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GERMS, Volume 8, Issue 2 (06 2018) – 6 articles , Pages 54-95

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182 KB  
Case Report
Community Acquired Klebsiella pneumoniae Meningitis: A Case Report
by Bianca Lee, Kevin Yeroushalmi, Hay Me Me, Paresh Sojitra, Usman Jilani, Syed Iqbal, Shadab Ahmed, Janice Verley and Jagadish Akella
GERMS 2018, 8(2), 92-95; https://doi.org/10.18683/germs.2018.1136 - 4 Jun 2018
Cited by 7
Abstract
Introduction: Klebsiella pneumoniae meningitis is most commonly seen as a nosocomial infection and in post-neurosurgical patients. Reports of community acquired Klebsiella pneumoniae meningitis cases are rare in the United States. The objective of this case report is to discuss an uncommon pathogen causing [...] Read more.
Introduction: Klebsiella pneumoniae meningitis is most commonly seen as a nosocomial infection and in post-neurosurgical patients. Reports of community acquired Klebsiella pneumoniae meningitis cases are rare in the United States. The objective of this case report is to discuss an uncommon pathogen causing meningitis, Klebsiella pneumoniae, its risk and prognostic factors and to emphasize the importance of early recognition and appropriate antibiotic treatment. Case report: We report a clinical case of adult community acquired Klebsiella pneumoniae meningitis with recovery. A 54-year-old diabetic male presented with two-week history of intermittent fevers, acute bilateral ear pain, headache and unsteady gait. Broad spectrum antibiotics were initiated. Klebsiella pneumoniae was isolated in the cerebrospinal fluid cultures. The patient recovered with only mild hearing loss in his left ear. Conclusion: Our case highlights the importance of suspecting Klebsiella pneumoniae in community acquired meningitis. Full article
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Article
Multidrug-Resistant Bacteria Isolated from Cell Phones in Five Intensive Care Units: Exploratory Dispersion Analysis
by Steev Loyola, Luz Gutierrez, Estrella Avendaño, Nixon Severino and Jesus Tamariz
GERMS 2018, 8(2), 85-91; https://doi.org/10.18683/germs.2018.1135 - 4 Jun 2018
Cited by 15
Abstract
Introduction: Cell phones are susceptible to bacterial contamination. The aim of this study was to characterize the bacterial isolates and to explore their dispersion in five Intensive Care Units (ICUs) over the time. Methods: We performed a secondary analysis of non-fermenting Gram-negative bacteria [...] Read more.
Introduction: Cell phones are susceptible to bacterial contamination. The aim of this study was to characterize the bacterial isolates and to explore their dispersion in five Intensive Care Units (ICUs) over the time. Methods: We performed a secondary analysis of non-fermenting Gram-negative bacteria and Gram-positive cocci isolated from a 5-month observational cohort study developed among health care workers’ cell phones in five ICUs. Cell phones were sampled using a swab every 15 days. Antimicrobial resistance was determined by the minimum inhibitory concentration method. We constructed resistance phenotypes to group the isolates according to species and antimicrobial resistance pattern to explore dispersion through time. Results: A total of 35 P. aeruginosa, 16 Acinetobacter spp., 30 S. aureus and 26 Enterococcus spp. were isolated from 491 phone samples. Multidrug resistance was 2.9% for P. aeruginosa, 31.3% for Acinetobacter spp., 46.7% for S. aureus and 80.8% for Enterococcus spp. The resistance to methicillin in S. aureus and to vancomycin in Enterococcus spp. was 26.7% and 42.3%, respectively. We did not observe distribution patterns or clusters over the time for P. aeruginosa, Acinetobacter spp. and Enterococcus spp. isolates. All the S. aureus isolates grouped into eight phenotypes. Interestingly, we observed S. aureus isolates with the same phenotype in consecutive and separate sampling dates in the same cell phone. Conclusion: Cell phones are contaminated with highly harmful bacteria and potentially can maintain them for prolonged periods of time. These devices could be considered as a potential source of nosocomial infections in ICUs. Full article
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Article
Occurrence, Molecular and Antimicrobial Resistance of Enterococcus spp. Isolated from Raw Cow’s Milk Trade by Street Trading in Meknes City, Morocco
by Aziz Bouymajane, Fouzia Rhazi Filali, Said Oulghazi, Abdelaziz Ed-Dra, Faouzia Benhallam, Abdallah El Allaoui, Jawad Anissi, Khalid Sendide, Bouchra Ouhmidou and Mohieddine Moumni
GERMS 2018, 8(2), 77-84; https://doi.org/10.18683/germs.2018.1134 - 4 Jun 2018
Cited by 19
Abstract
Background: Enterococcus spp. belongs to a group of pathogens which are responsible for serious infections. This study aims at highlighting the raw milk microbiological contamination and at providing data for prevalence and antimicrobial resistance of Enterococcus spp. isolated from raw cow’s milk marketed [...] Read more.
Background: Enterococcus spp. belongs to a group of pathogens which are responsible for serious infections. This study aims at highlighting the raw milk microbiological contamination and at providing data for prevalence and antimicrobial resistance of Enterococcus spp. isolated from raw cow’s milk marketed (without any pasteurization) by street traders. Methods: During the period of May 2015 through April 2016, 150 cow’s raw milk samples were collected from street traders in Meknes city. They were examined for the identification of Enterococcus spp. using biochemical tests and 16S rRNA gene sequencing. The antimicrobial susceptibility of the isolates was determined. Results: The results showed that 11.3% (17/150) of samples were positive for the presence of Enterococcus spp., of which 64.7% were identified as Enterococcus faecalis, 17.6% as Enterococcus faecium, 11.8% as Enterococcus durans and 5.9% as Enterococcus hirae. The antimicrobial susceptibility showed that all Enterococcus spp. were resistant to ampicillin. The species E. faecalis, E. faecium, E. durans and E. hirae were resistant to streptomycin, with percentages of 52.9% (9/17), 11.8% (2/17), 11.8% (2/17), and 5.9% (1/17) respectively. All isolated strains of E. faecalis and E. faecium were resistant to tetracycline. The multiple antibiotic resistance index was elevated in the majority of Enterococcus spp., reaching values higher than 0.5, indicating a risk for public health. Conclusion: This study shows that the raw milk consumed by the population is contaminated with strains of Enterococcus resistant to antibiotics used in breeding for prophylactic purposes. This requires raising the awareness of those involved in the production and marketing of milk, so as to take measures to apply good hygienic practices and rationalize the use of zootechnical antibiotics. Full article
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Article
Incidence and Predictors of Tenofovir Disoproxil Fumarate-Induced Renal Impairment in HIV Infected Nigerian Patients
by Bazim V. Ojeh, Isaac O. Abah, Placid Ugoagwu, Patricia A. Agaba, Oche O. Agbaji and Steven S. Gyang
GERMS 2018, 8(2), 67-76; https://doi.org/10.18683/germs.2018.1133 - 4 Jun 2018
Cited by 12
Abstract
Introduction: The use of tenofovir disoproxil fumarate (TDF) in the treatment of HIV infection has been associated with renal dysfunction. In Nigeria, data on the incidence and risk factors of TDF nephrotoxicity is sparse. We determined the cumulative incidence of and risk [...] Read more.
Introduction: The use of tenofovir disoproxil fumarate (TDF) in the treatment of HIV infection has been associated with renal dysfunction. In Nigeria, data on the incidence and risk factors of TDF nephrotoxicity is sparse. We determined the cumulative incidence of and risk factors for TDF-induced renal impairment in HIV-infected individuals accessing care at the antiretroviral therapy (ART) clinic of Jos University Teaching Hospital, Nigeria. Methods: This retrospective cohort analysis included patients aged ≥ 16 years that initiated ART between January 2008 and December 2011. Renal impairment, defined as glomerular filtration rate GFR < 60 mL/min/1.73 sqm using the Modification of Diet in Renal Disease (MDRD) equation was assessed at baseline and at 48 weeks on ART. Logistic regression was performed to determine factors associated with incident renal impairment. Results: The mean age was 39 ± 9 years, and 67.1% were female. The cumulative incidence of renal impairment among the TDF-exposed and TDF-unexposed groups was 4.6% and 2.3% respectively (p < 0.001). TDF exposure was significantly associated with renal impairment [OR = 2.0, 95%CI = (1.48-2.89), p < 0.001] in bivariate analysis. In multivariate analysis, older age (aOR = 1.06, 95%CI = (1.05-1.08), p < 0.001), TDF exposure [aOR = 1.85, 95%CI = (1.31-2.60), p < 0.001] and co-morbidities [aOR = 2.71, 95%CI = (1.72-4.25), p < 0.001] were significantly associated with renal impairment. Conclusion: TDF exposure, aging and comorbidities were predictors of renal toxicity among HIV positive patients. Regular monitoring of renal function in such high-risk individuals is recommended. Full article
620 KB  
Article
Phenotypic Typing and Epidemiological Survey of Antifungal Resistance of Candida Species Detected in Clinical Samples of Italian Patients in a 17 Months’ Period
by Margherita Scapaticci, Andrea Bartolini, Federica Del Chierico, Cristel Accardi, Francesco Di Girolamo, Andrea Masotti, Maurizio Muraca and Lorenza Putignani
GERMS 2018, 8(2), 58-66; https://doi.org/10.18683/germs.2018.1132 - 4 Jun 2018
Cited by 11
Abstract
Introduction: Yeast pathogens are emerging agents of nosocomial as well as community-acquired infections and their rapid and accurate identification is crucial for a better management of high-risk patients and for an adequate treatment. Methods: We performed a retrospective review of 156 [...] Read more.
Introduction: Yeast pathogens are emerging agents of nosocomial as well as community-acquired infections and their rapid and accurate identification is crucial for a better management of high-risk patients and for an adequate treatment. Methods: We performed a retrospective review of 156 yeast isolates collected during a 17 months’ period of regular clinical practice at the Microbiology Department of San Camillo Hospital in Treviso, Italy and analyzed by the traditional culture-based method combined with matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Results: Out of all the samples collected MALDI-TOF MS was able to characterize with a MT score ≥1.7 (accurate result at species level) 12 different yeast and yeast-like species from 140 samples: Candida albicans (63.7%), Candida glabrata (13.6%), Saccharomyces cerevisiae (6.5%), Candida parapsilosis (5.7%), Candida tropicalis (2.1%), Candida pararugosa (2.1%), Candida guilliermondii (2.1%), Candida kefyr (1.4%), Candida lusitaniae (0.7%), Candida palmioleophila (0.7%), Geotrichum silvicola (0.7%), Rhodotorula mucilaginosa (0.7%). Susceptibility testing toward seven common antifungal agents showed a characteristic MIC distribution of C. albicans isolates for echinocandins: particularly we noticed that 72% and 46% of C. albicans showed an MIC value close to clinical breakpoint as defined by EUCAST, respectively for anidulafungin and micafungin. Conclusion: Accurate identification of microorganisms and the study of their antifungal susceptibility allow to understand the epidemiology of a particular area, permitting the choice of the most appropriate early antifungal treatment. Full article
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Editorial
The Immune Profile in HIV: A Useful Signature in Future HIV Research?
by Padraig M. C. McGettrick, Elena Alvarez Barco, Greg Kaminskiy and Patrick W. G. Mallon
GERMS 2018, 8(2), 54-57; https://doi.org/10.18683/germs.2018.1131 - 4 Jun 2018
Abstract
Despite widespread availability of effective antiretroviral therapy (ART), people living with HIV (PLWH) still experience excess morbidity and mortality relative to the general population, being driven primarily by non-AIDS, age-related conditions such as cardiovascular disease and malignancy [...] Full article
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