Infection
-
Acinetobacter baumannii is a non-fermenting aerobic gram-negative bacteria and one of the important nosocomial pathogens, especially in intensive care units (ICUs). In recent years, multidrug-resistant (MDR) isolates have been an emerging problem, with limited therapeutic options. Tigecycline is a novel antimicrobial, with its in vitro activity against most gram-positive and gram-negative pathogens. ⋯ Although it is approved by the Food and Drug Administration (FDA) for the treatment of complicated intra-abdominal infections, complicated skin and soft tissue infections, and community-acquired bacterial pneumonia, emerged resistance of Acinetobacter spp. and limited therapeutic options left physicians no choice but to use tigecycline for off-label indications.
-
We report a 69-year-old patient who developed fever and dyspnea 3 weeks after the initiation of daptomycin therapy for spondylodiscitis with lumbar epidural and bilateral psoas abscesses due to ampicillin- and high-level-gentamicin-resistant Enterococcus faecium. There was profound hypoxia and the chest X-ray showed extensive patchy infiltrates bilaterally. ⋯ Daptomycin-induced eosinophilic pneumonia was diagnosed and the patient rapidly improved after the discontinuation of daptomycin and a brief course of prednisone. Increased attention must be paid to this rare but serious side effect of daptomycin.
-
To determine the incidence of patients co-colonised or co-infected with methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus faecium or extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in four German tertiary care hospitals. ⋯ Patients harbouring ESBL-producing Enterobacteriaceae or VRE faecium had a higher risk of being co-colonised or co-infected compared to what was to be extrapolated from their overall incidence. This might be linked to their gastrointestinal reservoir and impracticality to decolonise the gut of resistant VRE and ESBL-producing Enterobacteriaceae.
-
More than 1,500 perirectal swab cultures and 552 environmental and equipment cultures were collected during the study period. Enterococcus faecium was the most frequent species isolated, being responsible for 71% of the positive cultures. Fifty infections were documented, with bloodstream infections (18, 36%) being the most frequent, followed by urinary tract infection (15, 30%). ⋯ Seventy-six percent of E. faecium belong to type and subtype A by pulsed-field gel electrophoresis (PFGE). This predominant type was found in the environment and caused colonization and infection. In conclusion, the present study showed that reduction of the proportion of environmental and equipment contamination was associated with a decrease of colonization and infection due to VRE, and that the strategy to control VRE dissemination should be based on local problems.
-
To evaluate the impact of country socioeconomic status and hospital type on device-associated healthcare-associated infections (DA-HAIs) in neonatal intensive care units (NICUs). ⋯ Hospital type and country socioeconomic level influence DA-HAI rates and overall mortality in developing countries.