cefoxitin and Communicable-Diseases--Emerging

In the Calgary Health Region during 2000-2003, prospective, active, population-based laboratory surveillance for all cefoxitin-resistant Escherichia coli isolates was performed. Isolates were screened with an inhibitor-based disk test, and plasmid-mediated types were identified by multiplex PCR with sequencing. A total of 369 AmpC beta-lactamase-producing E. coli isolates were identified; annual incidence rates were 1.7, 4.3, 11.2, and 15 per 100,000 residents for each year, respectively. AmpC beta-lactamase-producing E. coli was 5x more likely to be isolated from female than male patients across all age groups except < 1 year. Of these isolates, 83% were community onset, and urine was the principal site of isolation (90% of patients). PCR showed that 125 (34%) were positive for bla(cmy) genes; sequencing identified these enzymes to be CMY-2. In this large Canadian region, AmpC beta-lactamase-producing E. coli is an emerging community pathogen that commonly causes urinary tract infections in older women.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacterial Proteins; beta-Lactamases; Canada; Cefoxitin; Child; Child, Preschool; Communicable Diseases, Emerging; Community-Acquired Infections; Drug Resistance, Bacterial; Escherichia coli; Escherichia coli Infections; Female; Genes, Bacterial; Humans; Incidence; Infant; Male; Middle Aged; Prospective Studies; Sentinel Surveillance; Urine

Propionibacterium acnes, which usually considered as a contaminant, has been found to be an emerging pathogen in human diseases. We describe a case of prosthetic valve related endocarditis caused by P. acnes. Sequencing of the genetic coding of 16S ribosomal RNA was used to identify the pathogen and random amplified polymorphic DNA patterns further confirmed the persistent bacteraemia, which help to determine the diagnosis.

Topics: Anti-Bacterial Agents; Cefoxitin; Clindamycin; Communicable Diseases, Emerging; Endocarditis, Bacterial; Gram-Positive Bacterial Infections; Heart Valve Prosthesis; Humans; Infusions, Intravenous; Male; Middle Aged; Molecular Sequence Data; Penicillin G; Polymerase Chain Reaction; Propionibacterium acnes; Prosthesis-Related Infections; Random Amplified Polymorphic DNA Technique; RNA, Ribosomal, 16S