Herman Goossens
Ann Clin Microbiol 2014 March, 17(1): 1-8. Published on 20 March 2014.
Europe has taken many political actions since 1999 to better control antimicrobial resistance and use, including two European Council Recommendations and actions taken by numerous European Union (EU) presidencies. These presidencies triggered many public health and research actions in the EU. Europe developed several very successful surveillance programmes on antimicrobial resistance and antimicrobial use, both currently coordinated by the European Centre for Disease Prevention and Control (ECDC). These surveillance programmes were able to identify emerging problems of antibiotic resistance and targets for quality improvement of antimicrobial use; they also conducted impact assessments of campaigns to reduce antibiotic use and increase hand hygiene. The public antibiotic awareness campaigns were very successful in reducing antibiotic use and resistance in countries like Belgium and France. The successes of these campaigns inspired ECDC to launch an annual European Antibiotic Awareness Day on November 18, 2008. The hand hygiene campaigns resulted in a dramatic decrease of MRSA infections in many EU Member States. However, ESBL- producing Gram-negative bacteria and Carbapenem- resistant Enterobacteriaceae and non-fermenters are increasing in most EU countries. Finally, the EU is investing hundreds of millions of EUROs in a Public Private Partnership (PPP), called the Innovative Medicines Initiative (IMI). An important initiative of IMI is the launch of the Combating Antibiotic Resistance NewDrugs4BadBugs programme. The goal of this new research programme is to create an innovative and collaborative PPP-based approach that will positively impact all aspects of the antimicrobial resistance issue, from the discovery of novel products to Phase 1-3 clinical trials.
Kyutaeg Lee, Woo Jin Kim, Dong Lyul Kim, Hyun Mi Ko, Seung Hee Baik, Mi Na Kim, Moo Sang Chong
Ann Clin Microbiol 2014 March, 17(1): 9-13. Published on 20 March 2014.
Background: Streptococcus agalactiae (Group B streptococcus, GBS) is known to be the leading cause of neonatal sepsis and meningitis in the United States and Europe. In addition, GBS infection has been increasingly noted in adults, particularly in those with underlying diseases, such as diabetes mellitus, malignancy and liver disease. A few studies reported that resistances to antibiotics, such as erythromycin, clindamycin, tetracycline are increasing. We report clinical and microbiological characteristics of GBS bacteremic patients in Jeju Island.
Methods: We retrospectively analyzed medical records, such as age, sex, underlying disease, mortality, skin defects, laboratory results and antibiotic resistances of GBS in hospitalized adult patients who were diagnosed with GBS bacteremia from 2008 to 2013 in Jeju Island.
Results: Twenty two adult patients were diagnosed as GBS bacteremia from 2008 to 2013. The mean age of GBS bacteremic patients was 66.2 years old. Of 22 bacteremic patients, fifteen patients (68%) were older than 60. Twenty patients (91%) of bacteremic patients had underlying diseases such as diabetes mellitus, malignancy and liver disease. Ten (45%) patients had skin defects which were on the lower extremities and buttock, fifteen (68%) patients had fever at the time of admission, twenty one (95%) patients were admitted via the emergency department. Two (9%) patients died. The mean white blood cell (WBC) count, percentile of neutrophil count, and C-reactive protein (CRP) levels were 11,488/μL, 84.3 %, 13.5 mg/dL respectively. All GBS isolates from bacteremia showed sensitivities to penicillin, ampicillin, and vancomycin, and showed resistances to erythromycin (25%), clindamycin (30%), and tetracycline (55%).
Conclusion: Bacteremia caused by GBS was prevalent in adult patients with underlying diseases. Most of the GBS bacteremic patients were emergency cases, with a high body temperature, WBC, CRP level, and neutrophil count. Half of them had skin defects, which are considered a source of GBS bacteremia.
[in Korean]
Eun-Ha Koh, Dong-Hyun Lee, Sunjoo Kim
Ann Clin Microbiol 2014 March, 17(1): 14-19. Published on 20 March 2014.
Background: By varying the collected blood volume and storage temperature of the blood culture bottles prior to entry in an automated blood culture system, growth of organisms will be affected.
Methods: Blood culture bottles with a 20 mL blood volume per set were stored at 37oC (1st period) and room temperature (RT, 2nd period) upon arrival at the laboratory after working hours compared to baseline period (10 mL, RT). The time to detection (TTD) for all strains and the number of days until the final report after bottle entry were compared among the three periods.
Results: The median TTD for all strains was 13.5 h, 10.6 h, and 11.3 h in the baseline (N=268), 1st (N=454), and 2nd period (N=370), respectively (P＜0.001). The final identification report was available within two days of bottle entry for 12.3%, 30.6% and 15.1% of bottles in the three different periods, respectively (P＜0.001).
Conclusion: Collecting an adequate blood volume is critical to reduce TTD. The preincubation of blood culture bottles at 37oC during the night shift might enable earlier final reports than storage at RT for samples with the same collected blood volume.
Kwang-Sook Woo, Jae-Lim Choi, Bo-Ram Kim, Ji-Eun Kim, Kyeong-Hee Kim, Jeong-Man Kim, Jin-Yeong Han
Ann Clin Microbiol 2014 March, 17(1): 20-22. Published on 20 March 2014.
Shigella bacteremia is rare, occurring mainly in children. Shigella species often cause diarrhea or gastrointestinal inflammation in humans and are rarely associated with bacteremia. This report describes an unusual case of Shigella boydii bacteremia in an 84-year-old patient visiting our hospital after experiencing nausea, vomiting, and febrile sensation for 2 days. Peripheral blood cultures revealed S. boydii and 16S rDNA sequence analysis produced the same result. However, the organism was not isolated from the patient’s stool. She was started on ciprofloxacin, to which this organism is sensitive, and was subsequently discharged with instructions to complete a 14-day course of ciprofloxacin. Shigellosis is usually a self-limiting enteric disease. However, in contrast to its isolation from both blood and stool, isolation of the organism from blood only is associated with a high mortality rate. As is frequently pointed out, blood cultures should be obtained from elderly or immunocompromised patients with acute febrile gastroenteritis to detect infection caused by enteric pathogens, including Shigella.
Ja Young Lee, Si Hyun Kim, Jeong Hwan Shin, Hyun-Kyung Lee, Young Min Lee, Sae Am Song, Il Kwon Bae, Chang-Ki Kim, Kyung Ran Jun, Hye Ran Kim, Jeong Nyeo Lee, Chulhun L. Chang
Ann Clin Microbiol 2014 March, 17(1): 23-27. Published on 20 March 2014.
Rapidly growing mycobacteria are ubiquitous in the environment and are increasingly being recognized as opportunistic pathogens. Recently, a new species, Mycobacteium conceptionense, has been validated from the Mycobacterium fortuitum third biovariant complex by molecular analysis. However, there are few reports, and postsurgical wound infection by this species is rare. We report a case of postsurgical wound infection caused by M. conceptionense in an immunocompetent patient that was identified by a sequencing analysis of 16S rRNA, hps65, and rpoB genes.
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