scholarly journals A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiologya

2018 ◽  
Vol 67 (6) ◽  
pp. e1-e94 ◽  
Author(s):  
J Michael Miller ◽  
Matthew J Binnicker ◽  
Sheldon Campbell ◽  
Karen C Carroll ◽  
Kimberle C Chapin ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Infectious Diseases ◽  
Clinical Medicine ◽  
Respiratory Infections ◽  
Disease Diagnosis ◽  
Etiologic Agent ◽  
Healthcare Team ◽  
Soft Tissue Infections ◽  
Microbiology Laboratory ◽  
Tract Infections

Abstract The critical nature of the microbiology laboratory in infectious disease diagnosis calls for a close, positive working relationship between the physician/advanced practice provider and the microbiologists who provide enormous value to the healthcare team. This document, developed by experts in laboratory and adult and pediatric clinical medicine, provides information on which tests are valuable and in which contexts, and on tests that add little or no value for diagnostic decisions. This document presents a system-based approach rather than specimen-based approach, and includes bloodstream and cardiovascular system infections, central nervous system infections, ocular infections, soft tissue infections of the head and neck, upper and lower respiratory infections, infections of the gastrointestinal tract, intra-abdominal infections, bone and joint infections, urinary tract infections, genital infections, and other skin and soft tissue infections; or into etiologic agent groups, including arthropod-borne infections, viral syndromes, and blood and tissue parasite infections. Each section contains introductory concepts, a summary of key points, and detailed tables that list suspected agents; the most reliable tests to order; the samples (and volumes) to collect in order of preference; specimen transport devices, procedures, times, and temperatures; and detailed notes on specific issues regarding the test methods, such as when tests are likely to require a specialized laboratory or have prolonged turnaround times. In addition, the pediatric needs of specimen management are also emphasized. There is intentional redundancy among the tables and sections, as many agents and assay choices overlap. The document is intended to serve as a guidance for physicians in choosing tests that will aid them to quickly and accurately diagnose infectious diseases in their patients.

A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiologya

2018 ◽  
Vol 67 (6) ◽  
pp. 813-816 ◽  
Author(s):  
J Michael Miller ◽  
Matthew J Binnicker ◽  
Sheldon Campbell ◽  
Karen C Carroll ◽  
Kimberle C Chapin ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Infectious Diseases ◽  
Clinical Medicine ◽  
Respiratory Infections ◽  
Disease Diagnosis ◽  
Etiologic Agent ◽  
Healthcare Team ◽  
Soft Tissue Infections ◽  
Microbiology Laboratory ◽  
Tract Infections

Abstract The critical nature of the microbiology laboratory in infectious disease diagnosis calls for a close, positive working relationship between the physician/advanced practice provider and the microbiologists who provide enormous value to the healthcare team. This document, developed by experts in laboratory and adult and pediatric clinical medicine, provides information on which tests are valuable and in which contexts, and on tests that add little or no value for diagnostic decisions. This document presents a system-based approach rather than specimen-based approach, and includes bloodstream and cardiovascular system infections, central nervous system infections, ocular infections, soft tissue infections of the head and neck, upper and lower respiratory infections, infections of the gastrointestinal tract, intra-abdominal infections, bone and joint infections, urinary tract infections, genital infections, and other skin and soft tissue infections; or into etiologic agent groups, including arthropod-borne infections, viral syndromes, and blood and tissue parasite infections. Each section contains introductory concepts, a summary of key points, and detailed tables that list suspected agents; the most reliable tests to order; the samples (and volumes) to collect in order of preference; specimen transport devices, procedures, times, and temperatures; and detailed notes on specific issues regarding the test methods, such as when tests are likely to require a specialized laboratory or have prolonged turnaround times. In addition, the pediatric needs of specimen management are also emphasized. There is intentional redundancy among the tables and sections, as many agents and assay choices overlap. The document is intended to serve as a guidance for physicians in choosing tests that will aid them to quickly and accurately diagnose infectious diseases in their patients.

Clinical Syndromes in Infectious Diseases

2012 ◽  
Author(s):  
Robert Orenstein
Keyword(s):  
Urinary Tract ◽  
Infective Endocarditis ◽  
Soft Tissue ◽  
Infectious Diseases ◽  
Sexually Transmitted Infections ◽  
Soft Tissue Infections ◽  
Gastrointestinal Infections ◽  
Sexually Transmitted ◽  
Clinical Syndromes ◽  
Tract Infections

This chapter approaches the field of infectious diseases from 3 perspectives. This second part covers clinical syndromes associated with various infections, such as infective endocarditis, meningitis, sexually transmitted infections, urinary tract infections, gastrointestinal infections, and soft-tissue infections. Symptoms, diagnosis, and treatment of these conditions are reviewed.

scholarly journals 2-es típusú diabetesesek és nem cukorbetegek területen szerzett, belgyógyászati osztályos felvételt igénylő bakteriális infekcióinak klinikai összehasonlítása

2019 ◽  
Vol 160 (41) ◽  
pp. 1623-1632
Author(s):  
László József Barkai ◽  
Emese Sipter ◽  
Dorottya Csuka ◽  
Tímea Baló ◽  
Zsuzsa Nébenführer ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Bacterial Infections ◽  
Respiratory Infections ◽  
Mortality Rates ◽  
Medical Ward ◽  
Soft Tissue Infections ◽  
General Medical Ward ◽  
International Data ◽  
Tract Infections

Abstract: Introduction: Previous data showed bacterial infections among diabetic patients to be more serious and frequent, with higher mortality rates in comparison with non-diabetics. Recent investigations, however, are contradictory. Aim: The goal of our prospective, observational study was to compare patients hospitalized on a general medical ward due to community-acquired bacterial infections with type 2 diabetes mellitus (T2DM) to those of non-diabetics (K) by 1) infection localization, 2) spectrum of pathogens, 3) three-month mortality rates. Method: Patients were consecutively involved (T2DM: n = 205, K: n = 202). We characterized the infections, clinical parameters, mortalities of the two groups, and matched them to international data. Results: No difference regarding clinical details of the groups were found except for glycemic parameters and BMI. In the T2DM group the skin- and soft tissue- (37.1%), in the K patients respiratory infections (37.1%) were the most common, followed by urinary ones (31.2% and 31.7%, respectively). Skin- and soft tissue infection incidence among T2DM subjects were higher compared to international results (37.1% vs. 16%). Co-presence of Gram positive and Gram negative bacteria in the skin- and soft tissue infections (23/76 vs. 5/46, p = 0.0149), and polymicrobial origin in the urinary tract infections (34.0% vs. 15.1%, p = 0.0335) were found to be more frequent in T2DM than in K. No difference regarding mortality rates were detected. In T2DM the skin- and soft tissue while in the K group the respiratory infections had the most death counts. Conclusions: We found higher rates of skin- and soft tissue infections among T2DM patients hospitalized on a general medical ward compared to international data. In total we did not find difference regarding three-month mortality between the groups. Our results highlight the importance of primary prevention and shows its inadequacy concerning skin and soft tissue infections among type 2 diabetics in Hungary. Orv Hetil. 2019; 160(41): 1623–1632.

scholarly journals Comparing the quantity and quality of randomised placebo-controlled trials of antibiotics for acute respiratory, urinary, and skin and soft tissue infections: a scoping review

BJGP Open ◽  
2020 ◽  
Vol 4 (4) ◽  
pp. bjgpopen20X101082
Author(s):  
Mina Bakhit ◽  
Tammy Hoffmann ◽  
Miriam Santer ◽  
Matthew Ridd ◽  
Nick Francis ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Scoping Review ◽  
Respiratory Infections ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Soft Tissue Infections ◽  
High Quality ◽  
Gradual Improvement ◽  
Tract Infections

BackgroundThe management of acute respiratory infections (ARIs), urinary tract infections (UTIs), and skin and soft tissue infections (SSTIs) should be guided by high quality evidence.AimTo compare the quantity and quality of randomised placebo-controlled trials of antibiotics for ARIs, UTIs, and SSTIs.Design & settingA scoping review of the literature was performed using comprehensive search strategies.MethodPubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched for published studies from inception until 17 April 2019. Randomised controlled trials (RCTs) that compared participants in primary care or in the community who had uncomplicated acute ARI, UTI, or studies, and were randomised to antibiotic or placebo (or no active treatment), were eligible for inclusion. Two groups of researchers independently screened articles for inclusion, extracted data, and assessed the quality of included studies.ResultsA total of 108 eligible studies were identified: 80 on ARI, eight on UTI, and 20 on SSTI. The quality of studies varied with unclear risk of bias (RoB) prevalent in many domains. There was a gradual improvement in the quality of trials investigating ARIs over time, which could not be assessed in SSTI and UTI studies.ConclusionThis review highlights a sparsity of trials assessing the effectiveness of antibiotics in people with UTIs and SSTIs, compared to trials targeting ARIs. This gap in the evidence needs to be addressed by conducting further high quality trials on the effects of antibiotics in patients with UTI and SSTI.

STUDY ON THE BACTERIA THAT CAUSE HOSPITAL INFECTIONS AT HUE CENTRAL HOSPITAL IN 2012

2012 ◽  
pp. 100-108
Author(s):  
Dien Hai Truong ◽  
Dinh Binh Tran ◽  
Thi Nam Lien Nguyen ◽  
et al
Keyword(s):  
Soft Tissue ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Bloodstream Infections ◽  
Soft Tissue Infections ◽  
Hospital Infections ◽  
Central Hospital ◽  
Local Hospital ◽  
Tract Infections ◽  
Common Infections

Objective: To study the bacterial etiologies causing hospital infections at Hue Central Hospital to determine the type of bacteria causing major hospital infections, distribution by local hospital infections, treatment areas contributing to control hospital infections. Subjects and methods: The study described on 311 bacteria strains that isolated in 242 patients who sufer hospital infections with 261 samples from 5/2011 to 5/2012. Results, discussion and conclusions: Hospital infections were 66.9% in male and 33.1%) in female patients, with 261 specimens we isolated 311 bacterial that cause hospital infections. - Respiratory tract infections were the highest rate (37.2%), followed by wound infection (20.2%) and the skin and soft tissue infections (13.2%), bloodstream infections (12,8%). - Five kinds of common infections were: respiratory infections, surgical wound infections, skin and soft tissue infections, urinary tract infections, blood infections. - Sputum is mainly specimens that accounted 35.2%, followed by 34.9% pus specimens, remaining is all kinds of other specimens. - Hospital infections due to Gram-negative bacteria 83.9% that was 5.2 times higher than that of Gram-positive bacterial (16.1%). - The bacterial etiologies causing hospital infections in Hue Central Hospital have five major types: the highest is Acinetobacter baumannii (27.3%), followed by Klebsiella pneumoniae (23.8%), Escherichia coli (15.8%), Staphylococcus aureus (10.6%), Pseudomonas aeruginosa (7.1%). - There are 43 specimens that were isolated two or more types of bacteria (16.5%).

scholarly journals Comparative Genomics ofEscherichia coliIsolated from Skin and Soft Tissue and Other Extraintestinal Infections

mBio ◽  
2017 ◽  
Vol 8 (4) ◽  
Author(s):  
Amit Ranjan ◽  
Sabiha Shaik ◽  
Nishant Nandanwar ◽  
Arif Hussain ◽  
Sumeet K. Tiwari ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Comparative Genomics ◽  
Soft Tissue ◽  
Multidrug Resistant ◽  
Primary Concern ◽  
Beta Lactamase ◽  
Soft Tissue Infections ◽  
E Coli ◽  
Recent Emergence ◽  
Tract Infections

ABSTRACTEscherichia coli, an intestinal Gram-negative bacterium, has been shown to be associated with a variety of diseases in addition to intestinal infections, such as urinary tract infections (UTIs), meningitis in neonates, septicemia, skin and soft tissue infections (SSTIs), and colisepticemia. Thus, for nonintestinal infections, it is categorized as extraintestinal pathogenicE. coli(ExPEC). It is also an opportunistic pathogen, causing cross infections, notably as an agent of zoonotic diseases. However, comparative genomic data providing functional and genetic coordinates for ExPEC strains associated with these different types of infections have not proven conclusive. In the study reported here, ExPECE. coliisolated from SSTIs was characterized, including virulence and drug resistance profiles, and compared with isolates from patients suffering either pyelonephritis or septicemia. Results revealed that the majority of the isolates belonged to two pathogenic phylogroups, B2 and D. Approximately 67% of the isolates were multidrug resistant (MDR), with 85% producing extended-spectrum beta-lactamase (ESBL) and 6% producing metallo-beta-lactamase (MBL). TheblaCTX-M-15genotype was observed in at least 70% of theE. coliisolates in each category, conferring resistance to an extended range of beta-lactam antibiotics. Whole-genome sequencing and comparative genomics of the ExPEC isolates revealed that two of the four isolates from SSTIs, NA633 and NA643, belong to pandemic sequence type ST131, whereas functional characteristics of three of the ExPEC pathotypes revealed that they had equal capabilities to form biofilm and were resistant to human serum. Overall, the isolates from a variety of ExPEC infections demonstrated similar resistomes and virulomes and did not display any disease-specific functional or genetic coordinates.IMPORTANCEInfections caused by extraintestinal pathogenicE. coli(ExPEC) are of global concern as they result in significant costs to health care facilities management. The recent emergence of a multidrug-resistant pandemic clone,Escherichia coliST131, is of primary concern as a global threat. In developing countries, such as India, skin and soft tissue infections (SSTIs) associated withE. coliare marginally addressed. In this study, we employed both genomic analysis and phenotypic assays to determine relationships, if any, among the ExPEC pathotypes. Similarity between antibiotic resistance and virulence profiles was observed, ST131 isolates from SSTIs were reported, and genomic similarities among strains isolated from different disease conditions were detected. This study provides functional molecular infection epidemiology insight into SSTI-associatedE. colicompared with ExPEC pathotypes.

scholarly journals 289. Impact of Clinician Specialty on the Use of Oral Antibiotic Therapy for Definitive Treatment of Uncomplicated Bloodstream Infections

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S144-S145
Author(s):  
Jasmine R Marcelin ◽  
Mackenzie R Keintz ◽  
Jihyun Ma ◽  
Erica J Stohs ◽  
Bryan Alexander ◽  
...  
Keyword(s):  
Social Media ◽  
Soft Tissue ◽  
Infectious Diseases ◽  
Antibiotic Therapy ◽  
Bloodstream Infections ◽  
Definitive Treatment ◽  
Oral Antibiotic ◽  
Soft Tissue Infections ◽  
Gram Positive ◽  
Oral Antibiotic Therapy

Abstract Background No established guidelines exist regarding the role of oral antibiotic therapy (OAT) to treat uncomplicated bloodstream infections (uBSIs) and practices may vary depending on clinician specialty and experience. Methods An IRB-exempt web-based survey was emailed to Nebraska Medicine clinicians caring for hospitalized patients, and widely disseminated using social media. The survey was open access and once disseminated on social media, it was impossible to ascertain the total number of individuals who received the survey. Chi-squared analysis for categorical data was conducted to evaluate the association between responses and demographic groups. Results Of 275 survey responses, 51% were via social media, and 94% originated in the United States. Two-thirds of respondents were physicians, 16% pharmacists, and infectious diseases clinicians (IDC) represented 71% of respondents. The syndromes where most were comfortable using OAT routinely for uBSI were urinary tract infection (92%), pneumonia (82%), pyelonephritis (82%), and skin/soft tissue infections (69%). IDC were more comfortable routinely using OAT to treat uBSIs associated with vertebral osteomyelitis and prosthetic joint infections than non-infectious diseases clinicians (NIDC), but NIDC were more likely to report comfort with routine use of OAT to treat uBSIs associated with meningitis and skin/soft tissue infections. IDC were more likely to report comfort with routine use of OAT for uBSIs due to Enterobacteriaceae and gram-positive anaerobes, while NIDC were more likely to be comfortable with routinely using OAT to treat uBSIs associated with S. aureus, coagulase-negative staphylococci and gram-positive bacilli. In one clinical vignette of S. aureus uBSI due to debrided abscess, 11% of IDC would be comfortable using OAT vs 28% of NIDC; IDC were more likely to report routinely repeating blood cultures (99% vs 83%, p< 0.05). Figure 1: Clinician comfort using oral antibiotic therapy to treat uncomplicated bacteremia due to specific syndromes Figure 2: Clinician comfort using oral antibiotic therapy to treat uncomplicated bacteremia due to specific organisms Conclusion Considerable variation in comfort using OAT for uBSIs among IDC vs NIDC exists, highlighting opportunities for IDC to continue to demonstrate their value in clinical practice. Understanding the reasons for variability may be helpful in creating best practice guidelines to standardize decision making. Disclosures All Authors: No reported disclosures

Dirithromycin: A New Macrolide

1996 ◽  
Vol 30 (10) ◽  
pp. 1141-1149 ◽  
Author(s):  
Susan M. Wintermeyer ◽  
Susan M. Abdel-Rahman ◽  
Milap C. Nahata
Keyword(s):  
Adverse Effect ◽  
Soft Tissue ◽  
Drug Interactions ◽  
Clinical Efficacy ◽  
Special Role ◽  
Soft Tissue Infections ◽  
Tissue Concentrations ◽  
Double Blind ◽  
Once Daily ◽  
Tract Infections

OBJECTIVE: To review the clinical microbiology and therapeutic use of dirithromycin, emphasizing comparative data between dirithromycin and the standard macrolide erythromycin, as well as clarithromycin and azithromycin. DATA SOURCES: A MEDLINE search of English-language literature during the years 1966–1996, and an extensive review of journals were conducted to prepare this article. DATA EXTRACTION: The data on pharmacokinetics, adverse effects, and drug interactions were obtained from open and controlled studies. Controlled single- or double-blind studies were evaluated to assess the efficacy of dirithromycin in the treatment of various upper and lower respiratory tract infections, as well as skin and soft tissue infections. DATA SYNTHESIS: The spectrum of activity of dirithromycin is similar to that of erythromycin, clarithromycin, or azithromycin, with some notable exceptions. Dirithromycin was more active in vitro against Campylobacter jejuni and Borrelia burgdorferi than was erythromycin or clarithromycin, but in general demonstrated less activity than erythromycin, clarithromycin, or azithromycin against a majority of microorganisms. The pharmacokinetic profile of dirithromycin offers the advantages of once-daily dosing and high and prolonged tissue concentrations; dosing adjustments are not needed in the elderly or in patients with renal or mild hepatic impairment. Clinical efficacy and bacteriologic eradication rates with dirithromycin and erythromycin are comparable for the treatment of respiratory and skin and soft tissue infections due to susceptible pathogens. Dirithromycin appears to have adverse effect profiles similar to those of the other macrolides, with reported problems most often related to the gastrointestinal tract. Dirithromycin does not seem to cause clinically important interactions with drugs such as theophylline, oral contraceptives, cyclosporine, or terfenadine. CONCLUSIONS: Dirithromycin offers some attractive pharmacokinetic properties. The long elimination half-life of dirithromycin allows once-daily dosing and higher and more prolonged tissue concentrations than are achievable with erythromycin. The spectrum of activity, adverse effect profile, clinical efficacy, and bacteriologic eradication rate of dirithromycin may be similar to those of erythromycin. No significant drug interactions with dirithromycin have been reported. Based on available data, dirithromycin may not offer any unique clinical advantage over clarithromycin or azithromycin. Future clinical trials may reveal a special role for dirithromycin in patient care.

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