phenylephrine-hydrochloride and Gram-Negative-Bacterial-Infections

Capnocytophaga canimorsus is a bacterium transmitted through the saliva of dogs. An infection can cause severe sepsis with acral necrosis and is potentially fatal. Here, we report the case of a 41-year-old man who was infected through a wound that was licked by his dog. He went into septic shock with disseminated intravascular coagulation and subsequently lost both lower legs, his nose and all the fingers on both hands.

Topics: Adult; Amputation, Surgical; Animals; Bites and Stings; Capnocytophaga; Dogs; Fingers; Gangrene; Gram-Negative Bacterial Infections; Humans; Leg; Male; Nose; Saliva; Shock, Septic; Treatment Outcome

To compare the presence of Staphylococcus aureus and pathogenic Gram-negative rods (GNR) in the anterior nares, posterior pharynx and three skin sites in community-based adults and nursing home-based adults before and after treatment with nasal mupirocin and topical chlorhexidine.. S. aureus-colonized adults were recruited from the community (n=26) and from nursing homes (n=8). Eligible participants were cultured for S. aureus and GNR during two study visits and then received intranasal mupirocin and topical chlorhexidine for 5days, with a 2-month follow-up period.. After decolonization, we found sustained decreases of S. aureus colonization in nose, throat and skin sites over 4-8weeks in both populations. Intranasal mupirocin did not increase GNR colonization in nose or throat. Chlorhexidine did not decrease GNR colonization in skin sites.. Decolonization with mupirocin and chlorhexidine leads to a sustained effect on S. aureus colonization without affecting GNR colonization.

Topics: Administration, Topical; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Carrier State; Chlorhexidine; Community-Acquired Infections; Cross Infection; Female; Gram-Negative Bacterial Infections; Gram-Positive Asporogenous Rods; Humans; Male; Middle Aged; Mupirocin; Nose; Nursing Homes; Pharynx; Prospective Studies; Skin; Staphylococcal Infections; Staphylococcus aureus; Treatment Outcome

The authors report a case of a recurrent pediatric ventral pontine ependymoma that they resected through an endonasal endoscopic transclival approach. Regarding the options for a surgical approach to ventral pontine tumors, traditional far-lateral approaches are associated with considerable morbidity due to the required muscle mobilization, brain retraction, and in-line obstruction of cranial nerves before reaching the target. The endoscopic endonasal transclival approach was made appealing by eliminating all of these concerns. The patient's fully pneumatized sphenoid sinus, laterally displaced basilar artery, and the direct ventral location of the bulky disease all further supported this unconventional choice of surgical corridor to achieve a palliative brainstem decompression of an incurable recurrence.

Topics: Adolescent; Basilar Artery; Brain Stem; Brain Stem Neoplasms; Cranial Fossa, Posterior; Decompression, Surgical; Ependymoma; Fatal Outcome; Gram-Negative Bacterial Infections; Humans; Male; Meningitis; Neoplasm Recurrence, Local; Neuroendoscopy; Neurosurgical Procedures; Nose; Palliative Care; Reoperation; Sphenoid Sinus

We examined the relationship between the use of nasal continuous positive airway pressure (CPAP) and nasal colonization among low-birth-weight (LBW) infants. We prospectively cultured the nares of LBW infants on admission and weekly until hospital discharge. The modality of respiratory support during each culture was recorded. Bivariate and multivariate analyses were conducted to test the relationship between CPAP and nasal colonization. Analyses were repeated after stratifying infants into three birth-weight categories: 1500 to 2499 g, 1000 to 1499 g, and < 1000 g. In total, 766 nasal cultures were obtained from 167 infants. Nasal colonization with gram-negative bacilli was increased with the use of CPAP in all birth-weight categories ( P < 0.05) and with vaginal delivery in infants weighing < 1000 g and 1500 to 2499 g ( P = 0.04 and P = 0.02, respectively). Nasal colonization with any potential pathogen increased with the use of CPAP in all birth-weight categories ( P < 0.001), with the presence of chorioamnionitis in infants < 1000 g ( P = 0.055) and at younger gestational age in infants 1000 to 1499 g ( P = 0.0026). Caucasian infants 1500 to 2499 g had less colonization than infants of other races ( P = 0.01). Nasal CPAP is associated with increased colonization with gram-negative bacilli.

Topics: Bacteremia; Chorioamnionitis; Colony Count, Microbial; Continuous Positive Airway Pressure; Delivery, Obstetric; Female; Gestational Age; Gram-Negative Bacteria; Gram-Negative Bacterial Infections; Humans; Incidence; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Logistic Models; Male; Nose; Pregnancy; Prospective Studies; Staphylococcal Infections; Staphylococcus aureus

Topics: Anti-Bacterial Agents; Carrier State; Cross Infection; Family; Gram-Negative Bacteria; Gram-Negative Bacterial Infections; Humans; Intensive Care Units; Methicillin; Methicillin Resistance; Nose; Skin; Staphylococcal Infections; Staphylococcus aureus; Visitors to Patients

The nasopharyngeal bacterial flora of healthy rhesus macaques was surveyed for the presence of Neisseria and Haemophilus species, as well as Moraxella catarrhalis. M. catarrhalis was found both in healthy rhesus macaques and in possibly immunocompromised rhesus macaques. Several Haemophilus spp. that are part of the normal nasopharyngeal bacterial flora of humans were found in many animals; these Haemophilus species included H. parahaemolyticus, H. segnis, and H. parainfluenzae. While Haemophilus influenzae was not identified, it is possible that the identification of H. influenzae types may have been thwarted by the growth of less fastidious species. A number of animals harbored Neisseria spp. such as N. sicca. However, Neisseria meningitidis was not found. In summary, it appears as though the rhesus macaque may be used as a model for M. catarrhalis infections. Moreover, in view of the susceptibility of macaques to organisms of the Haemophilus and Neisseria genera, it is possible that these animals may also accurately model nontypeable H. influenzae and N. meningitidis infections.

Topics: Animals; Disease Models, Animal; Gram-Negative Bacterial Infections; Haemophilus; Macaca mulatta; Moraxella catarrhalis; Nasopharynx; Neisseria; Nose; Pharynx