Clinical Microbiology Newsletter最新文献

{"title":"A comparative analysis of Orientia Tsutsugamushi (Scrub Typhus): Essential information on causes, symptoms, and care","authors":"Neetesh Jindal ,&nbsp;Kumar Abhishek ,&nbsp;Ashish Kumar ,&nbsp;Manas Ranjan Dikhit ,&nbsp;Roshan Kamal Topno ,&nbsp;Krishna Pandey ,&nbsp;Ganesh Chandra Sahoo","doi":"10.1016/j.clinmicnews.2025.01.004","DOIUrl":"10.1016/j.clinmicnews.2025.01.004","url":null,"abstract":"<div><div>Scrub typhus is a disease caused by the bacteria <em>Orientia tsutsugamushi</em>, spread primarily by chiggers, which are larval mites. These mites are commonly found in Southeast Asia, including countries like India, Indonesia, and Thailand. The disease is often hard to diagnose because its symptoms—fever, headache, muscle pain, and stomach issues—are similar to other illnesses. A key sign of scrub typhus is an “eschar,” a sore that appears at the bite site. Without treatment, which typically involves antibiotics like doxycycline or azithromycin, the disease can lead to severe complications such as sepsis, shock, and multi-organ failure, with a high mortality rate. Scrub typhus has been documented in various regions, with historical records dating back to the 19th century in China. Despite advances in treatment regimen since World War II, no vaccine is available. Diagnostic methods include serological tests and PCR techniques to detect the bacteria. Preventive measures focus on avoiding areas where chiggers are prevalent and using insect repellent. Even if the scrub typhus fever has been reported from regions such as Japan to northern Australia and the Arabian Peninsula, Indian people from different parts are suffering from this endemic disease and doxycycline has become the drug of choice for the treatment of scrub typhus fever. Clinical diagnosis of scrub typhus and research related to this endemic disease must be assorted as the scrub typhus may become resistant to the current treatment regimen.</div></div>","PeriodicalId":39211,"journal":{"name":"Clinical Microbiology Newsletter","volume":"50 ","pages":"Pages 34-40"},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Soft tissue infection with multidrug-resistant Kluyvera ascorbata of extended-spectrum bêta-lactamase type (CTX-M): Case report and literature review","authors":"Samir Kaddouri ,&nbsp;Abderrazak Saddari ,&nbsp;Said Ezrari ,&nbsp;Ouahiba Hafhaf ,&nbsp;Ismail Faiz ,&nbsp;Amjad Idrissi ,&nbsp;Omar El Mahi ,&nbsp;Elmostapha Benaissa ,&nbsp;Yassine Ben Lahlou ,&nbsp;Mostafa Elouennass ,&nbsp;Adil Maleb","doi":"10.1016/j.clinmicnews.2025.01.003","DOIUrl":"10.1016/j.clinmicnews.2025.01.003","url":null,"abstract":"<div><div><em>Kluyvera ascorbata</em>, which belongs to the Enterobacteriaceae family, is a commensal bacterium that is very rarely described in human infections. In this report, we describe a case of soft tissue infection due to <em>Kluyvera ascorbata</em> in a 72-year-old man with comorbidities. He was admitted to the vascular surgery department for the treatment of a gas gangrene of the left foot. The patient received probabilistic antibiotic therapy with metronidazole, ceftriaxone and gentamicin by parenteral route with an amputation of the left leg following critical ischemia of the left lower limb (LLL). Due to the superinfection of the left leg amputation stump, the patient underwent an amputation of the left thigh, followed by multiple debridements of the left thigh amputation stump and drainage of an abscess on the anterior surface of the left thigh in the operating room. A sample of superficial pus was collected intraoperatively for microbiological examination to identify the pathogen and guide therapeutic adjustments. This examination revealed the exclusive presence of <em>Kluyvera ascorbata</em>. The isolate was resistant to the majority of β-lactams, aminoglycosides and sulfonamides. However, it was susceptible at standard dosage to carbapenems, fluoroquinolones, chloramphenicol, fosfomycin-trometamol and nitrofurantoin. The antibiogram highlighted the potential for multi-resistance type ESBL (extended spectrum B-lactamases) which characterizes this bacterium. In addition, <em>Kluyvera spp</em>. have an innate antibiotic resistance mechanism, and it is now accepted that CTX-M are derived from chromosomal beta lactamases of species of the genus <em>Kluyvera</em>. They are part of the extended spectrum β-lactamases (ESBL). Given the above, the treatment regimen has been adapted according to the results of the antibiogram. The patient received parenteral antibiotic therapy with levofloxacin, and the clinical evolution was favorable. This leads us to discuss the pathogenicity of this germ and its multi-resistant potential.</div></div>","PeriodicalId":39211,"journal":{"name":"Clinical Microbiology Newsletter","volume":"50 ","pages":"Pages 41-47"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phage therapy to treat unresponsive infections: A primer for the clinical microbiology laboratory staff","authors":"Josephine M. Davey-Young ,&nbsp;Dinuri D. Punchihewa ,&nbsp;Bernadette Ng ,&nbsp;Jenna Wong ,&nbsp;Greg J. German","doi":"10.1016/j.clinmicnews.2025.01.002","DOIUrl":"10.1016/j.clinmicnews.2025.01.002","url":null,"abstract":"<div><div>With the increase in antimicrobial resistance and subsequent need for alternatives to traditional antibiotics, phage therapy (PT) has gained a renewed interest. Much like antibiotics, bacteriophages or simply phages, have shown promise in eradicating bacterial infections; however, their fundamental differences require specific laboratory protocols and practices. As bacterial-specific viruses, they must be detected, replicated, and purified for safety and efficacy. The narrow spectrum of activity of phages provides a targeted approach to infection but also necessitates expansive libraries and susceptibility testing to match phages to bacteria. Such testing is not standardized, complicating both research and clinical efforts. This review then provides a background on PT in the clinical microbiology laboratory and an overview of such protocols and practices specific to PT, such as classic susceptibility testing methods and updated approaches. Also covered are the challenges and future directions for the field, as well as resources for clinical and research laboratory personnel.</div></div>","PeriodicalId":39211,"journal":{"name":"Clinical Microbiology Newsletter","volume":"50 ","pages":"Pages 48-59"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maximizing the diagnostic potential of 1,3 beta-D-glucan assays for invasive fungal infections","authors":"Sejal Morjaria ,&nbsp;N. Esther Babady","doi":"10.1016/j.clinmicnews.2025.01.001","DOIUrl":"10.1016/j.clinmicnews.2025.01.001","url":null,"abstract":"<div><div>Invasive fungal infections (IFIs) pose a serious threat to patients, particularly those who are immunocompromised. Timely and accurate diagnosis of IFIs is critical to improving outcomes, and conventional diagnostic methods often fall short. The 1,3 Beta-D-Glucan <strong>(</strong>BDG) assay has become a significant test in the early diagnosis and management of IFIs when used in the appropriate clinical context.</div></div>","PeriodicalId":39211,"journal":{"name":"Clinical Microbiology Newsletter","volume":"50 ","pages":"Pages 24-33"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute appendicitis caused by Arcanobacterium haemolyticum","authors":"Ismail Faiz ,&nbsp;Abderrazak Saddari ,&nbsp;Said Ezrari ,&nbsp;Samir Kaddouri ,&nbsp;Elmostafa Benaissa ,&nbsp;Yassine BenLahlou ,&nbsp;Mostafa Elouennass ,&nbsp;Adil Maleb","doi":"10.1016/j.clinmicnews.2024.12.001","DOIUrl":"10.1016/j.clinmicnews.2024.12.001","url":null,"abstract":"<div><div><em>Arcanobacterium haemolyticum</em> is known for causing pharyngitis in young adults and skin/soft tissue infections in older and immunocompromised people. We report here the case of a 25-year-old patient admitted to the emergency room for pain in the right iliac fossa. Abdominal computed tomography (CT) scan showed acute uncomplicated appendicitis. The biological assessment revealed an inflammatory syndrome with CRP at 124 mg/L. The patient underwent an appendectomy by laparotomy. The cytobacteriological analysis of deep pus revealed an important leukocyte reaction to neutrophils, and the growth of <em>Arcanobacterium haemolyticum</em> in culture. Antibiotic susceptibility testing showed that the bacterium was susceptible to clindamycin, tetracycline, linezolid, and rifampicin, and resistant to penicillin G, sulfamethoxazole/trimethoprim, moxifloxacin, ciprofloxacin, and vancomycin. Most studies have shown that this bacterium is susceptible to all classes of antibiotics except sulfamethoxazole-trimethoprim, however, in our case and like certain recent studies, other resistances are emerging.</div></div>","PeriodicalId":39211,"journal":{"name":"Clinical Microbiology Newsletter","volume":"50 ","pages":"Pages 19-23"},"PeriodicalIF":0.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A fatal case of community-acquired Acinetobacter pittii necrotising fasciitis, and a review of the literature","authors":"Maja Johanne Søndergaard Knudsen,&nbsp;Peder Worning,&nbsp;Sarah Juel Paulsen,&nbsp;Anne Line Engsbro","doi":"10.1016/j.clinmicnews.2024.11.003","DOIUrl":"10.1016/j.clinmicnews.2024.11.003","url":null,"abstract":"<div><div>We report a fatal case of a comorbid male in his 70s admitted for erysipelas on the right lower leg. The condition developed rapidly and during debridement, the patient was diagnosed with necrotising fasciitis (NF). <em>A. pittii</em> was isolated from both blood and tissue samples. Despite broad-spectrum antibiotics, hyperbaric oxygen treatment and surgical intervention, the patient died from multiple organ failure. A review was conducted with a PubMed search for case reports/cohort studies with cases of <em>Acinetobacter</em> NF. Twenty-three articles were identified reporting on 30 cases with NF caused by <em>Acinetobacter</em> sp. (<em>Acinetobacter baumanii</em> 83 %, <em>A. pittii</em> 0). Infections were polymicrobial in 57 % of cases and fatal in 47 % of cases. For cases unrelated to war, most identified patients suffered from one or more comorbidities. <em>A. pittii</em> should be considered an important finding in a patient with a soft skin infection, and the risk of NF should be assessed.</div></div>","PeriodicalId":39211,"journal":{"name":"Clinical Microbiology Newsletter","volume":"50 ","pages":"Pages 13-18"},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbe snapshots: Dengue virus","authors":"Samuel M. Goodfellow ,&nbsp;Esther Vaugon","doi":"10.1016/j.clinmicnews.2024.11.002","DOIUrl":"10.1016/j.clinmicnews.2024.11.002","url":null,"abstract":"","PeriodicalId":39211,"journal":{"name":"Clinical Microbiology Newsletter","volume":"50 ","pages":"Pages 11-12"},"PeriodicalIF":0.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peritoneal Tuberculosis: Navigating diagnostic challenges","authors":"Reanay Berezovskiy ,&nbsp;Meher Sultana ,&nbsp;Jason Guyotte ,&nbsp;Daria Yunina-Distefano ,&nbsp;Niyati Goradia ,&nbsp;Irene E. Rossmer","doi":"10.1016/j.clinmicnews.2024.11.001","DOIUrl":"10.1016/j.clinmicnews.2024.11.001","url":null,"abstract":"<div><div>Peritoneal Tuberculosis (TB) is an uncommon manifestation of a mycobacterial infection, typically observed in immunocompromised individuals and/or those residing in endemic regions. Usually, patients will contract pulmonary TB, which results in dissemination or reactivation of latent infection months to years following the initial infection. Here, we present a case of peritoneal TB diagnosed in an immunocompetent patient devoid of recent travel history and with negative pulmonary findings. This case highlights the importance of considering peritoneal TB in the differential diagnosis, even in immunocompetent individuals with no apparent risk factors, highlighting the complexity and variability of TB presentations.</div></div>","PeriodicalId":39211,"journal":{"name":"Clinical Microbiology Newsletter","volume":"50 ","pages":"Pages 7-10"},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral otitis media as an initial manifestation of disseminated tuberculosis disease in a patient with late HIV infection diagnosis","authors":"Victoria Lobo-Antuña ,&nbsp;Marta Lobo-Antuña ,&nbsp;Juan Martínez-Andrés ,&nbsp;Cristina Rodríguez-Prado ,&nbsp;María Remedios Guna-Serrano ,&nbsp;Atilio Navarro-Gonzales ,&nbsp;Magdalena García-Rodríguez ,&nbsp;Carmen Ricart-Olmos","doi":"10.1016/j.clinmicnews.2024.10.004","DOIUrl":"10.1016/j.clinmicnews.2024.10.004","url":null,"abstract":"<div><div>Tuberculous otitis media is a rare form of extrapulmonary tuberculosis, often resulting in delayed diagnosis due to its nonspecific symptoms and low clinical suspicion. We present the case of a 29-year-old woman with initial symptoms of sudden speech impairment without other neurological manifestations. In the previous 3 months, the patient had consulted several times to the health care system due to bilateral otitis media, which did not improve with conventional treatments. Daily fever, diarrhea and weight loss were added to the picture. After admission to the Infectious Diseases department, she was diagnosed with advanced HIV infection and disseminated tuberculosis (TB) with pulmonary, intestinal, lymph node and otic involvement. This case underlines the complexity of diagnosing TB otitis media, especially in the context of HIV co-infection, and highlights the importance of routine HIV screening in patients with persistent, unexplained symptoms to facilitate early diagnosis and prevent complications.</div></div>","PeriodicalId":39211,"journal":{"name":"Clinical Microbiology Newsletter","volume":"50 ","pages":"Pages 1-6"},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medically important alphaviruses in the United States and how to test for them","authors":"Allison R. Eberly","doi":"10.1016/j.clinmicnews.2024.10.003","DOIUrl":"10.1016/j.clinmicnews.2024.10.003","url":null,"abstract":"<div><div>Alphaviruses are arthropod-borne viruses (i.e. arboviruses) transmitted by mosquitos that are classically divided into two groups that infect humans: encephalitic and arthralgia-associated. While the encephalitic alphaviruses are primarily endemic in North and South America, alphaviruses associated with arthralgia are distributed globally. Given the overlapping clinical manifestations of alphaviruses with other arboviruses, diagnosis is dependent on both exposure history and laboratory testing. In the United States, diagnostic approaches largely rely on detection of host antibodies against these viruses via enzyme-linked immunosorbent assays (ELISAs) or indirect immunofluorescence assays (IFAs) in serum and/or cerebrospinal fluid. Positive results can be confirmed by plaque reduction neutralization testing (PRNT), which remains the reference standard method for anti-alphavirus antibody detection. Increasingly, select public health and reference laboratories are also offering molecular testing for certain alphaviruses, including chikungunya virus and Eastern equine encephalitis virus. Molecular testing, however, is most useful in acutely ill, viremic patients who present within the first week of symptom onset. There are no targeted antivirals for treatment, and prevention relies on protection from mosquito bites.</div></div>","PeriodicalId":39211,"journal":{"name":"Clinical Microbiology Newsletter","volume":"49 ","pages":"Pages 28-36"},"PeriodicalIF":0.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}