11/330. Isolation, identification, and molecular characterization of strains of photorhabdus luminescens from infected humans in australia.We describe the isolation of photorhabdus (xenorhabdus) luminescens from four Australian patients: two with multiple skin lesions, one with bacteremia only, and one with disseminated infection. One of the patients had multiple skin lesions following the bite of a spider, while the lesions in the other patient were possibly associated with a spider bite. The source of infection for the remaining two patients is unknown. As a member of the family enterobacteriaceae, P. luminescens is unusual in that it fails to reduce nitrate and ferments only glucose and mannose. It gives negative reactions for lysine decarboxylase, arginine dihydrolase, and ornithine decarboxylase (Moeller). The species is motile, utilizes citrate, hydrolyzes urea, and usually produces a unique type of annular hemolysis on sheep blood agar plates incubated at 25 degrees C. A weak bioluminescence is the defining characteristic. P. luminescens is an insect pathogen and is symbiotically associated with entomopathogenic nematodes. Its isolation from human clinical specimens has been reported previously from the united states. Restriction fragment length polymorphism-PCR analysis of the 16S rRNA gene demonstrated a high level of similarity among the Australian clinical strains and significant differences between the Australian clinical strains and the U.S. clinical strains. However, numerical analyses of the data suggest that the two groups of clinical strains are more similar to each other than they are to the symbiotic strains found in nematodes. This is the first report of the isolation of P. luminescens from infected humans in australia and the second report of the isolation of this species from infected humans worldwide.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
12/330. Genital ulcer caused by human bite to the penis.BACKGROUND AND OBJECTIVES: Human bite injuries, while less frequent than cat or dog bites, usually stem from aggressive behavior, sports, or sexual activity. It has been thought that human bites have a higher rate of infection than animal bites, but this view is likely skewed because of the frequency of closed fist injuries presenting to emergency rooms. Human bites to the genitalia also occur, but are not often reported because of embarrassment. GOAL OF THE STUDY: We report a genital ulceration after a human bite to the penis and review appropriate diagnostic and therapeutic maneuvers. STUDY DESIGN: This article reports the development of a severe genital ulcer associated with a human bite to the penis secondarily infected, as verified by culture, with an oral flora organism eikenella corrodens. RESULTS: The genital ulceration healed after appropriate antibiotic therapy. CONCLUSIONS: Treatment of human bites focuses on obtaining an accurate history and performing a salient physical examination, as well as early irrigation and debridement. Transmission of communicable disease should be considered as a possible consequence. Prophylactic antibiotic treatment and primary closure of wounds continue to be areas of controversy.- - - - - - - - - - ranking = 0.5keywords = infection (Clic here for more details about this article) |
13/330. The application of immobilized polymyxin b fiber in the treatment of septic shock associated with severe acute pancreatitis: report of two cases.The elimination of endotoxin by direct hemoperfusion over immobilized polymyxin b fiber (PMX-F) was carried out in two patients who developed septic shock associated with severe acute pancreatitis. Parameters such as blood pressure, body temperature, and plasma endotoxin level improved after PMX-F treatment, and the infected lesions were successfully and safely removed by surgery. Although an aggressive operative strategy of debridement with ultimate closure over drains is generally associated with low mortality in patients with this devastating disease, we often hesitate to perform this operation due to the poor condition of the patient in the acute period, with multiple organ failure and/or septic shock status, and also because of the difficulty in diagnosing the pancreatic infection. In this situation, endotoxin elimination using PMX-F is a useful tool for treating secondary pancreatic infections to help the patient recover in preparation for surgery, or for treating perioperative endotoxemia.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
14/330. Emerging gram-negative pathogens in the immunocompromised host: agrobacterium radiobacter septicemia during hiv disease.Three out of 2,412 consecutive hiv-infected patients hospitalized since 1990, developed agrobacterium radiobacter septicemia. All patients were severely immunocompromised, showing a prior diagnosis of AIDS, concurrent opportunistic infections, a mean CD4 lymphocyte count below 100 cells/microL, and neutropenia. Nosocomial A. radiobacter sepsis occurred in two cases of three, and was related to a lower neutrophil and CD4 cell count. Antibiotic and cotrimoxazole treatment were carried out during the month preceding disease onset by two and three patients, respectively. Antimicrobial susceptibility assays showed resistance to ureidopenicillins and aztreonam, and complete sensitivity to carbapenems, amikacin, and ciprofloxacin. A therapeutic regimen including amikacin plus ceftriaxone or ceftazidime obtained clinical and microbiological cure in all cases, in the absence of related mortality or relapses. Only two episodes of hiv-associated A. radiobacter complications have been described to date: one case of sepsis and one patient with pneumonia. Despite their low frequency, gram-negative non-fermenting bacilli should be considered in hiv-infected patients with a suspected bacterial complication, because of their cumbersome identification procedures, and their unpredictable antibiotic susceptibility, with elevated resistance to many compounds expected to be effective against gram-negative organisms. A. radiobacter may play a pathogenic role in patients with advanced hiv disease, even when some commonly recognized risk factors are lacking (in-dwelling catheters and instrumentation), while a very low CD4 lymphocyte count, leukopenia-neutropenia, hospitalization, and concurrent AIDS-related infectious complications, may act as predisposing factors.- - - - - - - - - - ranking = 0.5keywords = infection (Clic here for more details about this article) |
15/330. Novel bacterium isolated from a lung transplant patient with cystic fibrosis.The major clinical problem for patients with cystic fibrosis (CF) is progressive loss of pulmonary function, usually due to chronic bacterial infections. A patient with CF and a lung transplant was severely infected with a previously unidentified gram-negative bacterium. We isolated this organism (strain DS15158) from the patient and characterized it by phylogenetic analysis of the small-subunit rRNA and biochemically by the BIOLOG GN MicroPlate assay, fatty acid analysis, and various standard laboratory tests. No close match to any other organism could be found. Isolate DS15158 represents a new genus-level divergence within the bacterial subdivision alpha-proteobacteria on the basis of the 16S rRNA gene analysis.- - - - - - - - - - ranking = 0.8976240276429keywords = infection, bacterial infection (Clic here for more details about this article) |
16/330. Outcome of an opportunistic infection after polymicrobial peritonitis in an hiv-infected patient treated with peritoneal dialysis.The prevalence of human immuodeficiency virus (hiv)-infected patients with end stage renal disease (ESRD) is likely to increase and many of them will be on peritoneal dialysis as renal replacement therapy. Infectious complications are a major problem associated with peritoneal dialysis (PD). It has been speculated that the hiv-positive peritoneal dialysis population may develop peritonitis more frequently than other peritoneal dialysis patients. We present the complications and unexpected good response to medical management of PD-associated peritonitis in a young hiv-infected black male. He had two unusual and serious infections; the first was a polymicrobial peritonitis which predisposed the patient to an unusual infection caused by Corynebacteria JK for which he was successfully treated without catheter removal. copyright copyright 1999 S. Karger AG, Basel- - - - - - - - - - ranking = 3keywords = infection (Clic here for more details about this article) |
17/330. Aeromonas abscess in an immunocompromised child.An 11-year-old immunocompromised child developed cellulitis and abscess due to aeromonas hydrophila at the site of bone marrow aspiration after swimming in a freshwater lake. The patient required treatment with intravenous antibiotics and surgical debridement to eradicate the infection. Both common and unusual organisms may complicate infections at the sites of percutaneous procedures.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
18/330. peritonitis due to Roseomonas fauriae in a patient undergoing continuous ambulatory peritoneal dialysis.Roseomonas is a newly described genus of pink-pigmented, nonfermentative, gram-negative bacteria that have been recognized as a cause of human infections. Roseomonas fauriae is a species rarely isolated from clinical specimens. We report the first known case of peritonitis caused by R. fauriae in a patient receiving continuous ambulatory peritoneal dialysis.- - - - - - - - - - ranking = 0.5keywords = infection (Clic here for more details about this article) |
19/330. Multiple recurrent gram-negative cerebrospinal fluid shunt infections associated with a patient with a retained ventricular foreign body.A 3-year-old boy experienced 10 recurrent gram-negative ventriculoperitoneal shunt (VPS) infections with identical strains over a 17-month period. Multiple cranial MRI and CT scans to identify a retained foreign body were negative. CT myelography and pressure infusion radionuclide cisternography were also unhelpful. Ventriculoscopy revealed a small retained foreign body which was successfully removed, and cultures subsequently yielded gram-negative organisms identical to the previously identified bacteria by pulsed field gel electrophoresis. No further infections were noted after removal of the retained fragment. Exploratory ventriculostomy should be considered in patients with recurrent VPS infections where other techniques fail to reveal a cause.- - - - - - - - - - ranking = 3.5keywords = infection (Clic here for more details about this article) |
20/330. Septic arthritis caused by a gram-negative bacterium representing a new species related to the bordetella-Alcaligenes complex.A knee-joint exudate culture yielded on two occasions a gram-negative bacterium. Regular methods for speciation did not provide an identification. The infection was successfully treated with ciprofloxacin. The unknown isolate, CCUG 36768, was subjected to further investigation, including 16S rDNA sequencing, protein profiling, cellular fatty acid analysis, and various biochemical tests, in order to produce a species identification. The 1469 bp-long 16S rDNA sequence did not reveal identity with any known species sequence. CCUG 36768 clustered in a group of species, including Alcaligenes defragrans, Denitrobacter permanens, taylorella equigenitalis, alcaligenes faecalis, and four strains of Alcaligenes species without a specific species name. bordetella species also showed a high degree of similarity with CCUG 36768. Protein profiling, cellular fatty acid analysis and computer-assisted analysis of biochemical profiles indicated similarity with bordetella-Alcaligenes species, often close to B. holmesii and B. avium. API 20 NE indicated the profile of moraxella species of poor identity. It is concluded that CCUG 36768 represents a new bacterial species of pathogenic potential in humans. It is related to the bordetella-Alcaligenes group. Powerful new methods for speciation are available and it is recommended that unknown isolates from normally sterile sites be submitted for further analysis. Several isolates are required for the definition of new species.- - - - - - - - - - ranking = 0.5keywords = infection (Clic here for more details about this article) |
| <- Previous || Next -> |