Rapid detection of Enterococcus spp. direct from blood culture bottles using Enterococcus QuickFISH Method: a multicenter investigation

The performance of a diagnostic method for detection and identification of Enterococcus spp. directly from positive blood culture was evaluated in a clinical study. The method, Enterococcus QuickFISH BC, is a second-generation peptide nucleic acid (PNA) fluorescence in situ hybridization (FISH) test, which uses a simplified, faster assay procedure. The test uses fluorescently labeled PNA probes targeting 16S rRNA to differentiate Enterococcus faecalis from other Enterococcus spp. by the color of the cellular fluorescence. Three hundred fifty-six routine blood culture samples were tested; only 2 discordant results were recorded. The sensitivities for detection of Enterococcus faecalis and non-faecalis Enterococcus were 100% (106/106) and 97.0% (65/67), respectively, and the combined specificity of the assay was 100%. The combined positive and negative predictive values of the assay were 100% (171/171) and 98.9% (185/187), respectively.     

绿脓杆菌败血症43例临床分析

本文报道绿脓杆菌败血症43例,均经血培养证实,35例的致病菌为单菌种绿脓杆菌,余8例为复数菌,其中绿脓杆菌与葡萄球菌3例;绿脓杆菌与肺炎杆菌2例;绿脓杆菌与变形杆菌、肺炎杆菌和变形杆菌、表皮葡萄球菌和类酵母菌各1例。院内感染34例(79％)。起病均急骤,伴畏寒、发热,严重者有休克、神态改变、颅内出血、弥漫性血管内凝血、下颌弥漫性蜂窝组织炎、肺迁徙性病灶、多脏器功能衰竭,病情凶险。病死率高达83.7％。     

细菌分类同步血培养在儿科的临床应用

目的　提高败血症的病原菌的培养阳性率 ,发现复数菌败血症以指导临床治疗。方法　临床送检的血标本同时做普通培养、厌氧培养和L型菌培养。结果　 80 0份血培养标本 ,有菌生长者 2 0 1份 ,阳性率为 2 5 .13% ;阳性标本中 86份为复数菌生长 ,占阳性标本的 4 2 .79%。结论　同步分类细菌培养阳性率为 2 5 .13% ,明显高于普通培养的 15 .0 0 % (30 / 2 0 0 ) (χ2 =9.2 3,P <0 .0 1) ,并能发现复数菌败血症。     

Monitoring of endotoxin,interleukin-6 and C-reactive protein serum concentrations in neutropenic patients with fever

Abstract: Serum endotoxin, interleukin-6 (IL-6) and C-reactive protein (CRP) were serially determined in 26 patients with hematological malignancies and chemotherapy-induced neutropenia who developed fever. Endotoxin in serum was detected in 69% of the patients, with the highest values being recorded in patients with gram-negative (Gr^-) bacteremia. High levels of IL-6 were found after start of fever, and in 6/9 patients with Gr^- bacteremia levels exceeded 200 ng/l in samples drawn within the first 72 hours. However, only in 2/17 patients with gram-positive bacteremias and blood culture-negative fever episodes did IL-6 exceed this concentration (p<0.05). High CRP values (exceeding 100 mg/l) did not discriminate between Gr^- and non-Gr^- episodes (7/9 versus 10/17, respectively). In patients with fever at day 3–5 (n = 15), IL-6 values > 100 ng/l were associated with fever continuing for more than 7 days after start of the episode; contrarily, CRP values did not indicate the persistence of fever. Determination of IL-6 may be a better test than CRP in monitoring the acute response to infection in the neutropenic patient. A combination of high endotoxin and IL-6 values may indicate a Gr^- bacteremia. This could have therapeutic implications before results of blood cultures are obtained.     

Plesiomonas Shigelloides Septicemia: Case Report and Literature Review

A 13-year-old girl with Plesiomonas shigelloides septicemia is reported. The infection occurred while she was receiving an allogeneic bone marrow transplantation for acute promyelocytic leukemia. Treatment with ciprofloxacin was successful. Twenty-one cases of Plesiomonas septicemia have been reported in the literature. Immunocompromised hosts, especially neonates, are commonly affected. The case mortality rate is high, with 13 of the reported patients dying of the infection. Successful treatment relies on the early identification of the organism and implementation of effective antibiotics.     

Pulmonary granulocyte accumulation is reduced by nebulized corticosteroid in septic pigs

Nebulized beclomethasone dipropionate was administered to 14 anesthetized and artificially ventilated pigs at 6-hourly intervals after infusion of live S. aureus (BDP group). Changes in pulmonary activity from autologous granulocytes labeled with In-111 was detected externally for 12 (n = 8) to 44 h (n = 6). The changes were compared with those in ten pigs (12 h n = 7, 44 h n = 3) subjected to the same insults but given no corticosteroid (placebo group). Serial measurements of blood radioactivity, and cardiac output were performed in animals observed for 12 h. Corticosteroid-treated pigs showed a gradual decline in decay-corrected pulmonary In-111 activity. The placebo group displayed a more varied reaction, but most animals had an increased activity compared to the corticosteroid group. The difference between the groups was significant at 8 h (BDP-group 92% (88-98), placebo-group 107% (97-121), median (lower-upper quartiles), baseline = 100%. P < 0.01, U-test). Blood radioactivity and cardiac output did not differ significantly between the two groups. Nebulized corticosteroid thus diminished pulmonary granulocyte accumulation, which may be of value in the treatment of septic respiratory distress.     

NEONATAL SEPTICEMIA AND PERINATAL RISK FACTORS

Abstract. Many methods for screening and prediction of neonatal septicemia have been tried. In this study a score, related to both perinatal risk factors and neonatal diseases, was tested upon healthy newborn infants, infants with septicemia and infants with other diseases. Statistical differences were found between infants with neonatal septicemia and infants with other neonatal diseases as well as normal newborns. It was also possible to find a relationship between certain predisposing factors and predominance of certain pathogens. Complications during pregnancy and delivery were most often found in the group B streptococcal, combinations of invasive procedures and neonatal diseases in the staphylococcal group and surgical procedures in the gram-negative group.     

Clostridium Perfringens Septicemia and Acute Leukemia

ABSTRACT. Three cases of fatal clostridial septicemia in patients with acute leukemia are described. Predisposing factors and treatment are discussed. Clostridium septicemia should always be suspected when a patient with neutropenia suddenly develops diffuse abdominal pain, fever, and tachycardia over 120/min. The importance of early treatment with penicillin or another adequate antibiotic is discussed.     

盐酸去甲万古霉素在新生儿葡萄球菌败血症中的应用研究

６３例患葡萄球菌败血症的足月新生儿在常规抗感染治疗疗效不佳时，接受国产盐酸去甲万古霉素治疗，首量１５ｍｇ／ｋｇ，静脉滴注，综之１０ｍｇ／ｋｇ维持治疗。结果；其血药浓度可达到２０－４０μｇ／ｍｌ的有效水平，治愈率达９０．％。用药不超过２周未见严重耳，肾毒性。