Evaluation of treatment outcomes for Stenotrophomonas maltophilia bacteraemia

Objective: The goal of this study was to retrospectively collect data about treatment outcomes in patients diagnosed with Stenotrophomonas maltophilia bacteraemia over a period of 20years and evaluate these data with respect to the efficacy of treatment options. Methods: The setting was a 700-bed tertiary care hospital in a large urban area. Hospital databases and medical records provided information about episodes of S. maltophilia, patient characteristics and treatment outcomes. Patients with at least one positive blood culture for S. maltophilia were included in the study. Data were analysed with respect to clinical improvement and mortality ≤30days after the onset of infection. We compared patient characteristics, laboratory values and treatments by using the Chi-square or Fisher's exact tests and the Mann-Whitney test. Results: We investigated 27 patients with S. maltophilia bacteraemia. The focus of infection was a central venous catheter in 18 (67%) cases. The 30-day mortality rate was 11%. All patients who were treated with an antibiotic that was effective in vitro against the pathogen recovered clinically and survived ≥30days after the onset of infection. The most frequently used antibiotic was trimethoprim-sulfamethoxazole administered alone or in combination with a fluoroquinolone. Conclusions: Despite the fact that S. maltophilia is resistant to multiple antibiotics, the prognosis for patients with S. maltophilia bacteraemia is good when they are treated with antibiotics that are effective against this pathogen in vitro

Hidden under a Cauliflower-Like Skin Tumor: Chromoblastomycosis

We present the case of an 80-year-old patient with a recurrent hyperpigmented and cauliflower-like skin tumor on the stump of his left index finger. Despite suggestive clinical appearance for chromoblastomycosis the tumor was initially clinically and also histopathologically misdiagnosed as recurrent squamous cell carcinoma. Due to a cardiogenic shock, the patient died shortly after the diagnosis of chromoblastomycosis, before adequate treatment could be introduced. In non-tropical regions chromoblastomycosis is an uncommon chronic fungal infection with Fonsecaea pedrosoi being the most prevalent etiological agent. Mostly lower extremities are involved. It is not unusual that, clinically, in the absence of pigmentation, and, histopathologically, because of pseudoepitheliomatous hyperplasia of the epidermis, chromoblastomycosis is confounded with squamous cell cancer, and delays in diagnosis of one to 3 years are common. Therefore, a high grade of clinical suspicion and inclusion of chromoblastomycosis in the differential diagnosis of pigmented skin tumors are important to initiate adequate therapy. Our case is remarkable in many aspects. The localization on an upper extremity and the grade of invasiveness with involvement of bone are unusual; furthermore the lack of a tropical travel history emphasizes that the infection almost surely occurred in Switzerland

Neglect of attention to reproductive health in women with HIV infection: contraceptive use and unintended pregnancies in the Swiss HIV Cohort Study.

Women with HIV infection are mainly of reproductive age and need safe, effective and affordable contraception to avoid unintended pregnancies. The aim of this study was to evaluate contraceptive use and unintended pregnancies in this population in Switzerland. A self-report anonymous questionnaire on contraceptive methods, adherence to them, and unintended pregnancies was completed by women included in the Swiss HIV Cohort Study (SHCS) between November 2013 and June 2014. Sociodemographic characteristics and information related to combined antiretroviral therapy and HIV disease status were obtained from the SHCS database. Of 462 women included, 164 (35.5%) reported not using any contraception. Among these, 65 (39.6%) reported being sexually active, although 29 (44.6%) were not planning a pregnancy. Of 298 women using contraception, the following methods were reported: condoms, 219 (73.5%); oral hormonal contraception, 32 (10.7%); and intrauterine devices, 28 (9.4%). Among all women on contraception, 32 (10.7%) reported using more than one contraceptive method and 48 (16%) had an unintended pregnancy while on contraception (18, condoms; 16, oral contraception; four, other methods). Of these, 68.1% terminated the pregnancy and almost half (43.7%) continued using the same contraceptive method after the event. Family planning needs in HIV-positive women are not fully addressed because male condoms remained the predominant reported contraceptive method, with a high rate of unintended pregnancies. It is of utmost importance to provide effective contraception such as long-acting reversible contraceptives for women living with HIV

Auritidibacter ignavus Yassin 2011

EMENDED DESCRIPTION OF AURITIDIBACTER IGNAVUS YASSIN ET AL. 2011 Auritidibacter ignavus (ig.na′ vus. L. masc. adj. ignavus inactive). In addition to properties described for the emended genus or as described for A. ignavus by Yassin et al. [1], strains may show the following characteristics: cells measure 1.85±0.45 µm in length and have a width of 0.44±0.05 µm. May assimilate substrate at pH 6. Reduction of nitrite not observed. Vogues–Proskauer (acetoin) production, DNase and starch hydrolyses are variable. Pyrrolidonyl arylamidase, esterase, leucine arylamidase and naphthol-AS-BIphosphohydrolase are variable. Isolates may grow at 42 °C and not at 25 °C. Isolates neither ferment nor assimilate conventional sugars nor those found in API panels. Using the Biolog panel, isolates may be positive or borderline positive for the utilization of dextrin, L-glutamic acid,L-pyroglutamic acid, p -hydroxyphenylacetic acid, D-galacturonic acid, L-lactic acid, Tween 40, Ɣ- aminobutyric acid, α-hydroxybutyric acid, β-hydroxy-DL-butyric acid, α-ketobutyric acid and acetic acid. In sensitivity tests, tetrazolium dyes may be reduced at pH 6, in 1%, 4%, and 8% NaCl, nalidixic acid, lithium chloride, potassium tellurite, aztreonam, sodium butyrate and sodium bromate. The remaining substrates are variably utilized or not used. Isolates have been obtained from ear infections from patients located in Germany, Switzerland and Canada and detected by DNA sequencing from a bacteremia in Spain. A. ignavus NML 100628 has been deposited in two culture collections (NCTC 14178= LMG 30897) to serve as an additional reference strain for this species. The genomic DNA G+C content of the type strain (A. ignavus DSM 45359 T) is 59.3% with those of other strains ranging from 59.4 to 59.5%.Published as part of Bernard, K. A., Pacheco, A. L., Burdz, T., Wiebe, D., Beniac, D. R., Hiebert, S. L., Booth, T. F., Jakopp, B., Goldenberger, D., Seth-Smith, H. M. B., Egli, A. & Bernier, A-M, 2020, Emendation of the Genus Auritidibacter Yassin et al. 2011 and Auritidibacter ignavus Yassin et al. 2011 based on features observed from Canadian and Swiss clinical isolates and wholegenome sequencing analysis, pp. 83-88 in International Journal of Systematic and Evolutionary Microbiology 70 (1) on pages 86-87, DOI: 10.1099/ijsem.0.003719, http://zenodo.org/record/604866

Auritidibacter YASSIN ET AL. 2011

EMENDED DESCRIPTION OF THE GENUS AURITIDIBACTER YASSIN ET AL. 2011 The genus Auritidibacter is as described by Yassin et al. [1] except that cells may be straight or curvy; morphologically, cells may or may not demonstrate a rod–coccus cycle over time. Motility may be difficult to demonstrate except by the hanging drop method. DNA G+C content of the type strain is 59.3% with a genome size of approx. 2589795 bps by WGS.Published as part of Bernard, K. A., Pacheco, A. L., Burdz, T., Wiebe, D., Beniac, D. R., Hiebert, S. L., Booth, T. F., Jakopp, B., Goldenberger, D., Seth-Smith, H. M. B., Egli, A. & Bernier, A-M, 2020, Emendation of the Genus Auritidibacter Yassin et al. 2011 and Auritidibacter ignavus Yassin et al. 2011 based on features observed from Canadian and Swiss clinical isolates and wholegenome sequencing analysis, pp. 83-88 in International Journal of Systematic and Evolutionary Microbiology 70 (1) on page 86, DOI: 10.1099/ijsem.0.003719, http://zenodo.org/record/604866