trimethoprim--sulfamethoxazole-drug-combination and Flavobacteriaceae-Infections

Topics: Aged; Anti-Bacterial Agents; Bacteremia; Chryseobacterium; Conjunctiva; Corneal Ulcer; Drug Resistance, Multiple, Bacterial; Female; Flavobacteriaceae Infections; Humans; Surgical Flaps; Treatment Failure; Trimethoprim, Sulfamethoxazole Drug Combination

To describe the epidemiological, clinical, and outcome data of patients infected or colonized with Chryseobacterium/Elizabethkingia spp including antibiotic susceptibility patterns.. This retrospective study was conducted at Prince Sultan Military Medical City, Riyadh,  Saudi Arabia. All patients infected or colonized by Chryseobacterium /Elizabethkingia spp who were admitted between June 2013 and May 2019 were included. Data were extracted from patient electronic medical records.. We enrolled 27 patients (13 males and 14 females) with a mean age of 35.6 years. Chryseobacterium/Elizabethkingia spp were isolated from blood cultures (n=13, 48%) and tracheal aspirations (n=11, 41%). The most frequent species isolated was Elizabethkingia meningoseptica (n=22). Although 6 patients were considered colonized, the remaining 21 patients presented with ventilator associated pneumonia (n=9), central line associated bloodstream infection (n=4), septic shock (n=4), or isolated bacteremia (n=4). In 25 cases the infections were health-care related. Three patients (11%) died within 28 days. Twenty-six isolates (96.5%) were resistant to carbapenems. Moxifloxacin and cotrimoxazole were the most active antibiotics.. Chryseobacterium/Elizabethkingia spp infection is rare, but can be responsible for severe hospital acquired infections. Cotrimoxazole and fluoroquinolone are the most effective antibiotic treatments.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Child; Child, Preschool; Chryseobacterium; Drug Resistance, Bacterial; Female; Flavobacteriaceae Infections; Humans; Infant; Infant, Newborn; Male; Middle Aged; Moxifloxacin; Retrospective Studies; Saudi Arabia; Trimethoprim, Sulfamethoxazole Drug Combination; Young Adult

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Topics: Anti-Bacterial Agents; Asia; Australia; Cross Infection; Drug Resistance, Bacterial; England; Flavobacteriaceae; Flavobacteriaceae Infections; Fluoroquinolones; Genome, Bacterial; Genomics; Humans; Microbial Sensitivity Tests; Tetracyclines; Trimethoprim, Sulfamethoxazole Drug Combination

Elizabethkingia meningoseptica is a multi-drug-resistant organism that is associated with high mortality and morbidity in newborn and immunocompromised patients. This study aimed to identify the best antimicrobial therapy for treating this infection.. A retrospective descriptive study was conducted from 2010 to 2017 in a tertiary paediatric hospital in Singapore. Paediatric patients aged 0 to 18 years old with a positive culture for E. meningoseptica from any sterile site were identified from the hospital laboratory database. The data collected included clinical characteristics, antimicrobial susceptibility and treatment, and clinical outcomes.. Thirteen cases were identified in this study. Combination therapy with piperacillin/tazobactam and trimethoprim/sulfamethoxazole or a fluoroquinolone resulted in a cure rate of 81.8  %. The mortality rate was 15.4  % and neurological morbidity in patients with bacteraemia and meningitis remained high (75 %).. Treatment with combination therapy of piperacillin/tazobactam and trimethoprim/sulfamethoxazole or a fluroquinolone was effective in this study, with low mortality rates being observed.

Topics: Anti-Bacterial Agents; Child; Child, Preschool; Female; Flavobacteriaceae; Flavobacteriaceae Infections; Fluoroquinolones; Humans; Infant; Infant, Newborn; Male; Microbial Sensitivity Tests; Piperacillin, Tazobactam Drug Combination; Retrospective Studies; Risk Factors; Singapore; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Aged; Amikacin; Anti-Bacterial Agents; Chryseobacterium; Drug Therapy, Combination; Flavobacteriaceae Infections; Humans; Male; Meropenem; Rifampin; Shock, Septic; Tigecycline; Trimethoprim, Sulfamethoxazole Drug Combination

Elizabethkingia meningoseptica is a non-fermentative Gram-negative bacillus that has emerged as an important pathogen in nosocomial infections and is usually associated with high mortality. E. meningoseptica is inherently resistant to many broad-spectrum antibiotics, and appropriate antibiotic selection is crucial for survival. Data about the therapeutic efficacy of fluoroquinolone in E. meningoseptica bacteraemia are limited. We retrospectively enrolled patients with E. meningoseptica bacteraemia who were treated with a single antimicrobial agent with in vitro activity against E. meningoseptica for at least 48 hours in a Taiwanese medical centre between January 2011 and June 2016. We compared the therapeutic efficacy of fluoroquinolone and non-fluoroquinolone treatment. A logistic regression and a propensity score-adjusted model were used to evaluate the risk factors for 14-day mortality. A total of 66 patients were identified, 24 who received fluoroquinolone treatment (ciprofloxacin, n = 9; levofloxacin, n = 15) and 42 who received non-fluoroquinolone treatment (piperacillin/tazobactam, n = 26; trimethoprim/sulfamethoxazole, n = 15; minocycline, n = 1). The fluoroquinolone group had significantly lower 14-day mortality than the non-fluoroquinolone group (8.3% vs. 33.3%, P = 0.023). The APACHE II score was significantly higher in the non-fluoroquinolone group than in the fluoroquinolone group. In a propensity-adjusted analysis, fluoroquinolone use was an independent factor associated with 14-day survival. After stratification using the APACHE II score, treatment with fluoroquinolone was associated with 14-day survival, but did not reach statistical significance in both groups with greater and lesser severity. Therefore, fluoroquinolone is a suitable antimicrobial agent for treating E. meningoseptica bacteraemia.

Topics: Aged; Anti-Bacterial Agents; Bacteremia; Chryseobacterium; Cross Infection; Female; Flavobacteriaceae Infections; Fluoroquinolones; Humans; Male; Microbial Sensitivity Tests; Minocycline; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Retrospective Studies; Taiwan; Trimethoprim, Sulfamethoxazole Drug Combination

The isolation of Chryseobacterium indologenes as a causative micro-organism in human diseases is rare. Risk factors for infections caused by this pathogen include very young and very old age, indwelling devices, immune suppression and recent use of broad-spectrum antibiotics. Most cases suffer from bacteraemia or nosocomial pneumonia, whilst infection of the central nervous system (CNS) is extremely rare. We present a term-born infant diagnosed prenatally with holoprosencephaly and obstructive hydrocephalus, requiring post-natal ventriculoperitoneal shunt insertion. At 6 weeks of age, he suffered from Escherichia coli meningitis, showing satisfactory clinical response with antimicrobial therapy. Aged 11 months, he suffered from hyper-drainage syndrome, resulting in the removal of the shunt system. He represented 11 days post-operatively, with low-grade fever, irritability and cerebrospinal fluid (CSF) leakage. C. indologenes from CSF was isolated and antimicrobial therapy with ceftazidime and trimethoprim-sulfamethoxazole for 3 weeks resulted in good clinical response. This is the first documented community-acquired CNS infection due to C. indologenes in an infant without concomitant indwelling device or previous antibiotic pressure.

Topics: Anti-Bacterial Agents; Ceftazidime; Central Nervous System Infections; Cerebrospinal Fluid; Chryseobacterium; Communicable Diseases, Emerging; Community-Acquired Infections; Flavobacteriaceae Infections; Humans; Infant; Male; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

There is an increase in the isolation of non-fermenting gramnegative bacilli in patients with cystic fibrosis (CF). The present study evaluates the frequency of isolates of Chryseobacterium spp., analyzing its characteristics, resistance patterns and clinical outcome of patients.. It has been collected all respiratory isolates of Chryseobacterium spp. of patients attended in the CF unit of Hospital de la Princesa for three years (march 2009-march 2012). For phenotypic and genotypic identification and sensitivity study conventional methodology was used. For the assessment of the patients lung function was considered the forced expiratory volume in one second (FEV1) and the results were analyzed with SPSS.. There was an increase in the incidence of Chryseobacterium spp. with 17 isolates from 9 patients. Three patients had chronic colonization by this microorganism and one showed significant impairment of lung function. Seven patients showed also colonization with Staphylococcus aureus and 4 of them with Pseudomonas aeruginosa.. Chryseobacterium spp. should be considered as a new emerging opportunistic pathogen in patients with CF. It is essential the clinical and microbiological monitoring of this group of patients for detection of Chryseobacterium spp. colonization and to prevent the chronic infection. In these circumstances it must assess its possible eradication, though its clinical impact is unknown. Cotrimoxazole being the best treatment option.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Chryseobacterium; Coinfection; Comorbidity; Cystic Fibrosis; Disease Susceptibility; Drug Resistance, Microbial; Flavobacteriaceae Infections; Forced Expiratory Volume; Genotype; Humans; Incidence; Lung; Opportunistic Infections; Phenotype; Pseudomonas Infections; Spain; Staphylococcal Infections; Trimethoprim, Sulfamethoxazole Drug Combination; Young Adult

Elizabethkingia meningoseptica is a recognised cause of meningitis in premature neonates and severe infections in immunocompromised adults; multi-drug resistance is a major issue. A premature infant developed sepsis, meningitis and hydrocephalus owing to E. meningoseptica and was treated successfully with trimethoprim-sulfamethoxazole (TMP-SMZ) for 3 weeks. A ventriculoperitoneal shunt was required for hydrocephalus. This is the youngest patient with meningitis caused by E. meningoseptica to have responded to TMP-SMZ.

Topics: Anti-Bacterial Agents; Brain; Drug Resistance, Multiple, Bacterial; Female; Flavobacteriaceae; Flavobacteriaceae Infections; Humans; Hydrocephalus; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature; Meningitis; Sepsis; Tomography, X-Ray Computed; Trimethoprim, Sulfamethoxazole Drug Combination; Ventriculoperitoneal Shunt

Topics: Anti-Bacterial Agents; Bacteremia; Blood; Cerebrospinal Fluid; Female; Flavobacteriaceae; Flavobacteriaceae Infections; Humans; Meningitis; Microscopy; Middle Aged; Rifampin; Stem Cell Transplantation; Transplantation; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Bronchopneumonia; Chryseobacterium; Flavobacteriaceae Infections; Humans; Kidney Transplantation; Male; Middle Aged; Ofloxacin; Sepsis; Trimethoprim, Sulfamethoxazole Drug Combination

To describe the history, clinical presentation, and successful medical management of a case of multidrug-resistant Flavobacterium indologenes keratitis.. An 83-year-old pseudophakic female presented with a 2-day history of decreased visual acuity, light sensitivity and dull ocular pain in her right eye. Two weeks before presentation, the patient had been treated for a red eye with combination topical loteprednol etabonate (0.5%) and tobramycin (0.3%) eye drops. Corneal scrappings were performed by the referring ophthalmologist, and hourly administration of gatifloxacin 0.3% eye drops was started. Evaluation consisted of slit lamp examination, organism identification, and antibiotic sensitivity testing.. Examination of the right eye revealed a central 5-mm X 2-mm anterior stromal infiltrate with an overlying epithelial defect. Gatifloxacin 0.3% eye drops were stopped, and hourly topical fortified vancomycin (50 mg/mL) and ceftazidime (50 mg/mL) eye drops were instituted. Oxidase-positive gram-negative bacilli were identified in the thioglycollate broth on day 3, and therefore, vancomycin was discontinued and hourly ciprofloxacin 0.3% eye drops were added to the regimen. The cultures ultimately grew F. indologenes, which was highly resistant to all antibiotics tested except for trimethoprim-sulfamethoxazole. Accordingly, ciprofloxacin 0.3% and ceftazidime were discontinued. The patient was started on hourly topical trimethoprim (16 mg/mL)/sulfamethoxazole (80 mg/mL) eye drops, resulting in clinical control of the infection over a period of 1 month.. Flavobacterium indologenes keratitis can be resistant to treatment with many medications, and antibiotic susceptibility profile testing in these cases may provide crucial information to help eradicate the infection.

Topics: Aged, 80 and over; Anti-Infective Agents; Drug Resistance, Multiple, Bacterial; Female; Flavobacteriaceae Infections; Flavobacterium; Humans; Keratitis; Microbial Sensitivity Tests; Trimethoprim, Sulfamethoxazole Drug Combination; Visual Acuity

A yellow-pigmented Gram-negative bacterium, Chryseobacterium indologenes, was found in the gut contents of about 65% of soft ticks Ornithodoros moubata from a perishing laboratory colony. The isolated putative pathogen, C. indologenes, was susceptible to cotrimoxazol and addition of this antibiotic (Biseptol 480) to the blood meal significantly decreased the tick mortality rate. The artificial infection of healthy O. moubata by membrane feeding on blood contaminated with C. indologenes was lethal to all ticks at concentrations 10(6) bacteria/ml. On the contrary, a similar infection dose applied to the hard tick Ixodes ricinus by capillary feeding did not cause significant mortality. Examination of guts dissected from infected O. moubata and I. ricinus revealed that C. indologenes was exponentially multiplied in the soft tick but were completely cleared from the gut of the hard ticks within 1 day. In both tick species, C. indologenes were found to penetrate from the gut into the hemocoel. The phagocytic activity of hemocytes from both tick species was tested by intrahaemocoelic microinjection of C. indologenes and evaluated by indirect fluorescent microscopy using antibodies raised against whole bacteria. Hemocytes from both tick species displayed significant phagocytic activity against C. indologenes. All O. moubata injected with C. indologenes died within 3 days, whereas the increase of the mortality rate of I. ricinus was insignificant. Our results indicate that hard ticks possess much more efficient defense system against infection with C. indologenes than the soft ticks. Thus, C. indologenes infection has the potential to be a relevant comparative model for the study of tick immune reactions to transmitted pathogens.

Topics: Animals; Anti-Infective Agents; Chryseobacterium; Disease Susceptibility; Flavobacteriaceae Infections; Hemocytes; Hemolymph; Ixodes; Ornithodoros; Phagocytosis; Trimethoprim, Sulfamethoxazole Drug Combination