Escherichia coli Pyomyositis Presenting as Right Hip Pain - a Case Report and Review of Literature

Pyomyositis typically occurs after hematogenous bacterial dissemination, and methicillin-resistant Staphylococcus aureus (MRSA) and Group A Streptococci are the mostcommon organisms isolated. Potential contributing factors to pyomyositis include underlyingmalignancy, trauma, or concurrent infection at other sites. In this case report,we present a 58-year-old woman with two months of fevers and two weeks of right hippain who was ultimately diagnosed with pyomyositis secondary to Escherichia coli

Interventions to Reduce Hospital-Associated Infections: Comparative Efforts at One HMORN Site and a Local Veterans Affairs Facility

Background/Aims: Health care-associated infections (HAI) affect 1.7 million patients and cause 100,000 deaths annually, yet preventive strategies are only partially effective. HAI are often transmitted between health care workers and patients; the sharp increase of antibiotic-resistant organisms compounds the problem. Fortunately, numerous efforts to reduce HAI incidence are being adopted, targeting clinical and environmental cleaning polices. We document current infectious disease work by investigators uniquely positioned within Scott & White and nearby Central Texas VA. Our involvement in several disinfection strategies and research protocols utilizes evidence-based findings to transform patient care while reducing unnecessary treatment costs. Methods: Besides aggressive hand-washing and antibiotic stewardship programs at both institutions, ongoing VA initiatives focus on novel pulsed-xenon ultraviolet ray (UV) technologies to eliminate patient room pathogens. Supported by laboratory experiments, this ongoing project examines the clinical efficacy and cost-effectiveness of portable UV devices, gauging implementation challenges. Other decontamination or preventive efforts include air disinfection in operating suites to target surgical site infections (Scott & White), and copper-infused room surfaces to thwart microbial build-up in high-touch areas (VA). A new veterinary medicine partnership is exploring MRSA transmission via animal contact, a major facet of rural Central Texas life. Results: Research and quality improvement findings highlight potential barriers in bridging technological advances and health care delivery realties, yet are quite promising. We found a 99.4% reduction in MRSA microbial counts with evidence of HAI declines where UV devices are routinely deployed; other tests suggest these machines work even absent manual cleaning and without bacteria developing resistance. Carbapenemase-resistant infections dropped 75% with higher overall treatment response since Scott & White initiated better HAI screening, selective antibiotic combination therapies (e.g. minocycline plus amikacin) and other infection control precautions. Discussion: Pragmatic clinical efforts paired with insightful research simultaneously tackle universal health care system concerns, as HAI perniciously evolve with containment strategies. However, mounting evidence provides optimism, encouraging future collaborative endeavors. Our work demonstrates a crucial need to involve multiple stakeholders (clinical leadership, housekeeping, researchers) spurring practical hygiene programs, educational training and creative advances to combat HAI. Future efforts will spotlight implementation and translational progress as we continue pursuing effective models across multiple health systems

Cryptococcus laurentii meningitis in a non-HIV patient

Cryptococcus species (other than Cryptococcus neoformans) have been labeled as saprophytic and nonpathogenic in immunocompetent individuals in the past. In recent years, infections caused by non-neoformans Cryptococcus species have been recognized. Cryptococcus laurentii is known to be a rare human pathogen. In this case report, we present a 59-year-old man who did not have HIV infection with meningoencephalitis caused by Cryptococcus laurentii. No significant underlying immunosuppressive disorder was found. The only identifiable risk factors were that the patient was a farmer with previous exposure to pigeon droppings. Here, we describe what we believe to be the fifth reported case of meningitis caused by Cryptococcus laurentii

Nontyphoidal Salmonella purulent pericarditis presenting with pericardial tamponade in a patient on infliximab therapy

Infection with nontyphoidal Salmonella is traditionally characterized by intestinal manifestations. However, extra-intestinal infections are known to occur, with purulent pericarditis associated with cardiac tamponade being rare. This case report is of a 57-year-old male with Crohn’s disease initiated on infliximab therapy two months prior to presentation. He presented with recurrent chest pain and a single occurrence of fever. A Computed Tomography (CT) scan of the chest revealed a pericardial effusion. An echocardiogram confirmed the presence of the fluid with tamponade physiology, requiring immediate surgical decompression. The pericardial fluid culture grew Salmonella enterica, despite the patient having only a single episode of fever, disproportionate to the severity of the infection. Conceivably, the lack of systemic symptoms may be attributed to recent infliximab therapy. Upon conducting a literature review, immunosuppressive factors seem to play a significant role in nontyphoid Salmonella enterica pericardial effusion presenting with cardiac tamponade

Effectiveness of Pfizer-BioNTech and Moderna Vaccines Against COVID-19 Among Hospitalized Adults Aged ≥65 Years — United States, January–March 2021

Adults aged ≥65 years are at increased risk for severe outcomes from COVID-19 and were identified as a priority group to receive the first COVID-19 vaccines approved for use under an Emergency Use Authorization (EUA) in the United States (1-3). In an evaluation at 24 hospitals in 14 states,* the effectiveness of partial or full vaccination† with Pfizer-BioNTech or Moderna vaccines against COVID-19-associated hospitalization was assessed among adults aged ≥65 years. Among 417 hospitalized adults aged ≥65 years (including 187 case-patients and 230 controls), the median age was 73 years, 48% were female, 73% were non-Hispanic White, 17% were non-Hispanic Black, 6% were Hispanic, and 4% lived in a long-term care facility. Adjusted vaccine effectiveness (VE) against COVID-19-associated hospitalization among adults aged ≥65 years was estimated to be 94% (95% confidence interval [CI] = 49%-99%) for full vaccination and 64% (95% CI = 28%-82%) for partial vaccination. These findings are consistent with efficacy determined from clinical trials in the subgroup of adults aged ≥65 years (4,5). This multisite U.S. evaluation under real-world conditions suggests that vaccination provided protection against COVID-19-associated hospitalization among adults aged ≥65 years. Vaccination is a critical tool for reducing severe COVID-19 in groups at high risk