Elizabethkingia meningoseptica is a multi-drug resistant organism that can cause meningitis in premature neonates. We report a case of Elizabethkingia meningoseptica meningitis that was detected early in an extremely premature low birth weight infant. He was successfully treated with a combination of ciprofloxacin and piperacillin-tazobactam. The spread of infection was controlled with no other reported cases.
AIM:To determine the distribution of vancomycin MIC and the frequency of S. aureus strains with reduced vancomycin susceptibility among Methicillin-Resistant Staphylococcus aureus (MRSA) isolates.METHODS:MRSA isolates (n = 100) were tested for reduced susceptibility to vancomycin using MIC broth microdilution method (BMD), vancomycin screening agar with different vancomycin concentrations with and without casein, and Vitek 2 system.RESULTS:BMD detected (22%) vancomycin-intermediate S. aureus (VISA) and (78%) vancomycin-susceptible S. aureus (VSSA) but couldn’t detect nine (Heterogeneous VISA) (hVISA) isolates (9%) with MIC ≤ 2 µg/ml that grew on screening agar 4 µg/ml or 6 µg/ml. Adding casein to vancomycin screening agar increased detection rate of VISA by 4.5%. Screening agar with 6 µg/ml vancomycin overall detection rate for VISA was 95.45%. Probable ‘pre-hVISA’isolates (17%) showed growth on vancomycin screening agar 2 µg/ml with casein. Vitek 2 system failed to detect any VISA isolates.CONCLUSION:Vancomycin screening agar; 2 µg/ml and (4 and 6 µg/ml) were able to detect; probable “pre hVISA and (hVISA and VISA) isolates respectively based on their BMD MIC values. Decreased vancomycin susceptibility in MRSA isolates might be related to MIC creep. Analysis of vancomycin MIC values over longer periods is recommended to further study this phenomenon and its impact on vancomycin treatment failure.
Background: Despite advances in therapy, sepsis is the leading cause of death in critical care settings. The early recognition of sepsis as well as the speed and appropriateness of therapy in the initial hours after presentation are likely to influence the outcomes of septic patients. This study was conducted to investigate the early diagnostic and differentiating value of pathfast presepsin assay (soluble CD14 subtype) compared to other biomarkers in patients presenting at emergency department with systemic inflammatory response syndrome and suspected sepsis. Methods: The current study included seventy suspected septic patients (patient group) and thirty apparently healthy individuals (control group). All subjects were subjected at first presentation to determination of plasma presepsin, quantitative C-reactive protein and total leucocytic count values, while patient group were subjected to blood culture as a gold standard method. Results: Presepsin levels showed a statistically significant increase between septic and systemic inflammatory response patients. The cut off value that gave the best sensitivity and specificity for presepsin was 395pg/ml. Conclusions: Presepsin can be a very useful promising biomarker not only for the early diagnosis of sepsis (15min) with discrimination between sepsis and systemic inflammatory response syndrome in patient presented in ED, but also for assessment of its severity and prognosis. Higher level was correlated with poor patient outcome. Future studies on large scale are needed to monitoring of prespsin level in response to antibiotic treatment.
Background: A group of neurodevelopmental diseases known as autism spectrum disorder (ASD) is characterized by difficulties with social interaction and communication as well as limited or repetitive activities. Objective: To estimate the quantity of Candida in stool of autism spectrum disorder (ASD) patients compared to normal children and to find the association between Candida colony count and severity of ASD. Patients and Methods:The study involved 40 children with autism and 40 typically developing children who were recruited from the pediatrics and adolescent psychiatric clinic at the pediatric hospitals of Ain Shams University. The research included participants who ranged in age from 3 to 14 years, (mean age of 6.30±2.40 years). Stool sample was collected from each patient in a sterile container, cultured on Sabouraud Dextrose Agar (SDA) and colony count was determined. Identification of isolated Candida species was done using chromogenic media. Results:The study revealed statistically significant difference in Candida isolation rate among patient and control group with p-value (p=0.006). Candida species were isolated from 23 patients (57.5%) and from 10 children in control group (25%), but there was statistical insignificant difference in Candida colony count between severe autistic group compared to mild to moderate autistic group. There were 14 patients (60.9%) with C. Albicans; 2 patients (8.7%) C. Glabrata; 6 patients (26.1%) C. Krusei and one patient (4.3%) C. Utilis. Conclusion:Children with ASD had increased rates of intestinal Candida species colonization, which may be a symptom of a condition associated to immune system abnormalities that may contribute to the etiology of ASD. In ASD, C. albicans was the most common isolate.
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