Wednesday, November 14, 2012
Adaptation of Pseudomonas aeruginosa to the cystic fibrosis airway: an evolutionary perspective.
Adaptation of Pseudomonas aeruginosa to the cystic fibrosis airway: an evolutionary perspective.
Nov 2012
Source
1] Department of Systems Biology, Technical University of Denmark, 2800 Lyngby, Denmark. [2].
Abstract
The airways of patients with cystic fibrosis (CF) are nearly always infected with many different microorganisms. This environment offers warm, humid and nutrient-rich conditions, but is also stressful owing to frequent antibiotic therapy and the host immune response. Pseudomonas aeruginosa is commonly isolated from the airways of patients with CF, where it most often establishes chronic infections that usually persist for the rest of the lives of the patients. This bacterium is a major cause of mortality and morbidity and has therefore been studied intensely. Here, we discuss how P. aeruginosa evolves from a state of early, recurrent intermittent colonization of the airways of patients with CF to a chronic infection state, and how this process offers opportunities to study bacterial evolution in natural environments. We believe that such studies are valuable not only for our understanding of bacterial evolution but also for the future development of new therapeutic strategies to treat severe chronic infections.
Labels: airway, antibiotic therapy, bacterial evolution, chronic infections, cystic fibrosis, immune response, Pseudomonas aeruginosa
# posted by Pat O'Connor @ 8:11 AM
Monday, October 29, 2012
Infections following the application of leeches: two case reports and review of the literature.
Infections following the application of leeches: two case reports and review of the literature.
Oct 2012
Abstract
ABSTRACT:
INTRODUCTION: Since the 1980s, leeches have been ingeniously used in the management of venous flap congestion. The presence of anticoagulative substances in their saliva improves the blood drainage. Their digestive tract contains several bacterial species, the main ones being Aeromonas hydrophila and Aeromonas veronii biovar sobria, which contribute to the digestion of ingested blood. These bacteria can be the cause of infections.
CASE PRESENTATION:
We report two cases of septicemia related to Aeromonas veronii biovar sobria that presented after leeches had been applied to congested transverse rectus abdominis myocutaneous flaps for delayed mammary reconstructions. Patient number 1 was a 55-year-old Caucasian woman who underwent a delayed breast reconstruction procedure. On the sixth postoperative day she showed a clinical presentation of septicemia. Aeromonas veronii biovar sobria was identified in the patient's skin and blood bacteriological samples. Her fever ceased after 4 days of antibiotic treatment. Patient number 2 was a 56-year-old Caucasian woman who underwent a delayed breast reconstruction procedure. On the seventh postoperative day we noticed that she showed a clinical presentation of septicemia. Aeromonas veronii biovar sobria was identified in the patient's blood cultures and local bacteriological samples. An antibiogram showed resistance to amoxicillin/clavulanic acid. Her fever ceased on the eleventh postoperative day after 4 days of antibiotic treatment.
CONCLUSION:
The rate of infection after application of leeches is not negligible. The concentration of Aeromonas inside the digestive tracts of leeches largely decreases when the patient is under antibiotic therapy. These germs are sensitive to third-generation cephalosporins and fluoroquinolones and resistant to amoxicillin/clavulanic acid. We recommend preventive treatment based on classical measures of asepsis and on oral antibioprophylaxy with a fluoroquinolone during the whole period of treatment by leeches.
Labels: amoxicillin, Antibiogram, antibiotic therapy, asepsis, blood, clavulanic acid, Infections, leeches, oral, skin, venous anticoagulative substances
# posted by Pat O'Connor @ 11:22 AM
Monday, August 27, 2012
New paradigms of urinary tract infections: Implications for patient management.
New paradigms of urinary tract infections: Implications for patient management.
Apr 2012
Source
Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
Abstract
Urinary tract infections (UTIs) represent one of the most commonly acquired diseases among the general population as well as hospital in-patients, yet remain difficult to effectively and consistently treat. High rates of recurrence, anatomic abnormalities, and functional disturbances of the urinary tract all contribute to the difficulty in management of these infections. However, recent advances reveal important molecular and genetic factors that contribute to bacterial invasion and persistence in the urinary tract, particularly for the most common causative agent, uropathogenic Escherichia coli. Recent studies using animal models of experimental UTIs have recently provided mechanistic insight into the clinical observations that question the effectiveness of antibiotic therapy in treatment. Ultimately, continuing research will be necessary to identify the best targets for effective treatment of this costly and widespread infectious disease.
Labels: Anatomic abnormalities, antibiotic therapy, recurrence, urinary infections, UTI
# posted by Pat O'Connor @ 9:57 AM
Sunday, March 23, 2008
The evaluation and treatment of complicated skin and skin structure infections
The evaluation and treatment of complicated skin and skin structure infections
April 2008
Exper Opinion on Parhmacotherapy
Paul B Cornia1,2 MD, Heather L Davidson1 MD & Benjamin A Lipsky1 MD
1University of Washington School of Medicine, Primary and Specialty Medicine Service, Veterans Affairs Puget Sound Health Care System and Department of Medicine, Seattle, WA 98108-1597, USA
2Assistant Professor of Medicine University of Washington, VA Puget Sound Health Care System (S-111), 1660 South Columbian Way, Seattle, WA 98108-1597, USA +1 206 764 2551; +1 206 764 2936; paul.cornia@med.va.gov
Background:
Skin and skin structure infections are frequently encountered in clinical practice. Fortunately, these infections usually produce only mild to moderate symptoms and signs. Some, however, are severe and may even be life-threatening.
Objective:
To review the approach to the evaluation and treatment of patients with complicated skin and skin structure infections and to discuss when to consider using either established antibiotics or recently licensed agents for treating these infections.
Methods:
In addition to a non-systematic literature review of complicated skin and skin structure infections and necrotizing fasciitis, we identified recent articles examining the microbiology and describing recently licensed antibiotics for treating these infections.
Results/conclusions:
Clinicians must learn to recognize the early symptoms and signs of severe skin and skin structure infections to ensure they select appropriate empiric antibiotic therapy and, when needed, obtain prompt surgical consultation. While the recent approvals of new agents for treating these infections are welcome, particularly in light of the continued emergence of antibiotic-resistant bacteria, traditional antibiotic regimens remain appropriate for most cases.
Expert Opinion
April 2008
Exper Opinion on Parhmacotherapy
Paul B Cornia1,2 MD, Heather L Davidson1 MD & Benjamin A Lipsky1 MD
1University of Washington School of Medicine, Primary and Specialty Medicine Service, Veterans Affairs Puget Sound Health Care System and Department of Medicine, Seattle, WA 98108-1597, USA
2Assistant Professor of Medicine University of Washington, VA Puget Sound Health Care System (S-111), 1660 South Columbian Way, Seattle, WA 98108-1597, USA +1 206 764 2551; +1 206 764 2936; paul.cornia@med.va.gov
Background:
Skin and skin structure infections are frequently encountered in clinical practice. Fortunately, these infections usually produce only mild to moderate symptoms and signs. Some, however, are severe and may even be life-threatening.
Objective:
To review the approach to the evaluation and treatment of patients with complicated skin and skin structure infections and to discuss when to consider using either established antibiotics or recently licensed agents for treating these infections.
Methods:
In addition to a non-systematic literature review of complicated skin and skin structure infections and necrotizing fasciitis, we identified recent articles examining the microbiology and describing recently licensed antibiotics for treating these infections.
Results/conclusions:
Clinicians must learn to recognize the early symptoms and signs of severe skin and skin structure infections to ensure they select appropriate empiric antibiotic therapy and, when needed, obtain prompt surgical consultation. While the recent approvals of new agents for treating these infections are welcome, particularly in light of the continued emergence of antibiotic-resistant bacteria, traditional antibiotic regimens remain appropriate for most cases.
Expert Opinion
Labels: antibiotic therapy, bacterial myonecrosis. skin structurw infections, necrotizing fasciitis, skin infections
# posted by Pat O'Connor @ 12:25 AM
