Prevalence and mechanisms of resistance to carbapenems in Enterobacteriaceae

Objectives: To determine the point prevalence of carbapenem-non-susceptible Enterobacteriaceae (CNSE) and carbapenemase-producing Enterobacteriaceae (CPE) isolates among hospitalized patients in Belgium. Methods: Twenty-four hospital-based laboratories prospectively collected 200 non-duplicated Enterobacteriaceae isolates from clinical specimens of hospitalized patients over a 2 month period. All isolates were screened locally for decreased susceptibility to carbapenem drugs using a disc diffusion method according to CLSI interpretative criteria. CNSE strains were referred centrally for confirmation of carbapenemase by phenotypic and molecular testing. Results: From February to April 2012, 158 of the 4564 screened Enterobacteriaceae isolates were categorized as non-susceptible to carbapenems, resulting in a point prevalence of CNSE of 3.5% (95% CI: 2.9%–4.2%; range per centre: 0.5%–8.5%). Of the 125 referred CNSE isolates, 11 Klebsiella pneumoniae isolates [OXA-48 (n=7), KPC type (n=3) and NDM type (n=1)], 1 OXA-48-positive Escherichia coli isolate and 1 KPC-positive Klebsiella oxytoca isolate were detected in eight hospitals. None of the 72 carbapenem-non-susceptible Enterobacter spp. isolates were confirmed as CPE. The minimal estimated point prevalence of CPE isolates was 0.28% (13/ 4564; 95% CI: 0.13%–0.44%) overall (range per centre: 0%–1.5%). Conclusions: Despite the overall low prevalence of CNSE found in this study, the detection of CPE isolates in one-third of the participating centres raises concerns and highly suggests the spread and establishment of CPE in Belgian hospitals

Erysipelothrix rhusiopathiae septicemia

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Fatal bacteremia due to staphylococcus schleiferi subsp. Schleiferi

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In situ bacteriologic diagnosis of total parenteral nutrition catheter infection

An evaluation of the in sity bacteriologic status of a total parenteral nutrition (TPN) catheter, when the patient is pyretic but the cause of infection is not obvious, permits continued use of the catheter if the result is negative, as opposed to removal of the suspected catheter. To find a predictive value for the infection of the catheter, semiquantitative blood cultures taken through the TPN catheter were examined during the pyretic episodes.A total of 227 catheters from 204 patients were studied. Of these 149 were investigated during pyretic episodes. Twenty TPN catheters were removed because their semiquantitative blood cultures were positive, and in all cases the clinical conditions of the patients improved after removal of the catheters. The remaining 129 catheters investigated showed negative results and had predictive values of 100%. These catheters were left in place and all subsequently proved to be sterile on their removal at the end of the TPN. Thus 87% of the 149 suspected catheters were saved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Intramuscular piperacillin sodium in uncomplicated lower urinary tract infections: Evaluation of safety, clinical and bacteriological responses and blood levels

Twenty hospitalized adults with lower urinary tract infections received piperacillin sodium intramuscularly 2 grams every 12 hours for 6 to 8 days. Eradication of the causative pathogen was achieved in all patients and was maintained in 14 of them for at least 6 weeks. The mean peak serum level, determined one hour after the 2-gram intramuscular dose, was 40 ug/ml (11-94). Minor side effects were observed including a slight and reversible elevation of blood urea in 3 subjects who had received - concurrently or recently - moderate doses of furosemide.SCOPUS: NotDefined.jinfo:eu-repo/semantics/publishe

Campylobacter fetus peritonitis followed by septicaemia in a patient on continuous ambulatory peritoneal dialysis

A 62-year-old man being treated by continuous ambulatory peritoneal dialysis (CAPD) developed peritonitis due to Campylobacter fetus subspecies fetus (intestinalis), an organism seldom isolated in such circumstances. After appropriate and apparently effective antibiotic therapy, the patient relapsed 6 weeks later with septicaemia. Blood cultures yielded a similar organism, thereby suggesting a clinically silent metastatic infection during the episode of peritonitis, probably at an old arteriovenous fistula. Parenteral tobramycin followed by oral erythromycin achieved a complete cure of this unusual complication. © 1985 The British Society for the Study of Infection.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Septicémies et péritonite à Campylobacter fetus ssp. fetus

Campylobacter fetus ssp. fetus has been isolated on three occasions in the course of a short period ;the strains have been isolated from peritoneal fluid and blood cultures in the first case and from blood cultures in the two other cases. The clinical observations as well as the bacteriological findings are reported in the present note. All these isolated strains exhibited the typical biochemical features of Campylobacter fetus ssp. fetus. The origin of the observed infections remains unknown in the three cases. © 1984.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Flavobacterium multivorum septicemia in a hemodialyzed patient

A case of Flavobacterium multivorum septicemia in a hemodialyzed patient is reported. Two blood cultures were positive at 48 h, and the patient became afebrile only after antimicrobial therapy. The origin of the septicemia could not be determined.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Lactobacillus plantarum Septicemia

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Post-traumatic gangrene and systemic mucormycosis

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