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Increasing secondary bacterial infections with Enterobacteriaceae harboring bla_(CTX-M-15) and bla_(CMY-6) in patients with bronchogenic carcinoma:an emerging point of concern

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Asian Pacific Journal of Tropical Medicine 2011年第1期4卷 5-12页

作者： Mohammed Shahid Abida Malik Rakesh Bhargava Section of Bacteriology & Molecular Biology Department of Medical MicrobiologyJN Medical College & HospitalAligarh Muslim UniversityAligarh-202 002U.P.India T.B.& Chest Diseases Jawaharlal Nehru Medical College & HospitalAligarh Muslim UniversityAligarh-202002Uttar PradeshIndia

Objective:To look for secondary bacterial infections in bronchogenic carcinoma（BCA） with resistant organisms harboring bla genes considering the paucity of relevant studies.Methods: A total of 137 confirmed cases of BCA and 34 healthy volunteers were studied for the occurrence and prevalence of blaCTX-M and and blaAmpC harboring-enterobacteriaceae.A subset of these patients（n=69） was previously reported for the secondary infection with the Aspergillus species. Bronchoalveolar lavages（BAL） were subjected for bacterial and fungal cultures and the bacterial isolates were screened by multiplex PCRs for the presence of blaCTX-M and blaAmpC.The isolates were also screened for the association of insertion sequence（IS26） by PCR and characterized by RAPD for any clonal relatedness.Results:A total of 143 bacterial isolates were obtained from 137 BAL specimens of BC,patients.The Enterobacteriaceae-isolates were multidrug-resistant showing concomitant resistance to fluoroquinolones and aminoglycosides.Both blaCTX-M and blaAmpC of CIT family were detected in 77.4%and 27.4%isolates,respectively.Sequencing revealed the presence of blaCTX-M-15 and blaCMY-6.Twenty one percent of the isolates were simultaneously harboring blaampC and blaCTX-M-15.IS26 PCR and RAPD typing revealed the presence of diverse bacterial population but no predominant clone was identified.The present study also suggests strong association of aspergillosis with lung cancer and further strengthens the potential use of non-validated serological tests suggested earlier.Conclusions:We emphasize that all patients of bronchogenic carcinoma should also be screened for secondary bacterial infections,along with secondary fungal infections,so as to introduce early and specific antimicrobial therapy and to prevent unwanted deaths.

关键词： Bronchogenic carcinoma Secondary bacterial infections CTX-M AmpC Enterobacteriaceae

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Concurrent infections of dengue viruses serotype 2 and 3 in patient with severe dengue from Jakarta, Indonesia

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Asian Pacific Journal of Tropical Medicine 2016年第2期9卷 130-135页

作者： Soroy Lardo Yaldiera Utami Benediktus Yohan Seri MMU Tarigan Widayat Djoko Santoso Leonard Nainggolan R Tedjo Sasmono Division of Tropical Medicine and Infectious Diseases Department of Internal Medicine Gatot Soebroto Central Army Hospital Department of Internal Medicine Faculty of Medicine University of Indonesia Eijkman Institute for Molecular Biology Division of Tropical Medicine and Infectious Diseases Department of Internal Medicine Cipto Mangunkusumo National Central Hospital

Objective: To describe the clinical manifestation of patient with severe dengue, to identify the serotypes and genotypes of dengue viruses(DENV) which concurrently infecting the patient, and to explore the possible relationship of severe dengue with the concurrent infection of DENV. Methods: Dengue diagnosis was performed using NS1 antigen detection and Ig G/Ig M ELISA. Standard clinical and laboratory examinations were performed to obtain the clinical and hematological data. DENV concurrent infections were detected and confirmed using RT-PCR and DENV Envelope gene sequencing. Phylogenetic analyses were performed to determine the genotypes of the viruses. Results: The patient was classified as having severe dengue characterized by severe plasma leakage, hemorrhage, and organ damage involving lung, liver, and kidney. Concurrent infection of DENV serotype 2 and 3 was observed. The infecting DENV-2 virus was grouped into Cosmopolitan genotype while DENV-3 virus was classified into Genotype Ⅰ. Both viruses were closely related to isolates that were endemic in Jakarta. Viremia measurement was conducted and revealed a significantly higher virus titer of DENV-3 compared to DENV-2. Conclusions: The occurrence of multi-serotype DENV infections was presented in a patient with severe clinical manifestation in Indonesia. The hyperendemicity of dengue in Indonesia may contribute to the DENV concurrent infections cases and may underlie the severity of the disease.

关键词： Severe dengue Concurrent infections DENV-2 DENV-3

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Divergent molecular and growth responses of young“Cabernet Sauvignon”(Vitis vinifera)plants to simple and mixed infections with Grapevine rupestris stem pitting-associated virus

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Horticulture Research 2020年第1期7卷 2706-2719页

作者： M.Tobar N.Fiore A.G.Pérez-Donoso R.León I.M.Rosales M.Gambardella Pontificia Universidad Católica de Chile Facultad de Agronomía e Ingeniería ForestalVicuña Mackena 4860MaculSantiago 7820436Chile Universidad de Chile Facultad de Ciencias AgronómicasAvenida Santa Rosa 11315La PintanaSantiago 8820808Chile

Grapevine rupestris stem pitting associated virus(GRSPaV)is one of the most widely distributed viruses;even so,little is known about its effect on Vitis vinifera.To provide new insights,the effects of single and mixed GRSPaV infections on the V.vinifera cultivar“Cabernet Sauvignon”were studied by evaluating growth parameters,such as measurements of the total plant length,the number and distance of internodes and the number of leaves per shoot.In addition,parameters relating to gas exchange,i.e.,the stomatal conductance,net photosynthetic rate,internal CO2 concentration and leaf transpiration,were also assessed.All the measurements were performed in one-and two-yearold plants with a single GRSPaV infection or mixed infections of GRSPaV and Grapevine fanleaf virus(GFLV).The results show that the plant phytosanitary status did not significantly alter the growth and gas exchange parameters in oneyear-old plants.However,in two-year-old plants,single GRSPaV infections increased shoot elongation,which was accompanied by the overexpression of genes associated with the gibberellic acid response pathway.The gas exchange parameters of these plants were negatively affected,despite exhibiting higher LHCII gene expression.Plants with mixed infections did not have modified growth parameters,although they presented a greater reduction in the primary photosynthetic parameters evaluated with no change in LHCII expression.The results presented here confirm the co-evolution hypothesis for V.vinifera and GRSPaV during the early stages of plant development,and they provide new evidence about the effects of GRSPaV and GFLV co-infections on the“Cabernet Sauvignon”cultivar.

关键词： Vitis infections vinifera

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Non-albicans Candida prosthetic joint infections: A systematic review of treatment

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World Journal of Clinical Cases 2019年第12期7卷 1430-1443页

作者： Christos Koutserimpas Stylianos G Zervakis Sofia Maraki Kalliopi Alpantaki Argyrios Ioannidis Diamantis P Kofteridis George Samonis Department of Orthopaedics and Traumatology “251” Hellenic Air Force General Hospital of Athens Athens 11525 Greece Department of Internal Medicine University Hospital of Heraklion Crete Heraklion 71110 Greece Department of Clinical Microbiology and Microbial Pathogenesis University Hospital of Heraklion Crete Heraklion 71110 Greece Department of Materials Science and Technology University of Crete Heraklion Heraklion 71110 Greece Department of General Surgery “Sismanoglion” General Hospital of Athens Athens 15126 Greece

BACKGROUND Non-albicans Candida prosthetic joint infections (PJIs) are rare. Optimal treatment involves a two-stage revision surgery in combination with an antifungal agent. However, no clear guidelines have been developed regarding the agent or treatment duration. Hence, a broad range of antifungal and surgical treatments have been reported so far. AIM To clarify treatment of non-albicans Candida PJIs. METHODS A literature review of all existing non-albicans Candida PJIs cases through April 2018 was conducted. Information was extracted about demographics, comorbidities, responsible species, duration and type of antifungal treatment, type of surgical treatment, time between initial arthroplasty and symptom onset, time between symptom onset and definite diagnosis, outcome of the infection and follow-up. RESULTS A total of 83 cases, with a mean age of 66.3 years, were located. The causative yeast isolated in most cases was C. parapsilosis (45 cases;54.2%), followed by C. glabrata (18 cases;21.7%). The mean Charlson comorbidity index was 4.4 ± 1.5. The mean time from arthropalsty to symptom onset was 27.2 ± 43 mo, while the mean time from symptom onset to culture-confirmed diagnosis was 7.5 ± 12.5 mo. A two stage revision arthroplasty (TSRA), when compared to one stage revision arthroplasty, had a higher success rate (96% vs 73%, P = 0.023). Fluconazole was the preferred antifungal agent (59;71%), followed by amphotericin B (41;49.4%). CONCLUSION The combination of TSRA and administration of prolonged antifungal therapy after initial resection arthroplasty is suggested on the basis of limited data.

关键词： Fungal prosthetic joint infection Knee arthroplasty infection Hip arthroplasty infection Antifungal treatment Non-albicans Candida prosthetic joint infections

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Fatal complications in a patient with severe multi-space infections in the oral and maxillofacial head and neck regions: A case report

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World Journal of Clinical Cases 2019年第23期7卷 4150-4156页

作者： Tian-Guo Dai Hong-Bing Ran Yin-Xiu Qiu Bo Xu Jin-Qiang Cheng Ying-Kai Liu Department of Oral and Maxillofacial Surgery Central Hospital of Panzhihua CityPanzhihua 617067Sichuan ProvinceChina Department of Otolaryngology Head and Neck Surgery Central Hospital of Panzhihua CityPanzhihua 617067Sichuan ProvinceChina

BACKGROUND Odontogenic infection is one of the common infectious diseases in oral and maxillofacial head and neck regions.Clinically,if early odontogenic infections such as acute periapical periodontitis,alveolar abscess,and pericoronitis of wisdom teeth are not treated timely,effectively and correctly,the infected tissue may spread up to the skull and brain,down to the thoracic cavity,abdominal cavity and other areas through the natural potential fascial space in the oral and maxillofacial head and neck.Severe multi-space infections are formed and can eventually lead to life-threatening complications(LTCs),such as intracranial infection,pleural effusion,empyema,sepsis and even death.CASE SUMMARY We report a rare case of death in a 41-year-old man with severe odontogenic multi-space infections in the oral and maxillofacial head and neck regions.One week before admission,due to pain in the right lower posterior teeth,the patient placed a cigarette butt dipped in the pesticide"Miehailin"into the"dental cavity"to relieve the pain.Within a week,the infection gradually spread bilaterally to the floor of the mouth,submandibular space,neck,chest,waist,back,temporal and other areas.The patient had difficulty breathing,swallowing and eating,and was transferred to our hospital as an emergency admission.Following admission,oral and maxillofacial surgeons immediately organized consultations with doctors in otolaryngology,thoracic surgery,general surgery,hematology,anesthesia and the intensive care unit to assist with treatment.The patient was treated with the highest level of antibiotics(vancomycin)and extensive abscess incision and drainage in the oral,maxillofacial,head and neck,chest and back regions.Unfortunately,the patient died of septic shock and multiple organ failure on the third day after admission.CONCLUSION Odontogenic infection can cause serious multi-space infections in the oral and maxillofacial head and neck regions,which can result in multiple LTCs.The management and treatment of LTCs such as multi-space inf

关键词： Odontogenic infection Multi-space infections Complication Oral Maxillofacial Head and neck Case report

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Management of bacterial and fungal infections in end stage liver disease and liver transplantation: Current options and future directions

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World Journal of Gastroenterology 2018年第38期24卷 4311-4329页

作者： Elda Righi Department of Infectious Diseases Santa Maria della Misericordia University Hospital

Patients with liver cirrhosis are susceptible to infections due to various mechanisms, including abnormalities of humoral and cell-mediated immunity and occurrence of bacterial translocation from the intestine. Bacterial infections are common and represent a reason for progression to liver failure and increased mortality. Fungal infections, mainly caused by Candida spp., are often associated to delayed diagnosis and high mortality rates. High level of suspicion along with prompt diagnosis and treatment of infections are warranted. Bacterial and fungal infections negatively affect the outcomes of liver transplant candidates and recipients, causing disease progression among patients on the waiting list and increasing mortality, especially in the early posttransplant period. Abdominal, biliary tract, and bloodstream infections caused by Gram-negative bacteria [e.g., Enterobacteriaceae and Pseudomonas aeruginosa(P. aeruginosa)] and Staphylococcus spp. are commonly encountered in liver transplant recipients. Due to frequent exposure to broad-spectrum antibiotics, invasive procedures, and prolonged hospitalizations, these patients are especially at risk of developing infections caused by multidrug resistant bacteria. The increase in antimicrobial resistance hampers the choice of an adequate empiric therapy and warrants the knowledge of the local microbial epidemiology and the implementation of infection control measures. The main characteristics and the management of bacterial and fungal infections in patients with liver cirrhosis and liver transplant recipients are presented.

关键词： Liver cirrhosis Liver transplant recipients Bacterial infections Fungal infections Multidrug resistant organisms Management

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Mycobacterium chimaera infections following cardiac surgery in Treviso Hospital, Italy, from 2016 to 2019: Cases report

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World Journal of Clinical Cases 2019年第18期7卷 2776-2786页

作者： Walter O Inojosa Mario Giobbia Giovanna Muffato Giuseppe Minniti Francesco Baldasso Antonella Carniato Francesca Farina Gabriella Forner Maria C Rossi Stefano Formentini Roberto Rigoli Pier G Scotton Infectious Diseases Unit Treviso HospitalTreviso 31100Italy Microbiology Unit Treviso HospitalTreviso 31100Italy Cardiac Surgery Unit Treviso HospitalTreviso 31100Italy Health Management Unit Treviso HospitalTreviso 31100Italy

BACKGROUND An epidemic of Mycobacterium chimaera (M. chimaera) infections following cardiac surgery is ongoing worldwide. The outbreak was first discovered in 2011, and it has been traced to a point source contamination of the LivaNova 3T heater-cooler unit, which is used also in Italy. International data are advocated to clarify the spectrum of clinical features of the disease as well as treatment options and outcome. We report a series of M. chimaera infections diagnosed in Treviso Hospital, including the first cases notified in Italy in 2016. CASE SUMMARY Since June 2016, we diagnosed a M. chimaera infection in nine patient who had undergone cardiac valve surgery between February 2011 and November 2016. The time between cardiac surgery and developing symptoms ranged from 6 to 97 mo. Unexplained fever, psychophysical decay, weight loss, and neurological symptoms were common complaints. The median duration of symptoms was 32 wk, and the longest was almost two years. A new cardiac murmur, splenomegaly, choroidoretinitis, anaemia or lymphopenia, abnormal liver function tests and hyponatremia were common findings. All the patients presented a prosthetic valve endocarditis, frequently associated to an ascending aortic pseudoneurysm or spondylodiscitis. M. chimaera was cultured from blood, bioprosthetic tissue, pericardial abscess, vertebral tissue, and bone marrow. Mortality is high in our series, reflecting the poor outcome observed in other reports. Three patients have undergone repeat cardiac surgery. Five patients are being treated with a targeted multidrug antimycobacterial regimen. CONCLUSION Patients who have undergone cardiac surgery in Italy and presenting with signs and symptoms of endocarditis must be tested for M. chimaera.

关键词： Mycobacterium chimaera Prosthetic valve endocarditis Spondylodiscitis Cardiac surgery infections Case report

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Clinical characteristics and 28-d outcomes of bacterial infections in patients with hepatitis B virus-related acute-on-chronic liver failure

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World Journal of Clinical Cases 2020年第6期8卷 1042-1055页

作者： Chen Li Hai-Bin Su Xiao-Yan Liu Jin-Hua Hu Liver Failure Treatment and Research Center The Fifth Medical Center of Chinese PLA General HospitalBeijing 100039China

BACKGROUND Acute-on-chronic liver failure(ACLF),which includes hepatic and multiple extrahepatic organ failure,is a severe emergency condition that has high mortality.ACLF can rapidly progress and requires an urgent assessment of condition and referral for liver transplantation.Bacterial infections(BIs)trigger ACLF and play pivotal roles in the deterioration of clinical course.AIM To investigate the clinical characteristics and 28-d outcomes of first BIs either at admission or during hospitalization in patients with hepatitis B virus(HBV)-ACLF as defined by the Chinese Group on the Study of Severe Hepatitis B(COSSH).METHODS A total of 159 patients with HBV-ACLF and 40 patients with acute decompensation of HBV-related chronic liver disease combined with first BIs were selected for a retrospective analysis between October 2014 and March 2016.The characteristics of BIs,the 28-d transplant-free survival rates,and the independent predictors of the 28-d outcomes were evaluated.RESULTS A total of 194 episodes of BIs occurred in 159 patients with HBV-ACLF.Among the episodes,13.4%were community-acquired,46.4%were healthcare-associated,and 40.2%belonged to nosocomial BIs.Pneumonia(40.7%),spontaneous bacterial peritonitis(SBP)(34.5%),and bloodstream infection(BSI)(13.4%)were the most prevalent.As the ACLF grade increased,the incidence of SBP showed a downward trend(P=0.021).Sixty-one strains of bacteria,including 83.6%Gramnegative bacteria and 29.5%multidrug-resistant organisms,were cultivated from 50 patients with ACLF.Escherichia coli(44.3%)and Klebsiella pneumoniae(23.0%)were the most common bacteria.As the ACLF grade increased,the 28-d transplant-free survival rates showed a downward trend(ACLF-1,55.7%;ACLF-2,29.3%;ACLF-3,5.4%;P<0.001).The independent predictors of the 28-d outcomes of patients with HBV-ACLF were COSSH-ACLF score(hazard ratio[HR]=1.371),acute kidney injury(HR=2.187),BSI(HR=2.339),prothrombin activity(HR=0.967),and invasive catheterization(HR=2.173).CONCLUSION For patients with HBV-ACLF combined with fir

关键词： Hepatitis B virus Acute-on-chronic liver failure Bacterial infections Outcomes Chronic liver disease Spontaneous bacterial peritonitis

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Infection management strategy based on prevention and control of nosocomial infections in intensive care units

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Chinese Medical Journal 2019年第1期132卷 115-119页

作者： Long-Xiang Su Xiao-Ting Wang Pan Pan Wen-Zhao Chai Da-Wei Liu Department of Critical Care Medicine Peking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesBeijing 100730China Department of Critical Care Medicine Beijing Tiantan HospitalCapital Medical UniversityBeijing 100071China

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection,which is clinical problem often faced by intensive care units (ICU) doctors.Without positive treatment,the incidence and mortality of sepsis are high.^[1]As hospital infection control plays an essential role in treating the nosocomial infections in the ICU,and according to the clinical presentation of critically ill patients,the biological characteristics of pathogenic microorganisms and the ICU environment,this article put forward a strategy for the nosocomial infections in the ICU.

关键词： nosocomial infections intensive care units prevention control

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Intestinal parasitic infections in suburban government schools,Lak Hok subdistrict,Muang Pathum Thani,Thailand

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Asian Pacific Journal of Tropical Medicine 2013年第9期6卷 699-702页

作者： Sirima Kitvatanachai Pochong Rhongbutsri Faculty of Medical Technology Rangsit University Department of Preclinical science Faculty of MedicineThammasat University

Objective:To provide baseline information of parasitic infections in 3 suburban government schools,Lakhok subdistrict of Muang Pathum Thani,Thailand.Methods:This study was conducted between May-June 2010 using simple direct smear and modified formalin ether and from a population of 1253 in 3 suburban government schools.Results:Total samples of 202registered and participated.The average of prevalence of infection from 3 schools was 13.9%,there were 13.7%,14.3%and 13.9%in N,S and R school,respectively with no significant difference between schools(P>0.05).The infection rates did not show significant difference between gender(P>0.05).The highest rate of infection was 20.4%in Pathom 2(8 years)students and the lowest was4%in Pathom 1(7 years)with statistically difference between age groups(Pinfections between Blastocwstis hominis(B.hominis)and Endolimax nana(E.nana)were reported at 7.1%.The only helminthic infection found in this study area was hookworm,found in 1 student(3.8%).The formalin ether concentration technique showed a higher efficacy of detection(78%-100%)than the simple direct smear method(0%-50%).Conclusions:Surveillance of protozoan infections may need to be focused on suburban areas.

关键词： Intestinal parasitic infections Suburban area Government school

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