meropenem and Actinomycetales-Infections

To investigate the clinical course and outcome of peritoneal dialysis-associated peritonitis secondary to Gordonia species.. We reviewed all Gordonia peritonitis episodes occurring in a single dialysis unit from 1994 to 2013.. During the study period, four episodes of Gordonia peritonitis were recorded. All were male patients. One patient responded to vancomycin therapy. One patient had refractory peritonitis despite vancomycin, but responded to imipenem and amikacin combination therapy. One patient had relapsing peritonitis and required catheter removal. The fourth patient had an elective Tenckhoff catheter exchange. No patient died of peritonitis. Causative organism was not fully identified until 7 to 18 days of peritonitis.. Gordonia species is increasingly recognized to cause serious infections. In patients undergoing peritoneal dialysis, Gordonia peritonitis should be considered in case of refractory Gram-positive bacilli peritonitis, especially when the exact organism could not be identified one week after the onset of peritonitis. A close liaison with a microbiologist is needed for a timely diagnosis.

Topics: Actinomycetales Infections; Aged; Anti-Bacterial Agents; Device Removal; Disease Management; Gordonia Bacterium; Humans; Infusions, Parenteral; Kidney Failure, Chronic; Male; Meropenem; Middle Aged; Peritoneal Dialysis, Continuous Ambulatory; Peritonitis; Prosthesis-Related Infections; Recurrence; Thienamycins; Treatment Outcome; Vancomycin

Purulent meningitis refers infection of the subarachnoid space by various purulent bacteria and the corresponding inflammation of the leptomeninges. However, purulent meningitis due to Rhodococcus equi is extremely rare.. A 40-year-old man presented with fever and intermittent headache for 6 days. Two hours prior to admission, he developed epileptic seizures.. Brain computed tomography and magnetic resonance imaging showed intracerebral malacic lesions. Bacterial culture of cerebrospinal fluid revealed the presence of R. equi. A diagnosis of purulent meningitis caused by R. equi was made.. The patient was treated with intravenous meropenem (1000 mg every 8 hours) for 19 days; then he was discharged and instructed to continue the intravenous meropenem for two weeks. After a follow-up period of 2 months, the patient had recovered completely.. After a follow-up period of 2 months, the patient had recovered completely.. Central nervous system infection caused by R. equi is rare. Early bacterial culture of CSF is important for timely diagnosis. With sufficient antibiotic therapy, the prognosis can be favorable.

Topics: Actinomycetales Infections; Adult; Anti-Bacterial Agents; Cerebrospinal Fluid; Humans; Male; Meningitis, Bacterial; Meropenem; Rhodococcus equi; Thienamycins

Topics: Actinomycetales Infections; Aged; Anti-Bacterial Agents; Bacteremia; Diagnosis, Differential; Drug Therapy, Combination; Erythema Multiforme; Glucocorticoids; Humans; Male; Meropenem; Prednisolone

In this report, a renal transplant recipient with Rhodococcus lung abscess is described. A high clinical suspicion and appropriate combination antibiotic therapy obviated the need for surgical intervention and was associated with a good clinical outcome. The optimal regimen of combination antibiotic therapy is discussed.

Topics: Actinomycetales Infections; Adult; Anti-Bacterial Agents; Drug Therapy, Combination; Humans; Kidney Transplantation; Lung Abscess; Male; Meropenem; Radiography; Rhodococcus equi; Rifampin; Sirolimus; Thienamycins; Treatment Outcome; Vancomycin

Opportunistic infections contribute to morbidity and mortality of patients undergoing hematopoietic stem cell transplantation and treatment for malignancies. Rothia mucilaginosa, a gram-positive bacterium, is responsible for rare, but often fatal meningitis in severely immunocompromised patients. We describe two cases of meningitis from discrete strains of R. mucilaginosa on our pediatric bone marrow transplant unit, summarize the published cases of R. mucilaginosa meningitis in oncology and stem cell transplant patients, and provide updated recommendations regarding the use of antibiotic therapy in this patient population.

Topics: Actinomycetales Infections; Adolescent; Anti-Bacterial Agents; Ceftazidime; Cerebrospinal Fluid Shunts; Child; Cord Blood Stem Cell Transplantation; Drug Therapy, Combination; Fatal Outcome; Female; Humans; Immunocompromised Host; Leukemia, Megakaryoblastic, Acute; Male; Meningitis, Bacterial; Meropenem; Micrococcaceae; Opportunistic Infections; Postoperative Complications; Rifampin; Sepsis; Thienamycins; Vancomycin