Serratia marcescens necrotizing fasciitis presenting as bilateral breast necrosis

Serratia marcescens is an extremely rare cause of necrotizing fasciitis. We report the first case of necrotizing fasciitis of the chest wall due to infection with S. marcescens that initially manifested as bilateral breast necrosis. The patient had a fulminant course leading to death within 72 h of presentation. Literature pertinent to S. marcescens-mediated necrotizing fasciitis is also reviewed

Real-Life Evidence for Tedizolid Phosphate in the Treatment of Cellulitis and Wound Infections: A Case Series

Introduction Tedizolid phosphate 200 mg, once daily for 6 days, has recently been approved for the treatment of patients with acute bacterial skin and skin structure infections (ABSSSIs) in several countries; however, clinical experience in real-life settings is currently limited. Here, we report on the use of tedizolid with an extended treatment duration for complex and severe ABSSSIs in real-world clinical settings. Methods Two patients with cellulitis and two patients with surgical site infection (SSI), aged 26–60 years, were treated with tedizolid phosphate 200 mg, intravenous/oral (IV/PO) or IV only, once daily at four different institutions. Results Two morbidly obese patients had non-necrotizing, non-purulent severe cellulitis, which were complicated by sepsis or systemic inflammatory response syndrome plus myositis. One female patient failed on first-line empiric therapy with IV cefalotin, clindamycin and imipenem (3–4 days), and was switched to IV/PO tedizolid (7 + 5 days). One male patient received IV clindamycin plus IV/PO tedizolid (5 + 5 days), but clindamycin was discontinued on Day 3 due to an adverse event. For both patients, clinical signs and symptoms improved within 72 h, and laboratory results were normalized by Days 7 and 8, respectively. Two other patients (one obese, diabetic female with chronic hepatitis and chronic obstructive pulmonary disease) had complicated SSIs occurring 10 days after hernia repair with mesh or 3 months after spinal fusion surgery with metal implant. First patient with previous methicillin-resistant Staphylococcus aureus (MRSA) bacteremia received a 7-day tedizolid IV course empirically. The second patient with culture-confirmed MRSA infection received a 14-day IV course. Both patients responded within 72 h, and local and systemic signs normalized by end of treatment. There were no reports of thrombocytopenia. Conclusion Tedizolid phosphate 200 mg for 7–14 days was a favored treatment option for patients with severe/complex ABSSSIs, and was effective following previous treatment failure or in late-onset infections

Effectiveness and Economics of Native Pasture Restoration Practices Designed for the Southern Great Plains

ABSTRACT: In the southern Great Plains pastures of nativegrass mixtures have been shown to provide early season forage and contain grasses that vary in seasonal forage distribution providing higher quality forage further into the growing season than monocultures such as switchgrass (Panicum virgatum). Compared to improved pastures of bermudagrass (Cynodon dactylon), nativegrass mixtures increase wildlife habitat, lower maintenance cost, and can improve land value. These benefits have increased interest in conversion of improved pasture land areas to nativegrass pastures. Because of its herbicide tolerance, ability to propagate from stolons, rhizomes, and seed, bermudagrass is difficult to control making conversion challenging. To be successful, conversion methods need to be acquired. A two-year, two location conversion study was developed to determine efficacy and economics of twelve conversion systems for bermudagrass control and establishment of a nativegrass mixture of little bluestem (Schizachyrium acoparium ‘Cimarron’), big bluestem (Andropogon gerardii ‘Kaw’), indiangrass (Sorghastrum nutans ‘common’), switchgrass (‘Alamo’), and green sprangletop (Leptochloa dubia ‘common’). Conversion systems consisted of combinations of preparation time (7, 11, 19 months from treatment initiation to planting), cover crops (0, 1, 2, 3), glyphosate application (6, 8, 10 qts/ac) (13.8, 18.4, 23 L ha-1) and tillage (conventional till, no-till). Nativegrass planting date for all conversion systems was April. Tillage systems were more effective than no-tillage. Mean yields across locations and years for no-till were 858 lb/ac and 2868 lb/ac compared to tillage yields of 2243 lb/ac and 6637 lb/ac for nativegrass and switchgrass respectively. Tillage systems with cover crops (2 or 3) and preparation time (11 or 19 months) were more successful in establishing nativegrass but had little effect on switchgrass establishment. For the base-case threshold measure of success (>=70% of total stand), the clean till system with three cover crops was most economical at the Burneyville, Oklahoma, location, realizing a $208 net return per acre. At the Ardmore, Oklahoma, location, systems established with clean-till and no-till methods with both 2 and 3 cover crops were equally more profitable than systems that utilized chemical fallow methods. Systems that utilized chemical fallow methods did not realize positive net returns, but did meet the minimum threshold of success requirement of at least 70% of total NG stand. Relative net returns between systems were most sensitive to prices of rye and sorghum-sudan hay

Antimicrobial susceptibility of Gram-positive bacterial isolates from the Asia–Pacific region and an in vitro evaluation of the bactericidal activity of daptomycin, vancomycin, and teicoplanin: a SENTRY Program Report (2003–2004)

Copyright © 2007 Elsevier B.V. and the International Society of Chemotherapy All rights reserved.Medical centres in eight countries in the Asia-Pacific region provided 2391 isolates for the SENTRY Antimicrobial Surveillance Program during 2003-2004 to determine their susceptibility to several antimicrobial classes, including daptomycin. Daptomycin, vancomycin and teicoplanin minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) were determined for 120 isolates of Staphylococcus aureus, which included wild-type (WT) methicillin-resistant S. aureus (MRSA) and strains with decreased susceptibility to vancomycin (hetero-vancomycin-intermediate S. aureus (hVISA)). Oxacillin-resistant staphylococcal isolates were much less susceptible to the other tested agents compared with oxacillin-susceptible strains. Vancomycin resistance was higher among Enterococcus faecium (10.3%) than Enterococcus faecalis (0.4%), and macrolide resistance was high both for beta-haemolytic (17.7%) and viridans group (48.7%) streptococci. Daptomycin (MIC for 90% of the organisms (MIC(90))=0.5-1mg/L) was two-fold more potent than vancomycin, with >99% susceptibility when tested against staphylococci. All tested isolates of E. faecalis (MIC(90)=2mg/L) and beta-haemolytic streptococci (MIC(90)=0.5mg/L) were susceptible to daptomycin. Daptomycin MIC and MBC values were slightly higher for the hVISA isolates compared with WT-MRSA, with MBC/MIC ratios of only 1-2 for both groups. The MBC/MIC ratio for vancomycin was often greater when tested against these strains, particularly hVISA. In contrast, teicoplanin MBC/MIC ratios were significantly higher, with many of the strains showing values consistent with tolerance (>or=32). Daptomycin was demonstrated to have excellent in vitro activity when tested against Gram-positive isolates collected from Asia-Pacific countries, including hVISA strains.Douglas J. Biedenbach, Jan M. Bell, Helio S. Sader, Thomas R. Fritsche, Ronald N. Jones and John D. Turnidgehttp://www.elsevier.com/wps/find/journaldescription.cws_home/505521/description#descriptio

Antimicrobial Activities of Gatifloxacin against Nosocomial Isolates of Stenotrophomonas maltophilia Measured by MIC and Time-Kill Studies

We determined in vitro activities of gatifloxacin and seven other drugs against 100 isolates of Stenotrophomonas maltophilia using the agar gradient diffusion (Etest) method. Percentages of susceptible isolates were as follows: trimethoprim-sulfamethoxazole, 90%; gatifloxacin, 71%; levofloxacin, 57%; ticarcillin-clavulanic acid, 54%; ceftazidime, 49%; ciprofloxacin, 29%; cefepime, 21%; and piperacillin-tazobactam, 20%. Time-kill studies of three isolates indicated that gatifloxacin was bactericidal at times as early as 3 h of incubation when tested at concentrations equivalent to twice the MIC (two isolates) and 4 times the MIC (one isolate)