RESUMEN
Seriously compromised patients may acquire deep airway ailments by Gram positive, commensal bacteria including Kytococcus and Rothia, pathogenic tracts of which still remain quite unexplored. Resistances they express have been poorly investigated over the years, and no published guidelines for susceptibility testing and antibiotic therapy exist. We would therefore revise the current knowledge about these opportunistic organisms' clinical impact, as well as discuss on recent patents focusing on lung infection management. Particularly, these deal with the use of inhalatory vancomycin, even as lipidic complex, that appears a promising adjunctive treatment to systemic antimicrobials.
Asunto(s)
Antibacterianos/administración & dosificación , Bacterias Grampositivas/patogenicidad , Enfermedades Respiratorias/tratamiento farmacológico , Enfermedades Respiratorias/microbiología , Vancomicina/administración & dosificación , Administración por Inhalación , Bacterias Grampositivas/efectos de los fármacos , HumanosRESUMEN
Candida guilliermondii is an uncommon isolate throughout most of the world, the behaviour of which as an environmental fungus, a human saprophyte and an agent of serious infections has been emphasised over the years. Notably, illnesses caused by this pathogen mostly involve compromised cancer hosts and commonly lead patients to unfavourable outcomes. It is of concern that the yeast may acquire or inherently express reduced in vitro sensitivity to all antifungal classes, although widespread resistance has not yet been described, and poor correlation exists between MICs and clinical outcome. However, the organism appears as constitutively less susceptible to polyenes and echinocandins than other yeast-like fungi, so that the emergence of such pathogen in the clinical settings is of concern and may appear as a new challenge in the context of mycoses and antifungal therapy.
Asunto(s)
Candida/aislamiento & purificación , Candidiasis/epidemiología , Candidiasis/microbiología , Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/microbiología , Antifúngicos/farmacología , Antifúngicos/uso terapéutico , Candida/clasificación , Candidiasis/tratamiento farmacológico , Enfermedades Transmisibles Emergentes/tratamiento farmacológico , Farmacorresistencia Fúngica , Humanos , Huésped Inmunocomprometido , Pruebas de Sensibilidad Microbiana , Insuficiencia del TratamientoRESUMEN
Organisms in the genus Kocuria are Gram-positive, coagulase-negative, coccoid actinobacteria belonging to the family Micrococcaceae, suborder Micrococcineae, order Actinomycetales. Sporadic reports in the literature have dealt with infections by Kocuria species, mostly in compromised hosts with serious underlying conditions. Nonetheless, the number of infectious processes caused by such bacteria may be higher than currently believed, given that misidentification by phenotypic assays has presumably affected estimates of the prevalence over the years. As a further cause for concern, guidelines for therapy of illnesses involving Kocuria species are lacking, mostly due to the absence of established criteria for evaluating Kocuria replication or growth inhibition in the presence of antibiotics. Therefore, breakpoints for staphylococci have been widely used throughout the literature to try to understand this pathogen's behaviour under drug exposure; unfortunately, this has sometimes created confusion, thus higlighting the urgent need for specific interpretive criteria, along with a deeper investigation into the resistance determinants within this genus. We therefore review the published data on cultural, genotypic and clinical aspects of the genus Kocuria, aiming to shed some light on these emerging nosocomial pathogens.
Asunto(s)
Infecciones por Actinomycetales/microbiología , Actinomycetales/efectos de los fármacos , Antibacterianos/farmacología , Actinomycetales/clasificación , Actinomycetales/citología , Actinomycetales/genética , Técnicas de Tipificación Bacteriana , Genoma Bacteriano , HumanosAsunto(s)
Infecciones por Acinetobacter/microbiología , Acinetobacter baumannii/efectos de los fármacos , Errores Diagnósticos , Unidades de Cuidados Intensivos , Resistencia betalactámica , Acinetobacter baumannii/aislamiento & purificación , Ampicilina/farmacología , Humanos , Sulbactam/farmacologíaAsunto(s)
Infecciones por Acinetobacter/microbiología , Acinetobacter baumannii/efectos de los fármacos , Antibacterianos/farmacología , Infección Hospitalaria/microbiología , Farmacorresistencia Bacteriana , Enfermedades Hematológicas/complicaciones , Minociclina/análogos & derivados , Acinetobacter baumannii/aislamiento & purificación , Enteritis/microbiología , Heces/microbiología , Humanos , Minociclina/farmacología , Esputo/microbiología , TigeciclinaAsunto(s)
Resistencia a las Cefalosporinas , Enterobacter aerogenes/efectos de los fármacos , Infecciones por Enterobacteriaceae/tratamiento farmacológico , Infecciones por Enterobacteriaceae/epidemiología , Humanos , Pruebas de Sensibilidad Microbiana , Infecciones Oportunistas/tratamiento farmacológico , Infecciones Oportunistas/epidemiologíaRESUMEN
This case report is a case history of a femoral prosthesis infection caused by Rhodotorula mucilaginosa in a human immunodeficiency virus patient. Though the pathogenicity of this organism for bone tissue has been previously reported, this is the first reported case of an orthopedic prosthesis infection by this species of the genus Rhodotorula.
Asunto(s)
Micosis/diagnóstico , Infecciones Relacionadas con Prótesis/microbiología , Rhodotorula/aislamiento & purificación , Adulto , Femenino , VIH , HumanosRESUMEN
We describe the case of a graft versus host disease (GvHD) patient, in whom Hafnia alvei was cultured as a single organism, and at high bacterial counts from stool samples, from the onset of the disease until its resolution. This case is a further example of the contentious role of this species in causing human intestinal disease. Furthermore, it focuses on enteric damage by GvHD as a risk factor for acquiring H. alvei colonization, and probably infection.
Asunto(s)
Portador Sano/microbiología , Infecciones por Enterobacteriaceae/microbiología , Gastroenteritis/microbiología , Enfermedad Injerto contra Huésped/complicaciones , Hafnia alvei/aislamiento & purificación , Corticoesteroides/uso terapéutico , Antibacterianos/uso terapéutico , Portador Sano/tratamiento farmacológico , Niño , Infecciones por Enterobacteriaceae/complicaciones , Infecciones por Enterobacteriaceae/tratamiento farmacológico , Anemia de Fanconi/complicaciones , Anemia de Fanconi/terapia , Heces/microbiología , Femenino , Gastroenteritis/complicaciones , Gastroenteritis/tratamiento farmacológico , Hafnia alvei/efectos de los fármacos , Humanos , Huésped Inmunocomprometido , Trasplante de Células MadreRESUMEN
In this article, a case of decubitus ulcer infection caused by an extended-spectrum beta-lactamase-producing Proteus mirabilis strain, successfully treated with oral amoxicillin-clavulanate (1-month therapy) is described. This article focuses on diffusion and clinical effect of extended-spectrum beta-lactamases-producing Proteus mirabilis on treatment of gram negative lower extremity infections.
Asunto(s)
Antibacterianos/uso terapéutico , Farmacorresistencia Bacteriana , Úlcera por Presión/microbiología , Infecciones por Proteus/tratamiento farmacológico , Proteus mirabilis , Infección de Heridas/tratamiento farmacológico , beta-Lactamas/uso terapéutico , Anciano , Antibacterianos/farmacología , Quimioterapia Combinada , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Infecciones por Proteus/diagnóstico , Infecciones por Proteus/microbiología , Infección de Heridas/diagnóstico , Infección de Heridas/microbiología , beta-Lactamas/farmacologíaRESUMEN
Genitourinary infections caused by non-Candida yeasts are uncommon, and especially due to Saccharomyces cerevisiae. We describe the cases of two adult females with vulvovaginal infections caused by itraconazole-resistant S. cerevisiae who made a full recovery after oral fluconazole therapy. We also provide a concise review of recently published studies on this topic.
Asunto(s)
Micosis/microbiología , Saccharomyces cerevisiae/patogenicidad , Vaginitis/microbiología , Adulto , Antifúngicos/farmacología , Candidiasis Vulvovaginal/diagnóstico , Diagnóstico Diferencial , Farmacorresistencia Fúngica , Femenino , Fluconazol/uso terapéutico , Humanos , Itraconazol/farmacología , Persona de Mediana Edad , Micosis/tratamiento farmacológico , Saccharomyces cerevisiae/efectos de los fármacos , Saccharomyces cerevisiae/aislamiento & purificación , Vaginitis/tratamiento farmacológico , Vulvovaginitis/tratamiento farmacológico , Vulvovaginitis/microbiologíaRESUMEN
The authors have reported the first case of vaginal infection caused by Enterococcus raffinosus. The latter is a rarely identified species, but some of the infections described in the literature should direct some attention to this, often opportunistic pathogen, and its emerging multidrug resistance.
Asunto(s)
Enterococcus/aislamiento & purificación , Infecciones por Bacterias Grampositivas/microbiología , Vaginosis Bacteriana/microbiología , Antibacterianos/uso terapéutico , Enterococcus/clasificación , Femenino , Infecciones por Bacterias Grampositivas/diagnóstico , Infecciones por Bacterias Grampositivas/tratamiento farmacológico , Humanos , Huésped Inmunocomprometido , Persona de Mediana EdadRESUMEN
Throat cultures from an adult pharyngitis patient yielded Streptococcus pneumoniae as a single organism, with a very high bacterial count. The isolate was found to be macrolide and fluoroquinolone resistant, and the same strain was cultured from the patient's denture washing solution. Ceftriaxone therapy, a gradual reduction in the bacterial count and progressive clinical improvement proceeded at the same pace, so we labelled this clinical case as a pneumococcal pharyngitis.
Asunto(s)
Faringitis/microbiología , Infecciones Neumocócicas/microbiología , Streptococcus pneumoniae/aislamiento & purificación , Anciano , Antibacterianos/uso terapéutico , Ceftriaxona/uso terapéutico , Femenino , Humanos , Faringitis/diagnóstico , Faringitis/tratamiento farmacológico , Infecciones Neumocócicas/diagnósticoRESUMEN
A case of decubitus ulcer infected with multidrug-resistant Enterococcus raffinosus is reported in this article. This is the first report of wound infection caused by an Enterococcus raffinosus isolate resistant to antibiotics other than beta-lactams, gentamicin, and ciprofloxacin. This case adds to the knowledge base concerning the onset of antibiotic resistance in this uncommon species and confirms the emerging role of daptomycin as a promising alternative in therapy of severe difficult-to-treat enterococcal infections.
Asunto(s)
Farmacorresistencia Bacteriana Múltiple , Enterococcus/efectos de los fármacos , Infecciones por Bacterias Grampositivas/tratamiento farmacológico , Úlcera por Presión/microbiología , Infección de Heridas/tratamiento farmacológico , Anciano , Antibacterianos/uso terapéutico , Daptomicina/uso terapéutico , Pruebas Antimicrobianas de Difusión por Disco , Humanos , Masculino , Úlcera por Presión/tratamiento farmacológicoRESUMEN
We report a case in which Escherichia fergusonii, an emerging pathogen in various types of infections, was associated with cystitis in a 52-year-old woman. The offending strain was found to be multidrug resistant. Despite in vitro activity, beta-lactam treatment failed because of a lack of patient compliance with therapy. The work confirms the pathogenic potential of E. fergusonii.
Asunto(s)
Cistitis/microbiología , Farmacorresistencia Bacteriana Múltiple , Infecciones por Enterobacteriaceae/microbiología , Escherichia/efectos de los fármacos , Enfermedad Aguda , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Escherichia/clasificación , Escherichia/aislamiento & purificación , Femenino , Humanos , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Orina/microbiología , beta-Lactamas/farmacología , beta-Lactamas/uso terapéuticoRESUMEN
We present two cases of exudative pharyngitis due to Streptococcus dysgalactiae subsp. equisimilis, Lancefield group G. While the participation of this organism as an agent of pharyngitis is well documented, we focus on failure of beta-lactam therapy, a phenomenon that is well described for pharyngitis due to Streptococcus pyogenes. Therefore, these case reports add to our knowledge of pharyngitis caused by non-S. pyogenes streptococci.