Posts filed under ‘Infecciones intraabdominales’
Clin Infect Dis. 2001 Oct 1;33(7):E69-74.
Sarria JC1, Vidal AM, Kimbrough RC 3rd.
1Division of Infectious Diseases, Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA. firstname.lastname@example.org
Kluyvera is a relatively newly described genus in the family Enterobacteriaceae that infrequently causes infections in humans. The organism has been isolated from various clinical specimens, but its significance has not been clearly established. In fact, it has been regarded alternatively as saprophytic, opportunistic, or pathogenic. Since the redefinition of this genus in 1981, case reports of diverse clinical infections occurring under various host conditions have been published. Here we present a critical review of all Kluyvera infections reported in the literature, along with our experience involving 5 additional cases. Most patients received prompt antimicrobial treatment on the basis of susceptibility testing, and overall the clinical outcomes were good. Antimicrobial agents active against most Kluyvera strains include third-generation cephalosporins, fluoroquinolones, and aminoglycosides. In contrast, the resistance to ampicillin, extended-spectrum penicillins, and first- and second-generation cephalosporins is significant. Kluyvera is a potentially virulent pathogen that deserves aggressive treatment designed with an awareness of the organism’s antimicrobial resistance patterns.
J Med Case Rep. 2010 Jun 29;4:197.
Moonah S1, Deonarine K, Freeman C.
1Department of Medicine, Howard University Hospital, 2041 Georgia Avenue NW, Washington DC, 20060, USA. email@example.com.
Kluyvera ascorbata has become increasingly significant due to its potential to cause a wide range of infections, as well as its ability to transfer gene encoding for CTX-M- type extended spectrum B-lactamases (ESBLs) to other Enterobacteriaceae.
We report the case of a 64-year-old African-American male diagnosed with severe sepsis due to a multidrug resistant Kluyvera ascorbata, which was isolated from his blood. He was treated with meropenem and had a favorable outcome.
To the best of our knowledge, this is the first case report of a multidrug resistant Kluyvera ascorbata isolated from the blood in an adult patient with sepsis.
Rev Esp Quimioter. 2013 Sep;26(3):226-7.
Article in Spanish
López-Larramona G1, Gómez-de-Oña E, Maestre-Muñiz MM, Ruiz-Chicote AM, Galán-Dorado E, González-Delgado L.
1Germán López-Larramona, Servicio de Medicina Interna. Hospital General de Tomelloso, Vereda de Socuéllamos s/n. 13700 Tomelloso (Ciudad Real), Spain firstname.lastname@example.org.
Am J Clin Pathol. 2005 Mar;123(3):334-8.
Carter JE1, Evans TN.
1Department of Pathology, University of South Alabama, Medical Center, Mobile 36617, USA.
To determine the clinical significance of Kluyvera isolates at our institution, we retrospectively analyzed clinical microbiology data from January 1999 to September 2003. We identified 11 isolates classified as Kluyvera ascorbata, 7 of which were considered clinically significant pathogens: 3 cases represented urinary tract infections; 2, bacteremia; 1, a soft tissue infection of the finger; and 1, acute appendicitis with a subsequent intra-abdominal abscess. The age distribution of patients was wide, ranging from 2 months to 73 years. Antimicrobial susceptibility studies of the clinically significant and non-clinically significant Kluyvera isolates showed susceptibility patterns similar to those reported in the medical literature, namely trends of resistance to ampicillin and first- and second-generation cephalosporins. Of the 4 non-clinically significant isolates in our study, 1 was resistant to ciprofloxacin, a finding reported in only 1 other isolate of Kluyvera in the medical literature. Patient outcome after treatment with third-generation cephalosporins and aminoglycosides in the 7 clinically significant cases was good, with no long-term sequelae. The potential virulence of K ascorbata highlights the need for heightened scrutiny of its antimicrobial susceptibility patterns for adequate clinical treatment.
Rev Esp Quimioter 2013;26(3):226-227
Carta al Director
Germán López-Larramona1 Ernesto Gómez-de-Oña2 Modesto M. Maestre-Muñiz1 Ana M. Ruiz-Chicote1
Enrique Galán-Dorado1 Laura González-Delgado3
1 Servicio de Medicina Interna. Hospital General de Tomelloso (Ciudad Real). España.
2 Servicio de Microbiología. Hospital General de Tomelloso (Ciudad Real). España.
3 Atención Primaria. Gerencia de Atención Primaria de Alcázar de San Juan (Ciudad Real). España
Sr. Editor: Kluyvera ascorbata es un bacilo gramnegativo descrito como agente etiológico en infecciones clínicamente significativas con distintos grados de severidad. Pertenece a la familia Enterobacteriaceae, y en el adulto puede producir un amplio espectro de infecciones, predominantemente a nivel de tracto urinario, sepsis y bacteriemia1 . Su capacidad para transferir genes codificadores de betalactamasas de espectro ampliado ha sido comunicado por distintos autores2,3. A continuación describimos un caso de bacteriemia por K. ascorbata en el contexto clínico de una colangitis aguda litiásica…
Case Rep Infect Dis. 2013;2013:543762.
Docekal J1, Hall J1, Reese B1, Jones J1, Ferguson T2.
1Department of Internal Medicine, Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96859, USA.
2Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96859, USA.
Prostatic abscess is a rarely described condition and is commonly caused by gram-negative organisms such as enterobacteria.
However, as the prevalence of methicillin resistant Staphylococcus aureus (MRSA) increases in the community, unusual infections due to this organism have been recently published.
In this report, we describe a patient with diabetes mellitus type 2, who presents with diabetic ketoacidosis-later found to be due to a prostatic abscess from which MRSA was cultured.
Evaluation of the efficacy and safety of tigecycline for treatment of respiratory tract infections: systematic review of literature.
Rev Chilena Infectol. 2013 Dec;30(6):591-7.
Article in Spanish
Moya Cordero P, Ruiz-Aragón J, Molina Linde JM, Márquez-Peláez S, Motiva Sánchez V.
Tigecycline is indicated for the treatment of complicated skin infections, soft tissue and intraabdominal infections. Its use could be extended to community-acquired pneumonia (CAP) and hospital pneumonia (HN). The objective was to evaluate the efficacy and safety of tigecycline in the treatment of respiratory infections.
systematic review (2012). Databases used were MEDLINE, EMBASE, Cochrane Library, CRD and WOK. We identified clinical trials of adults with respiratory infection, treated with tigecycline. The quality of the studies was assessed using CASPe checklist.
We selected four clinical trials of high-moderate quality. Three studies with patients with CAP and a trial with HN patients. In patients with CAP, efficacy of tigecycline (88.6 to 90.6%) was higher than levofloxacin (85.3 to 87.2%). The non inferiority testing was statistically significant (p < 0.001). In the study of patients with HN tigecycline showed an efficiency of 67.9% versus 78.2% for imipenem/cilastatin. Main adverse effects were gastrointestinal.
The efficacy of tigecycline is non inferior than levofloxacin in patients with CAP, but less than imipenem in patients with HN. Tigecycline demonstrates noninferiority versus others tested antibiotics, and it shows a good safety profile.