Browsing by Subject "Bacteremia"

Now showing 1 - 6 of 6
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    Epidemiology and source of infection in patients with febrile neutropenia: A ten-year longitudinal study
    (Elsevier, 2019-05-01) Al-Tawfiq, Jaffar A.; Hinedi, Kareem; Khairallah, Hanan; Saadeh, Bassam; Abbasi, Suhail; Noureen, Madeeha; Raza, Safia; Alkhatti, Adil; Medicine, School of Medicine
    Objectives No recent studies are available from Saudi Arabia on the etiology of febrile neutropenia. The objective of this study was to describe the characteristics of patients with febrile neutropenia and to calculate the rate of occurrence of bacteremia in these patients. Methods This is a hospital-based study of patients admitted with febrile neutropenia from 2006 to 2015. Results A total of 372 distinct episodes of febrile neutropenia representing 231 patients were included. Hematologic malignancies constituted 56.6% of the episodes. Positive blood cultures were reported in 13.5% with equal frequency of Gram-negative bacilli and gram positive cocci. The most commonly suspected sites of infection were blood 10.8% and pulmonary 9.2%, and the majority (72.5%) was thought to have no identifiable source of infection. Of all the episode, 32% had central venous catheters. The most frequently used single antimicrobial agents were imipenem (38%) and ceftazidime (7.5%). The mortality rate was 11.2% and it was significantly associated with the presence of bacteremia 24.4% versus 12.4% (P=0.016). Mortality was not significantly association with age, type of malignancy, presence of central venous catheter, or the severity of neutropenia. Compared to patients with hematological malignancy, patients with solid organ malignancy were more likely to be female 62% versus 14.9% (P<0.001) and were less likely to have bacteremia 8.7% versus 17.1%, P=0.042, respectively. Conclusion We had shown that febrile neutropenia in this study has a low rate of bacteremia and that about 45% received the recommended initial empiric therapy.
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    Francisella philomiragia Bacteremia in a Patient with Acute Respiratory Insufficiency and Acute-on-Chronic Kidney Disease
    (American Society for Microbiology, 2015-12) Relich, Ryan F.; Humphries, Romney M.; Mattison, H. Reid; Miles, Jessica E.; Simpson, Edward R.; Corbett, Ian J.; Schmitt, Bryan H.; May, M.; Department of Pathology & Laboratory Medicine, IU School of Medicine
    Francisella philomiragia is a very uncommon pathogen of humans. Diseases caused by it are protean and have been reported largely in near-drowning victims and those with chronic granulomatous disease. We present a case of F. philomiragia pneumonia with peripheral edema and bacteremia in a renal transplant patient and review the diverse reports of F. philomiragia infections.
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    Myiasis-induced sepsis: a rare case report of: Wohlfahrtiimonas chitiniclastica: and: Ignatzschineria indica: bacteremia in the continental United States
    (Wolters Kluwer, 2018-12) Lysaght, Travis B.; Wooster, Meghan E.; Jenkins, Peter C.; Koniaris, Leonidas G.; Surgery, School of Medicine
    Rationale: The presentation of sepsis and bacteremia in cutaneous and cavitary myiasis is uncommon. We present a patient, residing in a temperate region of the United States, with myiasis and sepsis from the emerging human pathogens Wohlfahrtiimonas chitiniclastica and Ignatzschineria indica. Patient concerns: A 37-year-old male patient with an 8-month history of chronic lymphedema and ulcers of the lower left extremity presented with myiasis of the left foot and leg. The patient was initially seen by his family practitioner many times and was prescribed antibiotics which he could not afford. Debridement of the myiasis was not conducted by the family practitioner due to the belief that the patient's current state of myiasis would effectively debride and eventually heal the chronic ulcers along with multiple antibiotic regimens. Over the 8-month period, the patient developed a progressive, painful, necrotizing infection of his lower left extremity. Diagnoses: Physical examination clearly showed myiasis of the patient's lower left extremity, believed to be caused by Lucilia sericata (green bottle fly). Blood cultures revealed the presence of Providencia stuartii, W chitiniclastica, and I indica to be the underlying cause of sepsis and bacteremia. Interventions: All visible maggots were extracted, debridement of devitalized tissue was performed, and the leg ulcers were wrapped in pH neutral bleach. The patient was initially treated with a broad-spectrum antibiotic regimen of vancomycin, clindamycin, piperacillin, and tazobactam which, following clinical improvement, was de-escalated to cefepime. Outcomes: The fly larvae and maggots were removed from the extremity by scrubbing, pulse lavage, and filing away the callused tissue. Additionally, the patient's sepsis and bacteremia, caused by W chitiniclastica and I indica, were successfully treated through antibiotic intervention. Amputation was avoided. Lessons: The use of pulse lavage and chlorhexidine-soaked brushes for the removal of cavitary myiasis is an effective and minimally invasive procedure which does not cause additional damage to surrounding tissue. W chitiniclastica and I indica are emerging bacteria that have known association to parasitic fly myiasis in humans and are capable of causing sepsis and/or bacteremia if not accurately identified and treated promptly.
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    Persistent bacteremia and psoas abscess caused by a lethal toxin-deficient Paeniclostridiumsordellii
    (Elsevier, 2022) Varley, Cara D.; Rogers, Lisa M.; Dixon, Beverly Rea; Bernard, Sarah C.; Lacy, D. Borden; Sulpizio, Emilio; Aronoff, David M.; Townes, John M.; Medicine, School of Medicine
    We present a case of persistent bacteremia and psoas abscess from Paeniclostridium sordellii without severe symptoms or the classically associated toxic shock syndrome. Further laboratory evaluation demonstrated that the Paeniclostridium sordellii isolate lacked the lethal toxin gene and there was no cytotoxicity to exposed Vero cells.
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    The systemic inflammatory response to dental plaque
    (2010) Wahaidi, Vivian Y.; Kowolik, Michael J.; Galli, Dominique M.; Dowsett, Sherie A.; Allen, Bradley L.; Gregory, Richard L.
    Introduction: Bacteremia involving oral bacteria and the systemic inflammatory responses are mechanisms that could causally link oral and systemic diseases. Objective: To use an experimental gingivitis model (EGM) in 2 clinical studies to 1) examine the systemic inflammatory responses to dental plaque, and assess racial differences in these responses; 2) determine whether dental plaque accumulation causes bacteremia and subsequent systemic responses following toothbrushing. Additionally, a laboratory study was conducted to examine the interaction between circulating human neutrophils and Fusobacterium nucleatum. Methods: For both clinical studies, healthy adults, aged 18-31 years, were recruited. In the first study, black and white, males and females participated in a 21-day EGM; in the second study, white adults participated in a 7-day EGM. In both studies, subjects visited the clinic weekly for: 1) measurement of the plaque index (PI) and gingival index (GI); 2) collection of peripheral blood samples to evaluate systemic markers of inflammation. In the second study, to analyze bacteremic episodes during the experimental phase, peripheral blood samples were collected at baseline and at 0.5, 5, and 30 minutes post-toothbrushing. In the laboratory study, interactions between F. nucleatum and circulating neutrophils were examined using a luminol-enhanced chemiluminescence assay. Results: During the experimental phases of both clinical studies, PI and GI increased (p<0.05) with a correlation between PI and GI ≥0.79. In the first study, dental plaque accumulation resulted in a systemic response that manifested as changes (p<0.05) in the level of inflammatory markers, hematologic factors, markers of lipid metabolism, and markers of metabolic change. This systemic response differed between individuals of different gender and race. In the second study, bacteremic episodes and changes in hematologic factors were observed post-toothbrushing during the experimental phase. Activation of neutrophils with F. nucleatum, in the laboratory study, increased the levels of neutrophil chemiluminescence (p<0.05). Conclusions: Overall, the findings of these investigations may shed light on the mechanistic pathways by which oral infection may impose risk for systemic diseases and provide some evidence to support a possible causal association between oral and systemic diseases. The clinical significance of this in systemic inflammatory diseases requires further investigation.
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    Transient Bacteremia in Patients During the Orthodontic Banding Procedure
    (1976) Macri, James V.; Miller, Chris; Barton, Paul; Dirlam, James; Shanks, James
    The purpose of this investigation was to determine if the fitting and placement of orthodontic bands on patients induced a transient bacteremia. Twenty patients were included, and a total of 12 teeth were banded in each patient. Before any procedure was performed, a preoperative blood sample was taken. Three additional blood samples were taken throughout the procedure 30 to 90 seconds after visible hemorrhage occurred from the placement of the bands. The blood cultures were then incubated for seven days. Cultures that became dark after seven days were subcultured and incubated for 24 hours anaerobically and 24 hours aerobically in an attempt to detect the presence of bacteria. Of the 80 blood cultures taken during this study, only one preoperative blood sample became positive. However, the fact that no bacteremia was detected during the banding procedures does not conclusively exclude its presence. Until more work is done to show conclusively that a bacteremia does not occur during the banding procedure it would be advisable to follow the suggestion of the American Heart Association and prophylactically premedicate patients who are susceptible to SBE with antibiotics for those procedures that may cause hemorrhage.