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bacteremia - Top 30 Publications

Fly Reservoir Associated with Wohlfahrtiimonas Bacteremia in a Human.

Wohlfahrtiimonas species bacteria were isolated from the bloodstream of a patient with septicemia and wound myiasis. Environmental investigations identified a Wohlfahrtiimonas sp. among insects in the Americas and in a previously undescribed vector, the green bottle fly (Lucilia sericata). The isolates possibly represent a new species within the genus Wohlfahrtiimonas.

Etiology of Invasive Bacterial Infections in Immunocompetent Children in Korea (2006-2010): a Retrospective Multicenter Study.

Invasive bacterial infections in apparently immunocompetent children were retrospectively analyzed to figure causative bacterial organisms in Korea.

Repair of a mycotic abdominal aortic aneurysm in a neonate using an everted jugular vein patch.

A 43-day-old boy presented with bacteremia after umbilical artery catheterization. Duplex ultrasound examination revealed a 1.1- × 1.6-cm mycotic infrarenal aortic aneurysm and an incidental asymptomatic occluded right common iliac artery. Resection and repair were completed by creating an everted, double-layered internal jugular vein patch. Screening ultrasound examination 10 months postoperatively demonstrated successful repair.

Unusual cause of severe diabetic ketoacidosis precipitated by Streptococcus bovis/equinus (SBSEC) bacteremia: Case report and review of literature.

Diabetic ketoacidosis is a feared complication in patients with diabetes mellitus and poses high risk of mortality and morbidity unless treated in timely manner. Infection is one of the most common precipitating factors for the development of diabetic ketoacidosis. Bacteremia with Group A and Group B beta hemolytic streptococcal strains are well known, however nonenterococcal Group D strains such as the Streptococcus bovis/Streptococcus equinus complex (SBSEC) still remains an understudied entity. Here we present a case of a 35-year-old Type I diabetic female presenting with severe diabetic ketoacidosis with overlapping features of hyperosmolar hyperglycemia, precipitated by Streptococcus alactolyticus bacteremia, successfully treated with four-week course of parenteral ceftriaxone. This case report emphasizes the potential importance of SBSEC as an emerging pathologic strain and culprit for triggering diabetic ketoacidosis which requires prompt diagnosis and targeted therapy.

Acute Hematogenous Osteomyelitis in a Five-Month-Old Male with Rickets.

Osteomyelitis is defined as an infection of the bone, bone marrow, and the surrounding soft tissues. Most cases of acute hematogenous osteomyelitis in children are caused by Gram-positive bacteria, principally Staphylococcus aureus. We present a case where a 5-month-old male had an acute onset of decreased movement of his left leg and increased irritability and was subsequently diagnosed with rickets and hematogenous osteomyelitis with bacteremia. The case explores a possible association between hematogenous osteomyelitis and rickets.

Draft Genome Sequence of Streptococcus canis Clinical Strain TA4, Harboring the M-Like Protein Gene and Isolated in Japan from a Patient with Bacteremia.

Streptococcus canis is an animal-origin β-hemolytic bacterium that can cause severe infections in animals and occasionally infects humans. Here, we report a draft genome sequence of an S. canis strain harboring the M-like protein gene. This strain was isolated from a patient with bacteremia (reported by Taniyama et al. [D. Taniyama, Y. Abe, T. Sakai, T. Kikuchi, and T. Takahashi, IDCases 7:48-52, 2017,]). The draft genome comprises 2,129,080 bp in 60 contigs.

Adjunctive Glucocorticoid Therapy in Patients with Septic Shock.

Background Whether hydrocortisone reduces mortality among patients with septic shock is unclear. Methods We randomly assigned patients with septic shock who were undergoing mechanical ventilation to receive hydrocortisone (at a dose of 200 mg per day) or placebo for 7 days or until death or discharge from the intensive care unit (ICU), whichever came first. The primary outcome was death from any cause at 90 days. Results From March 2013 through April 2017, a total of 3800 patients underwent randomization. Status with respect to the primary outcome was ascertained in 3658 patients (1832 of whom had been assigned to the hydrocortisone group and 1826 to the placebo group). At 90 days, 511 patients (27.9%) in the hydrocortisone group and 526 (28.8%) in the placebo group had died (odds ratio, 0.95; 95% confidence interval [CI], 0.82 to 1.10; P=0.50). The effect of the trial regimen was similar in six prespecified subgroups. Patients who had been assigned to receive hydrocortisone had faster resolution of shock than those assigned to the placebo group (median duration, 3 days [interquartile range, 2 to 5] vs. 4 days [interquartile range, 2 to 9]; hazard ratio, 1.32; 95% CI, 1.23 to 1.41; P<0.001). Patients in the hydrocortisone group had a shorter duration of the initial episode of mechanical ventilation than those in the placebo group (median, 6 days [interquartile range, 3 to 18] vs. 7 days [interquartile range, 3 to 24]; hazard ratio, 1.13; 95% CI, 1.05 to 1.22; P<0.001), but taking into account episodes of recurrence of ventilation, there were no significant differences in the number of days alive and free from mechanical ventilation. Fewer patients in the hydrocortisone group than in the placebo group received a blood transfusion (37.0% vs. 41.7%; odds ratio, 0.82; 95% CI, 0.72 to 0.94; P=0.004). There were no significant between-group differences with respect to mortality at 28 days, the rate of recurrence of shock, the number of days alive and out of the ICU, the number of days alive and out of the hospital, the recurrence of mechanical ventilation, the rate of renal-replacement therapy, and the incidence of new-onset bacteremia or fungemia. Conclusions Among patients with septic shock undergoing mechanical ventilation, a continuous infusion of hydrocortisone did not result in lower 90-day mortality than placebo. (Funded by the National Health and Medical Research Council of Australia and others; ADRENAL number, NCT01448109 .).

Reevaluation of the impact of methicillin-resistance on outcomes in patients with Staphylococcus aureus bacteremia and endocarditis.

Methicillin-resistant Staphylococcus aureus (MRSA) is highly prevalent in hospitals, and has recently emerged in the community. The impact of methicillin-resistance on mortality and medical costs for patients with S. aureus bacteremia (SAB) requires reevaluation.

Risk factors and outcomes for multidrug-resistant Gram-negative bacilli bacteremia.

The incidence of multidrug-resistant (MDR) organisms is increasing along with mortality. Identifying risk factors for the development of MDR Gram-negative bacilli (GNB) bacteremia could greatly impact patient care and management.

Rhinovirus in Febrile Infants and Risk of Bacterial Infection.

Febrile infants with viral respiratory infections have a reduced risk of bacterial infection compared with virus-negative infants. The risk of concomitant bacterial infection in febrile infants positive for human rhinovirus (HRV) by polymerase chain reaction (PCR) is unknown.

Is bacteremia the decisive factor for the duration of antimicrobial therapy in bacteremic urinary tract infections?

Accuracy of the Urinalysis for Urinary Tract Infections in Febrile Infants 60 Days and Younger.

Reports of the test accuracy of the urinalysis for diagnosing urinary tract infections (UTIs) in young febrile infants have been variable. We evaluated the test characteristics of the urinalysis for diagnosing UTIs, with and without associated bacteremia, in young febrile infants.

The genetic basis of emerging vancomycin, linezolid, and daptomycin heteroresistance in a case of persistent Enterococcus faecium bacteremia.

Whole-genome sequencing was used to examine a persistent E. faecium bacteremia that acquired heteroresistance to three antibiotics in response to prolonged multidrug therapy. Comparison of complete genomes before and after each change revealed the emergence of known resistance determinants for vancomycin and linezolid, and suggested that a novel mutation in fabF, encoding a fatty acid synthase, was responsible for daptomycin nonsusceptibility. Plasmid recombination contributed to progressive loss of vancomycin resistance after withdrawal of the drug.

Safety and preliminary efficacy of venetoclax with decitabine or azacitidine in elderly patients with previously untreated acute myeloid leukaemia: a non-randomised, open-label, phase 1b study.

Elderly patients (aged ≥65 years) with acute myeloid leukaemia have poor outcomes and no effective standard-of-care therapy exists. Treatment with hypomethylating agents such as azacitidine and decitabine is common, but responses are modest and typically short-lived. The oral anti-apoptotic B-cell lymphoma 2 protein inhibitor, venetoclax, has shown promising single-agent activity in patients with relapsed or refractory acute myeloid leukaemia and preclinical data suggested synergy between hypomethylating agents and venetoclax, which led to this combination phase 1b study.

Whole-Genome-Sequencing characterization of bloodstream infection-causing hypervirulent Klebsiella pneumoniae of capsular serotype K2 and ST374.

Hypervirulent K. pneumoniae variants (hvKP) have been increasingly reported worldwide, causing metastasis of severe infections such as liver abscesses and bacteremia. The capsular serotype K2 hvKP strains show diverse multi-locus sequence types (MLSTs), but with limited genetics and virulence information. In this study, we report a hypermucoviscous K. pneumoniae strain, RJF293, isolated from a human bloodstream sample in a Chinese hospital. It caused a metastatic infection and fatal septic shock in a critical patient. The microbiological features and genetic background were investigated with multiple approaches. The Strain RJF293 was determined to be multilocis sequence type (ST) 374 and serotype K2, displayed a median lethal dose (LD50) of 1.5 × 102 CFU in BALB/c mice and was as virulent as the ST23 K1 serotype hvKP strain NTUH-K2044 in a mouse lethality assay. Whole genome sequencing revealed that the RJF293 genome codes for 32 putative virulence factors and exhibits a unique presence/absence pattern in comparison to the other 105 completely sequenced K. pneumoniae genomes. Whole genome SNP-based phylogenetic analysis revealed that strain RJF293 formed a single clade, distant from those containing either ST66 or ST86 hvKP. Compared to the other sequenced hvKP chromosomes, RJF293 contains several strain-variable regions, including one prophage, one ICEKp1 family integrative and conjugative element and six large genomic islands. The sequencing of the first complete genome of an ST374 K2 hvKP clinical strain should reinforce our understanding of the epidemiology and virulence mechanisms of this bloodstream infection-causing hvKP with clinical significance.

Effectiveness and Cost of Weekly Recombinant Tissue Plasminogen Activator Hemodialysis Catheter Locking Solution.

Evidence to guide hemodialysis catheter locking solutions is limited. We aimed to assess effectiveness and cost of recombinant tissue plasminogen activator (rt-PA) once per week as a locking solution, compared with thrice weekly citrate or heparin, in patients at high risk of complications.

Effect of Porphyromonas gingivalis infection in the placenta and umbilical cord in pregnant mice with low birth weight.

Growing evidence indicates an association between periodontitis and delivery outcome; however, the mechanism is unclear. This study aimed to investigate the influence of Porphyromonas gingivalis (Pg) infection on delivery outcome in mice.

Community-acquired methicillin-resistant Staphylococcus aureus infections: hospitalization and case fatality risk in 10 pediatric facilities in Argentina.

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are prevalent both in Argentina and worldwide, and they may have a severe clinical course.

Vancomycin-resistant enterococcus infection in the hematopoietic stem cell transplant recipient: an overview of epidemiology, management, and prevention.

Vancomycin-resistant enterococcus (VRE) is now one of the leading causes of nosocomial infections in the United States. Hematopoietic stem cell transplantation (HSCT) recipients are at increased risk of VRE colonization and infection. VRE has emerged as a major cause of bacteremia in this population, raising important clinical questions regarding the role and impact of VRE colonization and infection in HSCT outcomes as well as the optimal means of prevention and treatment. We review here the published literature and scientific advances addressing these thorny issues and provide a rational framework for their approach.

In vitro and in vivo safety analysis of Enterococcus faecium 2C isolated from human breast milk.

Safety analysis of probiotic bacteria is an obligatory characteristic to be evaluated prior to application in food or pharmacological products. This study was designed to evaluate in vitro and in vivo safety parameters of Enterococcus faecium 2C strain, a probiotic candidate isolated from human breast milk.

Clinical impact of delayed catheter removal for patients with central venous catheter-related gram-negative bacteremia.

Gram-negative bacteria are increasingly the cause of catheter-related bloodstream infections (CRBSI), which show a rapidly rising prevalence of multidrug-resistant strains. We evaluated the impact of delayed central venous catheter (CVC) removal on clinical outcomes in patients with gram-negative CRBSI.

A relapsing fever group Borrelia sp. is widely distributed among wild deer in Japan.

A relapsing fever group Borrelia sp. was detected from the blood of wild deer (Cervus nippon) in Japan. The Borrelia sp. was distributed nationwide among deer with an overall prevalence of 26% in blood samples. The prevalence of infection was significantly higher in fawns (48.4%) compared to adult deer (23.6%). Sequencing analysis reveals that this Borrelia sp. belongs to the hard tick-borne relapsing fever borreliae, and that it forms a single lineage based on sequences of the flagellin and glycerophosphodiester phosphodiesterase genes. Borrelial genome copy number was estimated at 8.8 × 103 genome copies/μl of blood. Other hard tick-borne relapsing fever borrelia (e.g. Borrelia miyamotoi) were not detected in deer blood in this study. These findings suggest that wild deer may act as reservoirs for this Borrelia sp. in Japan.

Multi-drug resistant non-typhoidal Salmonella associated with invasive disease in western Kenya.

Non-typhoidal Salmonella (NTS) is a leading cause of bloodstream infections in Africa, but the various contributions of host susceptibility versus unique pathogen virulence factors are unclear. We used data from a population-based surveillance platform (population ~25,000) between 2007-2014 and NTS genome-sequencing to compare host and pathogen-specific factors between individuals presenting with NTS bacteremia and those presenting with NTS diarrhea. Salmonella Typhimurium ST313 and Salmonella Enteritidis ST11 were the most common isolates. Multi-drug resistant strains of NTS were more commonly isolated from patients presenting with NTS bacteremia compared to NTS diarrhea. This relationship was observed in patients under age five [aOR = 15.16, 95% CI (2.84-81.05), P = 0.001], in patients five years and older, [aOR = 6.70 95% CI (2.25-19.89), P = 0.001], in HIV-uninfected patients, [aOR = 21.61, 95% CI (2.53-185.0), P = 0.005], and in patients infected with Salmonella serogroup B [aOR = 5.96, 95% CI (2.28-15.56), P < 0.001] and serogroup D [aOR = 14.15, 95% CI (1.10-182.7), P = 0.042]. Thus, multi-drug-resistant NTS was strongly associated with bacteremia compared to diarrhea among children and adults. This association was seen in HIV-uninfected individuals infected with either S. Typhimurium or S. Enteritidis. Risk of developing bacteremia from NTS infection may be driven by virulence properties of the Salmonella pathogen.

Renal vein thrombosis complicating severe acute pyelonephritis with renal abscesses and associated bacteraemia caused by extended-spectrum beta-lactamase producing Escherichia coli.

Acute pyelonephritis might be complicated by the formation of renal and perirenal abscesses and very rarely by renal vein thrombosis, which is a life-threatening condition. The main causative agents of acute pyelonephritis are enterobacteriaceae with the incidence of extended-spectrum beta-lactamase (ESBL)-producing strains increasing worldwide. We present the case of a 71-year-old Greek man with history of diabetes mellitus and recent hospitalization, who suffered from severe pyelonephritis with renal abscesses formation and associated bacteraemia caused by ESBL-producing Escherichia coli, complicated by extensive thrombosis of the ipsilateral renal vein and its branches, protruding also in the inferior venal cava. Our patient was effectively treated with anticoagulants and targeted antibiotic therapy, respectively, consisted of low molecular weight heparin transitioned to oral acenocoumarol for 3 months and 2-week course of intravenous meropenem followed by oral fosfomycin for additional 3 weeks as quidded by clinical and computed tomographic follow-up. In conclusion, in complicated urinary infections, caused by ESBL-producing enterobacteriaceae, oral fosfomycin might represent an effective option for step-down therapy of carbapenems, allowing the shortness of the duration of patient's hospitalization and carbapenem use.

Consequences of Retained Defibrillator and Pacemaker Leads Following Heart Transplantation - an Underrecognized Problem.

Cardiovascular implantable electronic devices (CIED) are common in patients undergoing heart transplantation (HT) and complete removal is not always possible at the time of transplant.

Epidemiology and Outcomes of Hematopoietic Stem Cell Transplant in HIV (+) Patients from 1998 to 2012: A Nationwide Analysis.

Prior studies have shown that outcomes of hematopoietic stem cell transplantation (HSCT) in HIV (+) patients are similar to HIV (-) patients since effective implementation of HAART by 1998; but they are limited by small sample size or non-inclusion of recent data.

Site of entry and surgical timing in infective endocarditis.

: Infective endocarditis is the manifestation of the endocardial involvement during a systemic infectious process.The prognosis of this condition is still dismal, and the mortality associated with it remains high despite improvement in antimicrobial treatment. Antibiotic prophylaxis is still recommended only in high-risk cases, that is, procedures at high risk for inducing systemic bacteremia.It is important to provide an educational prophylaxis consisting of sound hygienic recommendations for the cleansing of the oral cavity, the skin, genital-urinary, and gastrointestinal systems. Same compulsory attention should be paid by doctors and nurses to observe standard practices for preparation of the skin and the mucosa membranes in the case of procedures apparently simple such as blood sampling and intravenous infusion. Identification of site of entry of the microorganisms responsible for this disorder, their typing and eradication are particularly important, allowing prevention of the not unusual recurrences. Early surgical treatment is recommended, when severe comorbidities are absent, for endocarditis associated with heart failure, when the infectious process is not controlled, when there is a paravalvular extension of the process, when multidrug resistant microorganisms are involved, and to prevent embolic events. For intracardiac devices, besides prolonged antibiotic treatment, the removal of the device, preferably percutaneously, is necessary. Present guidelines provide clear indication for optimal surgical treatment, but its timing is still debated.

Ileal GIST presenting with bacteremia and liver abscess: A case report and review of literature.

Small intestine gastrointestinal stromal tumors can infrequently present with intra-abdominal abscess, perforation, obstruction or fistula. Tumor-small intestine fistula is a rare phenomenon and occurs as a result of GISTs' propensity to cause mucosal ulceration. This allows bacteria from the gut to gain access to the systemic circulation and predisposes the patient to bacteremia and pyogenic liver abscess.

A rare case of Shewanella putrefaciens bacteremia in a patient of road traffic accident.

Shewanella putrefaciens rarely causes human infection. These are mostly found in environment and food stuffs. Shewanella are often found in mixed culture. It has been implicated in cellulitis, otitis media, and septicemia. It may be found in respiratory tract, urine, feces, and pleural fluid. There is no definite guideline for therapeutic option. In general, these are susceptible to various antimicrobial agents but are often resistant to penicillin and cephalothin. We report a rare case of bacteremia by S. putrefaciens in a patient of head injury with polytrauma after a road traffic accident.

Utility of fosfomycin as antibacterial prophylaxis in patients with hematologic malignancies.

Prolonged and profound neutropenia is common among hematology and hematopoietic stem cell transplant (HSCT) patients as a result of chemotherapy. The National Comprehensive Cancer Network (NCCN) and Infectious Diseases Society of America (IDSA) currently recommend antibacterial prophylaxis in patients who are deemed at intermediate or high risk for infection. Specifically, fluoroquinolone prophylaxis should be considered for high-risk neutropenic patients. However, with prolonged and frequent exposure to fluoroquinolones, these high-risk patients may develop resistance to these agents. Patients may also have allergies or other contraindications which prohibit the use of fluoroquinolones for antibacterial prophylaxis. Unfortunately, there is no standard recommendation for alternative antimicrobial therapy in this patient population, as well as there is a lack of data to support the use of potential alternative agents.