, Bojana Beović, Céline Pulcini, Emanuele Durante-Mangoni, Jesús Rodríguez-Baño, Keith S Kaye, George L Daikos, Lul Raka, Mical Paul
OBJECTIVES: To explore contemporary antibiotic management of infections caused by carbapenem-resistant Gram-negative bacteria (CRGNB) in hospitals. METHODS: Cross-sectional, internet-based questionnaire survey. We contacted representatives of all hospitals with more than 800 acute-care hospital beds in France, Greece, Israel, Italy, Kosovo, Slovenia, Spain and selected hospitals in the United States. We asked respondents to describe the most common actual practice at their hospital regarding management of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa through close-ended questions...
January 30, 2018: Clinical Microbiology and Infection
Tony Velkov, Alejandra Gallardo-Godoy, James D Swarbrick, Mark A T Blaskovich, Alysha G Elliott, Meiling Han, Philip E Thompson, Kade D Roberts, Johnny X Huang, Bernd Becker, Mark S Butler, Lawrence H Lash, Sónia Troeira Henriques, Roger L Nation, Sivashangarie Sivanesan, Marc-Antoine Sani, Frances Separovic, Haydyn Mertens, Dieter Bulach, Torsten Seemann, Jeremy Owen, Jian Li, Matthew A Cooper
Resistance to the last-resort antibiotic colistin is now widespread and new therapeutics are urgently required. We report the first in toto chemical synthesis and pre-clinical evaluation of octapeptins, a class of lipopeptides structurally related to colistin. The octapeptin biosynthetic cluster consisted of three non-ribosomal peptide synthetases (OctA, OctB, and OctC) that produced an amphiphilic antibiotic, octapeptin C4, which was shown to bind to and depolarize membranes. While active against multi-drug resistant (MDR) strains in vitro, octapeptin C4 displayed poor in vivo efficacy, most likely due to high plasma protein binding...
January 23, 2018: Cell Chemical Biology
Alexandra Fochtmann-Frana, Christian Freystätter, Vera Vorstandlechner, André Barth, Michael Bolliger, Elisabeth Presterl, Gerald Ihra, Gabriela Muschitz, Martina Mittlboeck, Athanasios Makristathis, Thomas Rath, Christine Radtke, Christina Forstner
OBJECTIVES: The objective was primarily to identify risk factors for bloodstream infections (BSI) caused by different pathogens. METHODS: A retrospective single-center cohort study was performed on 472 burn patients with an abbreviated burn severity index (ABSI)≥3, a total burn surface area (TBSA)≥10%, and an ICU stay of at least 24h. Risk factors for different BSI pathogens were analyzed by competing risks regression model of Fine and Gray. RESULTS: A total of 114 burn patients developed 171 episodes of BSIs caused by gram-negative bacteria (n=78;46%), gram-positive bacteria (n=69;40%), and fungi (n=24;14%) median after 14days (range, 1-164), 16days (range, 1-170), and 16days (range, 0-89), respectively...
January 29, 2018: Burns: Journal of the International Society for Burn Injuries
Robert Benson Jones, Arpana Paruchuri, Samik S Shah
No abstract text is available yet for this article.
January 31, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Craig R MacNair, Jonathan M Stokes, Lindsey A Carfrae, Aline A Fiebig-Comyn, Brian K Coombes, Michael R Mulvey, Eric D Brown
Plasmid-borne colistin resistance mediated by mcr-1 may contribute to the dissemination of pan-resistant Gram-negative bacteria. Here, we show that mcr-1 confers resistance to colistin-induced lysis and bacterial cell death, but provides minimal protection from the ability of colistin to disrupt the Gram-negative outer membrane. Indeed, for colistin-resistant strains of Enterobacteriaceae expressing plasmid-borne mcr-1, clinically relevant concentrations of colistin potentiate the action of antibiotics that, by themselves, are not active against Gram-negative bacteria...
January 31, 2018: Nature Communications
Fnu Zarlasht, Muzammil Khan
BACKGROUND Pasteurella multocida is a gram negative-penicillin sensitive bacterium and is part of normal respiratory microbiota of animals (e.g., cats and dogs) and some birds. Various infections in humans, such as cellulitis, rarely bacteremia, endocarditis, meningitis, and septic arthritis, are a result of domestic cat or dog bites. These infections are rarely seen in an immunocompetent person, without an associated animal bite. CASE REPORT We present a case of refractory Pasteurella multocida bacteremia without any animal bite in an immunocompetent person...
January 25, 2018: American Journal of Case Reports
Christina Sakarikou, Anna Altieri, Maria Cristina Bossa, Silvia Minelli, Camilla Dolfa, Micol Piperno, Cartesio Favalli
Rapid pathogen identification (ID) and antimicrobial susceptibility testing (AST) in bacteremia cases or sepsis could improve patient prognosis. Thus, it is important to provide timely reports, which make it possible for clinicians to set up appropriate antibiotic therapy during the early stages of bloodstream infection (BSI). This study evaluates an in-house microbiological protocol for early ID as well as AST on Gram negative bacteria directly from positive monomicrobial and polymicrobial blood cultures (BCs)...
March 2018: Journal of Microbiological Methods
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