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Gut Apr 2020
Topics: Adult; Bacteremia; Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Humans; Male; Portasystemic Shunt, Transjugular Intrahepatic
PubMed: 31154394
DOI: 10.1136/gutjnl-2019-318917 -
Clinical Microbiology and Infection :... Dec 2020The aim of this study was to assess the co-seasonality and co-detection of respiratory viral infections and bacteraemia in children since the introduction of the...
OBJECTIVES
The aim of this study was to assess the co-seasonality and co-detection of respiratory viral infections and bacteraemia in children since the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13).
METHODS
Children <18 years old were eligible for inclusion if they had a respiratory infection and a positive PCR-based assay for respiratory viruses as well as a positive blood culture between 2010 and 2018 at a single referral centre in the United States, regardless of their underlying medical condition or antibiotic treatment history. Monthly incidence rates of respiratory viruses and bacteraemia were analysed with a seasonal-trend decomposition procedure based on loess (STL) and cross-correlation functions using time series regression modelling.
RESULTS
We identified 7415 unique positive respiratory virus tests, including 2278 respiratory syncytial virus (RSV) (31%), 1825 influenza viruses (24%), 1036 parainfluenza viruses (14%), 1017 human metapneumovirus (hMPV) (14%), 677 seasonal coronaviruses (9%), and 582 adenoviruses (8%), together with a total of 11 827 episodes of bacteraemia. Significant co-seasonality was found between all-cause bacteraemia and RSV (OR = 1.76, 95%CI 1.50-2.06, p < 0.001), influenza viruses (OR = 1.38, 95%CI 1.13-1.68, p 0.002), and seasonal coronaviruses (OR = 1.18, 95%CI 1.09-1.28, p < 0.001), respectively. Analysis of linked viral-bacterial infections in individual children indicated that the rate ratio (RR) of bacteraemia associated with hMPV (RR = 2.73, 95%CI 1.12-6.85, p 0.019) and influenza (RR = 2.61, 95%CI 1.21-6.11, p 0.013) were more than double that of RSV. Staphylococcus aureus and Streptococcus pneumoniae were the most commonly identified pathogens causing bacteraemia.
CONCLUSIONS
There is a significant association between hMPV and influenza viruses and bacteraemia of all causes in hospitalized children at a single paediatric centre in the United States. Large multicentre studies are needed to confirm these findings and to elucidate the mechanisms by which hMPV potentiates the virulence and invasive capacity of diverse bacteria.
Topics: Adolescent; Bacteremia; Bacteria; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Pneumococcal Vaccines; Respiratory Tract Infections; Retrospective Studies; Seasons; Vaccination; Viruses
PubMed: 32919073
DOI: 10.1016/j.cmi.2020.09.006 -
Journal of the Royal College of... 2000
Review
Topics: Anti-Bacterial Agents; Bacteremia; Decision Making; Epithelium; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Immunity, Cellular; Microbiological Techniques
PubMed: 11191969
DOI: No ID Found -
Intensive & Critical Care Nursing Jun 2008Bacteraemia, defined as the presence of viable bacteria in the circulating blood can result in bloodstream infection, which is one of the most frequent and challenging... (Review)
Review
RATIONALE
Bacteraemia, defined as the presence of viable bacteria in the circulating blood can result in bloodstream infection, which is one of the most frequent and challenging hospital-acquired infections. Bacteraemia occurs in healthy populations with manipulation of the oral mucosa, including toothbrushing. Oral care is commonly administered to mechanically ventilated patients, it is important to determine whether this practice contributes to the incidence of bacteraemia. This paper reviews the literature on the link between the manipulation of the oral cavity and the development of bacteraemia in mechanically ventilated adults.
METHODS
Searches were conducted using Medline, CINAHL, and the Cochrane Library databases. Article inclusion criteria were (1) a focus on mechanical ventilation and critical illness, (2) human subjects, (3) adult subjects, and (4) publication in English (or available English translation).
RESULTS
Nine articles met inclusion criteria and were critiqued. All relied upon clinical data as outcome measures; many were retrospective. The three organisms most often associated with nosocomial bloodstream infections were Staphylococcus aureus, coagulase negative staphylococci, and Enterococcus species. Establishing the origin of bacteraemia was problematic in most studies.
CONCLUSIONS
Additional research is needed to understand the relationship of oral care practices to bacteraemia in mechanically ventilated adults.
Topics: Adult; Bacteremia; Critical Care; Cross Infection; Health Services Needs and Demand; Humans; Incidence; Infection Control; Mouth Mucosa; Nursing Evaluation Research; Oral Hygiene; Outcome Assessment, Health Care; Research Design; Respiration, Artificial; Retrospective Studies; Risk Factors
PubMed: 18403205
DOI: 10.1016/j.iccn.2008.01.004 -
Cancer May 2006Stenotrophomonas maltophilia bacteremia is frequently found in cancer patients. This study attempted to determine how often the catheters were the source of this...
BACKGROUND
Stenotrophomonas maltophilia bacteremia is frequently found in cancer patients. This study attempted to determine how often the catheters were the source of this infection and the risk factors associated with catheter-related bacteremias.
METHODS
The microbiology records were retrospectively reviewed of all cancer patients having S. maltophilia bacteremia and indwelling central venous catheters seen between January 1998 and January 2004. In a multivariate analysis the patients' clinical characteristics, antimicrobial therapy, outcome, and source of bacteremia that were significantly associated with definite catheter-related S. maltophilia bacteremia as opposed to secondary bacteremia were identified.
RESULTS
A total of 217 bacteremias were identified in 207 patients: 159 (73%) were primary catheter-related (53 definite, 89 probable, and 17 possible), 11 (5%) were primary noncatheter-related, and 47 (22%) were secondary. Multivariate analysis showed the following factors to be independently associated with definite catheter-related bacteremias: 1) polymicrobial bacteremia (odds ratio [OR], 7.6; 95% confidence interval [95% CI], 1.3-45.5); 2) no prior intensive care unit admission (OR, 0.06; 95% CI, 0.005-0.578); and 3) nonneutropenic status at onset (OR, 0.07; 95% CI, 0.013-0.419). The response rate to appropriate antibiotics and catheter removal was 95% in the patients with definite catheter-related bloodstream infections, compared with only 56% in the patients with secondary bacteremias (P = .001).
CONCLUSIONS
The majority of the S. maltophilia bacteremias occurring in cancer patients with indwelling central venous catheters appear to be catheter-related and are often polymicrobial. Catheter-related S. maltophilia bacteremias occurred more frequently in noncritically ill, nonneutropenic patients, and prompt removal of the catheter was found to be associated with a better prognosis.
Topics: Adult; Aged; Anti-Bacterial Agents; Bacteremia; Catheterization, Central Venous; Gram-Negative Bacterial Infections; Humans; Middle Aged; Neoplasms; Retrospective Studies; Stenotrophomonas maltophilia
PubMed: 16565968
DOI: 10.1002/cncr.21846 -
BMC Infectious Diseases Oct 2019The purposes of this study were to determine the incidence of central and peripheral venous catheter-related bacteraemias, the relationship between the suspected and...
BACKGROUND
The purposes of this study were to determine the incidence of central and peripheral venous catheter-related bacteraemias, the relationship between the suspected and final confirmed bacteraemia origins, and the differences in microbiological, epidemiological, clinical, and analytical characteristics between the groups, including evolution to death.
METHODS
This was a 7-year descriptive retrospective populational study of all bloodstream infections, comparing central (CB) and peripheral (PB) venous catheter-related bacteraemias in patients older than 15 years.
RESULTS
In all, 285 catheter-related bacteraemia patients, 220 with CBs (77.19%) and 65 with PBs (22.81%), were analysed among 1866 cases with bloodstream infections. The cumulative incidence per 1000 patients-day of hospital stay was 0.36 for CB and 0.106 for PB. In terms of the suspected origin, there was less accuracy in diagnosing catheter-related bloodstream infections (68. 2%) than those of other origins (78. 4%), p < 0.001. The accuracy was greater for PB (75%) than for CB (66. 2%), Coagulase-negative staphylococci were the most frequent microorganisms in both groups but occurred 1.57 times more frequently in CB (64.1%/40.6%) (p = 0.004), while Staphylococcus aureus (23. 4%/9.5%) (p = 0.02) and Enterobacteriae species (15.6%/6. 3%) (p = 0.003) were 2.5 times more frequent in PB. The CB patients stayed at the hospital for an average of 7.44 days longer than did the PB patients; more CB patients had active neoplasia (70. 4%/32.8%), more had surgery in the previous week (29. 2%/8. 3%), and fewer received adequate empirical treatment (53.9%/ 62.5%). Catheter was not removed in 8. 2% of CB and 3.7% of PB. On the other hand, the CB and PB patients had similar Pitt scores at blood extraction (median 0.89 versus 0.84 points, respectively; p = 0.8) and similar survival rates at hospital discharge (91.1% versus 90. 2%; p = 0.81).
CONCLUSIONS
Central catheters were more frequent sources of bacteraemias than were peripheral catheters. There were important differences in the microbiological aetiology as well. PB patients received correct empirical antibiotic treatment more frequently and had a higher initial rate of correct determination of the suspected source of bacteraemia. Differences in the microbiological aetiology and empirical antibiotic treatment received, and probably catheter removal and time to catheter removal could explain why CB and PB patients had similar survival rates .
Topics: Bacteremia; Catheter-Related Infections; Catheterization, Central Venous; Catheterization, Peripheral; Catheters, Indwelling; Enterobacteriaceae; Humans; Length of Stay; Retrospective Studies; Staphylococcus aureus; Survival Rate
PubMed: 31615450
DOI: 10.1186/s12879-019-4505-2 -
Brazilian Journal of Medical and... Oct 2008Enterococcus spp bacteremia is associated with high mortality and the appearance of high-level gentamicin resistance (HLGR) created additional challenges for the...
Enterococcus spp bacteremia is associated with high mortality and the appearance of high-level gentamicin resistance (HLGR) created additional challenges for the treatment of these infections. We evaluated the epidemiological and clinical characteristics of patients with bacteremias caused by HLGR and non_HLGR Enterococcus faecalis isolates at a teaching hospital in the State of São Paulo, Brazil. Patients with bacteremia due to E. faecalis diagnosed between January 1999 and December 2003 were included in the study. We collected clinical, epidemiological, and microbiological data from medical records. Banked isolates were typed using pulsed-field gel electrophoresis. We identified 145 cases of E. faecalis bacteremia: 66 (45.5%) were caused by HLGR isolates and 79 (54.5%) by non_HLGR. In the univariate analysis, patients with HLGR infection were older, had higher rates of bladder catheterization, and more often had treatment with cephalosporin, quinolone, and/or carbapenem compared with patients with non_HLGR infection (P < 0.05). Multivariate analysis indicated that older age, hematological malignancy, and previous use of vancomycin were independently associated with HLGR (P < 0.05). Mortality rates were not significantly different among patients with HLGR (50%) and non_HLGR (43%) infections (P = 0.40). Of the 32 genotyped isolates, 16 were distributed into 6 main electrophoresis patterns and 16 others had distinct patterns. E. faecalis bacteremia is associated with high mortality and is frequently caused by HLGR isolates at this teaching hospital. The variability among genotyped isolates suggests that endogenous infections, rather than patient-to-patient transmission of E. faecalis, are more common at this institution.
Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Bacteremia; Brazil; Child; Child, Preschool; Drug Resistance, Bacterial; Electrophoresis, Gel, Pulsed-Field; Enterococcus faecalis; Female; Gentamicins; Gram-Positive Bacterial Infections; Humans; Infant; Infant, Newborn; Male; Microbial Sensitivity Tests; Middle Aged; Young Adult
PubMed: 19030711
DOI: 10.1590/s0100-879x2008001000010 -
International Journal of Antimicrobial... Nov 2014Treatment of severe infections caused by vancomycin-resistant enterococci (VRE) is challenging due to the scarcity of reliable therapeutic alternatives. In this context,... (Review)
Review
Treatment of severe infections caused by vancomycin-resistant enterococci (VRE) is challenging due to the scarcity of reliable therapeutic alternatives. In this context, daptomycin (DAP), a lipopeptide antibiotic, has emerged as an interesting alternative as it is one of the few compounds that retain in vitro bactericidal activity against VRE isolates, although it has not been approved for this purpose by regulatory agencies. In this review, we will summarise the clinical, animal and in vitro evidence evaluating the efficacy of DAP for the management of deep-seated VRE infections. In addition, we will address important clinical concerns such as the emergence of DAP resistance during therapy and reports of therapeutic failure with DAP monotherapy. Finally, we will discuss possible future strategies (such as the use of higher doses and/or combination therapies) to optimise the use of this antibiotic against VRE.
Topics: Animals; Anti-Bacterial Agents; Bacteremia; Daptomycin; Disease Models, Animal; Gram-Positive Bacterial Infections; Humans; Microbial Sensitivity Tests; Treatment Outcome; Vancomycin-Resistant Enterococci
PubMed: 25261158
DOI: 10.1016/j.ijantimicag.2014.08.002 -
Internal Medicine Journal Feb 2022Social distancing was the predominant strategy used to mitigate the spread of Coronavirus disease 2019 (COVID-19) at the start of the COVID-19 pandemic.
BACKGROUND
Social distancing was the predominant strategy used to mitigate the spread of Coronavirus disease 2019 (COVID-19) at the start of the COVID-19 pandemic.
AIMS
To study the impact of social distancing on the incidence of bacteraemia. The number of admitted patients with positive blood cultures in April-May 2020 in one tertiary medical centre was compared with the number during the same period in the previous 3 years (April-May 2017-2019).
METHODS
Retrospective review of all positive blood cultures from January to July in the years 2017-2020.
RESULTS
There were fewer cases of Streptococcus bacteraemia as well as coagulase-negative Staphylococcus bacteraemia and other possible contaminated blood cultures in April-May 2020. Compared with the previous 3 years, the incidence of Streptococcus pneumoniae bacteraemia among all bacteraemias was lower in April-May 2020 (5%) than in 2017-2019 (12.0%; 95% confidence interval 10.3-14.1%). In general, fewer cases of bacteraemia caused by oropharynx organisms were observed in April-May 2020; only 6 cases versus 31 (95% confidence interval 10-53) during the same period in 2017-2019. Only one case of S. pneumoniae bacteraemia was observed in April-May 2020 and its percentage among all bacteraemias was lower in April-May 2020 (0.4%) than during the same period in 2017-2019 (3.3%).
CONCLUSION
The incidences of streptococcal bacteraemia and bacteraemia of organisms transmitted through respiratory secretions were lower when there were social distancing restrictions. Adopting measures of social distancing may decrease the morbidity from bacteraemia caused by oropharynx and respiratory bacteria.
Topics: Bacteremia; COVID-19; Humans; Pandemics; Physical Distancing; SARS-CoV-2
PubMed: 34617387
DOI: 10.1111/imj.15560 -
Epidemiology and Infection Jul 2020In mainland China, the clinical, epidemiological and genetic features of non-O1/non-O139 Vibrio cholerae (NOVC) bacteraemia have been scarcely investigated. Herein, we... (Review)
Review
In mainland China, the clinical, epidemiological and genetic features of non-O1/non-O139 Vibrio cholerae (NOVC) bacteraemia have been scarcely investigated. Herein, we describe a patient with NOVC bacteraemia diagnosed in our hospital and present a retrospective analysis of literature reports of 32 other cases in China, detailing the clinical epidemiology, antibiotic resistance and molecular characteristics of isolates. Most patients were male (84.8%; median age, 53 years) and had predisposing factors, such as cirrhosis, malignant tumours, blood diseases and diabetes. In addition to fever, gastroenteritis was the most frequent presenting symptom. The mortality rate during hospitalisation was 12.1%. NOVC bacteraemia cases were more common in June-August, with the majority in coastal provinces and the Yangtze River basin. Only 42.4% of cases were attributed to consumption of marine (aquatic) products. Tetracycline, third-generation cephalosporins, and fluoroquinolones were the most effective antimicrobial agents, and the highest frequencies of resistance were recorded for ampicillin/sulbactam (37.5%), amoxicillin/clavulanic acid (33.3%), ampicillin (29.2%) and sulfamethoxazole (20%). Multi-drug resistant isolates were not detected. Limited data indicate that ctxAB and tcpA genes were absent in all NOVC isolates but other putative virulence genes (hlyA, toxR, hap and rtxA) were common. Ten multilocus sequence types were identified with marked genetic heterogeneity between different isolates. As clinical manifestations of NOVC bacteraemia may vary widely, and isolates exhibit genetic diversity, clinicians and public health experts should be alerted to the possibility of infection with this pathogen because of the high prevalence of liver disease in China.
Topics: Aged; Anti-Bacterial Agents; Bacteremia; China; Cholera; Humans; Male; Vibrio cholerae
PubMed: 32635946
DOI: 10.1017/S0950268820001545