Posts filed under ‘Bacteriemias’

Diagnostic Accuracy of PCR Alone and Compared to Urinary Antigen Testing for Detection of Legionella spp.-Systematic Review.

J Clin Microbiol. 2016 Feb;54(2):401-11.

Avni T1, Bieber A2, Green H2, Steinmetz T2, Leibovici L2, Paul M3.

Author information

1 Medicine E, Beilinson Hospital and Sackler Faculty of Medicine, Tel-Aviv University, Israel tomerav@clalit.org.il

2 Medicine E, Beilinson Hospital and Sackler Faculty of Medicine, Tel-Aviv University, Israel.

3 Infectious Diseases Unit, Rambam Medical Center and Rappaport Faculty of Medicine, Tehnion, Israel Institute of Technology, Haifa, Israel.

Abstract

The diagnosis of Legionnaires’ disease (LD) is based on the isolation of Legionella spp., a 4-fold rise in antibodies, a positive urinary antigen (UA), or direct immunofluorescence tests. PCR is not accepted as a diagnostic tool for LD. This systematic review assesses the diagnostic accuracy of PCR in various clinical samples with a direct comparison versus UA. We included prospective or retrospective cohort and case-control studies. Studies were included if they used the Centers for Disease Control and Prevention consensus definition criteria of LD or a similar one, assessed only patients with clinical pneumonia, and reported data for all true-positive, false-positive, true-negative, and false-negative results. Two reviewers abstracted data independently. Risk of bias was assessed using Quadas-2. Summary sensitivity and specificity values were estimated using a bivariate model and reported with a 95% confidence interval (CI). Thirty-eight studies were included. A total of 653 patients had confirmed LD, and 3,593 patients had pneumonia due to other pathogens. The methodological quality of the studies as assessed by the Quadas-2 tool was poor to fair. The summary sensitivity and specificity values for diagnosis of LD in respiratory samples were 97.4% (95% CI, 91.1% to 99.2%) and 98.6% (95% CI, 97.4% to 99.3%), respectively. These results were mainly unchanged by any covariates tested and subgroup analysis. The diagnostic performance of PCR in respiratory samples was much better than that of UA. Compared to UA, PCR in respiratory samples (especially in sputum samples or swabs) revealed a significant advantage in sensitivity and an additional diagnosis of 18% to 30% of LD cases. The diagnostic performance of PCR in respiratory samples was excellent and preferable to that of the UA. Results were independent on the covariate tested. PCR in respiratory samples should be regarded as a valid tool for the diagnosis of LD.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4733173/pdf/zjm401.pdf

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November 20, 2017 at 11:32 am

2007 LEGIONELLA and the Prevention of LEGIONELLOSIS – WHO MANUAL 276 pags

World Health Organization 2007

Edited by:

Jamie Bartram, Yves Chartier, John V Lee,

Kathy Pond and Susanne Surman-Lee

PDF

http://www.who.int/water_sanitation_health/emerging/legionella.pdf

November 20, 2017 at 11:31 am

High Rate of MCR-1–Producing Escherichia coli and Klebsiella pneumoniae among Pigs, Portugal

Emerging Infectious Diseases December 2017 V.23 N.12 P.2023-2029

Research

Nicolas Kieffer, Marta Aires-de-Sousa, Patrice Nordmann, and Laurent Poirel

Author affiliations: Université de Fribourg, Fribourg, Switzerland (N. Kieffer, P. Nordmann, L. Poirel); Escola Superior de Saúde da Cruz Vermelha Portuguesa, Lisbon, Portugal (M. Aires-de-Sousa); University of Lausanne and University Hospital Centre, Lausanne, Switzerland (P. Nordmann)

The mcr-1 (mobile colistin resistance 1) gene, which encodes phosphoethanolamine transferase, has been recently identified as a source of acquired resistance to polymyxins in Escherichia coli.

Using the SuperPolymyxin selective medium, we prospectively screened 100 pigs at 2 farms in Portugal for polymyxin-resistant Enterobacteriaceae and recovered 98 plasmid-mediated MCR-1–producing isolates.

Most isolates corresponded to nonclonally related E. coli belonging to many sequence types; we also found 2 Klebsiella pneumoniae sequence types. The mcr-1 gene was carried on IncHI2 or IncP plasmid backbones.

Our finding of a high rate of MCR-1 producers on 2 pig farms in Portugal highlights the diffusion of that colistin-resistance determinant at the farm level.

The fact that the pigs received colistin as metaphylaxis in their feed during the 6 weeks before sampling suggests selective pressure.

PDF

https://wwwnc.cdc.gov/eid/article/23/12/pdfs/17-0883.pdf

November 19, 2017 at 1:02 pm

Characterization of Streptococcus pyogenes from Animal Clinical Specimens, Spain

Emerging Infectious Diseases December 2017 V.23 N.12 P.2011-2016

Research

Streptococcus pyogenes appears to be almost exclusively restricted to humans, with few reports on isolation from animals.

We provide a detailed characterization (emm typing, pulsed-field gel electrophoresis [PFGE], and multilocus sequence typing [MLST]) of 15 S. pyogenes isolates from animals associated with different clinical backgrounds.

We also investigated erythromycin resistance mechanisms and phenotypes and virulence genes.

We observed 2 emm types: emm12 (11 isolates) and emm77 (4 isolates).

Similarly, we observed 2 genetic linages, sequence type (ST) 26 and ST63. Most isolates exhibited the M macrolide resistance phenotype and the mefA/ermB genotype.

Isolates were grouped into 2 clones on the basis of emm-MLST-PFGE-virulence gene profile combinations: clone 1, characterized by the combined genotype emm12-ST36-pulsotype A-speG; and clone 2, characterized by the genotype emm77-ST63-pulsotype B-speC.

Our results do not show conclusively that animals may represent a new reservoir of S. pyogenes but indicate the ability of human-derived S. pyogenes isolates to colonize and infect animals.

PDF

https://wwwnc.cdc.gov/eid/article/23/12/pdfs/15-1146.pdf

November 19, 2017 at 1:00 pm

LEPTOSPIROSIS – Guia para el Equipo de Salud – Ministerio Salud de la Nación Argentina

LEPTOSPIROSIS 

Guia para el Equipo de Salud – Ministerio Salud de la Nación Argentina

Abril 2014

  1. Introducción
  2. Manifestaciones clínicas
  3. ¿Cuándo sospechar leptospirosis?
  4. ¿Cómo confirmar leptospirosis?
  5. ¿Cómo notificar el caso de leptospirosis?
  6. ¿Cómo se trata el paciente con leptospirosis?
  7. Flujograma de manejo de casos sospechosos de leptospirosis
  8. Diagnóstico diferencial
  9. ¿Qué hacer si se confirma?
  10. ¿Cómo se tratan los casos caninos de leptospirosis?
  11. Prevención de la leptospirosis en la familia y la comunidad

PDF

http://www.msal.gob.ar/images/stories/bes/graficos/0000000489cnt-guia-medica-leptospirosis.pdf

November 18, 2017 at 10:05 am

LEPTOSPIROSIS – Puesta al día

Revista Chilena de Infectología Junio 2007 V.24 N.3 P.220-226

Zunino, P. Pizarro

We review epidemiological, clinical, laboratory and therapeutic aspects of leptospirosis. In relation to the epidemiology it is worth noting the importance of recreational and occupational risk factors, as well as the lack of date available in Chile before the year 2000, when leptospirosis became the object of epidemiological surveillance. There are many forms of clinical presentations for this disease and often signs and symptoms may be nonspecific. Thus, differential diagnosis must include many clinical entities. Laboratory diagnosis, on the other hand, is complex and not widely available. Although still controversial, a literature review supports antimicrobial treatment, with different antibiotics to choose from.

PDF

http://www.scielo.cl/pdf/rci/v24n3/art08.pdf

November 18, 2017 at 10:04 am

Leptospirosis

Clinical Microbiology Reviews April 2001 V.14 N.2 P.296-326

REVIEW

Paul N. Levett

University of the West Indies, School of Clinical Medicine & Research, and Leptospira Laboratory, Ministry of Health, Barbados

Leptospirosis is a worldwide zoonotic infection with a much greater incidence in tropical regions and has now been identified as one of the emerging infectious diseases. The epidemiology of leptospirosis has been modified by changes in animal husbandry, climate, and human behavior. Resurgent interest in leptospirosis has resulted from large outbreaks that have received significant publicity. The development of simpler, rapid assays for diagnosis has been based largely on the recognition that early initiation of antibiotic therapy is important in acute disease but also on the need for assays which can be used more widely. In this review, the complex taxonomy of leptospires, previously based on serology and recently modified by a genotypic classification, is discussed, and the clinical and epidemiological value of molecular diagnosis and typing is also evaluated.

abstract

http://cmr.asm.org/content/14/2/296.abstract

PDF

http://cmr.asm.org/content/14/2/296.full.pdf+html

November 18, 2017 at 10:02 am

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