Ameba-associated Microorganisms and Diagnosis of Nosocomial Pneumonia

Ameba-associated microorganisms should be suspected when conventional microbiologic test results are negative

Amoeba-Resisting Bacteria and Ventilator-Associated Pneumonia

To evaluate the role of amoeba-associated bacteria as agents of ventilator-associated pneumonia (VAP), we tested the water from an intensive care unit (ICU) every week for 6 months for such bacteria isolates; serum samples and bronchoalveolar lavage samples (BAL) were also obtained from 30 ICU patients. BAL samples were examined for amoeba-associated bacteria DNA by suicide-polymerase chain reaction, and serum samples were tested against ICU amoeba-associated bacteria. A total of 310 amoeba-associated bacteria from10 species were isolated. Twelve of 30 serum samples seroconverted to one amoeba-associated bacterium isolated in the ICU, mainly Legionella anisa and Bosea massiliensis, the most common isolates from water (p=0.021). Amoeba-associated bacteria DNA was detected in BAL samples from two patients whose samples later seroconverted. Seroconversion was significantly associated with VAP and systemic inflammatory response syndrome, especially in patients for whom no etiologic agent was found by usual microbiologic investigations. Amoeba-associated bacteria might be a cause of VAP in ICUs, especially when microbiologic investigations are negative

Evaluation of the neo-glottal closure based on the source description in esophageal voice

The characteristics of esophageal voice render its study by traditional acoustic means to be limited and complicate. These limitations are even stronger when working with patients lacking minimal skills to control the required technique. Nevertheless the speech therapist needs to know the performance and mechanics developed by the patient in producing esophageal voice, as the specific techniques required in this case are not as universal and well-known as the ones for normal voicing. Each patient develops different strategies for producing esophageal voice due to the anatomical changes affecting the crico-pharyngeal sphincter (CPS) and the functional losses resulting from surgery. Therefore it is of fundamental relevance that practitioners could count on new instruments to evaluate esophageal voice quality, which on its turn could help in the enhancement of the CPS dynamics. The present work carries out a description of the voice of four patients after undergoing laryngectomy on data obtained from the study of the neo-glottal wave profile. Results obtained after analyzing the open-close phases and the tension of the muscular body on the CPS are shown

Vertebral infections caused by Haemophilus aphrophilus: case report and review

ObjectiveTo review in detail clinical presentation, bacteriologic findings, associated conditions and treatment of Haemophilus aphrophilus vertebral osteomyelitis and to compare them to a case we report herein.MethodsA Medline (National Library of Medicine) search of the literature was performed by using the key words H. aphrophilus, spondylodiscitis, discitis, and vertebral osteomyelitis. The references of the case reports were examined for additional cases, especially those cited in older articles that had not been entered onto the bibliographic database.ResultsA case report of spondylodiscitis due to H. aphrophilus in a 35-year-old patient with a history of dental abscess 7 months before admission is presented. The patient responded well to treatment with ceftriaxone and ciprofloxacin. To date, only 14 cases of H. aphrophilus vertebral osteomyelitis have been reported. They are usually reported in middle-aged patients, usually male. Most recent cases have been treated with fluoroquinolones. Duration of treatment usually ranges from 1 to 3 months.ConclusionsH. aphrophilus is an uncommon cause of vertebral osteomyelitis. Patients are regularly cured by antibiotic therapy, provided that a tissue biopsy is performed in order to isolate the causative bacterium

Direct Identification of Bacteria in Positive Blood Culture Bottles by Matrix-Assisted Laser Desorption Ionisation Time-of-Flight Mass Spectrometry

Background: With long delays observed between sampling and availability of results, the usefulness of blood cultures in the context of emergency infectious diseases has recently been questioned. Among methods that allow quicker bacterial identification from growing colonies, matrix-assisted laser desorption ionisation time-of-flight (MALDI-TOF) mass spectrometry was demonstrated to accurately identify bacteria routinely isolated in a clinical biology laboratory. In order to speed up the identification process, in the present work we attempted bacterial identification directly from blood culture bottles detected positive by the automate. Methodology/Principal Findings: We prospectively analysed routine MALDI-TOF identification of bacteria detected in blood culture by two different protocols involving successive centrifugations and then lysis by trifluoroacetic acid or formic acid. Of the 562 blood culture broths detected as positive by the automate and containing one bacterial species, 370 (66%) were correctly identified. Changing the protocol from trifluoroacetic acid to formic acid improved identification of Staphylococci, and overall correct identification increased from 59% to 76%. Lack of identification was observed mostly with viridans streptococci, and only one false positive was observed. In the 22 positive blood culture broths that contained two or more different species, only one of the species was identified in 18 samples, no species were identified in two samples and false species identifications were obtained in two cases. The positive predictive value of bacterial identification using this procedure was 99.2%. Conclusions/Significance: MALDI-TOF MS is an efficient method for direct routine identification of bacterial isolates in blood culture, with the exception of polymicrobial samples and viridans streptococci. It may replace routine identification performed on colonies, provided improvement for the specificity of blood culture broths growing viridans streptococci is obtained in the near future

Mimivirus in Pneumonia Patients

Mimivirus, the largest virus known to date, is an amebal pathogen like Legionella spp. When mimivirus was used as an antigen in a migration inhibition factor assay, seroconversion was found in patients with both community- and hospital-acquired pneumonia. Mimivirus DNA was found in respiratory samples of patients with hospital-acquired pneumonia