1/16. stenotrophomonas (xanthomonas) maltophilia infection in necrotizing pancreatitis.CONCLUSION: Although the therapy of infected pancreatic collections or organized pancreatic necrosis remains surgical, we have demonstrated that infected organized pancreatic necrosis can be treated endoscopically. BACKGROUND: stenotrophomonas (xanthomonas) maltophilia has been increasingly recognized as a nosocomial pathogen associated with meningitis, pneumonia, conjunctivitis, soft tissue infections, endocarditis, and urinary tract infections. This organism is consistently resistant to imipenem, a drug commonly employed in patients with necrotizing pancreatitis to prevent local and systemic infections. methods AND RESULTS: We report the first case of infected pancreatic necrosis by S. (X.) maltophilia. Our patient was treated successfully with endoscopic drainage of the pancreatic fluid collection and appropriate antibiogram-based antibiotic therapy. Endoscopic drainage has emerged as one of the treatment modalities for pancreatic fluid collections.- - - - - - - - - - ranking = 1keywords = nosocomial (Clic here for more details about this article) |
2/16. Open-label, multicentre, emergency-use study of clinafloxacin (CI-960) in the treatment of patients with serious life-threatening infections.In an open-label emergency-use study, 23 patients with bacterial infections caused by multiply drug resistant pathogens were treated with clinafloxacin. Efficacy and safety were evaluated by tabulating investigators' assessments at the end of treatment, treatment discontinuations and adverse event data. Most of the patients were seriously ill and had multi-organ infections, primarily respiratory tract infections such as nosocomial pneumonia and gastrointestinal infections. Eleven patients were successfully treated, two had treatment failure and 10 were not evaluable because the patients died of their underlying disease. Considering that most of the patients had several infections caused by multiply resistant pathogens, clinafloxacin may be useful for the treatment of such life-threatening episodes.- - - - - - - - - - ranking = 1keywords = nosocomial (Clic here for more details about this article) |
3/16. achromobacter xylosoxidans. An unusual neonatal pathogen.Perinatal acquisition of a rare pediatric pathogen, achromobacter xylosoxidans, with evidence for in utero transmission, is described. Cultures from the mother and neonate demonstrated A. xylosoxidans. An ascending bacterial infection in the mother with clinical chorioamnionitis is presented as the probable mode of transmission. Postmortem examination of the infant confirmed achromobacter meningitis. In contrast to the current case with transmission from mother to neonate, previously published neonatal cases of achromobacter infections indicate that nosocomial transmission of the organism is most common (79%). In addition, the literature review revealed a high mortality associated with meningitis (77%), frequent hydrocephalus, and subsequent neurologic sequelae (36%). To the authors' knowledge, this is the first documented case of maternal-fetal transfer of A. xylosoxidans.- - - - - - - - - - ranking = 1keywords = nosocomial (Clic here for more details about this article) |
4/16. Serious infections involving the CDC group Ve bacteria Chryseomonas luteola and Flavimonas oryzihabitans.Chryseomonas luteola and Flavimonas oryzihabitans are phenotypically similar gram-negative bacilli and are also referred to as CDC groups Ve-1 and Ve-2, respectively. These bacteria are rarely reported as pathogens in humans. Infections described in the literature include primarily bacteremia in critically ill patients and peritonitis in patients undergoing continuous ambulatory peritoneal dialysis. We describe three cases of polymicrobial infection secondary to infection with group Ve organisms, including the first reported case (to our knowledge) of CNS infection due to F. oryzihabitans. These three cases and a review of literature suggest an association between the presence of indwelling catheters and polymicrobial infections with CDC group Ve organisms. F. oryzihabitans and C. luteola should be added to the expanding list of nosocomial pathogens with a propensity to infect critically ill patients who have undergone surgical procedures and/or had indwelling catheters placed. The isolation of either of these organisms from clinical specimens should prompt a search for a device-related source.- - - - - - - - - - ranking = 1keywords = nosocomial (Clic here for more details about this article) |
5/16. A longterm follow-up study of children born to women with contagious diseases at delivery.Data are presented from a long-term follow-up study of 308 live born children to women admitted post partum to the Department of Infectious Diseases (DID), Danderyd Hospital, sweden, during a 10-year period (1975-1984) for avoiding nosocomial transmission of infections in the obstetrical wards. The rate of stillbirths (1/309 deliveries) was not higher than reported for all births in Stockholm. 20% of the live born children were transferred within 24 h after birth to the pediatric department for observation, but half of them could return to their mothers at the DID within 6 days (generally 3 days). Four newborns were treated at an intensive care unit. Only 3 fatalities occurred, all of them among newborns to mothers with an overt infection at delivery. The fatality rate (1.8%) was significantly higher among the newborns of these mothers than normally (0.3%) noted among all children born in Stockholm county during the period studied. Two of the 3 newborns, who all died within 3 days of life, had a low birth weight (600 and 1,000 g). The total number of newborns with low birth weights (less than 2,500 g) was, however, not higher in the above-mentioned group of newborns than for all children born in Stockholm county 1980. None of the 3 fatalities was caused by infection transmitted from the mother. No further deaths occurred. Infections in pregnancy at term, at birth or post partum were transmitted from the women to 41 (13%) of their newborns.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 1keywords = nosocomial (Clic here for more details about this article) |
6/16. Late, late-onset infections in the nursery.Infections affecting infants in the hospital nursery are generally divided into those with a prenatal onset and early- and late-onset postnatal infections. Little attempt has been made to differentiate infections affecting infants more than a week of age from those with an onset at several months of age. Three cases are presented which demonstrate how, currently, infants far older than one month of age are being treated for nosocomial, nursery-associated infections. This information has implications both for treatment decisions and for the gathering of epidemiologic data on nosocomial infections.- - - - - - - - - - ranking = 30.338320404148keywords = nosocomial infection, nosocomial (Clic here for more details about this article) |
7/16. pneumonia due to aeromonas hydrophila-complex: epidemiologic, clinical, and microbiologic features.review of published data examining the various types of infections produced by strains of the aeromonas hydrophila-complex demonstrates a paucity of information on lower respiratory tract infections due to this organism. Although it is rarely cited as a cause of pneumonitis, we have been able to collect epidemiologic, clinical, and microbiologic data on eight patients who have had evidence of Aeromonas pneumonia. Interestingly, seven of the eight patients were male, and the average age for the group was 54.3 years. In contrast to reports showing a prevalence of other types of A hydrophila infections during the summer months, five of the pneumonitis cases occurred during late fall and early winter. Infections were both community-acquired and nosocomial. A proven or suspected history of aspiration was present in six patients. Preexisting medical conditions were noted in all patients, the majority having multiple predisposing factors, which included alcohol abuse and alcoholic liver disease, cardiovascular and cerebrovascular disease, and chronic lung disease. Three patients died of their acute pulmonary infection. Based on in vitro antimicrobial susceptibility testing, aminoglycoside therapy would seem appropriate in the treatment of these infections.- - - - - - - - - - ranking = 1keywords = nosocomial (Clic here for more details about this article) |
8/16. Infections due to achromobacter xylosoxidans. Case report and review of the literature.achromobacter xylosoxidans is an uncommon nosocomial pathogen known to cause many serious infections. A 69-year-old woman with diabetes mellitus and chronic renal failure was admitted with pulmonary edema. The patient developed fever and pulmonary infiltrate with bilateral pleural effusions while she was on a respirator in the intensive care unit. culture of sputum, pleural fluid and blood grew A. xylosoxidans. Bilateral chest tubes were inserted and the patient was treated for one month with piperacillin and trimethoprim-sulfamethoxazole. Gradual response, both clinically and radiologically, was noted after prolonged therapy. A review of the literature on infections due to A. xylosoxidans, the unique susceptibility pattern of the organism to various antibiotics and the use of combination therapy in achromobacter infections are discussed.- - - - - - - - - - ranking = 1keywords = nosocomial (Clic here for more details about this article) |
9/16. Nosocomial pneumonia caused by a glucose-metabolizing strain of neisseria cinerea.We describe what appears to be the first reported case of nosocomial pneumonia caused by neisseria cinerea. The isolate metabolized glucose when tested in BACTEC Neisseria Differentiation Kits (Johnston laboratories), but did not produce detectable acid in cystine-Trypticase (BBL microbiology Systems) agar medium or in modified oxidation-fermentation medium. Clinical laboratories that rely on the BACTEC method for differentiation of pathogenic neisseriae should be aware of the fact that N. cinerea may mimic N. gonorrhoeae when tested in BACTEC Neisseria Differentiation kits. The ability of N. cinerea to grow well on tryptic soy and Mueller-Hinton agars and its inability to grow on modified Thayer-Martin medium are characteristics which help to distinguish N. cinerea from N. gonorrhoeae.- - - - - - - - - - ranking = 1keywords = nosocomial (Clic here for more details about this article) |
10/16. sepsis associated with urinary tract infection. Antibiotic treatment with piperacillin.Urosepsis is mostly induced by nosocomial gram-negative organisms. It is an infection that is difficult to treat and has high mortality, especially when associated with septic shock. For obstructive urosepsis, which occurs mostly after an acute stone occlusion of the upper urinary tract in pyelonephritis, intensive systemic medical therapy and drainage (and sometimes removal) of the septic kidney are necessary. For non-obstructive urosepsis, which is mostly an iatrogenic complication of diagnostic or therapeutic procedures on the genito-urinary tract, the same intensive medical care and urinary drainage are adequate. Systemic therapy in the treatment of urosepsis encompasses several disorders. Specific pathogenic mechanisms of shock, including failure of the microcirculation, hemostatic disorders, and microbiological problems, have to be considered in the systemic treatment of urosepsis. Appropriate antibiotic therapy may triple chances of survival. In this connection, piperacillin was successfully used in 30 patients with urosepsis treated at our institution.- - - - - - - - - - ranking = 1keywords = nosocomial (Clic here for more details about this article) |
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