Community-Acquired Meningitis and Sepsis Caused by Chryseobacterium meningosepticum in a Patient Diagnosed with Thalassemia Major

Chryseobacterium meningosepticum is a rare pathogen in cases of bacterial meningitis in adults and adolescents. We report on the case history of a 17-year-old boy with thalassemia major and meningitis and sepsis caused by C. meningosepticum in splenectomized. The patient received vancomycin therapy for 21 days and was discharged in a state of complete recovery

Change in Pathogens Causing Late-onset Sepsis in Neonatal Intensive Care Unit in Izmir, Turkey

Objective: Neonatal sepsis is a common cause of morbidity and mortality among newborns in the developing world. We have investigated the causative agents and their antimicrobial susceptibility of late-onset sepsis (>72 h post-delivery), and determined the possible association between various risk factors and the mortality due to neonatal sepsis in 2008. To view the changes in years, we compared them with the data which we gained in 2004

Prevalência e fatores de risco associados à colonização por enterococos resistente à vancomicina

Enterococci have been recognized as clinically important pathogen in high-risk population of hospitalized patients. The aims of this study were to detect the prevalence of intestinal vancomycin-resistant enterococci (VRE) colonization among patients in the high-risk departments and the risk factors related to resistance in hospitalized patients in where VRE had been rarely isolated previously in Tepecik Educational and Research Hospital, Izmir, Turkey. Following the first isolation of VRE in two patient in intensive care unit (ICU) and neonatal ICU in the same day, we carried out a point prevalence culture survey. Rectal swabs were obtained from patients. For comparison, 30 control patients hospitalized in internal medicine service were also analyzed. Ninety-three patients were investigated. Eighteen patients (19.3%) were found to be VRE carriers, whereas none of the control group patients had VRE. Thirteen strains were identified as Enterococcus faecium, four were Enterococcus gallinorum, and one was Enterococcus casseliflavus. Nine of E. faecium strains were resistant to vancomycin; the remainders were intermediate resistance to vancomycin and all of them sensitive to teicoplanin. Lengths of hospital stay, age and low birth weight for newborn were significantly associated with VRE colonization. A high prevalence of colonization by VRE was found at our ICUs, emphazing the importance of length stay in the ICU and low birth weight for newborn as a risk factor for colonization. VRE colonization must be monitored and risk factors should be determined, because of establish prevention and control measures.Os enterococos foram reconhecidos como patógenos clinicamente importantes na população de alto risco de pacientes hospitalizados. Os objetivos deste estudo foram detectar a prevalência da colonização por enterocos intestinais resistentes à vancomicina (VRE) no Hospital Tepecik, Izmir, Turquia, entre pacientes dos serviços de alto risco e os fatores de risco relacionados com a resistência em pacientes internados onde a VRE foi raramente isolada anteriormente. Após o primeiro isolamento de VRE em dois pacientes na unidade de terapia intensiva (UTI) e UTI neonatal, no mesmo dia, foi realizado um levantamento de prevalência utilizando swab retal. Para efeito de comparação, 30 amostras de pacientes-controle do serviço de controle de medicina interna também foram analisadas. Noventa e três pacientes foram investigados. Dezoito pacientes (19,3%) foram considerados portadores de VRE, apesar de nenhum dos pacientes do grupo controle tinham VRE. Treze cepas foram identificadas como Enterococcus faecium, quatro foram Enterococcus gallinorum, e um foi Enterococcus casseliflavus. Nove cepas de E. faecium foram resistentes à vancomicina, os restos eram de resistência intermediária à vancomicina e todos eles sensíveis à teicoplanina. O tempo de permanência hospitalar, idade e peso baixo ao nascer de recém-nascidos foram significativamente associados à colonização por VRE. A alta prevalência de colonização por VRE foi encontrado em nossas UTIs, enfatizando a importância do tempo de internação na UTI e baixo peso ao nascer de recém-nascidos como fator de risco para a colonização. A colonização por VRE deve ser monitorada e fatores de risco devem ser determinados, no intuito de estabelecer medidas de prevenção e controle

The Effect of Aminoglycosides on Colistin-Containing Regimens in the Treatment of Carbapenem-Resistant Gram-Negative Infections in Pediatric Intensive Care Units: A Two-Center Experience

WOS: 000485683800010Objective: This study aimed to assess the outcomes including morbidity and mortality of carbapenem-resistant gram-negative (CRGN) infections in pediatric critical care setting. The second aim was to investigate the impact of aminoglycosides on colistin-containing regimen in CRGN-infected pediatric critical care patients. Materials and Methods: We retrospectively evaluated medical records of 82 patients who had received colistin in combination with an aminoglycoside (CA group) or another antibiotic (CO group) at two reference pediatric intensive care units (PICUs) between February 2011 and February 2016. Results: We enrolled 82 CRGN-infected patients who were admitted to PICUs of two hospitals. The median age of the patients was 24 (25th-75th percentile; 8-78.75) months, and the median duration of hospital stay was 30 days (25th-75th percentile; 16.7-57.7). No statistical difference was observed in the variables, including microbiological response, attributable mortality, crude mortality, and the duration of achieving first negative culture (p>0.05). Clinical response was significantly more observed in the CA group (85.5% vs. 63.2; p=0.048), and attributable mortality was higher in the CO group (12.7% vs. 31.6%; p=0.055). Nephrotoxicity did not show statistical difference between groups (p=0.357), and neurotoxicity was not observed. Conclusion: Colistin-containing regimen in combination with an aminoglycoside may be an effective and safe antimicrobial agent without a significant increase in side effects