amoxicillin-potassium-clavulanate-combination and Actinomycetales-Infections

Rothia mucilaginosa is a Gram-positive, coagulase-negative, encapsulated, non-spore-forming coccus considered part of the commensal flora of the oral cavity and the upper respiratory tract in humans. Its involvement has been reported in an increasing spectrum of infections, above all among immunocompromised patients. To date, only 11 cases of pneumonia due to Rothia mucilaginosa have been described in the literature. The authors report a case of pneumonia due to Rothia mucilaginosa in a 72-year-old man with laryngeal cancer and review the published cases of pneumonia due to this pathogen.

Topics: Actinomycetales Infections; Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Carcinoma, Squamous Cell; Drug Resistance, Microbial; Humans; Incidental Findings; Laryngeal Neoplasms; Male; Micrococcaceae; Opportunistic Infections; Pneumonia, Bacterial; Preoperative Care; Pulmonary Disease, Chronic Obstructive; Tomography, X-Ray Computed

Rhodococcus equi is an emerging opportunistic pathogen of HIV-I infected patients. It is an aerobic, Gram-positive coryneform bacterium which acts as a facultative intracellular micro-organism, multiplying in the phagosome of macrophages. Eighteen cases of R. equi infection in HIV-I positive patients have now been reported. Sixteen of these had pneumonia, of which 12 had cavitating lung lesions. A history of contact with farm animals, which are the primary hosts of R. equi, was found in only three patients. There was a delay in establishing a definite diagnosis in most cases as this depended upon the isolation of R. equi from sputum, bronchoalveolar lavage fluid, or blood. Treatment included surgical resection in five patients and erythromycin with a second antibiotic in 13 cases, but II of the 18 patients died from the infection. In this report we describe our experience of R. equi pneumonia in two AIDS patients and review the published cases of the disease in man.

Topics: Acquired Immunodeficiency Syndrome; Actinomycetales Infections; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Clavulanic Acids; Doxycycline; Drug Therapy, Combination; HIV Seropositivity; HIV-1; Humans; Male; Microbial Sensitivity Tests; Pneumonia; Rhodococcus equi; Rifampin

Topics: Abscess; Actinomycetaceae; Actinomycetales Infections; Adult; Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Combined Modality Therapy; Drainage; Drug Resistance, Microbial; Female; Humans; Immunocompetence; Male; Mastitis; Prostatitis; Scrotum

Topics: Abscess; Actinomycetales Infections; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Female; Gordonia Bacterium; Humans; Injections, Subcutaneous; Middle Aged; Skin Diseases, Infectious

Topics: Actinomycetales Infections; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Drug Resistance, Multiple, Bacterial; Drug Substitution; Female; Humans; Immunocompromised Host; Kidney Transplantation; Micrococcaceae; Postoperative Complications; Pyelonephritis; Self Care; Urinary Catheterization; Young Adult

Streptomyces spp. are aerobic, Gram-positive bacteria of the order Actinomycetales, known for their ability to produce antimicrobial molecules such as streptomycin. Pneumonia due to Streptomyces is considered to be rare and limited to immunocompromised patients. Streptomyces spp. are only rarely associated with invasive systemic infections. To our knowledge, we report the first documented case of community-acquired Streptomyces atratus bacteremic pneumonia in an immunocompetent patient.. We describe a case of Streptomyces atratus bacteremic pneumonia in an otherwise healthy, 77-year-old Spanish man. Streptomyces identified by 16S ribosomal RNA sequencing grew in multiple blood cultures and bronchoalveolar lavage cultures. The infection resolved completely after treatment with imipenem and amoxicillin/clavulanic acid for 2 months.. The majority of cases reported in the literature make reference to the difficulty of determining the pathogenic role of Streptomyces spp. Usually considered a contaminant, the pathogenic role of Streptomyces spp. is easier to confirm when the species is isolated from a catheter tip and, in the case of blood cultures, in more than one sample with a high count of colonies. To our knowledge, we report the first documented case of Streptomyces atratus bacteremic pneumonia in an immunocompetent patient. As the experience is limited, further studies are needed to better understand the interpretation of the isolates of the genus Streptomyces; the predisposing factors for infection; and the course, treatment, and evolution of these infections.

Topics: Actinomycetales Infections; Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bronchoalveolar Lavage Fluid; Bronchoscopy; Community-Acquired Infections; Humans; Imipenem; Immunocompetence; Levofloxacin; Male; Pneumonia, Bacterial; Sequence Analysis, DNA; Streptomyces; Treatment Outcome

Topics: Actinomycetaceae; Actinomycetales Infections; Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bacteremia; Bacteroides fragilis; Bacteroides Infections; Catheter-Related Infections; Coinfection; Female; Gardnerella vaginalis; Gram-Positive Bacterial Infections; Humans; Klebsiella Infections; Klebsiella oxytoca; Leg Ulcer; Pressure Ulcer; Skin; Soft Tissue Infections; Species Specificity; Urinary Catheterization; Urinary Tract Infections

Respiratory infections are the most common complications in HIV patients, regardless of the degree of immunosuppression. Even though antiretroviral therapy has a protective effect on the risk of bacterial pneumonia, this still remains high (including those with CD(4)>500/mm(3)). The most frequently isolated bacteria are Streptococcus pneumoniae and Haemophilus influenzae. The clinical and radiological presentations of lower respiratory tract infections in HIV patients are quite variable. The clinical presentation is more severe and the radiological presentation is more atypical if the immunosuppression is severe. The first-line antibiotic therapy is an injectable third-generation cephalosporin (ceftriaxone or cefotaxime) or co-amoxiclav. Pneumococcal vaccination (as well as influenza vaccine) is recommended. Although rare, Nocardia spp. and Rhodococcus equi seem more common among AIDS patients.

Topics: Actinomycetales Infections; AIDS-Related Opportunistic Infections; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antiretroviral Therapy, Highly Active; Cephalosporins; Community-Acquired Infections; Evidence-Based Medicine; France; Haemophilus influenzae; HIV Infections; Humans; Immunocompromised Host; Influenza Vaccines; Nocardia Infections; Pneumococcal Vaccines; Pneumonia, Bacterial; Rhodococcus equi; Severity of Illness Index; Streptococcus pneumoniae; Treatment Outcome