The combination of linezolid use plus transmission of a multidrug-resistant clone drove expansion of invasive, linezolid-resistant S. epidermidis. Our results lend support to the notion that a combination of antibiotic stewardship plus infection control measures may help to control the spread of a multidrug-resistant pathobiont.
A 54-year-old ranch hand presented to the emergency room with an alleged spider bite and multiple abscesses. Both wound and blood cultures grew Photorhabdus asymbiotica, an enteric gram-negative rod that was initially misidentified by the hospital's rapid identification system. Clinical laboratories should be aware of the limitations of their rapid identification systems and always use them as an adjunct to analysis of morphological and phenotypic traits.A 54-year-old male presented to the emergency department of a local Houston hospital during July 2003. He was a ranch hand who believed that he was bitten by a spider on his left breast. He presented with multiple carbuncles on his left chest wall and multiple pustular nodular lesions over his extremities. The patient, who has a family history of diabetes, had a blood sugar level of 400 on admission. His temperature was 101°F, his blood pressure was 135/70, his respiratory rate was 20, and his pulse was 60. Culture of the left-breast abscess showed moderate numbers of methicillin-resistant Staphylococcus aureus and an unremarkable gram-negative rod identified by a MicroScan Neg Urine Combo Panel Type 34 on the MicroScan WalkAway (Dade Behring, Inc
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