Diagnostic microbiology and infectious disease
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Diagn. Microbiol. Infect. Dis. · Oct 2009
Review Case ReportsInfective endocarditis and osteomyelitis caused by Cellulomonas: a case report and review of the literature.
Cellulomonas spp. are often believed to be of low virulence and have never been reported as a pathogen causing human disease before. We report the first case of endocarditis caused by Cellulomonas and complicated with osteomyelitis of the lumbar spine in a 78-year-old woman. General weakness and aggravated lower back pain followed by sudden-onset of fever and chills were the major presentation. ⋯ The magnetic resonance imaging of the lumbar spine revealed infective spondylodisciitis at an early stage. After a full course of antibiotics treatment, the patient's fever subsided but her lower back pain persisted. A slow clinical response to appropriate antimicrobial agents was characteristic of Gram-positive bacillary endocarditis.
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Diagn. Microbiol. Infect. Dis. · Oct 2009
Case ReportsNosocomial outbreak of linezolid-resistant Enterococcus faecalis infection in a tertiary care hospital.
We describe 12 cases of linezolid-resistant Enterococcus faecalis. The present study was done in 2 wards of Hospital Universitario La Paz in Madrid, Spain. The 2 wards involved were the intensive care unit (ICU) and reanimation unit. ⋯ This is the first report of a clonal outbreak of linezolid-resistant E. faecalis in Spain. To prevent or minimize the emergence of resistance, we should use linezolid strictly after the therapeutic indications, courses of treatment should be kept as short as possible, and risk factors for resistance development should be considered before starting. In addition, we suggest that susceptibility testing of clinically significant Gram-positive pathogens should be done in all cases of treatment failure, and, depending on the local epidemiology of each ICU, it might be advisable to do it before starting treatment with linezolid.
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Diagn. Microbiol. Infect. Dis. · Oct 2009
Cutoff values for bacteria and leukocytes for urine flow cytometer Sysmex UF-1000i in urinary tract infections.
Because urinary tract infections (UTIs) are a quite common disease, the gold standard for diagnosing UTIs is still bacterial culture, although a large percentage of samples are negative: unnecessary cultures can be reduced by means of an effective screening test. The analytic performance of a new urine cytometer, the UF-1000i, has been tested on 1463 urine samples submitted to our laboratory for culture. Bacteria and leukocyte counts have been compared by means of the UF-1000i with colony-forming unit (CFU) quantification on citrate lactose electrolytes deficient agar to assess the best cutoff values. ⋯ Analytic parameters such as sensitivity, specificity, positive predictive value, negative predictive value, and correctly classified incidence were satisfactory. Based on the results obtained in this study, when using the UF-1000i analyzer for a screening test for UTI, a cutoff value of 40 white blood cells/microL should be adopted. The cutoff value for bacteria should be 125/microL for those clinical conditions in which 10 x 10(5) CFU/mL indicates a positivity.