-
Annals of Cardiac Anaesthesia 2008The objective of this study was to compare the risk factors and outcome of patients with preexisting resistant gram-negative bacilli (GNB) with those who develop...
The objective of this study was to compare the risk factors and outcome of patients with preexisting resistant gram-negative bacilli (GNB) with those who develop sensitive GNB in the cardiac intensive care unit (ICU). Of the 3161 patients ( n=3,161) admitted to the ICU during the study period, 130 (4.11%) developed health care-associated infections (HAIs) with GNB and were included in the cohort study. Pseudomonas aeruginosa (37.8%) was the most common organism isolated followed by Klebsiella species (24.2%), E. coli (22.0%), Enterobacter species (6.1%), Stenotrophomonas maltophilia (5.7%), Acinetobacter species (1.3%), Serratia marcescens (0.8%), Weeksella virosa (0.4%) and Burkholderia cepacia (0.4%). Univariate analysis revealed that the following variables were significantly associated with the antibiotic-resistant GNB: females (P=0.018), re-exploration (P=0.004), valve surgery (P=0.003), duration of central venous catheter (P<0.001), duration of mechanical ventilation (P<0.001), duration of intra-aortic balloon counter-pulsation (P=0.018), duration of urinary catheter (P<0.001), total number of antibiotic exposures prior to the development of resistance (P=0.014), acute physiology and age chronic health evaluation score (APACHE II), receipt of anti-pseudomonal penicillins (piperacillin-tazobactam) (P=0.002) and carbapenems (P<0.001). On multivariate analysis, valve surgery (adjusted OR=2.033; 95% CI=1.052-3.928; P=0.035), duration of mechanical ventilation (adjusted OR=1.265; 95% CI=1.055-1.517; P=0.011) and total number of antibiotic exposure prior to the development of resistance (adjusted OR=1.381; 95% CI=1.030-1.853; P=0.031) were identified as independent risk factors for HAIs in resistant GNB. The mortality rate in patients with resistant GNB was significantly higher than those with sensitive GNB (13.9% vs. 1.8%; P=0.03). HAI with resistant GNB, in ICU following cardiac surgery, are independently associated with the following variables: valve surgeries, duration of mechanical ventilation and prior exposure to antibiotics. The mortality rate is significantly higher among patients with resistant GNB.
Topics: APACHE; Adolescent; Adult; Aged; Aged, 80 and over; Analysis of Variance; Cardiac Care Facilities; Child; Critical Care; Cross Infection; Data Collection; Drug Resistance, Bacterial; Emergency Medical Services; Female; Gram-Negative Bacteria; Gram-Negative Bacterial Infections; Humans; India; Male; Middle Aged; Prospective Studies; Risk Factors; Treatment Outcome
PubMed: 18182755
DOI: 10.4103/0971-9784.38445 -
Revista Argentina de Microbiologia 2005Gram-negative nonfermentative bacilli (NFB) are widely spread in the environment. Besides of difficulties for identification, they often have a marked multiresistance to... (Comparative Study)
Comparative Study
Gram-negative nonfermentative bacilli (NFB) are widely spread in the environment. Besides of difficulties for identification, they often have a marked multiresistance to antimicrobial agents, including those active against Pseudomonas aeruginosa. The objective of this study was to evaluate the 'in vitro' activity of different antimicrobial agents on 177 gram-negative nonfermentative bacilli isolates (excluding Pseudomonas aeruginosa and Acinetobacter spp.) isolated from clinical specimens. Minimum inhibitory concentrations (MIC) were determined according to the Mueller Hinton agar dilution method against the following antibacterial agents: ampicillin, piperacillin, piperacillin-tazobactam, sulbactam, cefoperazone, cefoperazone-sulbactam, ceftazidime, cefepime, aztreonam, imipenem, meropenem, colistin, gentamicin, amikacin, trimethoprim-sulfamethoxazole, chloramphenicol, erythromycin, rifampin, norfloxacin, ciprofloxacin and minocycline. Seven isolates: Sphingobacterium multivorum (2), Sphingobacteriumspiritivorum (1), Empedobacterbrevis (1), Weeksella virosa (1), Bergeyella zoohelcum (1) and Oligella urethralis (1), were tested for amoxicillin-clavulanic acid and ampicillin-sulbactam susceptibility, and susceptibility to cefoperazone or sulbactam was not determined. Multiresistance was generally found in Stenotrophomonas maltophilia, Burkholderia cepacia, Chryseobacterium spp., Myroides spp., Achromobacter xylosoxidans, and Ochrobactrum anthropi isolates. On the other hand, Pseudomonas stutzeri, Shewanella putrefaciens-algae, Sphingomonas paucimobilis, and Pseudomonas oryzihabitans, Bergeyella zoohelcum, Weeksella virosa and Oligella urethralis were widely susceptible to the antibacterial agents tested. As a result of the wide variation in antimicrobial susceptibility shown by different species, a test on susceptibility to different antibacterial agents is essential in order to select an adequate therapy. The marked multiresistance evidenced by some species, prompts the need to develop new antimicrobial agents active against this group of bacteria and to search for synergistic combinations.
Topics: Anti-Bacterial Agents; Drug Resistance; Drug Resistance, Multiple, Bacterial; Gram-Negative Bacteria; Gram-Negative Bacterial Infections; Humans; Microbial Sensitivity Tests
PubMed: 15991478
DOI: No ID Found -
Environmental Microbiology Jun 2004'Aegyptianella ranarum' (order Rickettsiales), an ultrastructurally defined small, Gram-negative rod, is known to replicate in the red blood cells of frogs. Heretofore,... (Comparative Study)
Comparative Study
Proposal to transfer 'Aegyptianella ranarum', an intracellular bacterium of frog red blood cells, to the family Flavobacteriaceae as 'Candidatus Hemobacterium ranarum' comb. nov.
'Aegyptianella ranarum' (order Rickettsiales), an ultrastructurally defined small, Gram-negative rod, is known to replicate in the red blood cells of frogs. Heretofore, this bacterium has not been characterized genetically. We cloned and sequenced the 16S rRNA (1310 bp) and gyrB (718 bp) genes of 'A. ranarum' from a Canadian frog blood specimen. In situ hybridization (with an 'A. ranarum' 16S rRNA gene polymerase chain reaction product as probe) and electron microscopy confirmed that 'A. ranarum' forms cytoplasmic inclusions in frog erythrocytes. blast comparisons with GenBank 16S rRNA and gyrB sequences showed that both 'A. ranarum' genes were most similar (91% and 67% identity) to those of Chryseobacterium meningosepticum, a bacterium in the family Flavobacteriaceae. In contrast, 'A. ranarum' 16S rRNA shared only 61% identity with Aegyptianella pullorum. Phylogenetic analyses of these genes using phylip supported 'A. ranarum' as a member of Flavobacteriaceae, but suggested that its cladistic sibling may be Bergeyella zoohelcum or Weeksella virosa, rather than C. meningosepticum. We propose to classify 'Aegyptianella ranarum' as 'Candidatus Hemobacterium ranarum' in the family Flavobacteriaceae. Our results provide a starting point for studies of related intraerythrocytic bacterial infections in frogs.
Topics: Anaplasmataceae; Animals; Anura; Base Sequence; Cluster Analysis; DNA Gyrase; DNA Primers; Erythrocytes; Flavobacteriaceae; In Situ Hybridization; Inclusion Bodies; Microscopy, Electron; Molecular Sequence Data; Phylogeny; RNA, Ribosomal, 16S; Sequence Analysis, DNA; Species Specificity
PubMed: 15142244
DOI: 10.1111/j.1462-2920.2004.00559.x -
Journal of Clinical Microbiology Dec 1987A production model of the semi-automated PASCO MIC-ID system (PASCO Laboratories, Wheat Ridge, Colo.) was evaluated with 122 groups or species of gram-negative bacilli,...
A production model of the semi-automated PASCO MIC-ID system (PASCO Laboratories, Wheat Ridge, Colo.) was evaluated with 122 groups or species of gram-negative bacilli, which included typical (499 cultures) and atypical (37 cultures) strains of fermenters and nonfermenters. The PASCO system identified 90.9% of 536 cultures accurately; these included 90.8% of 152 nonfermenters, 93.8% of 308 enteric fermenters, and 78.9% of 76 oxidase-positive fermenters. These results were obtained with the aid of serologic tests and a few additional biochemical tests, when recommended by the PASCO system. Of the 14 misidentified nonfermenters, 3 were Pseudomonas paucimobilis, 3 were Weeksella virosa (Centers for Disease Control group IIf), 2 were Xanthomonas (Pseudomonas) maltophilia, and 6 were randomly distributed among the other groups and species tested. The 19 enteric fermenters that were misidentified were randomly distributed among the groups and species tested. Of the 16 misidentified oxidase-positive fermenters, 4 were Pasteurella ureae, and 12 were randomly distributed among the other groups and species. The system identified the most commonly encountered organisms at a rate of 95% or better. The PASCO system is easy to inoculate and read. A slightly improved data base should remedy most of the identification problems.
Topics: Bacteriological Techniques; Fermentation; Gram-Negative Bacteria; Microbial Sensitivity Tests; Microcomputers
PubMed: 3323230
DOI: 10.1128/jcm.25.12.2363-2366.1987 -
Journal of Comparative Pathology 2008Lymphoepithelioma-like carcinoma (LELCA) of the urinary bladder is reported in a 7-year-old cow that had grazed pasture rich in bracken fern and had suffered from severe...
Lymphoepithelioma-like carcinoma (LELCA) of the urinary bladder is reported in a 7-year-old cow that had grazed pasture rich in bracken fern and had suffered from severe intermittent haematuria from 3 to 4 years of age. On necropsy examination there were multiple haemorrhagic foci scattered over the mucosal surface of the urinary bladder. Microscopically there were nests, cords and sheets of neoplastic cells infiltrating the lamina propria and muscularis propria. These had a syncytial appearance with ill-defined cytoplasmic borders, large nuclei and prominent nucleoli. There was a prominent associated inflammatory infiltrate comprising lymphocytes and plasma cells with sparse histiocytes and granulocytes. Immunohistochemically, LELCA cells expressed cytokeratin but not vimentin. The LELCA was focally admixed with a concomitant papillary high-grade carcinoma that also infiltrated the lamina propria. A diffuse carcinoma in situ was also present. Bovine papillomavirus type-2 (BPV-2) DNA was amplified from frozen neoplastic tissue and from selected areas of formalin-fixed, paraffin wax-embedded tissue obtained by laser capture microdissection. Microbiological culture of a urine sample resulted in isolation of Weeksella virosa, Rhizobium radiobacter and Staphylococcus warneri. Flow cytometric analysis performed on blood mononuclear cells revealed down-regulation of a panel of markers including CD3, CD4, CD8alpha, CD45, MHC class I and MHC class II (HLA-DRalpha, HLA-DQ, HLA-DP). This report extends the spectrum of neoplastic urothelial lesions described in cattle and provides further evidence that some features of these tumours are similar to human counterparts.
Topics: Animals; Biomarkers, Tumor; Bovine papillomavirus 1; Carcinoma; Cattle; Immunohistochemistry; Papillomavirus Infections; Pteridium; Urinary Bladder Neoplasms
PubMed: 18675990
DOI: 10.1016/j.jcpa.2008.06.002