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1.
Naoki Tsujimoto Takeshi Saraya Ken Kikuchi Saori Takata Yasuyuki Kurihara Sayuki Hiraoka Hiroshi Makino Shota Yonetani Koji Araki Haruyuki Ishii Hajime Takizawa Hajime Goto 《Journal of thoracic disease》2012,4(6):577-582
Background
Opportunistic pulmonary infection with Nocardia species is rare in humans, and only a few studies have radiologically analyzed patients with pulmonary nocardiosis using high-resolution computed tomography (HRCT).Methods
We retrospectively reviewed the medical records of patients with pulmonary nocardiosis at our hospital between April 2006 and December 2011 to assess HRCT and clinical findings. We also searched the medical literature for pulmonary nocardiosis reported in Japan between 2002 and 2011 for comparison.Results
We identified seven patients at our institution and 33 reported infections in Japan. Four of our patients were immunocompetent, whereas the other three had impaired cellular immunity due to type 2 diabetes mellitus or having been inappropriately treated with steroid. Thoracic HRCT revealed no zonal predominance, but tropism for distribution from the middle to the peripheral area, and radiological findings of nodules, cavitation, mass, consolidations, bronchial wall thickening, septal line thickening and ground glass opacity (GGO) were evident. The main HRCT finding in our study comprised nodules (n=5, 71.4%) <30 mm and four patients had multiple nodules as described in other reports. Furthermore, we discovered a crazy paving appearance (CPA) around nodules, cavities, masses or consolidations in five patients (71.4%).Conclusions
Multiple nodules distributed from the middle to the peripheral area on HRCT might reflect pulmonary nocardiosis, and CPA seemed to be a worth paying attention to the diagnosis.KEY WORDS : Crazy paving appearance, multiple nodules, lung infections, opportunistic pathogen, pulmonary nocardiosis 相似文献2.
Larissa Anuska Zeni CONDAS Márcio Garcia RIBEIRO Marisol Domingues MURO Agueda Palmira Castagna de VARGAS Tetsuhiro MATSUZAWA Katsukiyo YAZAWA Amanda Keller SIQUEIRA Tatiana SALERNO Gustavo Henrique Batista LARA Rafaela Mastrangelo RISSETI Karen Spadari FERREIRA Tohru GONOI 《Revista do Instituto de Medicina Tropical de S?o Paulo》2015,57(3):251-256
Nocardia is a ubiquitous microorganism related to pyogranulomatous
infection, which is difficult to treat in humans and animals. The occurrence of the
disease is on the rise in many countries due to an increase in immunosuppressive
diseases and treatments. This report of cases from Brazil presents the genotypic
characterization and the antimicrobial susceptibility pattern using the
disk-diffusion method and inhibitory minimal concentration with E-test® strips. In
summary, this report focuses on infections in young adult men, of which three cases
were cutaneous, two pulmonary, one neurological and one systemic. The pulmonary,
neurological and systemic cases were attributed to immunosuppressive diseases or
treatments. Sequencing analysis of the 16S rRNA segments (1491 bp) identified four
isolates of Nocardia farcinica, two isolates of Nocardia
nova and one isolate of Nocardia asiatica. N.
farcinica was involved in two cutaneous, one systemic and other pulmonary
cases; N. nova was involved in one neurological and one pulmonary
case; and Nocardia asiatica in one cutaneous case. The
disk-diffusion antimicrobial susceptibility test showed that the most effective
antimicrobials were amikacin (100%), amoxicillin/clavulanate (100%), cephalexin
(100%) and ceftiofur (100%), while isolates had presented most resistance to
gentamicin (43%), sulfamethoxazole/trimethoprim (43%) and ampicillin (29%). However,
on the inhibitory minimal concentration test (MIC test), only one of the four
isolates of Nocardia farcinica was resistant to
sulfamethoxazole/trimethoprim. 相似文献
3.
Erin Peebles Robert Morris Roger Chafe 《The Canadian Journal of Infectious Diseases & Medical Microbiology》2014,25(1):13-16
BACKGROUND:
First-generation cephalosporins and antistaphylococcal penicillins are typically the first choice for treating skin and soft tissue infections (SSTI), but are not effective for infections caused by methicillin-resistant Staphylococcus aureus (MRSA). It is currently unclear what percentage of SSTIs is caused by community-associated MRSA in different regions in Canada.OBJECTIVES:
To determine the incidence of MRSA in children presenting to a pediatric emergency department with SSTI, and to determine which antibiotics were used to treat these infections.METHODS:
All visits to a pediatric emergency department were reviewed from April 15, 2010 to April 14, 2011. Diagnoses of cellulitis, abscess, impetigo, folliculitis and skin infection (not otherwise specified) were reviewed in detail to determine whether a culture was taken and which antibiotic was prescribed.RESULTS:
There were 367 cases of SSTI diagnosed over the study period. Forty-five (12.3%) patients had lesions that were swabbed for culture and sensitivity. S aureus was the most common organism found, with 14 (66%) methicillin-sensitive cases and seven (33%) methicillin-resistant cases. Of the seven cases of MRSA identified, only one patient had clear risk factors for hospital-acquired MRSA. First-generation cephalosporins were initially prescribed for 280 (76%) patients.CONCLUSIONS:
The overall incidence of MRSA in the population presenting to a pediatric emergency department in Newfoundland and Labrador appeared to be low, although only a small percentage of infections were cultured. At this time, there appears to be no need to change empirical antibiotic coverage, which remains a first-generation cephalosporin. 相似文献4.
BACKGROUND:
The incidence and severity of Clostridium difficile infections are increasing, and there is a need to optimize the prevention of complicated disease.OBJECTIVE:
To identify modifiable processes of care associated with an altered risk of C difficile complications.METHODS:
A retrospective cohort study (with prospective case ascertainment) of all C difficile infections during 2007/2008 at a tertiary care hospital was conducted.RESULTS:
Severe complications were frequent (occurring in 97 of 365 [27%] C difficile episodes), with rapid onset (median three days postdiagnosis). On multivariable analysis, nonmodifiable predictors of complications included repeat infection (OR 2.67), confusion (OR 2.01), hypotension (OR 0.97 per increased mmHg) and elevated white blood cell count (OR 1.04 per 109 cells/L). Protection from complications was associated with initial use of vancomycin (OR 0.24); harm was associated with ongoing use of exacerbating antibiotics (OR 3.02).CONCLUSION:
C difficile infections often occur early in the disease course and are associated with high complication rates. Clinical factors that predicted a higher risk of complications included confusion, hypotension and leukocytosis. The most effective ways to improve outcomes for patients with C difficile colitis are consideration of vancomycin as first-line treatment for moderate to severe cases, and the avoidance of unnecessary antibiotics. 相似文献5.
Philippe Guillaume Poliquin Philippe Lagacé-Wiens Mauro Verrelli David W Allen John M Embil 《The Canadian Journal of Infectious Diseases & Medical Microbiology》2015,26(1):52-55
BACKGROUND:
Pasteurella species are Gram-negative coccobacilli that are a part of the normal oropharyngeal flora of numerous domestic animals. They have been recognized as a rare but significant cause of peritonitis in patients undergoing peritoneal dialysis (PD). A consensus about management strategies for PD-associated peritonitis caused by Pasteurella species currently does not exist.METHODS:
The microbiological database serving the Manitoba Renal Program was searched from 1997 to 2013 for cases of Pasteurella species PD-associated peritonitis, and charts were reviewed. PubMed was searched for case reports and data were abstracted.RESULTS:
Seven new local cases and 30 previously reported cases were analyzed. This infection is clinically similar to other forms of PD peritonitis, with household pet exposure appearing to be the strongest risk factor. Cats are the most commonly implicated pet. Direct contact between the pet and the equipment was commonly reported (25 of 37 patients) but was not necessary for infection to develop. The mean duration of treatment was 15 days. Complication rates were low, with only 11% of patients requiring PD catheter removal. There was no mortality reported.CONCLUSION:
Pasteurella species are a rare cause of PD-associated peritonitis that can be successfully treated with a two-week course of intraperitoneal antibiotics with a high likelihood of catheter salvage. 相似文献6.
Prenilla Naidu Stephanie Smith 《The Canadian Journal of Infectious Diseases & Medical Microbiology》2012,23(4):165-169
BACKGROUND:
Stenotrophomonas maltophilia has emerged as a significant nosocomial pathogen with increasing resistance to trimethoprim/sulphamethoxazole (TMP/SMX), the current drug of choice for treatment.OBJECTIVES:
To describe the microbiological and clinical characteristics of S maltophilia bloodstream infections (BSIs) over an 11-year period at a tertiary care centre in Canada.METHODS:
All adult S maltophilia BSIs from 1999 to 2009 in a 750-bed tertiary care teaching hospital (University of Alberta Hospital, Edmonton, Alberta) were identified through the infection control nosocomial infection surveillance program. Demographic and clinical data were extracted from the infection control database and from patient charts. Microbiological data were confirmed through the laboratory information system.RESULTS:
Twenty-five episodes of S maltophilia BSI (0.9% of all BSIs) involving 24 patients were identified between 1999 and 2009. The patient age range was 18 to 83 years (average 45.7 years). The majority were men (14 of 24 [58.3%]). The mean length of hospital stay was 83.3 days (range eight to 310 days). The rate of S maltophilia BSIs per 1000 admissions ranged from 0.04 to 0.22 (average 0.09). Greater than one-half of the episodes (13 of 25 [52%]) were admitted to the intensive care unit before BSI onset. Laboratory data were available for 24 of the 25 isolates. Polymicrobial infections were present in 11 of 24 (45.8%) patients. Resistance to TMP/SMX occurred in 8.3% of all infections. Fifteen per cent of isolates were resistant to ticarcillin/clavulanate. Mortality attributed to bacteremia was 16.7%.CONCLUSIONS:
In the University of Alberta Hospital, the rate of S maltophilia BSI remains low and constant, and TMP/SMX remains the drug of choice for treatment. 相似文献7.
María E Negrón Herman W Barkema Kevin Rioux Jeroen De Buck Sylvia Checkley Marie-Claude Proulx Alexandra Frolkis Paul L Beck Levinus A Dieleman Remo Panaccione Subrata Ghosh Gilaad G Kaplan 《Journal canadien de gastroenterologie》2014,28(7):373-380
BACKGROUND:
The impact of Clostridium difficile infections among ulcerative colitis (UC) patients is well characterized. However, there is little knowledge regarding the association between C difficile infections and postoperative complications among UC patients.OBJECTIVE:
To determine whether C difficile infection is associated with undergoing an emergent colectomy and experiencing postoperative complications.METHODS:
The present population-based case-control study identified UC patients admitted to Calgary Health Zone hospitals for a flare between 2000 and 2009. C difficile toxin tests ordered in hospital or 90 days before hospital admission were provided by Calgary Laboratory Services (Calgary, Alberta). Hospital records were reviewed to confirm diagnoses and to extract clinical data. Multivariate logistic regression analyses were performed among individuals tested for C difficile to examine the association between C difficile infection and emergent colectomy and diagnosis of any postoperative complications and, secondarily, an infectious postoperative complication. Estimates were presented as adjusted ORs with 95% CIs.RESULTS:
C difficile was tested in 278 (58%) UC patients and 6.1% were positive. C difficile infection was associated with an increased risk for emergent colectomy (adjusted OR 3.39 [95% CI 1.02 to 11.23]). Additionally, a preoperative diagnosis of C difficile was significantly associated with the development of postoperative infectious complications (OR 4.76 [95% CI 1.10 to 20.63]).CONCLUSION:
C difficile diagnosis worsened the prognosis of UC by increasing the risk of colectomy and postoperative infectious complications following colectomy. Future studies are needed to explore whether early detection and aggressive management of C difficile infection will improve UC outcomes. 相似文献8.
A Bahrami Y Rassi N Maleki MA Oshaghi M Mohebali MR Yagoobi-Ershadi S Rafizadeh 《亚太热带病杂志(英文版)》2014,4(2):110-114
Objective
To identify the vector(s), the parasite and the species composition of sand flies in the district during May-October 2012.Methods
For reaching our objectives we used polymerase chain reaction of kDNA, ITS1-rDNA, followed by restriction fragment length polymorphism.Results
Two species of Phlebotomus sergenti and Phlebotomus tobbi were the most prevalent among 8 species identified comprising 51.1% and 32.9% respectively. Among the 160 specimens of female sand flies tested by polymerase chain reaction of kDNA, ITS1-rDNA, followed by restriction fragment length polymorphisms, only 1 out of 80 Phlebotomus tobbi (1.25%) were positive to Leishmania infantum parasites.Conclusions
Our finding showed that Phlebotomus tobbi may play as a vector to circulate the parasite of Leishmania infantum among reservoir(s) and human. 相似文献9.
Jia Hu Joan L Robinson 《The Canadian Journal of Infectious Diseases & Medical Microbiology》2010,21(2):83-88
INTRODUCTION:
Clinicians are generally familiar with Acinetobacter as an etiological agent for serious nosocomial infections in intensive care units. However, there are no previous reviews of the full spectrum of invasive infections in children.METHODS:
A systematic review of the literature was completed up to December 2008 for reports of invasive Acinetobacter infections in children.RESULTS:
There were 101 studies that met the inclusion criteria including 18 possible outbreaks, 33 case series and 49 case reports. Suspected outbreaks were concentrated in neonatal intensive care units (16 of 18 outbreaks) and involved bacteremia or meningitis. Proof of isolate clonality or identification of the source of the outbreak was seldom established. Case series were primarily of children younger than five years of age presenting with bacteremia (sometimes multiresistant), meningitis, endocarditis or endophthalmitis, with many community-acquired infections being reported from India. Case reports consisted of unique presentations of disease or the use of novel therapies. Attributable mortality in the outbreaks and case series combined was 68 of 469 (14.5%).DISCUSSION:
Invasive Acinetobacter infections in children usually manifest as bacteremia, meningitis or both, but can result in a wide variety of clinical presentations. Outbreaks are primarily a problem in newborns with underlying medical conditions. Most reports of community-acquired infections are from tropical countries. The study of the mechanism of colonization and infection of children in intensive care units and of neonates in tropical countries may provide some insight into prevention of invasive infections. 相似文献10.
BACKGROUND:
Tracheal bronchus is a congenital malformation comprising an abnormal bronchus originating from the trachea or other bronchus. This malformation has been associated with recurrent pneumonia in children, but is rarely associated with infection in adults. Actinomyces species are rare causes of necrotizing pneumonias that often masquerade as malignancy, lung abscesses and tuberculosis.METHODS AND RESULTS:
A case involving a 46-year-old man with a tracheal bronchus and chronic pneumonia syndrome is presented. Bronchialveolar lavage and transthoracic needle biopsy demonstrated the presence of Actinomyces meyeri and Fusobacterium species.CONCLUSIONS:
The present article reports the first documented case of actinomycosis occurring in a patient with a tracheal bronchus. 相似文献11.
Objective
To determine the mosquito repellent activity of herbal essential oils against female Aedes aegypti and Culex quinquefasciatus.Methods
On a volunteer''s forearm, 0.1 mL of each essential oil was applied to 3 cm×10 cm of exposed skin. The protection time was recorded for 3 min after every 30 min.Results
Essential oil from clove oil in olive oil and in coconut oil gave the longest lasting period of 76.50 min and 96.00 min respectively against Aedes aegypti. The citronella grass oil in olive oil, citronella grass oil in coconut oil and lemongrass oil in coconut oil exhibited protection against Culex quinquefasciatus at 165.00, 105.00, and 112.50 min respectively.Conclusions
The results clearly indicated that clove, citronella and lemongrass oil were the most promising for repellency against mosquito species. These oils could be used to develop a new formulation to control mosquitoes. 相似文献12.
Alon Vaisman Kevin Pivovarov Allison McGeer Barbara Willey Bjug Borgundvaag Vanessa Porter Piraveina Gnanasuntharam Yanliang Wei Geoffrey C Nguyen 《The Canadian Journal of Infectious Diseases & Medical Microbiology》2013,24(4):e117-e121
BACKGROUND:
Patients with inflammatory bowel disease (IBD) experience frequent hospitalizations and use of immunosuppressive medications, which may predispose them to colonization with antimicrobial-resistant organisms (ARO).OBJECTIVE:
To determine the prevalence of ARO colonization on admission to hospital and the incidence of infection during hospitalization among hospitalized IBD patients.METHODS:
A chart review comparing the prevalence of colonization and incidence of infection with methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci and extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL) in hospitalized IBD patients with those of non-IBD controls was performed.RESULTS:
On admission, there were no significant differences between IBD inpatients and controls in the prevalence of colonization of methicillin-resistant S aureus (1.0% versus 1.2%; P=0.74), vancomycin-resistant enterococci (0.2% versus 0%; P=1.0) or ESBL (4.1% versus 5.5%; P=0.33). Pooling data from historical clinic-based cohorts, IBD patients were more likely than controls to have ESBL colonization (19% versus 6.6%; P<0.05). Antibiotic use on admission was associated with ESBL colonization among IBD inpatients (OR 4.2 [95% CI 1.4 to 12.6]). The incidence of ARO infections during hospitalization was not significantly different between IBD patients and controls. Among IBD patients who acquired ARO infections during hospitalizations, the mean time interval from admission to infection was shorter for those who were already colonized with ARO on admission.CONCLUSIONS:
This particular population of hospitalized IBD patients was not shown to have a higher prevalence or incidence of ARO colonization or infection compared with non-IBD inpatients. 相似文献13.
Mohammad Rubayet Hasan Rusung Tan Ghada N Al-Rawahi Eva Thomas Peter Tilley 《The Canadian Journal of Infectious Diseases & Medical Microbiology》2014,25(4):217-221
BACKGROUND:
Bordetella pertussis infections continue to be a major public health challenge in Canada. Polymerase chain reaction (PCR) assays to detect B pertussis are typically based on the multicopy insertion sequence IS481, which offers high sensitivity but lacks species specificity.METHODS:
A novel B pertussis real-time PCR assay based on the porin gene was tested in parallel with several previously published assays that target genes such as IS481, ptx-promoter, pertactin and a putative thialase. The assays were evaluated using a reference panel of common respiratory bacteria including different Bordetella species and 107 clinical nasopharyngeal specimens. Discrepant results were confirmed by sequencing the PCR products.RESULTS:
Analytical sensitivity was highest for the assay targeting the IS481 element; however, the assay lacked specificity for B pertussis in the reference panel and in the clinical samples. False-positive results were also observed with assays targeting the ptx-promoter and pertactin genes. A PCR assay based on the thialase gene was highly specific but failed to detect all reference strains of B pertussis. However, a novel assay targeting the porin gene demonstrated high specificity for B pertussis both in the reference panel and in clinical samples and, based on sequence-confirmed results, correctly predicted all B pertussis-positive cases in clinical samples. According to Probit regression analysis, the 95% detection limit of the new assay was 4 colony forming units/reaction.CONCLUSION:
A novel porin assay for B pertussis demonstrated superior performance and may be useful for improved molecular detection of B pertussis in clinical specimens. 相似文献14.
15.
Frank Wong George Ou Sigrid Svarta Ricky Kwok Kieran Donaldson Joe Frenette Robert Enns 《Journal canadien de gastroenterologie》2013,27(11):636-638
BACKGROUND:
Helicobacter pylori infection is the most common chronic infection in humans. It is a major contributor to the cause of duodenal and gastric ulcers worldwide. Its eradication has been shown to reduce rates of H pylori-related ulcers as well as other complications such as gastric cancer.OBJECTIVE:
To determine the rate of appropriate treatment in patients following a diagnosis of H pylori infection on biopsy during esophagoduodenoscopy for upper gastrointestinal bleeding over a four-year period at a tertiary centre in Vancouver, British Columbia. Also evaluated was the rate of eradication confirmation using the urea breath test.METHODS:
A retrospective review of 1501 inpatients who underwent esophagoduodenoscopy for upper gastrointestinal bleeding (January 2006 to December 2010) was undertaken. Patients who were biopsy stain positive for H pylori were selected for drug review either via a provincial database (PharmaNet) or via records from patients’ family practitioners. Data were also obtained via two provincial laboratories that perform the urea breath test to determine the rates of confirmation of eradication.RESULTS:
Ninety-eight patients had biopsy-proven H pylori. The mean (± SD) age was 56.13±17.9 years and 65 were male. Data were not available for 22 patients; the treatment rate was 52.6% (40 of 76). Of those treated, 12 patients underwent a post-treatment urea breath test for eradication confirmation.CONCLUSION:
There was substantial discrepancy between the number of diagnosed H pylori infections and the rate of treatment as well as confirmation of eradication. Numerous approaches could be taken to improve treatment and eradication confirmation. 相似文献16.
Hong SJ Sung IK Kim JG Lee SW Choi SC Yang CH Lee SI Lee DH Kim GH Jeon SW Park MI Park SK Park BJ Seol SY;H. pylori Dyspepsia Study Group of Korean College of Helicobacter Upper Gastrointestinal Research 《Gut and liver》2011,5(4):468-471
Background/Aims
The role of Helicobacter pylori eradication in patients with functional dyspepsia (FD) is still uncertain. We originally planned a randomized clinical study to observe dyspeptic symptoms after H. pylori eradication therapy. However, we failed to complete the study; therefore, we analyzed the factors that affected the failure of the study.Methods
Interviews and questionnaire surveys were conducted to analyze the factors that induced early termination from the study.Results
Many patients were screened by gastroenterologists at 11 tertiary referral hospitals between July 2009 and August 2010; however, only 4 patients met the enrollment criteria. Most patients who visited our clinics had been experiencing FD symptoms for less than 6 months or were already taking medication. They also demanded to continue taking medications and using other drugs. Only 3 of the 4 patients signed informed consent.Conclusions
The application of the current Rome III criteria to FD is difficult to evaluate in Korean patients with dyspeptic symptoms because of the early medical evaluation. Most Korean patients who were diagnosed with FD by the Rome III criteria did not overcome their fear of being unable to use rescue medications during the study period. 相似文献17.
Yu Mi Lee Kyu Chan Huh Soon Man Yoon Byung Ik Jang Jeong Eun Shin Hoon Sup Koo Yunho Jung Sae Hee Kim Hee Seok Moon Seung Woo Lee Daejeon-Chungchung Intestinal Research Group 《Gut and liver》2016,10(2):250-254
Background/Aims
To determine the incidence and clinical characteristics of tuberculosis (TB) medication-associated Clostridium difficile infection.Methods
This multicenter study included patients from eight tertiary hospitals enrolled from 2008 to 2013. A retrospective analysis was conducted to identify the clinical features of C. difficile infection in patients who received TB medication.Results
C. difficile infection developed in 54 of the 19,080 patients prescribed TB medication, representing a total incidence of infection of 2.83 cases per 1,000 adults. Fifty-one of the 54 patients (94.4%) were treated with rifampin. The patients were usually treated with oral metronidazole, which produced improvement in 47 of the 54 patients (87%). Twenty-three patients clinically improved with continuous rifampin therapy for C. difficile infection. There were no significant differences in improvement between patients treated continuously (n=21) and patients in whom treatment was discontinued (n=26).Conclusions
The incidence of C. difficile infection after TB medication was not low considering the relatively low TB medication dosage compared to other antibiotics. It may not be always necessary to discontinue TB medication. Instead, decisions concerning discontinuation of TB medication should be based on TB status. 相似文献18.
19.
Background
Disseminated nocardiosis is a rare disease mostly occurring in immunocompromised patients.Methods
We report a case of disseminated nocardiosis in a diabetic patient with both pulmonary and cutaneous involvement. Nocardia elegans was isolated and identified using the 16s ribosomal RNA gene sequence data.Results
Clinical improvement was observed within 3 months after initiation of antimicrobial treatment with oral doxycycline, trimethoprim-sulfamethoxazole and intravenous penicillin, but the patient died 5 months later after arbitrary discontinuation of the treatment.Conclusions
This is the first case report of disseminated nocardiosis caused by Nocardia elegans in China.20.
Boonyanugomol W Chomvarin C Sripa B Bhudhisawasdi V Khuntikeo N Hahnvajanawong C Chamsuwan A 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2012,14(3):177-184