RESUMEN
A 65-year-old male with a history of urinary tract trauma requiring cystotomy and chronic bladder catheterization, presenting with chronic and uninvestigated changes in the color of the urine bag system, with no urine color change, and positive urine culture for Proteus mirabilis . These characteristics refer to the purple urine bag syndrome, a not weel-known condition, with a benign course in most cases, and associated with urinary tract infection in patients with chronic bladder catheterization. Although it is characterized by marked changes, it is underdiagnosed by healthcare professionals.
Asunto(s)
Infecciones Relacionadas con Catéteres/microbiología , Reservorios Urinarios Continentes/efectos adversos , Infecciones Urinarias/microbiología , Anciano , Infecciones Relacionadas con Catéteres/patología , Humanos , Masculino , Proteus mirabilis/aislamiento & purificación , Factores de Riesgo , Síndrome , Infecciones Urinarias/patología , Orina/microbiologíaRESUMEN
ABSTRACT A 65-year-old male with a history of urinary tract trauma requiring cystotomy and chronic bladder catheterization, presenting with chronic and uninvestigated changes in the color of the urine bag system, with no urine color change, and positive urine culture for Proteus mirabilis . These characteristics refer to the purple urine bag syndrome, a not weel-known condition, with a benign course in most cases, and associated with urinary tract infection in patients with chronic bladder catheterization. Although it is characterized by marked changes, it is underdiagnosed by healthcare professionals.
RESUMO Homem de 65 anos com história de trauma do sistema urinário, sendo necessário cistotomia e sondagem vesical crônica, apresentando alterações crônicas e não investigadas da cor do sistema coletor de urina, sem alteração da cor da urina, e urocultura positiva para Proteus mirabilis . Tais características remetem à síndrome do saco coletor de urina roxo, uma entidade pouco conhecida, de curso benigno na maioria da vezes, associada à infecção urinária em paciente com cateterismo vesical de demora. Embora seja caracterizada por alterações marcantes, é subdiagnosticada pelos profissionais de saúde.
Asunto(s)
Humanos , Masculino , Anciano , Infecciones Urinarias/microbiología , Reservorios Urinarios Continentes/efectos adversos , Infecciones Relacionadas con Catéteres/microbiología , Proteus mirabilis/aislamiento & purificación , Síndrome , Infecciones Urinarias/patología , Orina/microbiología , Factores de Riesgo , Infecciones Relacionadas con Catéteres/patologíaRESUMEN
Systemic infections due to Candida tropicalis are conditions which can frequently lead to death. The aim of this report is to describe the features of C. tropicalis biofilm in a patient with catheter-associated fungemia.
Asunto(s)
Candida tropicalis/aislamiento & purificación , Candidiasis Invasiva/diagnóstico , Candidiasis Invasiva/patología , Infecciones Relacionadas con Catéteres/diagnóstico , Infecciones Relacionadas con Catéteres/patología , Neoplasias de la Lengua/complicaciones , Biopelículas/crecimiento & desarrollo , Candidiasis Invasiva/microbiología , Infecciones Relacionadas con Catéteres/microbiología , Catéteres/microbiología , Humanos , Microscopía Electrónica de RastreoRESUMEN
We present a case report of a fungal bloodstream infection due to an unusual pathogen. This is a 30 years-old female patient diagnosed with Crohn's disease and a disseminated Mycobacterium bovis infection subsequently complicated by fungemia due to the emergent yeast pathogen Candida ciferrii, who was unresponsive to fluconazole and made a full recovery after treatment with posaconazole. To our knowledge, this is the first report of Candida ciferrii isolation from blood in an adult associated to a central venous catheter and which was successfully treated with posaconazole.
Asunto(s)
Candida/aislamiento & purificación , Candidemia/diagnóstico , Infecciones Relacionadas con Catéteres/diagnóstico , Enfermedad de Crohn/complicaciones , Mycobacterium bovis/aislamiento & purificación , Tuberculosis/complicaciones , Adulto , Antifúngicos/administración & dosificación , Candida/clasificación , Candidemia/tratamiento farmacológico , Candidemia/patología , Infecciones Relacionadas con Catéteres/tratamiento farmacológico , Infecciones Relacionadas con Catéteres/patología , Cateterismo Venoso Central/efectos adversos , Femenino , Humanos , Huésped Inmunocomprometido , Resultado del Tratamiento , Triazoles/administración & dosificaciónRESUMEN
Among cancer patients with Candida glabrata (the Candida species with the slowest in-vitro growth) fungemia, time-to-positive blood culture reporting (TTR) was shorter in catheter-associated candidemia (mean±standard deviation: 67±35 h) than in candidemia from other sources (79±31, P<.01). TTR<48 h was 92% specific for catheter-associated C. glabrata fungemia.
Asunto(s)
Sangre/microbiología , Candida glabrata/aislamiento & purificación , Candidemia/patología , Infecciones Relacionadas con Catéteres/patología , Catéteres Venosos Centrales/efectos adversos , Neoplasias/complicaciones , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Cultivo de Sangre , Candidemia/microbiología , Infecciones Relacionadas con Catéteres/microbiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Tiempo , Adulto JovenRESUMEN
A 71-year-old woman in a nursing home, with indwelling urinary catheter, bedridden, presented with a purple urine collector bag. The purple urine bag syndrome is a rare condition associated with the metabolism of tryptophan by overgrowth of intestinal bacteria. The purple color is formed by a combination of indigo and indirubin produced as a result of phosphatase and sulfatase enzymatic activity of bacteria on indoxyl sulfate, under alkaline pH of the urine. We present the second case of this syndrome reported in Colombia detailing the management of this rare syndrome associated with urinary tract infection. Several conditions should be considered in the differential diagnose of diseases that cause discoloration of the urine.
Asunto(s)
Infecciones Bacterianas/diagnóstico , Infecciones Relacionadas con Catéteres/diagnóstico , Fenómenos Químicos , Pigmentos Biológicos/análisis , Infecciones Urinarias/diagnóstico , Orina/química , Anciano , Antibacterianos/uso terapéutico , Infecciones Bacterianas/patología , Infecciones Relacionadas con Catéteres/patología , Ciprofloxacina/uso terapéutico , Colombia , Color , Diagnóstico Diferencial , Enterococcus faecalis/aislamiento & purificación , Escherichia coli/aislamiento & purificación , Femenino , Humanos , Concentración de Iones de Hidrógeno , Proteus mirabilis/aislamiento & purificación , Resultado del Tratamiento , Infecciones Urinarias/patologíaRESUMEN
Nosocomial fungal bloodstream infections (BSI) are increasing significantly in hospitalized patients and Candida parapsilosis has emerged as an important pathogen responsible for numerous outbreaks. The objective of this study was to evaluate C. parapsilosis sensu lato infection scenarios, regarding species distribution and strain relatedness. One hundred isolates of C. parapsilosis sensu lato derived from blood cultures and catheter tips were analysed by multiplex microsatellite typing and by sequencing D1/D2 regions of the ribosomal DNA. Our results indicate that 9.5â% of patients presented infections due to C. parapsilosis and Candida orthopsilosis, 57.1â% due to C. parapsilosis, 28.3â% due to C. orthopsilosis and 4.8â% due to Candida metapsilosis. Eighty per cent of the C. parapsilosis BSIs were due to a single strain that was also identified in the catheter, but in 10â% of the cases C. parasilosis was identified in the catheter but the BSI was due to C. orthopsilosis. There is a significant probability that C. parapsilosis isolates collected from the same patient at more than 3 months interval are of different strains (Pâ=â0.0179). Moreover, several isolates were identified persistently in the same hospital, infecting six different patients. The incidence of polyfungal BSI infections with C. parapsilosis and C. orthopsilosis is reported herein for the first time, emphasizing the fact that the species identified in the catheter is not always responsible for the BSI, thus impacting the treatment strategy. The observation that strains can remain in the hospital environment for years highlights the possible existence of reservoirs and reinforces the need for accurate genotyping tools, such as the markers used for elucidating epidemiological associations and detecting outbreaks.