1/35. ochrobactrum anthropi bacteremia.ochrobactrum anthropi (O. anthropi ), formerly known as achromobacter CDC group Vd, is a gram-negative bacillus that is aerobic, oxidase producing, and nonlactose fermenting. This organism has been found in environmental and hospital water sources and has pathogenic potential in humans. Most reports in the literature of O. anthropi bacteremia are associated with intravenous line infections. We describe a case of bacteremia with O. anthropi in a 33-month-old boy with acute osteomyelitis. O. anthropi bacteremia also has been reported in immunocompromised hosts. Rarely, O. anthropi has been a cause of soft tissue or bone infection.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
2/35. serratia marcescens pseudobacteraemia in neonates associated with a contaminated blood glucose/lactate analyzer confirmed by molecular typing.Three episodes of serratia marcescens pseudobacteraemia occurred on a neonatal intensive care unit. Following the first two cases, one full term and one pre-term infant, the source was identified as a glucose/lactate analyzer. Blood culture and environmental isolates of the organisms involved were indistinguishable when subjected to pulsed-field gel electrophoresis of Spe 1 digests and PCR ribotyping. Failure to recognize pseudobacteraemia in neonates results in inappropriate therapy for the individual and increased antibiotic pressures on the unit. attention to the possibility of cross infection when using automated analyzers is required to minimize the risks of true or pseudoinfection to patients.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
3/35. Recurrent bacteremia caused by a "Flexispira"-like organism in a patient with X-linked (Bruton's) agammaglobulinemia.helicobacter spp., except for helicobacter cinaedi, have only rarely been reported in cases of septicemia. A patient with X-linked (Bruton's) agammaglobulinemia was found to have persistent sepsis with a helicobacter-like organism despite multiple courses of antibiotics. His periods of sepsis were associated with leg swelling thought to be consistent with cellulitis. The organism was fastidious and required a microaerophilic environment containing H(2) for growth. Optimal growth was observed at 35 to 37 degrees C on sheep blood, CDC anaerobe, and Bordet-Gengou agars. Serial subcultures every 4 to 5 days were required to maintain viability. The organism was strongly urease positive and showed highest relatedness to helicobacter-like organisms with the vernacular name "Flexispira rappini" by 16S rRNA gene sequence analysis. Genomic dna hybridization studies, however, found 24 to 37% relatedness to "F. rappini" and even less to other helicobacter spp. Although the organism phenotypically resembles "Flexispira" and helicobacter, it is thought to represent a new taxon. The patient's infection was eventually cleared with a prolonged (5-month) course of intravenous imipenem and gentamicin.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
4/35. Molecular identification of a Nocardiopsis dassonvillei blood isolate.Nocardiopsis dassonvillei is an environmental aerobic actinomycete seldom isolated in cutaneous and pulmonary infections. We herein report the first N. dassonvillei blood isolate in a patient hospitalized for cholangitis. Although morphological characteristics and biochemical tests allowed a presumptive identification of this isolate, cell wall fatty acid chromatographic analysis confirmed identification at the genus level, and 16S rRNA gene sequencing achieved definite identification. This study illustrates the usefulness of 16S rRNA gene sequencing as a routine method for the identification of actinomycetes.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
5/35. Primary vibrio vulnificus bacteremia in a liver transplant recipient after ingestion of raw oysters: caveat emptor.vibrio vulnificus is responsible for severe infections in chronically ill patients. Organ transplant recipients are also at risk for severe infections due to V vulnificus. We report here the first case of V. vulnificus primary bacteremia due to raw shellfish consumption in a liver transplant recipient. All transplant patients should be cautioned against consuming uncooked seafood and warned about the risk of severe vibrio infections from seemingly innocuous wounds acquired in a salt water environment.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
6/35. bacillus cereus infections among oncology patients at a children's hospital.BACKGROUND: bacillus cereus can cause severe infections in immunocompromised persons. methods: We report 3 cases of bacteremia/septicemia (1 fatal) among oncology patients in a children's hospital. Because all cases occurred during a 10-day period, a common source outbreak was suspected. An epidemiologic investigation was performed. Molecular comparison of patient and environmental isolates was performed by using pulsed-field gel electrophoresis. RESULTS: After an extensive investigation, no common hospital source could be found. Pulsed-field gel electrophoresis proved that the isolates were not related. CONCLUSION: Sporadic infections in immunocompromised persons do occur and can be associated with significant morbidity.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
7/35. methylobacterium mesophilicum infection: case report and literature review of an unusual opportunistic pathogen.methylobacterium mesophilicum is a methylotrophic, pink pigmented, gram-negative rod that was initially isolated from environmental sources that is being increasingly reported as a cause of opportunistic infections in immunocompromised hosts. We present the case of an immunocompromised woman who developed a central catheter infection with M. mesophilicum and review the other 29 cases reported in the literature, noting that it is frequently resistant to beta-lactam agents but is generally susceptible to aminoglycosides and quinolones.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
8/35. Recurrent achromobacter xylosoxidans bacteremia associated with persistent lymph node infection in a patient with hyper-immunoglobulin m syndrome.achromobacter xylosoxidans (formerly alcaligenes xylosoxidans) is a rare but important cause of bacteremia in immunocompromised patients, and strains are usually multiply resistant to antimicrobial therapy. We report an immunocompromised patient with hyper-immunoglobulin m syndrome who suffered from 14 documented episodes of A. xylosoxidans bacteremia. Each episode was treated and resulted in rapid clinical improvement, with blood cultures testing negative for bacteria. Between episodes, A. xylosoxidans was isolated from an excised right axillary lymph node, whereas the culture of the central venous catheter, removed at the same time, was negative. Multiple cultures from sputum, stool, and urine samples, as well as from gastrointestinal biopsies or environmental sources, were negative. Results from antibiotic sensitivity testing and pulsed-field gel electrophoresis suggested that a single strain of A. xylosoxidans caused the recurrent bacteremias in this patient; this strain originated from persistently infected lymph nodes. Lymphoid hyperplasia is a prominent characteristic of hyper-IgM syndrome and may serve as a source of bacteremia with low-pathogenicity organisms.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
9/35. Infection of hickman catheter by Pseudomonas (formerly flavimonas) oryzihabitans traced to a synthetic bath sponge.Pseudomonas (formerly Flavimonas) oryzihabitans is an uncommon pathogen that may cause catheter-associated infections. Although it has occasionally been isolated from the environment, the source of human infection has not previously been documented. We describe an AIDS patient who developed Pseudomonas oryzihabitans bacteremia due to colonization of a Hickman catheter. The patient reported having strictly followed the recommendations for catheter hygiene. The only flaw detected was the use of a synthetic bath sponge in the shower. The sponge was cultured and yielded P. oryzihabitans among other nonfermentative, gram-negative bacilli. To determine the prevalence of P. oryzihabitans in sponges, we cultured 15 samples from unrelated households. The microorganism was isolated from 3 of the 15 samples. molecular typing by arbitrarily primed PCR (AP-PCR) was performed with the environmental and clinical isolates. Three different profiles were obtained for the six isolates analyzed from the patient's sponge. The strain from the AIDS patient was identical to one of those from his sponge and was different from all the remaining strains. The AP-PCR typing results were subsequently confirmed by pulsed-field gel electrophoresis. It can be concluded that sponges are occasionally colonized by P. oryzihabitans. For the first time a probable source of an indwelling catheter contamination with this bacterium has been found. patients carrying these devices should avoid using sponge-like materials, as these are suitable environments for nonfermentative, gram-negative bacilli.- - - - - - - - - - ranking = 3keywords = environment (Clic here for more details about this article) |
10/35. Fatal multi-resistant pseudomonas aeruginosa septicemia outbreak in a neonatal intensive care unit in Trinidad.Between July 2-3, 1998, six infants on the neonatal intensive care unit (ICU) at San Fernando General Hospital died following septicemia with multi-resistant pseudomonas aeruginosa. All patients were infected with the same strain and all were resistant to gentamicin, tobramycin, piperacillin and ceftazidime. Samples of hand washing liquids from the hands of the neonatal ICU staff were cultured and no P. aeruginosa was detected. patients' environment and environmental surfaces: latches and interiors of incubators, sink traps and the operating theater environment and suction tubing were cultured, and P. aeruginosa with the same antibiogram was recovered from the suction tubing and the sink trap of the only tap on the neonatal ICU. Following the intervention of the infection control team and their strong re-emphasis on compliance with proper hand washing procedures and sterilization techniques, no cluster of infection with this strain or any other strain of P. aeruginosa were subsequently observed. The infecting strain may have been transferred from the operating theater via a neonate delivered by caesarean section and from this infant to the others by a neonatal health care worker who failed to wash hands properly between patients. This is the first documented fatal P. aeruginosa outbreak described at the San Fernando General hospital.- - - - - - - - - - ranking = 3keywords = environment (Clic here for more details about this article) |
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