Archive for October 13, 2016

A cohort study of bacteremic pneumonia: The importance of antibiotic resistance and appropriate initial therapy?

Medicine (Baltimore). August 2016  V.95 N.35 e4708.

Guillamet CV1, Vazquez R, Noe J, Micek ST, Kollef MH.

Author information

1aDivision of Pulmonary, Critical Care, and Sleep Medicine bDivision of Infectious Diseases, University of New Mexico School of Medicine, Albuquerque, NM cDivision of Pulmonary and Critical Care Medicine, Washington University School of Medicine dSt. Louis College of Pharmacy, St. Louis, MO.

Abstract

Bacteremic pneumonia is usually associated with greater mortality. However, risk factors associated with hospital mortality in bacteremic pneumonia are inadequately described.

The study was a retrospective cohort study, conducted in Barnes-Jewish Hospital (2008-2015).

For purposes of this investigation, antibiotic susceptibility was determined according to ceftriaxone susceptibility, as ceftriaxone represents the antimicrobial agent most frequently recommended for hospitalized patients with community-acquired pneumonia as opposed to nosocomial pneumonia.

Two multivariable analyses were planned: the first model included resistance to ceftriaxone as a variable, whereas the second model included the various antibiotic-resistant species (methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and Enterobacteriaceae).In all, 1031 consecutive patients with bacteremic pneumonia (mortality 37.1%) were included.

The most common pathogens associated with infection were S aureus (34.1%; methicillin resistance 54.0%), Enterobacteriaceae (28.0%), P aeruginosa (10.6%), anaerobic bacteria (7.3%), and Streptococcus pneumoniae (5.6%).

Compared with ceftriaxone-susceptible pathogens (46.8%), ceftriaxone-resistant pathogens (53.2%) were significantly more likely to receive inappropriate initial antibiotic treatment (IIAT) (27.9% vs 7.1%; P < 0.001) and to die during hospitalization (41.5% vs 32.0%; P = 0.001).

The first logistic regression analysis identified IIAT with the greatest odds ratio (OR) for mortality (OR 2.2, 95% confidence interval [CI] 1.5-3.2, P < 0.001).

Other independent predictors of mortality included age, mechanical ventilation, immune suppression, prior hospitalization, prior antibiotic administration, septic shock, comorbid conditions, and severity of illness.

In the second multivariable analysis that included the antibiotic-resistant species, IIAT was still associated with excess mortality, and P aeruginosa infection was identified as an independent predictor of mortality (OR 1.6, 95% CI 1.1-2.2, P = 0.047), whereas infection with ceftriaxone-resistant Enterobacteriaceae (OR 0.6, 95% CI 0.4-1.0, P = 0.050) was associated with lower mortality.

More than one-third of our patients hospitalized with bacteremic pneumonia died. IIAT was identified as the most important risk factor for hospital mortality and the only risk factor amenable to potential intervention.

Specific antibiotic-resistant pathogen species were also associated with mortality

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008591/pdf/medi-95-e4708.pdf

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October 13, 2016 at 2:49 pm

The Association between Invasive Group A Streptococcal Diseases and Viral Respiratory Tract Infections.

Front Microbiol. 2016 Mar 21;7:342.

Herrera AL1, Huber VC1, Chaussee MS1.

Author information

1Division of Basic Biomedical Sciences, The Sanford School of Medicine of the University of South Dakota Vermillion, SD, USA.

Abstract

Viral infections of the upper respiratory tract are associated with a variety of invasive diseases caused by Streptococcus pyogenes, the group A streptococcus, including pneumonia, necrotizing fasciitis, toxic shock syndrome, and bacteremia.

While these polymicrobial infections, or superinfections, are complex, progress has been made in understanding the molecular basis of disease.

Areas of investigation have included the characterization of virus-induced changes in innate immunity, differences in bacterial adherence and internalization following viral infection, and the efficacy of vaccines in mitigating the morbidity and mortality of superinfections.

Here, we briefly summarize viral-S. pyogenes superinfections with an emphasis on those affiliated with influenza viruses.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800185/pdf/fmicb-07-00342.pdf

October 13, 2016 at 2:47 pm

Staphylococcus aureus in Animals and Food: Methicillin Resistance, Prevalence and Population Structure. A Review in the African Continent.

Microorganisms. 2016 Feb 4;4(1).

Lozano C1, Gharsa H2,3, Ben Slama K4,5, Zarazaga M6, Torres C7.

Author information

1Area of Biochemistry and Molecular Biology, University of La Rioja, Madre de Dios 53, Logroño 26006, Spain. carmencita_lf@hotmail.com

2Laboratoire des Microorganismes et Biomolécules Actives, Faculté de Sciences de Tunis, Université de Tunis El Manar, Tunis 2092, Tunisia. haythemgharsa@yahoo.fr

3Institut Supérieur des Sciences Biologiques Appliquées de Tunis, Université de Tunis El Manar, Tunis 1006, Tunisia. haythemgharsa@yahoo.fr

4Laboratoire des Microorganismes et Biomolécules Actives, Faculté de Sciences de Tunis, Université de Tunis El Manar, Tunis 2092, Tunisia. Karim.BenSlama@fst.rnu.tn

5Institut Supérieur des Sciences Biologiques Appliquées de Tunis, Université de Tunis El Manar, Tunis 1006, Tunisia. Karim.BenSlama@fst.rnu.tn

6Area of Biochemistry and Molecular Biology, University of La Rioja, Madre de Dios 53, Logroño 26006, Spain. myriam.zarazaga@unirioja.es

7Area of Biochemistry and Molecular Biology, University of La Rioja, Madre de Dios 53, Logroño 26006, Spain. carmen.torres@unirioja.es

Abstract

The interest about Staphylococcus aureus (S. aureus) and methicillin resistant S. aureus (MRSA) in livestock, and domestic and wild animals has significantly increased.

The spread of different clonal complexes related to livestock animals, mainly CC398, and the recent description of the new mecC gene, make it necessary to know more about the epidemiology and population structure of this microorganism all over the world.

Nowadays, there are several descriptions about the presence of S. aureus and/or MRSA in different animal species (dogs, sheep, donkeys, bats, pigs, and monkeys), and in food of animal origin in African countries.

In this continent, there is a high diversity of ethnicities, cultures or religions, as well as a high number of wild animal species and close contact between humans and animals, which can have a relevant impact in the epidemiology of this microorganism.

This review shows that some clonal lineages associated with humans (CC1, CC15, CC72, CC80, CC101, and CC152) and animals (CC398, CC130 and CC133) are present in this continent in animal isolates, although the mecC gene has not been detected yet.

However, available studies are limited to a few countries, very often with incomplete information, and many more studies are necessary to cover a larger number of African countries.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5029517/pdf/microorganisms-04-00012.pdf

October 13, 2016 at 8:08 am


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