Sunday, July 13, 2008
Six cases of Aerococcus sanguinicola infection: Clinical relevance and bacterial identification.
Six cases of Aerococcus sanguinicola infection: Clinical relevance and bacterial identification.
Scand J Infect Dis. 2008 Apr
Ibler K, Jensen KT, Ostergaard C, Sonksen UW, Bruun B, Schønheyder HC, Kemp M, Dargis R, Andresen K, Christensen JJ.
From the Department of Bacteriology, Mycology and Parasitology, Statens Serum Institute, Copenhagen.
Aerococcus sanguinicola is a Gram-positive coccus first described in 2001. Infections in humans are rare but the use of 16S rRNA gene sequencing and improved phenotypic methods has facilitated the identification of A. sanguinicola. We report here 6 cases of A. sanguinicola bacteraemia, 2 of which were associated with infective endocarditis. Most patients were elderly (median age 70 y) and had underlying neurological disorders including dementia, cerebral degeneration, and myelomeningocele. The primary focus of infection was the urinary tract in 3 cases and the gallbladder in 1; no focus was detected in 2 cases. Long-term prognosis was poor reflecting the frailty of the patients. All strains were susceptible to penicillin, ampicillin, cefuroxime, vancomycin, erythromycin, and rifampicin. The optimal treatment of infection with A. sanguinicola has yet to be determined.
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Bacterial superinfection in upper respiratory tract infections estimated by increases in CRP values: A diagnostic follow-up in primary care.
Scand J Prim Health Care. 2008 Jul
Lingard H, Zehetmayer S, Maier M.
Department of General Practice and Family Medicine, Medical University Vienna, Vienna, Austria.
Objective.
The aim of this study was to estimate the rate of bacterial superinfection in patients with URTI by using on-site determination of C-reactive protein (CRP). Design. A prospective cohort study.
Setting.
A total of 30 primary care practices. Subjects. Patients with URTI. Intervention. The CRP value was determined at the first consultation and at a follow-up within 3-5 days. CRP values of 30 units (mg) or higher were considered to be an indication of bacterial involvement. Main outcome measures. CRP values during follow-up and duration of illness.
Results.
Among the 506 patients included, 73.1% exhibited a CRP value below the defined limit at their first visit and were considered to suffer from URTI of viral origin. The rate of subsequent bacterial superinfection was 8.1%. Compared with patients suffering from URTI of bacterial or viral origin the duration of illness in patients with bacterial superinfection was significantly longer.
Conclusion.
During follow-up of patients with URTI, the prevalence of bacterial superinfection detected by using a near patient CRP determination is surprisingly low. This result should help to reduce the prescription rate of antibiotics in primary care.
InformaWorldLabels: bacterial superinfection; respiratory tract; URTI; CRP; family practice; primary care
