Catheter-related bacteremia due to Kocuria rosea in a patient undergoing peripheral blood stem cell transplantation

BACKGROUND: Micrococcus species may cause intracranial abscesses, meningitis, pneumonia, and septic arthritis in immunosuppressed or immunocompetent hosts. In addition, strains identified as Micrococcus spp. have been reported recently in infections associated with indwelling intravenous lines, continuous ambulatory peritoneal dialysis fluids, ventricular shunts and prosthetic valves. CASE PRESENTATION: We report on the first case of a catheter-related bacteremia caused by Kocuria rosea, a gram-positive microorganism belonging to the family Micrococcaceae, in a 39-year-old man undergoing peripheral blood stem cell transplantation due to relapsed Hodgkin disease. This uncommon pathogen may cause opportunistic infections in immunocompromised patients. CONCLUSIONS: This report presents a case of Kocuria rosea catheter related bacteremia after stem cell transplantation successfully treated with vancomycin and by catheter removal

Brucella detection in blood: comparison of the BacT/Alert standard aerobic bottle, BacT/Alert FAN aerobic bottle and BacT/Alert enhanced FAN aerobic bottle in simulated blood culture

The objective of this study was to compare the performances of the standard aerobic bottle (StAe), FAN aerobic (FANAe) and enhanced FAN aerobic (E-FANAe) (the charcoal component of the FANAe was revised recently to improve the feasibility of Gram smear interpretation) blood culture bottles for BacT/Alert system for the detection of Brucella melitensis in simulated blood culture. Triplicate strains of eight clinical isolates of B. melitensis were studied. Each bottle was inoculated with 5 mL of freshly collected human blood at three different targeted bacterial inocula (10(1), 10(2) and 10(3) CFU/bottle). All bottles were monitored for up to 21 days or until they became positive. The results of time to detection (TTD) on the eight B. melitensis samples were as follows: at 10(1) CFU/bottle, the E-FANAe had a mean TTD significantly shorter than the StAe (48 h vs. 56.2 h, P < 0.05); and at 10(3) CFU/bottle, the FANAe and E-FANAe had a mean TTD significantly shorter than the StAe (41.2 h and 40 h vs. 45.6 h, P < 0.05). The reproducibilities (no.of positive signals/no.of all bottles) of three bottle systems were as follows: at 10(1) CFU/bottle, the reproducibilities of StAe, FANAe and E-FANAe were 96, 83 and 58%, respectively. At 10(3) CFU/bottle, the reproducibilities of StAe, FANAe and E-FANAe were 95, 95 and 91%, respectively. Positive results for the presence of bacteria in Gram smears were confirmed in 68% of StAe, 54% of FANAe and 90% of E-FANAe. In case of suspected brucellosis, the combination of one StAe bottle and one E-FANAe bottle seems to provide the highest and fastest recovery of the organism

Antimicrobial susceptibilities of 40 isolates of Bacillus anthracis isolated in Turkey

Forty clinical isolates of Bacillus anthracis were studied. The MIC90 values of penicillin G, doxycycline, ciprofloxacin, gatifloxacin, and levofloxacin were 0.016, 0.03, 0.06, 0.06 and 0.12 mg/l, respectively. Susceptibilities suggest that the quinolones may also be considered as an alternative therapy for anthrax. (C) 2003 Elsevier Science B.V. and the International Society of Chemotherapy. All rights reserved

Prostatitis and hepatitis due to Brucella melitensis: a case report

A case is reported of a 43-year-old man who presented prostatitis and hepatitis due to Brucella melitensis. His symptoms were icterus, weakness, anorexia, fever, and urinary discomfort, Physical examination revealed icterus and hepatosplenomegaly, Lymphomonocytosis, elevated erythrocyte sedimentation rate and abnormal liver functions had been detected in laboratory tests, Brucella melitensis was isolated from prostatic fluid and blood cultures

Prospective evaluation of blood cultures in a Turkish university hospital: epidemiology, microbiology and patient outcome

The aims of this prospective study were to: (1) determine the rate of blood culture contamination; (2) describe and compare the epidemiologic, clinical and microbiological characteristics of hospital- and community-acquired bloodstream infections; and (3) determine the mortality resulting from bloodstream infections. The rate of true bacteremia was 12.1%, and 10.7% of cultures were contaminated. Of the 567 episodes of bloodstream infection, 73.4% were hospital-acquired, and 26.6% were community-acquired. The most commonly isolated microorganisms were staphylococci (44%, methicillin resistant 69.4%), enterococci (15%) and Escherichia coli (12.5%) in hospital-acquired episodes, and Brucella spp. (21.9%), E. coli (19.2%) and Staphylococcus aureus (14.6%, methicillin resistant 9.1%) in community-acquired episodes. While the overall mortality rate was 25.4%, death attributable to bloodstream infections was 16.6% in hospital-acquired episodes and 13.9% in community-acquired episodes. The highest mortality occurred in patients with bacteremia due to Pseudomonas aeruginosa (37.5%) in hospital-acquired episodes, and in patients with bacteremia due to Streptococcus pneumoniae (50%) in community-acquired episodes. Underlying diseases, severity of illness, presence of bladder catheter, previous use of antibiotics, tracheal intubation and adequacy of treatment were found to be significantly associated with death

Clinical manifestations, complications and treatment of brucellosis: a retrospective evaluation of 480 patients

The aim of this study was to evaluate the clinical, laboratory findings, and therapeutic features of patients with brucellosis. The diagnosis was made by clinical findings, positive agglutination titer. and/or the isolation of Brucella species. Three hundred and twenty-two cases were acute, 121 sub-acute, 24 chronic, and 13 asymptomatic. Symptoms of patients were malaise in 432 (90%) patients, sweating in 405 (184.4%), arthralgia in 393 (81.9%), fever in 383 (79.8%), and back pain in 281 (58.5%). The most frequent findings were fever in 187 (39%) patients, hepatomegaly in 102 (21.3%). osteoarticular involvement in 91 (19%), splenomegaly in 68 (14.2%), nervous system involvement in 31 (6.5%) patients. Lymphocytosis was determined in 328 patients, anemia in 262 patients, thrombocytopenia in 35 patients, leukopenia in 37 patients, leukocytosis in 31 patients. and elevated erythrocyte sedimentation rate in 282 patients. Cultures were positive in 194 (45%) patients and all strains were identified as Brucella melitensis. Various treatment regimens were given to patients, No therapeutic failure was observed. The time to defervescence ranged from 2 to 15 days. Relapse occurred in 26 of the 480 patients (5.4%). There was no correlation between relapse and positive culture or complications. Brucellosis can present various clinical forms in endemic areas and mimics several diseases. (C) 2002 Editions scientifiques et medicales Elsevier SAS. All rights reserved

Intravitreal trovafloxacin against experimental Staphylococcus epidermidis endophthalmitis

This study was designed to test the effects of intravitreal trovafloxacin on an experimental rabbit model of Staphylococcus epidermidis endophthalmitis, Out of 26 rabbits, 22 were given intravitreal S, epidermidis (100,000 CFU). At 24 h, group 1 (8 rabbits) and, at 48 h, group 2 (8 rabbits) received 100 mu g intravitreal trovafloxacin. Group 3 (6 rabbits) was used as inoculated but untreated controls. Four rabbits (group 4) were used as uninfected controls. Clinical scores were calculated at 24, 48 and 72 h. Microbiological and histopathological scorings were made. Microbiological analysis showed that trovafloxacin administered at 24 or 48 h significantly reduced the number of bacteria compared to the untreated group, We conclude that trovafloxacin applied at 24 or 48 h is effective against S, epidermidis endophthalmitis in this experimental rabbit model. Copyright (C) 2000 S. Karger AG, Basel

Treatment of neurobrucellosis with a combination of ceftriaxone, rifampicin and doxycycline (a study on ten cases)

Ten cases of neurobrucellosis treated with a combination of ceftriaxone, rifampicin and doxycycline were assessed, Six patients were diagnosed as meningitis, two as myelitis, one as meningoencephalitis and one as polyradiculoneuritis. They were treated with ceftriaxone added to a rifampicin and doxycycline combination, for a period of 2-3 weeks. Rifampicin and doxycycline combination was continued for a period of 8-24 weeks, based on the improvement in clinical findings and CSF abnormality. Fever lasted between 3 and 12 days (7 out of 10 patients had fever on admission). CSF cyto-chemical parameters were back to normal within 2 to 5 months