Human Brucella canis infection incidence is unknown. Most identified cases are associated with pet dogs. Contact with pathogenic Brucella spp. can lead to laboratory-acquired infections. We identified a pediatric B. canis case, the source, and other exposed persons. A three-year-old New York City child with fever and dyspnea was hospitalized for 48 hours for bronchiolitis. After her admission blood culture grew B. canis, she was prescribed antimicrobials and recovered. B. canis was isolated from blood of the child's pet dog. Isolates from the child and the dog were genetically similar. The dog originated from an Iowa breeding facility which was quarantined after identification of the puppy's infection. Thirty-one laboratory workers were exposed and subsequently monitored for symptoms; 15 completed post-exposure prophylaxis. This first report strongly suggesting B. canis transmission from a canine to a child in the United States highlights the need for coordinated control policies to minimize human illness.

We report the first case of recurrent intravascular-catheter-related bacteremia in a pediatric hemodialysis patient caused by Delftia acidovorans, previously called Comamonas acidovorans or Pseudomonas acidovorans. The patient had a history of multiple infections of central vascular catheters with other organisms, requiring courses of antibiotics and catheter replacements. Previously reported cases of D. acidovorans infections are reviewed. The isolate appeared to become resistant to cephalosporins after antibiotic treatment, but resistance could not be confirmed with additional testing. In vitro susceptibility testing for cephalosporins is not reliable for this organism. CASE REPORTA 10-year-old girl with renal cortical necrosis and end-stage renal disease was receiving hemodialysis via a Quinton PermCath dual-lumen catheter for 5 years. Over this period, she had a history of 24 episodes of catheter-related infections, requiring multiple courses of antibiotics and catheter replacements. While receiving outpatient dialysis treatment on day 120 of the catheter, she developed a fever of 38°C and chills. There was no erythema, warmth, tenderness, or swelling at the exit site in the femoral area. A blood culture was obtained from the catheter which subsequently grew a Gram-negative rod identified as Delftia acidovorans by MicroScan WalkAway-40 BP combo panel type 34 (Siemens, Munich, Germany). The organism was susceptible to expanded-spectrum and broad-spectrum cephalosporins, aztreonam, carbapenems, piperacillin-tazobactam, ticarcillinclavulanate, and quinolones but resistant to all aminoglycosides, penicillin, and narrow-spectrum cephalosporins and intermediately susceptible to ampicillin-sulbactam. A 14-day course of cefepime was given through the catheter with hemodialysis when microbial identification and susceptibility results were available. The patient remained afebrile. Blood cultures drawn from the catheter before starting antibiotic therapy, 3 days and 7 days after the end of therapy, were negative. The catheter was not removed.Twenty-four days after cefepime was stopped, she became febrile again (38°C), with chills, after hemodialysis. Blood cultures were obtained from the catheter and peripheral vein. Vancomycin and cefepime were started, and she defervesced within 24 h. Staphylococcus epidermidis and D. acidovorans were identified from both specimens. The D. acidovorans isolate was initially not identifiable by MicroScan WalkAway (Siemens, Munich, Germany). Additional testing was done with Vitek and API 20 NE version 6.0 (bioMérieux, Marcy l'Etoile, France). The Vitek reported D. acidovorans with 53% probability, and the API 20 NE version 6.0 reported D. acidovorans as a significant taxon with an unacceptable profile. Finally, it was further characterized with long-chain-fatty-acid analysis by gas chromatography using the MIDI 62 system (Microbial Identification Systems, Newark, DE). The susceptibilities of the second D. acidovorans isolate by MicroScan were now reported as resistant to cefotaxime, cef...

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Doxycycline suppressed the C. pneumoniae-induced production of IgE and IL-4, but not IFN-γ, in PBMCs from IgE+ allergic asthmatic subjects. These findings resulted from the immunomodulatory anti-allergic properties of tetracyclines.

Background: Congenital syphilis (CS) is a devastating yet preventable disease affecting the fetus. Recent increase in cases of CS in the United States has been reported by Centers for Disease Control and Prevention. There is a lack of data on hospitalization trends and healthcare utilization related to CS. We sought to describe CS hospitalization trends, morbidity and mortality during 2009 through 2016 and related healthcare expenditure. Methods: National inpatient level data collected from Kid’s Inpatient Database and National Inpatient Sample databases from 2009 to 2016 were analyzed. CS hospitalizations were identified using International Classification of Diseases codes in age less than 1 year. Related demographics, risk factors and outcomes were calculated. Infant mortality related to CS were calculated per number of hospitalizations. Results: From 2009 to 2016, there were a total of 5912 CS-related hospitalizations. The overall trends in hospitalizations related to CS was up trending since 2009. African American ethnicity, public insurance/uninsured, low socioeconomic status, geographic location (South and West hospital regions), prematurity and low birth weight were significantly associated with CS and remained as independent risk factors. The mean length of stay (12.38 ± 0.10 d vs. 3.42 ± 0.1 d) and mean hospitalization charges were significantly higher in CS (P < 0.001) as compared with other hospitalized infants without CS. The total inflation-adjusted hospitalization charges have more than doubled over the years ($120,665,203 in 2016 vs. $54,290,310 in 2009). The rate of in-hospital deaths in CS hospitalization was 0.54% (32 deaths among 5912 hospitalizations). Conclusions: The incidence of CS hospitalization has been increasing since 2009. CS contributes to a significant healthcare utilization burden; its prevention can save a large amount of healthcare-related expenditure.

The in vitro activities of nemonoxacin, levofloxacin, azithromycin, and doxycycline were tested against 10 isolates each of Chlamydia trachomatis and Chlamydia pneumoniae. The MICs at which 90% of the isolates of both C. trachomatis and C. pneumoniae were inhibited (MIC 90 s) were 0.06 g/ml (range, 0.03 to 0.13 g/ml). The minimal bactericidal concentrations at which 90% of the isolates were killed by nemonoxacin (MBC 90 s) were 0.06 g/ml for C. trachomatis (range, 0.03 to 0.125 g/ml) and 0.25 for C. pneumoniae (range, 0.015 to 0.5 g/ml).

Antibody was first detected at 11 years of age, likely coinciding with sexual debut. The prevalence of antibody was higher and appeared earlier in females, mirroring national surveillance trends based on nucleic acid amplification testing. The delay in male antibody detection may be due to biological or behavioral differences between genders. These data are critical in informing potential C. trachomatis vaccine strategies.

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