Archive for November 21, 2018

European Journal of Clinical Microbiology & Infectious Diseases December 2018 V.37 N.12 P.2347–2354

Large variation in ESBL-producing Escherichia coli carriers in six European countries including Russia

Sofia Ny, Roman Kozlov, Uga Dumpis, Petra Edquist, Kirsi Gröndahl-Yli-Hannuksela, Anna-Maria Kling, Danuta O. Lis, Christoph Lübbert, Monika Pomorska-Wesołowska, Ivan Palagin, Aija Vilde, Jaana Vuopio, Jan Walter & Karin Tegmark Wisell

We investigated the faecal carriage prevalence of extended-spectrum β-lactamase production in Escherichia coli (EP-EC) and/or Klebsiella pneumoniae (EP-KP) and risk factors associated with carriage among adult study subjects in Finland, Germany, Latvia, Poland, Russia and Sweden (partner countries).

The aim was to get indicative data on the prevalence of ESBL-carriage in specific populations in the region. Faecal samples were collected from four study populations and screened on ChromID-ESBL and ChromID-OXA-48 plates.

Positive isolates were further characterised phenotypically.

Our results show a large variation in carrier prevalence ranging from 1.6% in Latvia to 23.2% in Russia for EP-EC. For the other partner countries, the prevalence of EP-EC were in increasing numbers, 2.3% for Germany, 4.7% for Finland, 6.6% for Sweden, 8.0% for Poland and 8.1% for all partner countries in total.

Carriers of EP-KP were identified only in Finland, Russia and Sweden, and the prevalence was < 2% in each of these countries. No carriers of carbapenemase-producing isolates were identified.

This is the first study reporting prevalence of carriers (excluding traveller studies) for Finland, Latvia, Poland and Russia.

It contributes with important information regarding the prevalence of EP-EC and EP-KP carriage in regions where studies on carriers are limited.

PDF

https://link.springer.com/content/pdf/10.1007%2Fs10096-018-3382-8.pdf

November 21, 2018 at 12:31 pm

A systematic review of randomised clinical trials for oral antibiotic treatment of acute pyelonephritis

European Journal of Clinical Microbiology & Infectious Diseases December 2018 V.37 N.12 P.2285–2291

Jonathan W. S. Cattrall, Alyss V. Robinson & Andrew Kirby

There is increasing resistance to the oral antibiotics currently recommended for the treatment of pyelonephritis, and increased healthcare costs are associated with the reliance on alternative intravenous agents.

We, therefore, performed a systematic review of randomised controlled trials to determine the clinical efficacy and safety of oral antibiotics for the treatment of pyelonephritis in adults.

A search of four major medical databases (MEDLINE, Embase+ Embase classic, CENTRAL and Cochrane Database for Systematic Reviews) in addition to manual reference searching of relevant reviews was conducted.

Clinical cure and adverse event rates were reported, and trial quality and bias were assessed. A total of 277 studies were reviewed; five studies matched all eligibility criteria and were included.

Antibiotics included were cefaclor, ciprofloxacin, gatifloxacin, levofloxacin, lomefloxacin, loracarbef, norfloxacin, rufloxacin and trimethoprim-sulfamethoxazole.

In included studies, the clinical success of the outpatient treatment of pyelonephritis by cefaclor, ciprofloxacin and norfloxacin at 4 to 6 weeks was comparable at between 83 to 95%. Relatively high rates of adverse events were noted in a trial of ciprofloxacin (24%) and trimethoprim-sulfamethoxazole (33%).

Significant heterogeneity between all aspects of the trial designs was identified, with all studies having a potential for bias.

This review demonstrates a need for high-quality clinical trials into the oral antibiotic treatment of pyelonephritis, with more consistent designs and reporting of outcomes.

There are data to support further research into oral norfloxacin and cefaclor for the outpatient treatment of pyelonephritis in adults.

PDF

https://link.springer.com/content/pdf/10.1007%2Fs10096-018-3371-y.pdf

 

November 21, 2018 at 12:29 pm

Infective endocarditis due to Streptococcus dysgalactiae: clinical presentation and microbiological features

European Journal of Clinical Microbiology & Infectious Diseases December 2018 V.37 N.12 P.2261–2272

Anna Bläckberg, Nilson, Volkan Özenci, Lars Olaison, Magnus Rasmussen

Knowledge of infective endocarditis (IE) caused by Streptococcus dysgalactiae (SD) is limited.

This study aimed to identify the clinical and microbiological features of SD-caused IE and to investigate any possible synergy between penicillin and gentamicin on SD isolates.

Cases of IE 2008–2016 due to SD reported to the Swedish Registry of Infective Endocarditis (SRIE) were identified. Isolates were emm typed and synergy between antibiotics was determined in time-kill experiments. Medical records were reviewed and SD-cases were compared to cases of IE due to other pathogens reported to the SRIE.

Fifty cases of SD-caused IE were confirmed. emm types stC74a, stG62647, and stG643 were most commonly encountered.

The patients had a median age of 74 years (range 38–93) and were significantly older compared to patients with Staphylococcus aureus-caused IE, (65 years (p = 0.003)).

The median time to diagnosis from symptom onset was 1 day for patients with SD-caused IE which was less compared to patients with IE due to the other pathogens (2–15 days). Embolization was seen in 46% and the in-hospital mortality was 8%.

Etest-based methods did not indicate any synergy between penicillin and gentamicin whereas synergy was noted for four out of nine isolates applying time-kill assays.

This is the largest study of SD-caused IE, a condition with an acute onset predominantly affecting elderly people. Synergy between penicillin and gentamicin against some SD isolates was distinguished but the potential benefit of this must be weighed against the risk of aminoglycoside side effects.

PDF

https://link.springer.com/content/pdf/10.1007%2Fs10096-018-3367-7.pdf

November 21, 2018 at 12:27 pm

Related carbapenemase-producing Klebsiella isolates detected in both a hospital and associated aquatic environment in Sweden

European Journal of Clinical Microbiology & Infectious Diseases December 2018 V.37 N.12 P.2241–2251

Faisal Ahmad Khan, Bengt Hellmark, Ralf Ehricht, Bo Söderquist & Jana Jass

Carbapenem antibiotics are one of the last-resort agents against multidrug-resistant (MDR) bacteria.

The occurrence of carbapenemase-producing Enterobacteriaceae (CPE) in wastewater and aquatic environments is an indication of MDR bacteria in the community.

This study evaluated CPE in aquatic environments and compared them to the local hospital isolates in Sweden. Phenotypic and genotypic analyses of antibiotic resistance of environmental and clinical CPE were performed.

The relatedness of the isolates and possible clonal dissemination was evaluated using phylogenetic and phyloproteomic analysis. Klebsiella oxytoca carrying carbapenemase genes (blaVIM-1, blaIMP-29) were isolated from wastewater and the recipient river, while K. oxytoca (blaVIM-1) and Klebsiella pneumoniae (blaVIM-1, blaOXA-48, blaNDM-1, blaKPC-3) were isolated from patients at the local clinics or hospital.

The K. oxytoca classified as sequence type 172 (ST172) isolated from the river was genotypically related to two clinical isolates recovered from patients.

The similarity between environmental and clinical isolates suggests the dispersion of blaVIM-1 producing K. oxytoca ST172 from hospital to aquatic environment and the likelihood of its presence in the community.

This is the first report of CPE in aquatic environments in Sweden; therefore, surveillance of aquatic and hospital environments for CPE in other urban areas is important to determine the major transfer routes in order to formulate strategies to prevent the spread of MDR bacteria.

FULL TEXT

https://link.springer.com/article/10.1007/s10096-018-3365-9?wt_mc=alerts.TOCjournals&utm_source=toc&utm_medium=email&utm_campaign=toc_10096_37_12

PDF

https://link.springer.com/content/pdf/10.1007%2Fs10096-018-3365-9.pdf

November 21, 2018 at 12:24 pm

Virus Mayaro: una nueva amenaza para el continente Americano

Revista LatinoAmericana de Infectología Pediátrica Ene-Mar 2017 V.30 N.1 P.12-14

Iván Renato Zúñiga Carrasco,* Janett Caro Lozano**

* Jefe del Departamento de Epidemiología. HGR. 251 IMSS, Metepec, Estado de México.

** Coordinadora de Educación e Investigación HGZ. C/MF. 1 IMSS, Chetumal, Quintana Roo.

Es una enfermedad causada por el virus de Mayaro perteneciente al género Alphavirus (grupo A de arbovirus), estrechamente relacionada con fiebre de Chikungunya.

Se transmite por la picadura de mosquitos hembras infectados con este virus principalmente del género Haemagogus spp., en zonas selváticas y rurales y por Aedes aegypti y Aedes albopictus en la parte urbana, áreas ubicadas entre 0 y 2,200 metros sobre el nivel del mar.

Inicia con una rápida elevación de la temperatura corporal e incluye malestar general, cefalea, dolor retroocular, mialgias, artralgia, dolor abdominal, mareos, náuseas, pérdida de apetito, erupción en piel principalmente en pecho, piernas, espalda, brazos y con menor frecuencia en la cara.

En algunos casos se presenta dolor de garganta, congestión nasal, tos y algunas hemorragias.

El cuadro febril es de corta duración, entre tres y siete días y suele resolverse por sí solo, aunque en algunos pacientes la afectación articular puede ser severa y de duración prolongada.

El diagnóstico es mediante la técnica de RT-PCR.

No existe tratamiento específico y el manejo debe ser sintomático de soporte.

PDF

http://www.medigraphic.com/pdfs/infectologia/lip-2017/lip171c.pdf

November 21, 2018 at 8:24 am

Review – Will Mayaro virus be responsible for the next outbreak of an arthropod-borne virus in Brazil?

The Brazilian Journal of Infectious Diseases 2017 V.21 N.5 P.540-544

Danillo Lucas Alves Esposito, Benedito Antonio Lopes da Fonseca

Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departmento de Clínica Médica, Ribeirão Preto, SP, Brazil

Mayaro virus is an alphavirus from the Togaviridae family and is transmitted mainly by Hemagogus mosquitoes.

This virus circulates in high-density tropical forests or rural areas of Central and South America causing a disease characterized by high-grade fever, maculopapular skin rash and marked arthralgia that, in some patients, can persist for long periods after infection and may be misinterpreted as chikungunya.

Although only a few outbreaks involving this virus have been reported, in the last years the number of Mayaro virus infections has increased in the central and northern regions of Brazil.

In this review, we describe the reported prevalence of this infection over the years and discuss the circumstances that can contribute to the establishment of an urban mayaro virus epidemic in Brazil and the problems encountered with the specific diagnosis, especially the antigenic cross-reactivity of this pathogen with other viruses of the same family.

PDF

http://www.scielo.br/pdf/bjid/v21n5/1413-8670-bjid-21-05-0540.pdf

 

FACT SHEET / INFORMACION GENERAL

https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/VSP/abece-mayaro.pdf

November 21, 2018 at 8:22 am

Anopheles mosquitoes may drive invasion and transmission of Mayaro virus across geographically diverse regions

Public Library of Science – Neglected Tropical Diseases November 7, 2018

Anopheles mosquitoes may drive invasion and transmission of Mayaro virus across geographically diverse regions

The Togavirus (Alphavirus) Mayaro virus (MAYV) was initially described in 1954 from Mayaro County (Trinidad) and has been responsible for outbreaks in South America and the Caribbean.

Imported MAYV cases are on the rise, leading to invasion concerns similar to Chikungunya and Zika viruses.

Little is known about the range of mosquito species that are competent MAYV vectors.

We tested vector competence of 2 MAYV genotypes in laboratory strains of six mosquito species (Aedes aegypti, Anopheles freeborni, An. gambiae, An. quadrimaculatus, An. stephensi, Culex quinquefasciatus).

Ae. aegypti and Cx. quinquefasciatus were poor MAYV vectors, and had either poor or null infection and transmission rates at the tested viral challenge titers.

In contrast, all Anopheles species were able to transmit MAYV, and 3 of the 4 species transmitted both genotypes.

The Anopheles species tested are divergent and native to widely separated geographic regions (Africa, Asia, North America), suggesting that Anopheles may be important in the invasion and spread of MAYV across diverse regions of the world.

FULL TEXT

https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0006895

PDF

https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0006895&type=printable

November 21, 2018 at 8:10 am

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