DOCSLIB.ORG

Case Studies the Wonderful World of Weirdobacter Weirdii Species!

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Case Studies the Wonderful World of Weirdobacter Weirdii Species! 10/11/19 Case Studies Lars F. Westblade, Ph.D, D(ABMM) (E-mail: [email protected]) Weill Cornell Medicine SCASM, San Diego October 26, 2019 1 1 The Wonderful World of Weirdobacter weirdii species! Lars F. Westblade, Ph.D, D(ABMM) (E-mail: [email protected]) Weill Cornell Medicine SCASM, San Diego October 26, 2019 2 2 1 10/11/19 Disclosures • Grant/Research suPPort: - Accelerate Diagnostics, Inc. - BioFire Diagnostics, LLC - Hardy Diagnostics • Advisory Board: - Roche Molecular Systems, Inc. 3 3 Objectives • List diagnostic features of microorganisms not commonly encountered or recognized in the clinical microbiology laboratory • Describe their significance and clinical Presentation • Discuss their key antimicrobial suscePtibility traits 4 4 2 10/11/19 What are Weirdobacter weirdii Species? • Organisms rarely encountered or recognized in the clinical microbiology laboratory à be at the ready! • Can be difficult to identify using biochemical methods • Provide oPPortunity for inane trivia! 5 5 Case 1: Color Me Bad • 11-year-old male from Alabama Presents to regional community hospital with gluteal abscess • Had been standing in stagnant water • Oral (PO) clindamycin administered as outPatient 2 days Lesions ~2 cm in diameter 6 Richard et al., 2015 Am J Case Rep 16:740-4 6 3 10/11/19 Case 1: Color Me Bad • Within 24 h develoPed fever and admitted to local community hospital for surgical drainage of Presumed Staphylococcus aureus soft tissue infection • Intravenous (IV) clindamycin and ceftriaxone initiated • Within 36 h of admission develoPs dyspnea/hypoxia • Transferred to PICU at tertiary care medical center 7 7 Case 1: Color Me Bad • Patient intubated for imPending respiratory failure and Progressive shock • Physical examination revealed two large, indurated abscesses on buttocks • MultiPle Pustules on chest, abdomen, and extremities: concern for staPhylococcal infection or ecthyma 8 Richard et al., 2015 Am J Case Rep 16:740-4 8 4 10/11/19 Case 1: Color Me Bad • DeveloPed acute respiratory distress syndrome • Placed on venoarterial extracorPoreal membrane oxygenation (ECMO) to maximize cardiac outPut • Antimicrobial coverage: vancomycin, clindamycin, nafcillin (for Presumed staPhylococcal infection) • Rare Gram-negative rods (GNR) observed in wound Gram stain • Ceftriaxone added based on wound Gram stain result; later changed to meroPenem because of Patient’s decomPensation 9 9 Case 1: Color Me Bad • Wound/blood cultures grew a GNR • Grew on blood agar (BAP) à violet pigmentation Gram stain: medium sized GNR Violet-colored colonies on BAP 10 Image credit: https://www.cdc.gov/microbenet/ 10 5 10/11/19 Case 1: Color Me Bad • Chromobacterium violaceum • Treated with meroPenem, IV ciProfloxacin and IV trimethoPrim- sulfamethoxazole (SXT) – all low MIC values (theraPy Paired to meroPenem and ciProfloxacin once antibiotic suscePtibility data available) • Discharged on day 40 on ertapenem (?) and PO SXT • After ~4 mo of theraPy, ESR mildly elevated, continued on PO ciProfloxacin and SXT for a total of 6 mo theraPy • DeveloPed autoamputation of distal end of right thumb and several toes, required skin graft of dorsum of right foot • Returned to school 4 mo after initial illness, no other Permanent sequelae 11 11 Case 1: Color Me Bad • Diagnosed with chronic granulomatous disease (CGD) • c.75-76delGT mutation in NCF1 gene (NCF1 encodes a subunit of the Phagocyte NADPH oxidase) • Past medical history of submental abscess at 2 yrs that grew Nocardia spP, suPPorts diagnosis of CGD 12 12 6 10/11/19 C. violaceum: Clinical Significance • Inhabits soil/water in troPical/subtroPical climates • Clinical Presentation (entry through skin [rarely oral]): - Localized infection (wound infections) - Disseminated infection, sePsis • Endowed with numerous virulence factors: adhesins, invasins, cytolytic proteins • Associated with CGD/glucose-6-Phosphate dehydrogenase deficiency à high mortality rate 13 13 Chronic Granulomatous Disease • An inherited immunodeficiency disorder: inability of Phagocytes to kill microbes they have ingested (usually discovered early in childhood) • Recurrent infection (every 3 to 4 yrs) of lung, skin, lymPh nodes, and liver (granulomatous inflammation of affected organs) • CGD infections caused by (catalase POS [environmental] organisms): - Aspergillus spP - Nocardia spP - S. aureus - (Pigmented) Gram-negatives: C. violaceum, Burkholderia cepacia comPlex, Serratia marcescens, and Pseudomonas aeruginosa • Defective enzyme in Phagocytes - NADPH oxidase complex - results in imPaired Production of reactive oxygen species (ROS), in Phagocytes • ROS kill microbes à thus lower levels of ROS leads to decreased microbial killing 14 14 7 10/11/19 Relationship between CGD and Catalase- Positive Organisms Human NADPH oxidase complex - + + NADPH + 2O2 à 2O2 + NADP + H Human Superoxide dismutase + - 2H + 2O2 à H2O2 + O2 Bacterial Catalase 2H2O2 à 2H2O + O2 15 15 Relationship between CGD and C. violaceum in the SE USA 16 Macher et al., 1982 Ann Intern Med 97:51-5 16 8 10/11/19 C. violaceum: Microbiology • Motile GNR, glucose-fermenter (non-lactose-fermenter) • Facultative anaerobe • Cultures have almond-like odor (ammonium cyanide) • Pigmented (~90%) and non-Pigmented (~10%) strains • Oxidase (OX) POS/indole (IND) variable (V) - Non-Pigmented strains typically IND POS • Non-Pigmented strains can be confused with Aeromonas spP and Vibrio spP (automated systems can misidentify as Burkholderia pseudomallei) 17 17 C. violaceum: Microbiology Vibrio spp: Aeromonas spp: - OX, POS - OX, POS - IND, POS - IND, POS - Lysine decarboxylase, POS - Violet Pigmentation, NEG (excePt, A. caviae comPlex) - TCBS growth, POS - TCBS growth, NEG C. violaceum: - OX, POS - IND, V - Lysine decarboxylase, NEG - Violet Pigmentation, V - Almond-like odor - TCBS growth, NEG 18 Image credit: Selma Salter, Stamford Health 18 9 10/11/19 C. violaceum: Microbiology Aeromonas spp: Vibrio spp: - OX, POS - OX, POS - IND, POS - IND, POS - Lysine decarboxylase, POS - Violet Pigmentation, NEG (excePt, A. caviae comPlex) - TCBS growth, POS - TCBS growth, NEG C. violaceum: - OX, POS - IND, V - Lysine decarboxylase, NEG - Violet Pigmentation, V - Almond-like odor - TCBS growth, NEG 19 Image credit: Selma Salter, Stamford Health 19 Oxidase Activity of Pigmented Strains: Ascending Paper Chromatography Inset bottom of filter Filter PaPer paper in petri dish Organism Schmear Petri dish filled with 2-10 mL oxidase reagent (TMPD) Dhar and Johnson, 1973 J Clin Pathol 26:304-6 20 Slesak et al., 2009 Ann Clin Microbiol Antimicrob 8:24 20 10 10/11/19 Oxidase Activity of Pigmented Strains: Ascending Paper Chromatography - + + Product of reaction (indoPhenol blue) Filter PaPer “wicks” uP PaPer Petri dish filled with 2-10 mL oxidase reagent (TMPD) Dhar and Johnson, 1973 J Clin Pathol 26:304-6 21 Slesak et al., 2009 Ann Clin Microbiol Antimicrob 8:24 21 Testing Oxidase Activity of Pigmented C. violaceum Strains E. coli C. violaceum P. aeruginosa - + + Distilled water (2-10 mL) Schmear of organism 1% TMPD (oxidase reagent, 2-10 mL) Schmear of organism Dhar and Johnson, 1973 J Clin Pathol 26:304-6 22 Slesak et al., 2009 Ann Clin Microbiol Antimicrob 8:24 22 11 10/11/19 C. violaceum: Antibiotic Susceptibility • No established breakpoints for AST results • High MIC values: Polymyxins/some b-lactams • Low MIC values: fluoroquinolones, tetracyclines, SXT 23 McAuliffe et al., 2015 Am J Trop Med Hyg 92:605-10 23 Color Me Bad: Violacein • Ethanol-soluble violet Pigment • Two molecules of L-tryptoPhan à Pyrrolidone scaffold • Role in evading the immune system: - Neutralization of ROS - Induce aPoPtosis of leukocytes (Potential chemotheraPy) • Strong antimicrobial activity against bacteria/Protozoa 24 Image credit: LoPes et al., 2009 Antimicrob Agents Chemother 53:2149-52 24 12 10/11/19 Case 2: Look What the Dog Dragged In • 4-year-old dog (mixed breed) • Rescue recently imPorted from Thailand • Paralyzed hind legs (spinal injury), urinary incontinence • Urine culture requested because of incontinence Case Courtesy of K. Deriziotis, J. Moody, D. Peck, R. Franklin-Guild, and A. Thachil College of Veterinary Medicine, Animal Health Diagnostic Center, Cornell University 25 Image credit: httP://www.handicaPPedPets.com/blog/ 25 Case 2: Look What the Dog Dragged In • Urine Culture: - 24 h: >105 PinPoint colonies on BAP and eosin methylene blue agar (EMB) - 48 h: mucoid colonies on BAP and EMB (NLF) • MALDI-TOF MS (Bruker), Burkholderia thailandensis (≥2.00) • Culture immediately moved to BSL-3 facility 26 Image credit: Cornell University, AHDC 26 13 10/11/19 Case 2: Look What the Dog Dragged In • “PresumPtive B. pseudomallei” NYS DOH PHL Biodefense Laboratory (determined by PCR) • Confirmed as an atypical strain of B. pseudomallei at CDC • Atypical characteristics: - Beta-hemolytic on BAP at 48 h (sometimes observed around areas of confluent growth, not around individual colonies) - Catalase NEG – unusual! • Tier 1 select agent; Federal Select Agent Program 27 httPs://www.selectagents.gov/ohP-app1.html 27 B. pseudomallei: Clinical Significance • Agent of human/animal melioidosis (~165,000 cases yr/worldwide) • Endemic in SE Asia, N Australia, India, China, Caribbean (Puerto Rico) - troPical areas: case fatality rate estimated as high as 50%! • Environmental organism, resident in soil/water • Infection is seasonal, uP to 85% of cases during monsoon wet season • Severe weather events/environmental disturbances have been associated with clusters (e.g., Asian tsunami 2004) 28 28 14 10/11/19 B. pseudomallei:
Load more

Recommended publications
  • HACEK Endocarditis: State-Of-The-Art Matthieu Revest, Gérald Egmann, Vincent Cattoir, Pierre Tattevin
    HACEK endocarditis: state-of-the-art Matthieu Revest, Gérald Egmann, Vincent Cattoir, Pierre Tattevin To cite this version: Matthieu Revest, Gérald Egmann, Vincent Cattoir, Pierre Tattevin. HACEK endocarditis: state- of-the-art. Expert Review of Anti-infective Therapy, Expert Reviews, 2016, 14 (5), pp.523-530. 10.1586/14787210.2016.1164032. hal-01296779 HAL Id: hal-01296779 https://hal-univ-rennes1.archives-ouvertes.fr/hal-01296779 Submitted on 10 Jun 2016 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. HACEK endocarditis: state-of-the-art Matthieu Revest1, Gérald Egmann2, Vincent Cattoir3, and Pierre Tattevin†1 ¹Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes; ²Department of Emergency Medicine, SAMU 97.3, Centre Hospitalier Andrée Rosemon, Cayenne; 3Bacteriology, Pontchaillou University Hospital, Rennes, France †Author for correspondence: Prof. Pierre Tattevin, Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, 2, rue Henri Le Guilloux, 35033 Rennes Cedex 9, France Tel.: +33 299289564 Fax.: + 33 299282452 [email protected] Abstract The HACEK group of bacteria – Haemophilus parainfluenzae, Aggregatibacter spp. (A. actinomycetemcomitans, A. aphrophilus, A. paraphrophilus, and A. segnis), Cardiobacterium spp. (C. hominis, C. valvarum), Eikenella corrodens, and Kingella spp.
    [Show full text]
  • A. Fastidious Organisms MCQ 1 Explanation: the Most Common
    MCQ Answer 1: A. Fastidious organisms MCQ 1 Explanation: The most common cause of culture-negative infective endocarditis in patients who have not been treated previously with antibiotics is fastidious organisms (1). In our patient, serology for Bartonella, Pasteurella and Coxiella was negative, but the Brucella antibody titer was 1:160 (reference range <1:20). Brucella titers higher than 1:160 in conjunction with a compatible clinical presentation are considered highly suggestive of infection especially in a non-endemic area (2), (3). Brucellosis can affect any organ system and cardiac involvement is rare, but endocarditis is the main cause of death due to brucellosis. Ideally, the diagnosis should be made by culture, however this test has a low sensitivity, is time-consuming, and poses a health risk for laboratory staff (4). HACEK organisms used to be considered the most common agent of culture-negative endocarditis, but with the current blood culture techniques, they can be easily isolated when incubated for at least five days. In our patient, the HACEK organism culture was negative at 5 days (5). Antibacterial therapy prior to blood culture sampling is a common cause of culture negative endocarditis. Our patient received empiric antibiotic therapy after the blood cultures were drawn. Valvular vegetations can be caused by noninfectious conditions and should be considered in the differential diagnoses of any patient with endocarditis. Nonbacterial thrombotic endocarditis (NBTE), such as marantic or Libman-Sachs endocarditis, happens in the setting of systemic lupus erythematosus, malignancy, or hypercoagulable state. The vegetations of NBTE are composed of fibrin thrombi that usually deposit on normal or minimally degenerated valves.
    [Show full text]
  • Blood Culture Bottles Incubation Period, 5 Days Or More?
    February 2015 02/2015 NEWSLETTER Best Practices in Blood Culture Collection Blood culture bottles incubation period, 5 days or more? Introduction Blood is one of the most important specimens re- ceived by the microbiology laboratory for culture, and culture of blood is the most sensitive method for de- tection of bacteremia or fungemia. As we all know that the blood stream infection is one of the most se- rious problems in all infectious diseases. In general, adult patients with bacteremia are likely to have low quantities of bacteria in the blood, even in the setting of severe clinical symptoms. In addition, bacteremia in adults is generally intermittent. For this reason, multiple blood cultures, each containing large volumes of blood, are required to detect bacteraemia. Prior to initiation of antimicrobial therapy, at least two sets of blood cultures taken from separate venipuncture sites should be obtained. The technique, number of cultures, and volume of blood are more important factors for detection of bacteremia than timing of culture collection. Length of Incubation of Blood Cultures In routine circumstances, using automated continuous monitoring systems such as Becton Dickinson BACTEC System, blood cultures need not be incubated for longer than 5 days (1, 2, 3, 4, 5). For laborato- ries using manual blood culture systems, 7 days should suffice in most circumstances (6). Patient suspected Infectious Endocarditis (IE) A recent study at the Mayo Clinic, in which one of the widely used continuous monitoring blood culture systems was used, demonstrated that 99.5% of non-endocarditis BSIs and 100% of endocarditis epi- sodes were detected within 5 days of incubation (1).
    [Show full text]
  • Microbiology Course Specification 1St, 2Nd Year of M.B.B.Ch
    Faculty of Medicine Aswan University Microbiology Course Specification 1st, 2nd year of M.B.B.Ch. Program (Integrated system) 2019-2020 No. ILOs Practical Topic wks. hrs 1. B.1, C.1 Lab safety -Microscope 1st 2hrs D.1, D2 2. A6, B3 Sterilization, disinfection and 1st 2hrs D1, D2 antisepsis 3. A2, B.1 Laboratory diagnosis of bacterial 2nd 2 hrs C1, C2 infection (Simple and Gram’s stain) D1, D2 4. A6, B3 Ziehl Neelsen stain 2nd 2hrs 5. A3, B.1, Laboratory diagnosis of bacterial 3rd 2hrs C3 infection (Culture media I) D1, D2 6. A3, B1, Laboratory diagnosis of bacterial 3rd 2hrs C3, infection (Culture media II) D1, D2 7. A3, B2, , Laboratory diagnosis of bacterial 4th 2hrs C3, D1, infection (Biochemical reactions D2 Molecular diagnostic techniques) 8. A7, B.4 Antimicrobial susceptibility testing 4th 2hrs 9. A8, B5, Laboratory diagnosis of viral 5th 2hrs C5, D1, infections D2 A8, C2, Laboratory diagnosis of fungal 01. B.6, D1, 5th infections D2 A10, 10. B.7, C4, Serology I 6th D1, D2 A10, 12. B.7, C4 Serology II 6th D.1, D2 A10, 13. B.7, C4 Serology III 7th D.1, D2 A20, 04. B12, C8- Basics of infection control 7th 9 A2- Memorize the microorganism morphology A3- Recall bacterial growth requirements and replication. A6- Describe different methods of sterilization A7- Recognize proper selection of antimicrobials. A8- Recall general knowledge in the field of viral and fungal diseases. A10- Identify the role of the immune system against microbial infection. A20- State the basics of infection control B1- Differentiate the microorganism morphology B2- Explain genotypic variations and recombinant DNA technology B3- Compare between the different sterilization methods.
    [Show full text]
  • Bacteriology
    SECTION 1 High Yield Microbiology 1 Bacteriology MORGAN A. PENCE Definitions Obligate/strict anaerobe: an organism that grows only in the absence of oxygen (e.g., Bacteroides fragilis). Spirochete Aerobe: an organism that lives and grows in the presence : spiral-shaped bacterium; neither gram-positive of oxygen. nor gram-negative. Aerotolerant anaerobe: an organism that shows signifi- cantly better growth in the absence of oxygen but may Gram Stain show limited growth in the presence of oxygen (e.g., • Principal stain used in bacteriology. Clostridium tertium, many Actinomyces spp.). • Distinguishes gram-positive bacteria from gram-negative Anaerobe : an organism that can live in the absence of oxy- bacteria. gen. Bacillus/bacilli: rod-shaped bacteria (e.g., gram-negative Method bacilli); not to be confused with the genus Bacillus. • A portion of a specimen or bacterial growth is applied to Coccus/cocci: spherical/round bacteria. a slide and dried. Coryneform: “club-shaped” or resembling Chinese letters; • Specimen is fixed to slide by methanol (preferred) or heat description of a Gram stain morphology consistent with (can distort morphology). Corynebacterium and related genera. • Crystal violet is added to the slide. Diphtheroid: clinical microbiology-speak for coryneform • Iodine is added and forms a complex with crystal violet gram-positive rods (Corynebacterium and related genera). that binds to the thick peptidoglycan layer of gram-posi- Gram-negative: bacteria that do not retain the purple color tive cell walls. of the crystal violet in the Gram stain due to the presence • Acetone-alcohol solution is added, which washes away of a thin peptidoglycan cell wall; gram-negative bacteria the crystal violet–iodine complexes in gram-negative appear pink due to the safranin counter stain.
    [Show full text]
  • Bugs & Drugs Antimicrobial Pocket Reference 2001
    Bugs & Drugs Antimicrobial Pocket Reference 2001 FOREWORD Authors (unless otherwise noted) & Editors: Edith Blondel-Hill, MD, FRCP(C) Associate Medical Officer of Health Infectious Diseases Specialist/Medical Microbiologist Capital Health/DKML and Susan Fryters, B.Sc.Pharm. Antimicrobial Utilization/Infectious Diseases Pharmacist Capital Health in collaboration with: · Regional Antimicrobial Advisory Subcommittee · Antimicrobial Working Group (Dr. E. Blondel-Hill, S. Fryters, Dr. M. Foisy, Dr. E. Friesen, M. Gray, R. Muzyka, Dr. P. Robertson, C. Zenuk) · Therapeutic Drug Monitoring (TDM) Task Force (Dr. G. Blakney, Dr. E. Blondel-Hill, S. Fryters, M. Gray, Dr. D. LeGatt, Dr. N. Yuksel) · Antibiotics in Dentistry Working Group (Dr. E. Blondel-Hill, Dr. T. Carlyle, Dr. K. Compton, Dr. T. Debevc, S. Fryters, Dr. D. Gotaas, Dr. K. Kowalewska-Grochowska, Dr. K. Lung, Dr. T. Mather, Dr. H. McLeod, M. Mehta, Dr. J. Nigrin, Dr. S. Ponich, Dr. B. Preshing, Dr. J. Robinson, Dr. S. Shafran) · Divisions of Adult and Paediatric Infectious Diseases · Dynacare Kasper Medical Laboratories (DKML) · UAH Medical Microbiology Department · Regional Pharmacy Services · Regional Public Health · Antibiotics Working Group of AMA Clinical Practice Guidelines Program Secretarial Support: L. Clarke The authors are indebted to Laura Lee Clarke for her outstanding preparation of this manuscript. Editorial Contributions: Dr. J. Galbraith, Infectious Diseases/Medical Microbiologist Ms. M. Gray, BSP Dr. A. Joffe, Paediatric Infectious Diseases Dr. J. Nigrin, Medical Microbiologist Dr. S. Shafran, Adult Infectious Diseases Ms. C. Zenuk, BSP Cover Design: A. Hill Funding provided by: Capital Health Regional Pharmacy Services & Dynacare Kasper Medical Laboratories While every effort has been made to ensure the accuracy of the information presented, the authors, Capital Health, and DKML cannot accept liability for errors or any consequences arising from its use.
    [Show full text]
  • 06 ‐ Bone, Joint and Musculoskeletal Infections Speaker: Sandra Nelson, MD
    06 ‐ Bone, Joint and Musculoskeletal Infections Speaker: Sandra Nelson, MD Disclosures of Financial Relationships with Relevant Commercial Interests • None Bone, Joint and Musculoskeletal Infections Sandra B. Nelson, MD Director, Musculoskeletal Infectious Diseases Division of Infectious Diseases Massachusetts General Hospital Osteomyelitis: Osteomyelitis: General Principles • Hematogenous Osteomyelitis • MRI and CT are the best radiographic studies – Metaphyseal long bone (more common in children) – Bone scan has good negative predictive value but lacks specificity – Vertebral spine (Spondylodiscitis) – MRI and CT not useful as test of cure – Usually monomicrobial • Diagnosis best confirmed by bone histopathology and culture • Contiguous Osteomyelitis – Identification of organism improves outcomes – Trauma / osteofixation – Swab cultures of drainage are of limited value – Diabetic foot ulceration • Optimal route and duration of therapy an evolving target – Often polymicrobial – 6 weeks of IV antimicrobial therapy commonly employed – Longer oral suppression considered in setting of retained hardware 3 4 Brodie’s Abscess (Subacute hematogenous osteomyelitis) Case #1 • 57 year old male presented with a 3 month • More common in children and history of progressive lower back pain young adults • On ROS denied fevers or chills but wife • Bacteria deposit in medullary canal noticed weight loss of metaphyseal bone, become • Originally from Cambodia, emigrated as a surrounded by rim of sclerotic bone child. Employed at a seafood processing → intraosseous
    [Show full text]
  • Infective Endocarditis: a Focus on Oral Microbiota
    microorganisms Review Infective Endocarditis: A Focus on Oral Microbiota Carmela Del Giudice 1 , Emanuele Vaia 1 , Daniela Liccardo 2, Federica Marzano 3, Alessandra Valletta 1, Gianrico Spagnuolo 1,4 , Nicola Ferrara 2,5, Carlo Rengo 6 , Alessandro Cannavo 2,* and Giuseppe Rengo 2,5 1 Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy; [email protected] (C.D.G.); [email protected] (E.V.); [email protected] (A.V.); [email protected] (G.S.) 2 Department of Translational Medical Sciences, Medicine Federico II University of Naples, 80131 Naples, Italy; [email protected] (D.L.); [email protected] (N.F.); [email protected] (G.R.) 3 Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy; [email protected] 4 Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, 119435 Moscow, Russia 5 Istituti Clinici Scientifici ICS-Maugeri, 82037 Telese Terme, Italy 6 Department of Prosthodontics and Dental Materials, School of Dental Medicine, University of Siena, 53100 Siena, Italy; [email protected] * Correspondence: [email protected]; Tel.: +39-0817463677 Abstract: Infective endocarditis (IE) is an inflammatory disease usually caused by bacteria entering the bloodstream and settling in the heart lining valves or blood vessels. Despite modern antimicrobial and surgical treatments, IE continues to cause substantial morbidity and mortality. Thus, primary Citation: Del Giudice, C.; Vaia, E.; prevention and enhanced diagnosis remain the most important strategies to fight this disease. In Liccardo, D.; Marzano, F.; Valletta, A.; this regard, it is worth noting that for over 50 years, oral microbiota has been considered one of the Spagnuolo, G.; Ferrara, N.; Rengo, C.; significant risk factors for IE.
    [Show full text]
  • Identification of Haemophilus Species and the HACEK Group of Organisms
    UK Standards for Microbiology Investigations Identification of Haemophilus species and the HACEK group of organisms This publication was created by Public Health England (PHE) in partnership with the NHS. Identification | ID 12 | Issue no: 4 | Issue date: 08.01.21 | Page: 1 of 34 © Crown copyright 2021 Identification of Haemophilus species and the HACEK group of organisms Acknowledgments UK Standards for Microbiology Investigations (UK SMIs) are developed under the auspices of PHE working in partnership with the National Health Service (NHS), Public Health Wales and with the professional organisations whose logos are displayed below and listed on the website https://www.gov.uk/uk-standards-for-microbiology- investigations-smi-quality-and-consistency-in-clinical-laboratories. UK SMIs are developed, reviewed and revised by various working groups which are overseen by a steering committee (see https://www.gov.uk/government/groups/standards-for- microbiology-investigations-steering-committee). The contributions of many individuals in clinical, specialist and reference laboratories who have provided information and comments during the development of this document are acknowledged. We are grateful to the medical editors for editing the medical content. PHE publications gateway number: GW-959 UK Standards for Microbiology Investigations are produced in association with: Identification | ID 12 | Issue no: 4 | Issue date: 08.01.21 | Page: 2 of 34 UK Standards for Microbiology Investigations | Issued by the Standards Unit, Public Health England
    [Show full text]
  • Cambridge University Press 978-1-107-03891-2 - Clinical Infectious Disease Edited by David Schlossberg Index More Information
    Cambridge University Press 978-1-107-03891-2 - Clinical Infectious Disease Edited by David Schlossberg Index More information Index Page references in bold indicate tables; those in italic indicate figures. abacavir (ABC), 650 otitis media, 49 PCP pneumonia, 1151–1152, abdominal infections. See intra- pregnant patients, 618 See also Pneumocystis jirovecii abdominal infections viral hemorrhagic fevers, 1246 pneumonia (PCP) Abiotrophia spp., 1042 Achromobacter spp., 1046 pregnant patients, 616 A. defectiva, 247 A. denitrificans, 1046 progressive multifocal abscess A. xylosoxidans, 1046 leukoencephalopathy abdominal, 367–369 clinical syndromes, 1046 association, 529–531 diagnosis, 367 epidemiology, 1046 treatment, 533–534 treatment, 367–369, 380 Acinetobacter baumannii, 1045–1046 splenic abscess, 372 brain. See brain abscess multidrug resistance, 1046 toxoplasmic encephalitis, 1279–1280 breast, 620 nosocomial infections, 1045 Acrobacter, 810 coccidioidomycosis, 1144 pneumonia, 222 acrodermatitis chronica atropicans, cranial epidural, 500–501, 501 Acinetobacter spp., 1044–1046, See also 1062 dental, 64,66 Acinetobacter baumannii Actinomyces spp. (actinomycosis), 829 HACEK organism-associated, 904, catheter-related infections, 721, 723 clinical presentation, 829–830 906 epidemiology, 1045 abdominal disease, 830–831 iliopsoas. See iliopsoas abscess (IPA) meningitis, 477 CNS disease, 831 intraperitoneal, 366, 375, 380 post-transplant infection, 576 disseminated disease, 831 lacrimal sac, 116 sepsis, 15 musculoskeletal disease, 831 liver. See liver
    [Show full text]
  • Gram-Negative Infective Endocarditis: a Retrospective Analysis of 10 Years Data on Clinical Spectrum, Risk Factor and Outcome
    Monaldi Archives for Chest Disease 2020; volume 90:1359 Gram-negative infective endocarditis: a retrospective analysis of 10 years data on clinical spectrum, risk factor and outcome Vineeth Varghese Thomas1, Ajay Kumar Mishra2, Sudha Jasmine1, Sowmya Sathyendra1 1Internal Medicine, Christian Medical College and Hospital, Vellore, Tamil Nadu, India; 2Internal Medicine, Saint Vincent Hospital, Worcester, MA, USA fied Duke’s criteria and a culture-proven diagnosis of gram-neg- Abstract ative IE were eligible for inclusion. A total of 27 patients were enrolled from Jan 2006 to Dec 2016, among whom 78% were Infective endocarditis (IE) is a significant cause of morbidity male. Prior structural heart disease was common in our cohort and mortality. Underlying congenital heart disease and acquired (41%) with renal (55%) and embolic (51%) complications being valvular disease significantly increases the IE risk, which is still the most common systemic complications. A comparison of mor- prevalent in developing countries. Gram-negative organism relat- tality with survivors found that congenital and acquired structur- ed IE prevalence appears to be rising with limited data on their al heart disease had a higher risk of mortality. Non-fermenting presentation and outcomes. This study hopes to shed further light GNB accounted for 52% of the cohort, with Pseudomonas on this subject. This retrospective cross-sectional study occurred accounting for 19%. E. coli was the most common bacilli isolat- in a tertiary care center in South India. ed, constituting 37% of theonly cohort. Assessment of risk factors for A retrospective cross-sectional study performed in a single adverse outcomes found that renal dysfunction and intravascular tertiary care center in South India.
    [Show full text]
  • Microbiology
    Microbiology Bacteria Gram positive Gram negative Cocci Staphylococcus (clusters and catalase +ve) Diplococci ↘Coagulase +ve (aureus) – skin, pneumonia, Neisseria endocarditis, abscess formation ↘meningitidis – meningitis ↘Coagulase -ve (epidermidis; saprophyticus) ↘gonorrhoeae –gonorrhoea, conjunctivitis, pharyngitis, disseminated CONS = Contaminants (unless foreign bodies present) infection, arthritis Streptococcus (strips and catalase -ve) Moraxella ↘α-haemolytic i.e. partially lyse RBCs ↘catarrhalis –URTI s, chronic lung disease exacerbations, pneumonia -pneumoniae – pneumonia, meningitis, URTIs, invasive -viridans group (mitis, mutans, salivarius, sanguinis, anginosus) – endocarditis, dental ↘β-haemolytic i.e. completely lyse RBCs -Group A strep (pyogenes) – skin, Rh fever, scarlet fever, strep throat, post-strep GN, erysipelas, nectrotising fascitis, strep toxic shock -Group B strep (agalactiae) – vaginal colonisation, neonatal infection ↘Non-haemolytic -Group D strep (bovis; equinus) – bacteraemia -Enterococcus (faecium; faecalis) –UTIs, bacteraemia, endocarditis, diverticulitis Rods (bacilli) Big and spore forming Enteric Non-enteric Clostridium (anaerobic) Long Coccobacilli ↘difficile – C diff diarrhoea E. Coli Haemophilus ↘tetani – tetanus – UTIs, gastroenteritis, ↘influenzae neonatal meningitis ↘perfringens – gas gangrene Aerobic glucose + – pneumonia, meningitis, Klebsiella epiglottits ↘botulinum – botulism lactose fermenting – pneumonia, UTIs (COLIFORMS – Bordetella Enterobacter ↘pertussis Bacillus normal bowel
    [Show full text]