Archive for December 24, 2014

Infectious prosthetic hip joint loosening: bacterial species involved in its aetiology and their antibiotic resistance profiles against antibiotics recommended for the therapy of implant-associated infections.

New Microbiol. 2014 Apr;37(2):209-18.

Bogut A1, Niedźwiadek J, Strzelec-Nowak D, Blacha J, Mazurkiewicz T, Marczyński W, Kozioł-Montewka M.

Author information

1Department of Medical Microbiology, Medical University of Lublin, Poland.

Abstract

Reliable microbiological diagnosis along with surgery and prolonged antibiotic therapy are key elements in the management of prosthetic-joint infections (PJIs).

The purpose of this study was to characterize antibiotic resistance profiles of bacteria involved in the aetiology of PJIs.

A total of 33 bacterial isolates cultured from 31 patients undergoing exchange of total hip prostheses were analyzed.

The diagnostic approach toward isolation of prosthesis- associated microorganisms included sonication of retrieved implants and conventional cultures of periprosthetic tissues and synovial fluid.

The in vitro resistance profiles of bacterial isolates were determined in relation to antibiotics recommended for the therapy of PJIs using the disc diffusion method, E-tests(®) and broth microdilution system.

Coagulase-negative staphylococci (CNS) were predominant microorganisms followed by Staphylococcus aureus, Enterobacter cloacae, Streptococcus mitis, and Propionibacterium acnes.

Twenty out of 30 and 12 out of 30 staphylococcal isolates were methicillin- and multi-drug resistant, respectively. Only two isolates were rifampicinresistant. All staphylococci were susceptible to glycopeptides and linezolid.

This paper stresses the pathogenic role of staphylococci in patients suffering from implant loosening and reports high methicillin- and multidrug-resistance rates in these bacteria.

Hence, antimicrobial susceptibility tests of individual bacterial isolates must always be performed to guide selection of the optimal therapeutic option.

PDF

http://www.newmicrobiologica.org/PUB/allegati_pdf/2014/2/209.pdf

 

2014-04 Infectious prosthetic hip joint loosening

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December 24, 2014 at 7:51 pm

Combination antibiotic therapy lowers mortality among severely ill patients with pneumococcal bacteremia.

Am J Respir Crit Care Med. 2004 Aug 15;170(4):440-4.

Baddour LM1, Yu VL, Klugman KP, Feldman C, Ortqvist A, Rello J, Morris AJ, Luna CM, Snydman DR, Ko WC, Chedid MB, Hui DS, Andremont A, Chiou CC; International Pneumococcal Study Group.

Author information

1Mayo Clinic, Rochester, NY, USA.

Abstract

Retrospective studies have suggested that combination antibiotic therapy for severe bacteremic pneumococcal pneumonia may reduce mortality.

We assessed this issue in a prospective, multicenter, international observational study of 844 adult patients with bacteremia due to Streptococcus pneumoniae.

The effect of combination antibiotic therapy versus monotherapy on mortality was examined by univariate analyses and by logistic regression models.

The 14-day mortality was not significantly different for the two groups. However, among critically ill patients, combination antibiotic therapy was associated with lower 14-day mortality (23.4 versus 55.3%, p = 0.0015).

This improvement in survival was independent of country of origin, intensive care unit support, class of antibiotics, or in vitro activity of the antibiotics prescribed.

Combination antibiotic therapy improved survival among critically ill patients with bacteremic pneumococcal illness.

PDF

http://www.atsjournals.org/doi/pdf/10.1164/rccm.200311-1578OC

December 24, 2014 at 7:46 pm

Community acquired pneumonia. New guidelines of the Spanish Society of Chest Diseases and Thoracic Surgery (SEPAR).

Arch Bronconeumol. 2010 Oct;46(10):543-58.

Menéndez R1, Torres A, Aspa J, Capelastegui A, Prat C, Rodríguez de Castro F; Sociedad Española de Neumología y Cirugía Torácica.

Author information

1Hospital Universitario La Fe, Valencia, CIBERES, España. rmenend@separ.es

PDF

http://apps.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=13156293&pident_usuario=0&pcontactid=&pident_revista=6&ty=66&accion=L&origen=bronco&web=www.archbronconeumol.org&lan=es&fichero=6v46n10a13156293pdf001.pdf

December 24, 2014 at 7:43 pm

Etiology of community-acquired pneumonia: increased microbiological yield with new diagnostic methods.

Clin Infect Dis. 2010 Jan 15;50(2):202-9.

Johansson N1, Kalin M, Tiveljung-Lindell A, Giske CG, Hedlund J.

Author information

1Department of Medicine, Karolinska Institutet, Stockholm, Sweden. sniclas.johansson@karolinska.se

Abstract

BACKGROUND:

The microbial etiology of community-acquired pneumonia (CAP) is still not well characterized. During the past few years, polymerase chain reaction (PCR)-based methods have been developed for many pathogens causing respiratory tract infections. The aim of this study was to determine the etiology of CAP among adults-especially the occurrence of mixed infections among patients with CAP-by implementing a new diagnostic PCR platform combined with conventional methods.

METHODS:

Adults admitted to Karolinska University Hospital were studied prospectively during a 12-month period. Microbiological testing methods included culture from blood, sputum, and nasopharyngeal secretion samples; sputum samples analyzed by real-time quantitative PCR for Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis; nasopharyngeal specimens analyzed by use of PCR; serological testing for Mycoplasma pneumoniae, Chlamydophila pneumoniae, and viruses common in the respiratory tract; and urine antigen assays for detection of pneumococcal and Legionella pneumophila antigens.

RESULTS:

A microbial etiology could be identified for 67% of the patients (n = 124). For patients with complete sampling, a microbiological agent was identified for 89% of the cases. The most frequently detected pathogens were S. pneumoniae (70 patients [38%]) and respiratory virus (53 patients [29%]). Two or more pathogens were present in 43 (35%) of 124 cases with a determined etiology.

CONCLUSIONS:

By supplementing traditional diagnostic methods with new PCR-based methods, a high microbial yield was achieved. This was especially evident for patients with complete sampling.

Mixed infections were frequent (most commonly S. pneumoniae together with a respiratory virus).

PDF

http://cid.oxfordjournals.org/content/50/2/202.full.pdf+html

December 24, 2014 at 7:40 pm

Assessment of mortality after long-term follow-up of patients with community-acquired pneumonia.

Clin Infect Dis. 2003 Dec 15;37(12):1617-24.

Mortensen EM1, Kapoor WN, Chang CC, Fine MJ.

Author information

1Division of General Internal Medicine, Department of Medicine, and Center for Research on Health Care, University of Pittsburgh, Pennsylvania, USA. mortensen@verdict.uthscsa.edu

Abstract

Although studies have assessed short-term mortality among patients with community-acquired pneumonia, there is limited data on prognosis and risk factors that affect long-term mortality.

The mortality among patients enrolled at 4 sites of the Pneumonia Patient Outcome Research Team cohort study who survived at least 90 days after presentation to the hospital was compared with that among age-matched control subjects.

Overall, 1419 of 1555 patients survived for >90 days, with a mean follow-up period of 5.9 years. There was significantly higher long-term mortality among patients with pneumonia than among age-matched controls.

Factors significantly associated with long-term mortality were age (stratified by decade), do-not-resuscitate status, poor nutritional status, pleural effusion, glucocorticoid use, nursing home residence, high school graduation level or less, male sex, preexisting comorbid illnesses, and the lack of feverishness.

This study demonstrates that there is significantly higher long-term mortality among patients with pneumonia than among age-matched controls and that long-term mortality largely is not affected by acute physiologic derangements.

PDF

http://cid.oxfordjournals.org/content/37/12/1617.full.pdf+html

December 24, 2014 at 7:36 pm


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