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Author Yu, W.-L.; Lee, M.-F.; Chen, C.-C.; Tang, H.-J.; Ho, C.-H.; Chuang, Y.-C.
Title Impacts of Hypervirulence Determinants on Clinical Features and Outcomes of Bacteremia Caused by Extended-Spectrum beta-Lactamase-Producing Klebsiella pneumoniae Type Journal Article
Year 2017 Publication Microbial Drug Resistance (Larchmont, N.Y.) Abbreviated Journal Microb Drug Resist
Volume 23 Issue 3 Pages 376-383
Keywords Aged; Anti-Bacterial Agents/therapeutic use; Bacteremia/drug therapy/*microbiology; Bacterial Proteins/genetics; Cross Infection/drug therapy/microbiology; Female; Hospital Mortality; Humans; Klebsiella Infections/drug therapy/*microbiology; Klebsiella pneumoniae/*genetics; Male; Middle Aged; Serogroup; Urinary Tract Infections/drug therapy/microbiology; Virulence Factors/*genetics; beta-Lactamases/*genetics; Esbl; Klebsiella pneumoniae; hypermucoviscosity; hypervirulence; rmpA; virulence
Abstract We investigated the implications of hypervirulence determinants on clinical features of 48 adult patients with bacteremia caused by extended-spectrum beta-lactamase-producing Klebsiella pneumoniae. Isolates in the hypervirulence group included any of the following virulence determinants: K1/K2 capsule serotypes, hypermucoviscosity phenotype, rmpA gene, or rmpA2 gene. Nonhypervirulence group isolates were negative for all of the above virulence factors. In this study, all isolates used were non-K1/K2 strains. Statistically significant differences were observed in clinical features of patients between the two groups. The hypervirulent isolates (n = 19), including 11 isolates with the hypermucoviscosity phenotype, 15 with the rmpA gene, and 16 with the rmpA2 gene, were more commonly recovered from diabetic patients and mainly manifested as secondary bacteremia (such as pneumonia, urinary tract infections, or other localized infections). The nonhypervirulent isolates (n = 29) were more commonly recovered from patients after prolonged hospital stays (>30 days) and mostly manifested as primary bacteremia. The overall in-hospital mortality was 56.3%. Hazard ratio (HR) analysis revealed the following positive predictors for mortality: nosocomial infection, stay in an intensive care unit, no removal of the central venous catheter, Charlson comorbidity score, and APACHE II score (>==15). The negative predictors were initial appropriate antibiotic therapy (HR 0.42) and urinary tract infection (HR 0.19). Charlson score was an independent confounder based on multivariate analysis (HR 1.43, 95% confidence interval 1.04-1.99). In conclusion, hypervirulence determinants played a role in causing secondary infections in diabetic patients; however, the presence of morbidity cofactors could themselves influence mortality, despite the absence of hypervirulence determinants.
Address 6 Department of Internal Medicine, Chi Mei Medical Center-Liou Ying , Tainan City, Taiwan
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 1076-6294 ISBN Medium
Area Expedition Conference
Notes PMID:27380450 Approved no
Call Number ref @ user @ Serial (down) 100535
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Author Yossuck, P.; Miller-Canfield, P.; Moffett, K.; Graeber, J.
Title Leuconostoc spp sepsis in an extremely low birth weight infant: a case report and review of the literature Type Journal Article
Year 2009 Publication The West Virginia Medical Journal Abbreviated Journal W V Med J
Volume 105 Issue 5 Pages 24-27
Keywords Ampicillin/therapeutic use; Anti-Bacterial Agents/therapeutic use; Catheterization, Central Venous/*adverse effects; Gentamicins/therapeutic use; Gram-Positive Bacterial Infections/*drug therapy/microbiology; Humans; *Infant, Extremely Low Birth Weight; Infant, Newborn; Leuconostoc/*drug effects/isolation & purification; Male; Sepsis/*microbiology; *Vancomycin Resistance
Abstract A three week old extremely low birth weight (ELBW) infant infected by vancomycin-resistant Leuconostoc spp is presented. Treatment with appropriate antibiotics was successful after the percutaneous inserted central catheter (PICC) was removed. The infection with Leuconostoc spp is rare but should be suspected when vancomycin-resistant organisms resembling streptococci are isolated. Previous pediatric case reports are also summarized and reviewed.
Address WVU School of Medicine Department of Pediatrics, Morgantown, WV, USA
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0043-3284 ISBN Medium
Area Expedition Conference
Notes PMID:19806867 Approved no
Call Number ref @ user @ Serial (down) 100534
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Author Yorganci, K.; Krepel, C.; Weigelt, J.A.; Edmiston, C.E.
Title Activity of antibacterial impregnated central venous catheters against Klebsiella pneumoniae Type Journal Article
Year 2002 Publication Intensive Care Medicine Abbreviated Journal Intensive Care Med
Volume 28 Issue 4 Pages 438-442
Keywords Analysis of Variance; Anti-Bacterial Agents/*administration & dosage; Bacteremia/*prevention & control; Bacterial Adhesion/drug effects; *Catheterization, Central Venous; Equipment Contamination/*prevention & control; Humans; Klebsiella pneumoniae/*drug effects/physiology
Abstract OBJECTIVE: Antibiotically coated or impregnated catheters are effective in eliminating gram-positive bacteria from their surfaces. However, their activity against gram-negative bacteria is not well known. The aim of this study was to evaluate and compare the adherence, persistence and colonization of Klebsiella pneumoniae on catheter surfaces and also to assess bacteriostatic and bactericidal levels. DESIGN: Randomized, controlled, laboratory study. SETTING: University surgical microbiology laboratory. SUBJECTIVE: Silver sulfadiazine-chlorhexidine impregnated (SSC), minocycline and rifampin bonded (M+R), silver, platinum and carbon incorporated (SP+C) and non-antiseptic central venous catheter segments. INTERVENTIONS: Catheter segments were immersed in 1 ml of phosphate buffered saline (0.01 mol/l) with 0.25% dextrose (PBSD) and incubated at 37 degrees C. The PBSD was replaced daily. Effluents were frozen at -70 degrees C for subsequent determination of bacteriostatic and bactericidal activity. On days 1,3,7,14 and 21 after initial immersion, 1 ml standardized inoculum of Klebsiella pneumoniae was added to 90 tubes for a period of 30 min. The inoculum was then replaced with PBSD. One third of the samples were immediately sonicated and plated for the determination of bacterial adherence. The remaining segments were incubated for 4 and 24 h, followed by the same procedure to determine bacterial persistence and colonization with time. All plates were read after 24 h of incubation. MEASUREMENTS AND RESULTS: There was a significant reduction in initial bacterial adherence for SP+C catheters on all days ( p<0.05). SSC catheters prevented initial bacterial adherence for the first 7 days only ( p<0.05). SSC and SP+C catheters prevented bacterial persistence and further colonization on all days. However M+R catheters prevented bacterial colonization for 3 days only. Effluent studies indicated that the impregnated agents in catheter SSC were bactericidal compared to catheter M+R, which were bacteriostatic to K. pneumoniae. No antibacterial activity was detected in the effluents from catheter SP+C. CONCLUSIONS: SSC and SP+C catheters are effective in eliminating K. pneumoniae from their surfaces for at least 21 days. M+R catheters are less effective in eliminating bacterial adherence and colonization may be due to their bacteriostatic property.
Address Hacettepe University, Faculty of Medicine, Department of General Surgery, Ankara, Turkey. yorganci@ada.net.tr
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0342-4642 ISBN Medium
Area Expedition Conference
Notes PMID:11967598 Approved no
Call Number ref @ user @ Serial (down) 100533
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Author Yorganci, K.; Krepel, C.; Weigelt, J.A.; Edmiston, C.E.
Title In vitro evaluation of the antibacterial activity of three different central venous catheters against gram-positive bacteria Type Journal Article
Year 2002 Publication European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology Abbreviated Journal Eur J Clin Microbiol Infect Dis
Volume 21 Issue 5 Pages 379-384
Keywords Anti-Bacterial Agents/*administration & dosage/*pharmacology; Bacteremia/*prevention & control; Bacterial Adhesion/drug effects; *Catheterization, Central Venous/adverse effects; Colony Count, Microbial; Drug Combinations; *Equipment Contamination/prevention & control; Gram-Positive Bacteria/*drug effects; Humans; Staphylococcus aureus/drug effects; Staphylococcus epidermidis/drug effects; Time Factors
Abstract The aim of this study was to evaluate the activity of three different catheters against Staphylococcus aureus ATCC 29213 and the slime-producing Staphylococcus epidermidis ATCC 35984 (RP62A). Three central venous catheters were evaluated: one impregnated with silver sulfadiazine-chlorhexidine, one to which minocycline/rifampin is bonded and a novel one into which silver, platinum and carbon are incorporated. A nonantiseptic catheter was used as the control catheter. One-centimeter trisected pieces of catheter were immersed in phosphate-buffered saline (0.01 mol/l) with 0.25% dextrose and incubated. On days 1, 3, 7, 14 and 21, a 1 ml standardized inoculum was added for 30 min and then replaced with phosphate-buffered saline with 0.25% dextrose. One-third of the samples were immediately sonicated and plated to determine bacterial adherence. The remaining segments were incubated for 4 and 24 h to determine the persistence of bacterial adherence. Bacterial adherence to the catheters impregnated with silver sulfadiazine-chlorhexidine was reduced 91-98% for the first 7 days. Adherence of Staphylococcus aureus to catheters into which silver, platinum and carbon are incorporated was reduced 70% on day 1 and 35% on day 3. Adherence to minocycline/rifampin-bonded catheters was quite variable. There was an 85.6-99.8% reduction in the persistence of bacterial adherence to the three catheters compared to controls. Bacteriostatic and bactericidal studies indicated that the effluents from the catheters impregnated with silver sulfadiazine-chlorhexidine were bactericidal, while effluents from the minocycline/rifampin-bonded catheters were bacteriostatic. The antibacterial activity of the effluents from catheters impregnated with silver sulfadiazine-chlorhexidine dissipated by day 7, while the activity of effluents from the minocycline/rifampin-bonded catheters continued to show activity at day 21. No measurable antibacterial activity was detected in the effluents of the catheters into which silver, platinum and carbon are incorporated. These data suggest that catheters coated with antibiotic/antibacterial agents and the novel catheters that incorporate antiseptic agents have different activities against initial bacterial adherence. All of them, however, effectively prevent bacterial colonization by gram-positive bacteria.
Address G.M.K. Bulvari 129/9 Koz Apt., 06530 Maltepe, Ankara, Turkey. yorganci@hacettepe.edu.tr
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0934-9723 ISBN Medium
Area Expedition Conference
Notes PMID:12072923 Approved no
Call Number ref @ user @ Serial (down) 100532
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Author Yeshurun, M.; Gafter-Gvili, A.; Thaler, M.; Keller, N.; Nagler, A.; Shimoni, A.
Title Clinical characteristics of Stenotrophomonas maltophilia infection in hematopoietic stem cell transplantation recipients: a single center experience Type Journal Article
Year 2010 Publication Infection Abbreviated Journal Infection
Volume 38 Issue 3 Pages 211-215
Keywords Adolescent; Adult; Aged; Aged, 80 and over; Bacteremia/drug therapy/microbiology; Catheterization, Central Venous/adverse effects; Catheters, Indwelling/microbiology; Communicable Diseases, Emerging/drug therapy/*microbiology; Cross Infection/drug therapy/*microbiology; Female; Gram-Negative Bacterial Infections/drug therapy/*microbiology; Hematopoietic Stem Cell Transplantation/*adverse effects; Humans; Male; Middle Aged; Neutropenia/microbiology; Retrospective Studies; Stenotrophomonas maltophilia/*isolation & purification; Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use
Abstract BACKGROUND: Recipients of hematopoietic stem-cell transplantation (HSCT) are at high risk for infections caused by Stenotrophomonas maltophilia. METHODS: We conducted a retrospective analysis of all infections caused by S. maltophilia in HSCT recipients in a single center in Israel during a 4 year period. RESULTS: Of 570 patients undergoing HSCT, 19 patients with an invasive S. maltophilia infection were identified. Sixteen had allogeneic HSCT and 3 had autologous HSCT. Seventeen patients (90%) had an indwelling central venous catheter (CVC) at the time of infection. S. maltophilia infections were detected in three clinical settings: as a complication of prolonged neutropenia (n = 9), as a CVC-related non-neutropenic infection occurring after CVC manipulation (n = 8) and as a respiratory tract infection (n = 2). Eleven patients (58%) had a polymicrobial infection. Ten patients (52.6%) received carbapenems during the previous month. The treatment for all patients included broad spectrum antibiotics, which were switched according to susceptibilities upon identification of the isolates. All isolates were susceptible in vitro to TMP-SMX. CVCs were removed in 12 patients (70%). Six patients, all after allogeneic HSCT, died. The CVC was removed in only two of the five patients with CVCs who died. CONCLUSIONS: Stenotrophomonas maltophilia is an emerging nosocomial pathogen in HSCT recipients, both in the early neutropenic phase and in the non-neutropenic phase. It is commonly associated with the presence and manipulation of an indwelling CVC. Removal of the CVC in addition to appropriate antibiotic therapy (TMP-SMX) is crucial for infection control.
Address Department of Hematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Beilinson Campus, 49100, Petah-Tiqva, Israel. Moshey@clalit.org.il
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0300-8126 ISBN Medium
Area Expedition Conference
Notes PMID:20425134 Approved no
Call Number ref @ user @ Serial (down) 100531
Permanent link to this record