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Critical Reviews in Microbiology May 2024Systemic antibiotics are an effective adjunct in the treatment of periodontitis, but their judicious use is necessary as antimicrobial resistance is a growing global... (Review)
Review
Systemic antibiotics are an effective adjunct in the treatment of periodontitis, but their judicious use is necessary as antimicrobial resistance is a growing global concern. This review aims to explore the current understanding and insight related to antibiotic resistance in the subgingival microbiota of periodontitis patients. A search of MEDLINE (PubMed) was carried out from 1 January 2012 to 25 November 2021 for studies related to antibiotic resistance in periodontitis patients. Of the 90 articles identified, 12 studies were selected for inclusion. A significant incidence of antibiotic resistant isolates was reported for , , , , , , , , , and but resistance to specific antibiotics did not reach above 10% of isolates in most studies except for amoxicillin resistance in . The highest frequency of resistance across all bacterial species was for amoxicillin, clindamycin, and metronidazole. However, resistance patterns were widely variable across geographical locations, and the high heterogeneity between antibiotic-resistant isolates across studies precludes any clinical recommendations from this study. Although antibiotic resistance has yet to reach critical levels in periodontitis patients, an emphasis on antibiotic stewardship interventions such as point-of-care diagnostics and education for key stakeholders is needed to curb a growing problem.
Topics: Humans; Periodontitis; Anti-Bacterial Agents; Microbiota; Drug Resistance, Bacterial; Bacteria
PubMed: 37140235
DOI: 10.1080/1040841X.2023.2197481 -
Revista Do Instituto de Medicina... 2023Streptococcus constellatus is a gram-positive coccus member of the Streptococcus anginosus group (SAG). It can be found in the oral flora, and may cause abscess more...
Streptococcus constellatus is a gram-positive coccus member of the Streptococcus anginosus group (SAG). It can be found in the oral flora, and may cause abscess more commonly in the gastrointestinal tract, lungs, and heart. Brain abscesses are severe neurological infections with high mortality rates. Streptococcus species other than S. pneumoniae are rare causes of brain abscesses. This case report highlights a severe case of extra and intracranial abscesses due to S. constellatus in an immunocompetent host.
Topics: Humans; Streptococcus constellatus; Sagittal Sinus Thrombosis; Brain Abscess
PubMed: 36722672
DOI: 10.1590/S1678-9946202365010 -
Case Reports in Obstetrics and... 2019Previous reports have described cases of abscess formation by involving the oral cavity, gastrointestinal tract, and septic thrombophlebitis of the right ovarian vein...
BACKGROUND
Previous reports have described cases of abscess formation by involving the oral cavity, gastrointestinal tract, and septic thrombophlebitis of the right ovarian vein with subsequent bacteremia and septic shock. Ascending infection from the genital tract to the fallopian tubes resulting in peritonitis from is a rare clinical circumstance where there is minimal information in the literature to guide its diagnosis, management, and expected prognosis.
CASE
A 36-year-old G3P0111 developed a tubo-ovarian abscess two weeks after intrauterine device (IUD) removal and then rapidly decompensated with septic shock from peritonitis due to infection. The patient was also newly diagnosed with diabetes and in diabetic ketoacidosis (DKA) on presentation. She received broad-spectrum antibiotic coverage and required two exploratory surgical procedures to obtain source control. Two Interventional Radiology- (IR-) guided drainage procedures were subsequently performed to drain remaining fluid collections. Her recovery involved a prolonged ICU stay. On hospital day seventy-three, after receiving approximately 8 weeks of antibiotics and the above noted procedures the patient was discharged to a subacute rehabilitation facility.
CONCLUSION
is a highly pathogenic organism once a systemic septic infection has become established that can cause an ascending genital tract infection resulting in tubo-ovarian abscess formation, peritonitis, and septic shock.
PubMed: 31467746
DOI: 10.1155/2019/6491617 -
Cureus Aug 2020Streptococcus constellatus is a member of Streptococcus milleri group which is a subgroup of Viridans streptococci, first described by Guthof in 1956 after being...
Streptococcus constellatus is a member of Streptococcus milleri group which is a subgroup of Viridans streptococci, first described by Guthof in 1956 after being isolated from dental abscesses. S. constellatus, a gram positive, non-sporing, non-motile, catalase negative cocci, is the normal flora of the oropharyngeal, gastrointestinal and urogenital tract. It is not a commonly encountered pathogen but has a propensity to form abscesses and cause bacteremia in the immunocompromised patient. Here, we report a 78-year-old man with sepsis due to Streptococcus constellatus liver abscess. The patient had a history of hypertension, stroke, benign prostatic hyperplasia, vascular dementia and myocardial infarction status post coronary artery bypass grafting. There has been no particular link between any of these conditions to S. constellatus. However, immunocompromised status predisposes to fulminant infection and formation of abscesses. The patient was febrile with a temperature of 99.1°F, blood pressure of 143/73 mmHg and the heart rate (HR) of 98. Labs revealed a leukocytosis of 16.90 K/uL, hemoglobin 11.8 g/dL, hematocrit 35.8%, total bilirubin 1.7 mg/dL, direct bilirubin 1.0 mg/dL, aspartate aminotransferase (AST) 44 IU/L, alanine aminotransferase (ALT) 28 IU/L, alkaline phosphatase (ALKP) 176 IU/L and lactate dehydrogenase (LDH) was 290 IU/L. He was started on intravenous Maxipime and Unasyn which was switched to Rocephin and Clindamycin based on the Infectious disease recommendations. Metronidazole was also started and the serologies were sent for Entamoeba histolytica. Computerized tomography (CT) scan showed an abscess in the right lobe of the liver which was finally drained using an interventional radiology (IR)-guided approach. The cultures from the fluid and blood yielded S. constellatus and thus Metronidazole was discontinued. The patient improved after a few days and the drainage catheter was pulled out and the patient discharged in stable condition.
PubMed: 32953314
DOI: 10.7759/cureus.9802 -
Frontiers in Cellular and Infection... 2022The combination of maxillofacial infections (MI) with descending necrotizing mediastinitis (DNM) is a complex disease characterized by rapid development and high...
The combination of maxillofacial infections (MI) with descending necrotizing mediastinitis (DNM) is a complex disease characterized by rapid development and high mortality. Here, we performed metagenomic next-generation sequencing (mNGS) using samples from 21 patients with MI and eight patients with DNM. In this study, we found that the species richness of the DNM group was higher than that of the MI group, and the species diversity of the DNM group was higher than that of the MI group, with no statistically significant differences between groups (P > 0.05). LefSE analysis revealed that the main species differing between groups were , , , and ( and ). In addition, the PLS-DA analysis revealed that the dominant groups in the DNM group at the species level were , , , , , and . Next, we correlated the clinical characteristics of the patients with the relative abundance of the pathogens identified in the LefSe and PLS-DA analyses. The relative abundance of was positively correlated with C-reactive protein (CRP) and calcitoninogen (PCT) but negatively correlated with the percentage of lymphocytes (Lymph%) (P < 0.05). On the other hand, was positively correlated with the percentage of neutrophils (Neut%) and glycated hemoglobin (GLU) (P < 0.05), and was positively correlated with CRP (P < 0.05).
Topics: Eubacterium; Humans; Mediastinitis; Streptococcus
PubMed: 35755831
DOI: 10.3389/fcimb.2022.873161 -
Cureus Feb 2022Infective endocarditis (IE) is a severe infection of the endocardium and cardiac valves by multiple etiologic agents. Clinical presentation can be acute or subacute...
Infective endocarditis (IE) is a severe infection of the endocardium and cardiac valves by multiple etiologic agents. Clinical presentation can be acute or subacute based on the host immunity and the causative agent's virulence. Although are responsible for most community-acquired native valve bacterial IE, is an infrequent cause. can rarely infect prosthetic cardiac valves. A middle-aged white male with poorly controlled type 2 diabetes mellitus was transferred to our facility for suspected stroke with an initial presentation of acute encephalopathy of uncertain duration. Transthoracic echocardiogram revealed a left ventricular apical mural vegetation, and brain imaging displayed multiple white matter hypodensities indicative of numerous small strokes. Blood cultures were positive for . Clinical presentation was unusual with an acute encephalopathy due to multiple septic emboli and primary mural IE with high-grade bacteremia due to . PubMed medical literature review reveals this to be a rare clinical presentation by an uncommon etiological agent with an infrequent echocardiogram finding.
PubMed: 35340460
DOI: 10.7759/cureus.22238 -
Yakugaku Zasshi : Journal of the... 2022We report a rare case of suppurative thrombophlebitis of the posterior neck caused by Streptococcus constellatus. A 69-year-old female patient was admitted to the... (Review)
Review
We report a rare case of suppurative thrombophlebitis of the posterior neck caused by Streptococcus constellatus. A 69-year-old female patient was admitted to the hospital with neck pain and fever, which had persisted for 16 days prior to hospitalization. On day 1 (day of admission), blood cultures (later identifying S. constellatus) were performed, and ceftriaxone (CTRX) IV (2 g SID) was started. On day 3, suppurative thrombophlebitis of the posterior neck was diagnosed by CT scan. The antimicrobials were changed from CTRX to ampicillin/sulbactam IV (12 g QID) to guard against the possibility of complicated infection with Fusobacterium spp. or Prevotella spp. On day 17, a CT scan revealed that the thrombus remained. Therefore, oral edoxaban (30 mg SID) was started. On day 27, the patient was discharged after her medication was changed to oral amoxicillin/clavulanate (1500 mg/375 mg TID). On day 33, the amoxicillin/clavulanate was changed to oral cefaclor (1500 mg TID) and edoxaban was discontinued due to itching. On day 45, the course of cefaclor was completed. The patient went on to follow an uneventful course with no relapses or complications for two years since the conclusion of treatment. These results suggest that when a patient presents with persistent neck pain accompanied by fever, suppurative thrombophlebitis of the posterior neck should be considered. In antimicrobial therapy, the treatment could be switched from intravenous to oral. In addition, direct-acting oral anticoagulants may be an alternative to other forms of anticoagulants.
Topics: Administration, Oral; Aged; Amoxicillin-Potassium Clavulanate Combination; Ampicillin; Anti-Bacterial Agents; Cefaclor; Deoxyuridine; Drug Substitution; Female; Humans; Infusions, Intravenous; Neck; Streptococcal Infections; Streptococcus constellatus; Sulbactam; Suppuration; Thrombophlebitis; Treatment Outcome
PubMed: 35110455
DOI: 10.1248/yakushi.21-00179 -
Acta Gastro-enterologica Belgica 2021Congenital hepatic cysts are a common disorder. Usually they are asymptomatic and do not have to be treated. However, some serious complications can occur. We report...
Congenital hepatic cysts are a common disorder. Usually they are asymptomatic and do not have to be treated. However, some serious complications can occur. We report here the case of an 86-year old patient who has been treated by a percutaneous drainage for an infected solitary hepatic cyst due to urinary sepsis. She was admitted to the Department of Internal Medicine for epigastric pain with fever and chills. The patient was treated for a urinary tract infection 3 weeks ago by her General Practitioner. On admission, blood tests showed 21 620 neutrophils per microliter with a C-reactive protein level at 443.7 mg/L, procalcitonin > 200 ng/mL, total bilirubin at 1.43 mg/dL, lactate dehydrogenase at 666 U/L and alanine aminotransferase at 227 U/L. Urinalysis and hemocultures highlighted the presence of Escherichia coli and Streptococcus constellatus. The abdominal tomodensitometry indicated the presence of a left hepatic biliary cyst with banal appearance. She was first treated with intravenous amoxicillin clavulanic acid. After a few days, another abdominal tomodensitometry with contrast pinpointed a large abscess of 11 centimeters in diameter extending to liver segments II and IV with a similar small lesion in segments IV and V. clindamycin per os was added to the treatment because of its good diffusion in tissues. Percutaneous drain was inserted under tomodensitometric control and stayed in place until the follow-up at three weeks. Bacteriologic culture on the fluid sample demonstrated the presence of Escherichia coli and Streptococcus constellatus. The abscess completely regressed after 6 weeks of treatment and the biologic abnormalities resolved at the same time.
Topics: Aged, 80 and over; Cysts; Drainage; Female; Humans; Liver Diseases; Sepsis
PubMed: 33639705
DOI: 10.51821/84.1.319 -
Archive of Clinical Cases 2022are gram-positive cocci belonging to the group that have a propensity to cause bacteremia and abscesses, especially in immunocompromised patients. Here, we report the...
are gram-positive cocci belonging to the group that have a propensity to cause bacteremia and abscesses, especially in immunocompromised patients. Here, we report the case of a 39-year-old male who was initially admitted to the hospital for diabetic ketoacidosis. During the hospitalization, he developed sepsis and blood cultures grew . CT imaging revealed multiple hepatic abscesses. A periapical abscess of the left mandibular central incisor found on CT Scan of face was identified as the likely source of infection. IR-guided drainage was performed however the patient went on to develop septic shock despite attempted source control and IV antibiotic therapy. Repeat imaging showed persistent hepatic abscesses in addition to new intraperitoneal abscesses necessitating exploratory laparotomy, drainage and abdominal washout. Fluid cultures grew and common enteric flora. Our report highlights the need for high clinical suspicion in cases of bacteremia to obtain diagnostic imaging for any abscess formation. Prolonged antibiotic therapy is a must and imaging guided or surgical drainage may be needed.
PubMed: 36176498
DOI: 10.22551/2022.36.0903.10215 -
Case Reports in Infectious Diseases 2020is an oropharyngeal commensal Gram-positive coccus, frequently associated with the respiratory tract. is part of the or group, which has traditionally been...
is an oropharyngeal commensal Gram-positive coccus, frequently associated with the respiratory tract. is part of the or group, which has traditionally been considered to have propensity to cause empyema and purulent abscesses, a property that is sometimes overlooked as the severity of infections it causes may have a varying degree. In this case, we present the case of a 54-year-old male with known liver cirrhosis who developed a severe empyema during an acute liver failure episode, requiring extensive decortication and prolonged hospital admission.
PubMed: 32733717
DOI: 10.1155/2020/4630809