RESUMEN
Introduction. Kocuria kristinae is becoming a growing public health challenge, especially for its ability to cause infections in immunocompromised patients. This bacterium is a Gram+coccus, catalase+, coagulase, and it is a common inhabitant of skin and oral mucosa.Aim. To investigate the spectrum of infections caused by K. K ristinae.Methodology. Between January-March 2018, we carried out a systematic search in PubMed utilizing the key search term 'Kocuria kristinae'. The selection criteria for studies were studies reporting cases of human infections due to K. kristinae, case-control and cohort studies and studies published in English or Spanish.Results. The literature search yielded 48 publications: after title, abstract and full-text analysis, 20 papers were consistent with the selection criteria. These studies were carried out in the period 2001-2017 in the USA, Japan, Taiwan, Hong Kong, Ukraine, Egypt, Bahrain, Serbia, India, Italy, Spain, Turkey and Mexico. K. kristinae was involved in 17 cases of central venous catheter-related bacteremia, four infective endocarditis, three acute peritonitis, one abdominal abscess, umbilical sepsis, acute cholecystitis and urinary tract infection. Additionally, K. kristinae was found in 40 % of carious cavities, although it is not clear whether they are directly involved in the development of caries. Antibiotic susceptibility testing has sometimes revealed multi-drug resistance.Conclusions. The clinical spectrum of K. kristinae infections has recently widened. The increasing spread of this underestimated bacterium and its resistance to antibiotics represent a new challenge for public health, which requires specific actions to limit it.
Asunto(s)
Infecciones por Actinomycetales/microbiología , Infecciones Relacionadas con Catéteres/microbiología , Micrococcaceae/aislamiento & purificación , Infecciones por Actinomycetales/inmunología , Adulto , Anciano , Antibacterianos/farmacología , Estudios de Casos y Controles , Farmacorresistencia Bacteriana , Femenino , Humanos , Huésped Inmunocomprometido , Masculino , Micrococcaceae/efectos de los fármacos , Micrococcaceae/genética , Micrococcaceae/fisiología , Persona de Mediana Edad , Adulto JovenRESUMEN
Beside behavioral assessment of patients with disorders of consciousness, neuroimaging modalities may offer objective paraclinical markers important for diagnosis and prognosis. They provide information on the structural location and extent of brain lesions (e.g., morphometric MRI and diffusion tensor imaging (DTI-MRI) assessing structural connectivity) but also their functional impact (e.g., metabolic FDG-PET, hemodynamic fMRI, and EEG measurements obtained in "resting state" conditions). We here illustrate the role of multimodal imaging in severe brain injury, presenting a patient in unresponsive wakefulness syndrome (UWS; i.e., vegetative state, VS) and in a "fluctuating" minimally conscious state (MCS). In both cases, resting state FDG-PET, fMRI, and EEG showed a functionally preserved right hemisphere, while DTI showed underlying differences in structural connectivity highlighting the complementarities of these neuroimaging methods in the study of disorders of consciousness.