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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Kodamaea (Pichia) ohmeri is a yeast-like fungus that has recently emerged as an important etiologic agent of fungemia in immunocompromised patients. We report such a case in a premature neonate born at 29 weeks of gestation. Prior to developing fungemia, she had two episodes of bacterial sepsis on day 13 and day 32 due to Enterobacter cloacae and Staphylococcus epidermidis, respectively. Kodamaea ohmeri was repeatedly isolated from blood cultures and its identity was determined by phenotypic characteristics and sequencing of the ITS and D1/D2 regions of rDNA. The neonate was successfully treated with amphotericin B. The published cases of K. ohmeri fungemia reported in pediatric patients are reviewed highlighting its increasing importance as a bloodstream pathogen.
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PMID:Kodamaea ohmeri as an emerging pathogen: a case report and review of the literature. 2143 92

Rhodotorula is emerging as an important cause of nosocomial and opportunistic infections. We present two cases of Rhodotorula mucilaginosa fungemia diagnosed over a period of 3 months at our hospital. The first case was of a pre-term neonate in the neonatal ICU who presented with respiratory failure and sepsis. The second involved an adult female who had been injured in a road traffic accident requiring an operation for a hematoma and was later shifted to the medical ICU. For a new hospital like ours, finding two cases of Rhodotorula fungemia within a span of 3 months prompted us to describe them in this report. These cases emphasize the emerging importance of Rhodotorula mucilaginosa as a pathogen and the importance of identification and MIC testing for all fungal isolates recovered from the blood stream.
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PMID:Rhodotorula fungemia: two cases and a brief review. 2159 9

Malassezia furfur, an etiological agent of catheter-associated fungemia, requires long-chain fatty acids for in vitro growth. We examined the applicability of rDNA sequence analysis, autoaggregation testing in liquid culture, utilization of parenteral lipid emulsions, and phospholipase activity for discrimination of catheter-associated M. furfur strains. The rDNA sequence types of catheter-associated M. furfur strains were distinct from those of other isolates. All M. furfur isolates recovered from blood culture bottles and the tips of catheters from patients receiving fat emulsion therapy were type I-3. Only M. furfur isolate GIFU 01 from a blood culture bottle showed no autoaggregation in liquid culture. All strains of M. furfur examined grew well on Sabouraud's dextrose agar supplemented with Intralipid lipid emulsion as compared to individual Tweens (20, 40, 60, 80) and Cremophor EL. A high percentage of type I-3 M. furfur strains (80.0%) showed very high phospholipase activity compared to type I-1 and I-4 strains obtained from healthy skin of the same subjects or healthy control subjects (20.0% and 0.0%, respectively). The blood culture bottle isolate GIFU 01 showed very high lipolytic enzymes activity for Intralipid but no phospholipase activity. These results suggest that particular factors, such as non-autoaggregation and very high lipolytic enzyme activity for parenteral lipid emulsions, play important roles in the growth and pathogenicity of Malassezia-related sepsis.
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PMID:Genetic and biological features of catheter-associated Malassezia furfur from hospitalized adults. 2161 98

Aureobasidium pullulans is a causal agent of phaeohyphomycosis, occasionally found in men and animals. As an agent of different opportunistic fungal processes, it may cause fungemia, systemic infections and abscesses in different viscera. This paper aims to report a case of a patient with infection of the lymphatic system by A. pullulans. A 23-year-old patient being treated for erythema nodosum leprosum presented a 60-day complaint of daily fever, hoarseness, odynophagia and weight loss. Laboratory tests showed pancytopenia with severe neutropenia, cervical adenomegaly and solid contrast uptake lesion in the oropharyngeal region. Due to neutropenia and sepsis the patient was initially treated with cefepime and vancomycin, but there was no clinical improvement. Lymph node puncture-aspiration showed yeast-form fungus identified as A. pullulans by sequencing ITS region. The patient was treated with amphotericin B deoxycholate, leading to complete recovery of bone marrow function and regression of adenomegaly and the oropharyngeal lesion.
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PMID:Infection of the lymphatic system by Aureobasidium pullulans in a patient with erythema nodosum leprosum. 2167 Sep 33

The yeast Kodamaea (Pichia) ohmeri is a rare human pathogen with infrequent report of neonatal infection. Native valve endocarditis by Kodamaea ohmeri is extremely rare. The current case report describes a case of fatal nosocomial native valve endocarditis without any structural heart defects in a 40dayold baby. The patient was referred to our institute after having ICU stay of 18 days in another hospital for necrotizing enterocolitis and was found to have obstructive tricuspid valve mass and fungemia with Kodamaea ohmeri. In spite of the treatment, patient developed sepsis with disseminated intravascular coagulation and could not be revived.
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PMID:Kodamaea ohmeri tricuspid valve endocarditis with right ventricular inflow obstruction in a neonate with structurally normal heart. 2167 14

Procalcitonin (PCT) levels can distinguish between infectious and non-infectious systemic inflammatory response. However, there are some differences between Gram-negative (G-), Gram-positive (G+), and fungal bloodstream infections, particularly in different cytokine profiles, severity and mortality. The aim of current study was to examine whether PCT levels can serve as a distinguishing mark between G+, G-, and fungal sepsis as well. One hundred and sixty-six septic patients with positive blood cultures were examined on C-reactive protein (CRP) and PCT on the same date of blood culture evaluation. The median (interquartile range, IQR) of CRP and PCT in G+, G-, and fungal cohorts and comparison of measured values between groups were made using the Kruskal-Wallis test with subsequent Bonferroni's corrections, with p < 0.05. In 83/166 (50 %) of blood cultures, G+ microbes, 78/166 (47 %) G- rods, and 5/166 (3 %) fungi were detected. PCT concentrations (ng/ml) were significantly higher in G- compared to other cohorts: 8.90 (1.88; 32.60) in G-, 0.73 (0.22; 3.40) in G+, and 0.58 (0.35; 0.73) in fungi (p < 0.00001). CRP concentrations did not differ significantly in groups. Significantly higher PCT levels could differentiate G- sepsis from G+ and fungemia. In contrast to CRP, PCT is a good discriminative biomarker in different bloodstream infections.
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PMID:Significantly higher procalcitonin levels could differentiate Gram-negative sepsis from Gram-positive and fungal sepsis. 2264 64

Lamellar Ichthyosis is a rare condition requiring thickened collodion-like skin for clinical diagnosis. These infants have abnormal epidermal barrier, which leads to serious complications. It may present with extensive skin lesions and should be considered a diagnostic possibility in sick neonates. Recent studies have identified a condition characterized by deficiency of the interleukin-1 receptor antagonist (DIRA) resembling Ichthyosis. We report dizygotic twins that presented lamellar ichthyosis. Twin #1 had a neonatal period complicated with sepsis, fungemia and urinary tract infection. Twin #2 had sepsis, urinary tract infection and conjunctivitis. We tested the parents and one patient for DIRA. Tests were negative. To our knowledge, this is the first case of dizygotic twins that presented with lamellar ichthyosis in Puerto Rico. Physicians should include DIRA in the differential diagnosis of skin lesions in newborns.
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PMID:First case of dizygotic twins with lamellar ichthyosis in Puerto Rico. 2278 77

Direct demonstration of bacterial and/or fungal nucleic acids in the clinical samples of patients with blood stream infections is crucial in terms of rapid diagnosis, early and accurate therapy and patient management. This study was aimed to determine the presence of bacteria and fungi by polymerase chain reaction (PCR) in the clinical samples of experimental sepsis induced animals, to compare the results with culture and to evaluate the efficiency of PCR in the discrimination of bacteremia and fungemia. A total of 12 rabbits experimentally infected with standard strains of Staphylococcus aureus, Escherichia coli, Aspergillus fumigatus and Candida albicans to generate bacteremia (n= 4), fungemia (n= 4) and polymicrobial blood stream infection (n= 4), were included in the study. A total of 63 specimens of which 27 were blood and 36 were tissue (12 spleen, 12 liver, 12 kidney) samples were collected at 24, 48, 72 and 96th hours of infection. Uninfected healthy rabbits (n= 4), colony suspensions of standard bacterial and fungal strains (n= 15) and human blood samples contaminated with standard bacterial and fungal strains (n= 10) were used as controls. Microbial DNAs were searched by using real-time PCR in all the samples, and quantitative cultures were performed simultaneously. Gram-positive and gram-negative PCR protocols were performed for the samples of bacteremic animals, whereas panfungal PCR, Aspergillus and Candida PCR protocols were performed for the samples of animals with fungemia. All of those PCR protocols were applied separately for the samples of polymicrobial blood stream infection cases. Culture positivity was detected in 8 (29.6%) of the blood samples and bacterial and/or fungal DNAs were demonstrated in 20 (74%) of the blood samples by PCR. Microbial DNAs were also detected in 32 (89%) of 36 tissue samples (11 spleen, 11 liver, 10 kidney). Sensitivity rates of culture method to detect bacteremia and fungemia were 30% and 21.7%, respectively, whereas those rates were 69.2% and 69.5% for PCR, respectively. All PCR protocols gave positive results 16.5 hours before the blood cultures. Amplification of DNA from colony suspensions yielded positive results for all of the samples with a lower detection limit ranged between 30-50 cfu/ml. Detection limit of all PCR applications was 50 cfu/ml for simulated blood samples. It was concluded that the adaptation of the tested PCR method to the clinical samples obtained from patients might help to the early diagnosis of blood stream infections. However, further clinical studies are necessary to support the results of this study.
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PMID:[Accuracy of PCR for the detection of bacterial and fungal DNA in the blood and tissue samples of experimentally infected rabbits]. 2318 78

Candida krusei has been recognised as a potentially multidrug resistant fungal pathogen due to its intrinsic fluconazole resistance and reports of decreased susceptibility to amphotericin B. Moreover, the medical literature provides only four articles that report on four cases of fungemia caused by C. krusei in newborns. The objective of this study was to report on the clinical and epidemiological characteristics of three cases of fungal sepsis in the neonates caused by C. krusei.
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PMID:Neonatal fungal sepsis by Candida krusei: A report of three cases and a literature review. 2437 29

Bacteremia and fungemia account for a substantial proportion of all cases of severe sepsis. Antibiotic resistance is a contributing factor in many hospital-acquired infection deaths. Traditional phenotypic methods for the identification of bacteria and yeasts from positive blood cultures and determining antimicrobial susceptibility require 48-72 h, delaying optimal therapy and negatively impacting patient outcomes. Molecular methods, including nonamplified DNA probe panels and peptide nucleic acid probes, and nucleic acid amplification methods such as PCR, proteomic methods (matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry) and direct biochemical tests provide more rapid identification of bacteria and fungi, and in some cases antimicrobial resistance markers, from positive blood cultures, as well as directly from whole blood. These methods vary in the breadth of organisms that they detect, and equally important, their ease of use. This article examines the principles, performance and practicality of the various rapid, nonculture techniques for the detection of bacteremia and fungemia.
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PMID:Nonculture techniques for the detection of bacteremia and fungemia. 2481 Mar 52


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