Endophthalmitis Caused by Alcaligenes Faecalis: A Case Series

Pal, Swakshyar Saumya; Panigrahi, Pradeep Kumar; Roy, Rupak; Nandi, Krishnendu; Das, Sudipta Sekhar

doi:10.3109/09273948.2013.817592

Cited by 14 publications

(6 citation statements)

References 3 publications

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“…Being a common bacterium in the human intestinal microbiota, A. faecalis occasionally moves to blood and respiratory tract, and causes infections [3]. Few rare cases of A. faecalis- associated peritonitis, eye infections and urinary tract infections are available [3,7,8]. In our case, A. faecalis infection was identified in the bloodstream of the patient staying in the hospital.…”

Section: Discussionmentioning

confidence: 71%

Bloodstream infection with pandrug-resistant Alcaligenes faecalis treated with double-dose of tigecycline

Hasan

Nizhu

Rabbani

2019

IDCases

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Introduction Alcaligenes faecalis is a species of gram-negative, rod-shaped, aerobic bacteria commonly found in the environment. A. faecalis -associated nosocomial infections are common in hospitalized patients, but serious life threatening infections are rare. Here, we report a rare case of BSI with A. faecalis resistant to all available antibiotics; successfully treated with double-dose of tigecycline. Presentation of case A 60-year-old female presented with A. faecalis bloodstream infection, where the organism was completely resistant to all commercially available antibiotics including polymyxins and tigecycline. The physical condition of the patient was deteriorating and there were no active antibiotics available to prescribe based on sensitivities. Despite the organism’s resistance to tigecycline, double-dose of tigecycline therapy (100 mg twice daily, intravenously after a 200 mg single intravenous loading dose) was prescribed intentionally for the treatment of this infection. The organism was completely eradicated from the bloodstream of that patient within the 5 days of therapy-initiation. Discussion Double-dose of tigecycline maintains a higher serum drug concentration rather than the standard dose, and in this case, double-dose of tigecycline completely cleared the pandrug-resistant A. faecalis from the blood where initially, that organism was resistant to tigecycline. Previously, A. faecalis isolates were found resistant to fluoroquinolones, but here it was found very rarely resistant to even reserve antibiotics, polymyxins, carbapenems and tigecycline. Conclusion Pandrug-resistant A. faecalis- associated bloodstream infection is a very uncommon case and double-dose of tigecycline may be an effective option to treat it.

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Section: Discussionmentioning

confidence: 71%

Bloodstream infection with pandrug-resistant Alcaligenes faecalis treated with double-dose of tigecycline

Hasan

Nizhu

Rabbani

2019

IDCases

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“…To our knowledge, there were 66 sporadically reported cases of A. faecalis infection in the literature after 1997 [1,2,[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. Fillipe reported 20 cases of chronic otitis media in Angola [19].…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

“…The organism has been isolated from a range of clinical materials, such as urine, blood, wound discharge, stool, cerebrospinal uid, and respiratory secretions [3][4][5][6]. A. faecalis has been associated with endocarditis, bacteremia, meningitis, endophthalmitis, skin and soft tissue infections, urinary tract infections, otitis media, peritonitis and pneumonia [1,2,[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. A. faecalis infection is often challenging to treat due to its increased resistance to many antibiotics, such as anti-pseudomonas penicillin, cephalosporins, carbapenems, aminoglycosides, and quinolones [17,23,24,26].…”

Section: Introductionmentioning

confidence: 99%

Extensively drug-resistant Alcaligenes faecalis infection

Huang¹

2020

Preprint

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Background: Alcaligenes faecalis is usually opportunistic infection in humans. Alcaligenes faecalis infection is often challenging to treat due to its increased resistance to many antibiotics. The results from a clinical study of Alcaligenes faecalis infection may help improve patients’ clinical care. Methods: We conducted a retrospective analysis of all patients presenting with Alcaligenes faecalis infection from January 2014 through December 2019. The medical records of all patients were reviewed for demographic information, clinical symptoms and signs, comorbidities, use of intravenous antibiotics within the past 3 months, bacterial culture, antibiotics sensitivity test, and clinical outcomes.Results: Sixty-one cases of Alcaligenes faecalis infection were seen during the study period, including 25 cases of cystitis, 9 cases of diabetic foot ulcer with infection, 8 cases of pneumonia, 7 cases of acute pyelonephritis, 3 cases of bacteremia, 9 cases of infection at specific sites. Thirty-seven patients (60.7%) had a history of receiving intravenous antibiotics within 3 months of the diagnosis. Fifty-one (83.6%) cases were mixed with other bacterial infections. Extensively drug-resistant infections have been reported since 2018. The highest antibiotic sensitivity rate for Alcaligenes faecalis, 66.7%, was reported in 2019. Ciprofloxacin and piperacillin/tazobactam are not good choices for empiric therapy of Alcaligenes faecalis infection. Conclusions: The most frequent Alcaligenes faecalis infection sites were in the urinary tract, skin and soft tissue, and lung. Alcaligenes faecalis showed markedly decreased sensitivity to commonly used antibiotics and, more recently, extensively drug-resistant Alcaligenes faecalis infections have emerged.

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“…A. faecalis is a gram-negative bacillus that is present in soil and contaminated water, and is a rare cause of postoperative endophthalmitis or keratitis. 10À12 In a case series of 5 patients with A. faecalis endophthalmitis, 12 visual acuity outcomes varied from 6/24 in 2 patients, to 6/ 190 to 6/380 in 2 patients, to no light perception in the fifth patient. The poor visual outcomes and eventual enucleation of our third case are consistent with the poor outcomes in A. faecalis endophthalmitis.…”

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confidence: 99%

Complications of ocular tattooing: a Canadian case series

Chan

Freund

Gjerde

et al. 2019

Canadian Journal of Ophthalmology

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Body modification is the practice of deliberate alterations to the human body, such as tattoos, piercings, and scarification, to achieve self-expression or control over one's body. 1 The "body modification movement" has seen an increasingly popular practice of tattooing the eye. Typically, ink is injected into the subconjunctival space with pigmentation of the episclera and/or sclera. This has resulted in complications ranging from conjunctival edema and nodules 2 to more serious complications such as orbital cellulitis, 3 scleritis, panuveitis, 4 and secondary glaucoma. 5 Here we present 3 Canadian cases of ocular tattooing resulting in complications ranging from scleral laceration and serious corneal and anterior segment injury to endophthalmitis requiring enucleation. These cases reinforce the need for specific legislature surrounding ocular tattooing in Canadian provinces. A 39-year-old female (case 1) presented with severe left eye pain after allowing her partner (case 2) to attempt scleral tattooing at home using tattoo ink ordered from an online source (StarBrite, Somers, Conn). They did not have access to topical anaesthetics and used a 31-gauge insulin needle to perform the tattoo. She was otherwise healthy and did not take any ocular or systemic medications. On examination, her visual acuity was 6/6 in both eyes, with intraocular pressures of 18 mm Hg in the right eye and 13 mm Hg in the left eye. Slit-lamp examination revealed a shallow left anterior chamber and a Seidel-positive puncture wound temporally, where there was blue tattoo dye staining. Dilated fundoscopic examination findings were within normal limits bilaterally without any obvious evidence of intraocular penetration of tattoo dye in the left eye. To allow a complete examination and closure of the apparent wound, she was taken to the operating room. Despite an extensive exploration, a leaking scleral puncture wound was not found. The conjunctiva was closed in a watertight closure technique with 9-0 Vicryl. Postoperatively, her anterior chamber deepened, and her temporal sclera was Seidel-negative. An epithelial defect required a temporary bandage contact lens. She recovered well in the next week but was subsequently lost to follow-up. A 41-year-old male (case 2) presented with vision loss in his right eye after inadvertent globe penetration and intraocular injection of blue tattoo ink (StarBrite) during selfadministration of the dye. After watching a YouTube video, the patient attempted to tattoo his lateral right sclera. Increased force had been applied to the plunger to clear an obstruction, which resulted in the needle penetrating his eye. He injected approximately 1 mL of blue tattoo ink into his eye. On examination, his uncorrected visual acuity was light perception in the right eye and 6/6 in the left eye. Intraocular pressures were 44 and 12 mm Hg in the right and left eyes, respectively. Slit-lamp examination of the right eye revealed blue tattoo dye filling the anterior chamber (Fig. 1A) and evidence of inferotemporal needle penet...

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Endophthalmitis Caused by Alcaligenes Faecalis: A Case Series

Cited by 14 publications

References 3 publications

Bloodstream infection with pandrug-resistant Alcaligenes faecalis treated with double-dose of tigecycline

Bloodstream infection with pandrug-resistant Alcaligenes faecalis treated with double-dose of tigecycline

Extensively drug-resistant Alcaligenes faecalis infection

Complications of ocular tattooing: a Canadian case series

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