1/14. nocardia asteroides pneumonia, subcutaneous abscess and meningitis in a patient with advanced malignant lymphoma: successful treatment based on in vitro antimicrobial susceptibility.nocardia asteroides pneumonia, subcutaneous abscess and meningitis without brain abscesses developed in a patient with advanced non-Hodgkin's lymphoma, who had received corticosteroid therapy and cancer chemotherapy for a long time. At the time of nocardial pneumonia, profound lymphocytopenia and hypogammaglobulinemia was seen. The severely immunosuppressed condition most likely accounted for the uncommon infection, nocardiosis. The organism isolated from the sputum, subcutaneous abscess and cerebrospinal fluid was strongly resistant to cotrimoxazole, which is the recommended standard treatment, but it was susceptible to imipenem (IPM) and erythromycin (EM) in an in vitro antimicrobial susceptibility study. The patient's nocardiosis responded well to chemotherapy including IPM and EM.- - - - - - - - - - ranking = 1keywords = susceptibility (Clic here for more details about this article) |
2/14. A case of haemophilus parainfluenzae pneumonia.A 41 year old woman presented with community acquired pneumonia (CAP) which failed to resolve following treatment with amoxycillin and cefaclor prior to referral. Quantitative culture of sputum revealed a pure growth of haemophilus parainfluenzae and, following antibiotic susceptibility testing of the isolate, ciprofloxacin was prescribed resulting in resolution of the infection. Immunological investigations showed that the patient had a high titre of H parainfluenzae specific IgM. The combination of a pure growth of H parainfluenzae, a response to appropriate antimicrobial therapy, and the presence of a specific antibody response indicated that this organism had a pathogenic role in the patient's pneumonia and should be considered in the differential diagnosis of CAP.- - - - - - - - - - ranking = 0.2keywords = susceptibility (Clic here for more details about this article) |
3/14. eikenella corrodens: an unusual cause of severe parapneumonic infection and empyema in immunocompetent patients.Over the past 25 years, eikenella corrodens has increasingly been recognized for its pathogenic potential. Previously identified as an organism most likely to cause opportunistic infection in the immunocompromised host, Eikenella more recently has been implicated in a number of clinical infections in non-immunocompromised patients. We report a case of community-acquired pneumonia, caused by Eikenella, in a patient with diabetes mellitus and a past history of testicular cancer. A review of the literature was conducted in order to review other cases of pulmonary infection with Eikenella, in immunocompetent adults. The condition was diagnosed in 15 patients, occurring most often in men with a mean age of 50. patients most often presented with fever, cough and pleuritic chest pain. Complications often involved parapneumonic effusion, empyema, and necrotic parenchymal disease. mortality rates appear to be low. Eikenella is most often susceptible to ampicillin and has variable susceptibility to aminoglycosides. The addition of clindamycin in non-immunocompromised patients with Eikenella infection, co-infected with other pathogens, also appears to be useful. Surgical intervention plays an important role in the recovery of these patients.- - - - - - - - - - ranking = 0.2keywords = susceptibility (Clic here for more details about this article) |
4/14. rhodococcus equi pneumonia in a patient with human immunodeficiency virus: case report and review.rhodococcus equi is a facultative, intracellular, gram-positive coccobacillus increasingly reported as an opportunistic pathogen in patients positive for human immunodeficiency virus (hiv). An hiv-positive man developed R. equi pneumonia and sepsis. He failed to improve despite surgical drainage of localized infection and many empiric antibiotics. time-kill studies of R. equi isolated from the patient were performed against various antimicrobial agents to optimize therapy. levofloxacin seemed to offer excellent in vitro bactericidal activity. Antagonism was observed with certain antibiotic combinations. Our anecdotal case report suggests that fluoroquinolones such as levofloxacin may offer superior efficacy to standard therapy in rhodococcal infections; their clinical utility deserves further investigation. In view of potential antagonism, prospective susceptibility testing for various drugs and drug combinations should be considered when clinically indicated.- - - - - - - - - - ranking = 0.2keywords = susceptibility (Clic here for more details about this article) |
5/14. Multidrug-resistant corynebacterium striatum pneumonia in a heart transplant recipient.corynebacterium striatum is a rare, but likely underreported, cause of serious infections in immunocompromised hosts and generally is susceptible to multiple classes of antimicrobial agents. Here we report the first case of C. striatum infection in a solid organ transplant recipient. Three years after heart transplantation, a 58-year-old man developed bilateral pneumonia and pulmonary embolism. He did not improve with levofloxacin, piperacillin/tazobactam, and heparin treatment. A homogeneous population of abundant gram-positive rods was repeatedly demonstrated in sputum and bronchoalveolar lavage fluid, and C. striatum was grown in pure culture. The isolate was unusual for its multidrug-resistant (MDR) antimicrobial susceptibility pattern. The pneumonia resolved with 4 weeks of vancomycin therapy, in combination with rifampin given only during the first 2 weeks of treatment. The isolation of coryneforms ("diphtheroids") is often attributed to contamination. Their abundant presence on direct examination of specimens and/or their growth in pure culture suggest a pathogenic role, however, and indicate the need for accurate microbiological identification, particularly in immunocompromised hosts who have been hospitalized and previously treated with antibiotics. Combination therapy that includes vancomycin may be the most prudent treatment for MDR C. striatum infections.- - - - - - - - - - ranking = 0.2keywords = susceptibility (Clic here for more details about this article) |
6/14. melioidosis in a traveller from thailand: case report.A 42-year old Italian male with type 2 diabetes and HCV-related chronic hepatitis spent 6 months in thailand. After his return in June 2002 he was admitted to the Infectious Diseases Unit of the Hospital of Livorno (italy) because of fever, chest pain and skin abscesses in the legs. Chest x-rays and CT scan revealed multiple bilateral cavitary lesions in the lungs. ultrasonography and CT scan showed numerous subcentimetric spleen abscesses. burkholderia pseudomallei was isolated from the cutaneous lesions and sputum and thus melioidosis was diagnosed. A 6-week course of i.v. ceftazidime plus oral doxycycline was given during the acute phase of the illness. The in vitro susceptibility testing showed that long-term (20 weeks) antimicrobial therapy with doxycycline and moxifloxacin was required. Complete resolution of pulmonary and spleen lesions was obtained within 6 weeks of therapy and of cutaneous abscesses in 10 weeks. No significant side effects were noted during the follow-up period using this scheme of antimicrobial therapy.- - - - - - - - - - ranking = 0.2keywords = susceptibility (Clic here for more details about this article) |
7/14. Amoebal coculture of "Mycobacterium massiliense" sp. nov. from the sputum of a patient with hemoptoic pneumonia.A nonphotochromogenic, rapidly growing Mycobacterium strain was isolated in pure culture from the sputum and the bronchoalveolar fluid of a patient with hemoptoic pneumonia by using axenic media and an amoebal coculture system. Both isolates grew in less than 7 days at 24 to 37 degrees C with an optimal growth temperature of 30 degrees C. The isolates exhibited biochemical and antimicrobial susceptibility profiles overlapping those of Mycobacterium abscessus, mycobacterium chelonae, and Mycobacterium immunogenum, indicating that they belonged to M. chelonae-M. abscessus group. They differed from M. abscessus in beta-galactosidase, beta-N-acetyl-beta-glucosaminidase, and beta-glucuronidase activities and by the lack of nitrate reductase and indole production activities, as well as in their in vitro susceptibilities to minocycline and doxycycline. These isolates and M. abscessus differed from M. chelonae and M. immunogenum by exhibiting gelatinase and tryptophane desaminase activities. Their 16S rRNA genes had complete sequence identity with that of M. abscessus and >99.6% similarity with those of M. chelonae and M. immunogenum. Further molecular investigations showed that partial hsp65 and sodA gene sequences differed from that of M. abscessus by five and three positions over 441 bp, respectively. Partial rpoB and recA gene sequence analyses showed 96 and 98% similarities with M. abscessus, respectively. Similarly, 16S-23S rRNA internal transcribed spacer sequence of the isolates differed from that of M. abscessus by a A-->G substitution at position 60 and a C insertion at position 102. Phenotypic and genotypic features of these two isolates indicated that they were representative of a new mycobacterial species within the M. chelonae-M. abscessus group. Phylogenetic analysis suggested that these isolates were perhaps recently derived from M. abscessus. We propose the name of "Mycobacterium massiliense" for this new species. The type strain has been deposited in the Collection Institut Pasteur as CIP 108297(T) and in culture Collection of the University of Goteborg, Goteborg, sweden, as CCUG 48898(T).- - - - - - - - - - ranking = 0.2keywords = susceptibility (Clic here for more details about this article) |
8/14. Pneumonia and empyema caused by penicillin-resistant neisseria meningitidis: a case report and literature review.Pneumonia is an uncommon manifestation of neisseria meningitidis infection, and empyema is rarely reported. Uniform penicillin susceptibility has been assumed for meningococcal infections for many years, but decreased penicillin susceptibility has been recognized recently with increasing frequency. Breakpoints to define different categories of susceptibility were published recently by the Clinical and Laboratory Standards Institute. We report the case of a teenage girl with sepsis and extensive bilateral pneumonia with empyema caused by an N meningitidis isolate that was resistant to penicillin. Her protracted clinical course suggested that penicillin resistance contributed to her delayed recovery. Our experience with this patient suggests that susceptibility testing should be performed in every case of N meningitidis isolation, and treatment with a third-generation cephalosporin should be provided until the susceptibility results are known. Clinical suspicion of N meningitidis as a possible cause of respiratory symptoms accompanied by hypotension, even in the absence of a rash, may aid in diagnosis and therefore in the treatment and provision of prophylaxis to contacts of patients with meningococcal disease.- - - - - - - - - - ranking = 1keywords = susceptibility (Clic here for more details about this article) |
9/14. The spread of klebsiella pneumoniae carbapenemase-producing K. pneumoniae to upstate new york.klebsiella pneumoniae carbapenemases (KPCs) have previously been identified in distinct geographic locations. We report the spread of KPC-2 to upstate new york. Our intention is to alert clinicians to problems encountered in identifying KPC-containing isolates. Possible errors as a result of inferring susceptibility of untested carbapenems from the routine antibiogram using agar-based methodology or microdilution testing are discussed.- - - - - - - - - - ranking = 0.2keywords = susceptibility (Clic here for more details about this article) |
10/14. Bacteraemic pneumonia caused by neisseria lactamica with reduced susceptibility to penicillin and ciprofloxacin in an adult with liver cirrhosis.This report presents a case of bacteraemic pneumonia caused by neisseria lactamica in an adult patient with liver cirrhosis who was successfully treated with ceftriaxone. The isolate was confirmed as N. lactamica by analysis of a partial sequence of the 16S rRNA gene; it had reduced susceptibilities to penicillin (MIC 0.75 microg ml(-1)) and ciprofloxacin (MIC > or =0.5 mg l(-1)).- - - - - - - - - - ranking = 0.8keywords = susceptibility (Clic here for more details about this article) |
| | Next -> |