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Clinical Evaluation
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
A positive tuberculin test is not indicative of an active TB infection. The test is positive in patients who had BCG vaccination and negative in debilitated and anergic patients. Acid-fast bacillus (AFB) smear and culture are diagnostic methods to identify the organism. Cultures grow organisms in 1 to 12 weeks on a Lowenstein–Jensen medium.
Central Venous Catheter Infection in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Emilio Bouza, Almudena Burillo
Risk factors for infection with a gram-negative bacillus include the existence of an outbreak (of CR-BSI), spinal cord injury, femoral location of the catheter, hematological malignancy with neutropenia, previous colonization of the gastrointestinal tract with multi-resistant gram-negative bacilli, prolonged CCU stay, postoperative status, and diabetes mellitus [4].
Ventilator-Associated Pneumonia
Published in Stephen M. Cohn, Peter Rhee, 50 Landmark Papers, 2019
Multiple studies have investigated the optimal duration of antibiotic therapy. Chastre and colleagues found that an 8-day antibiotic regimen was non-inferior to a 15-day course (Chastre et al., 2003). The survival rates were similar between the two groups. In addition, there was no difference between them in the recurrence of pulmonary infection, relapse, or superinfections. The recent guidelines published by the Infectious Diseases Society of America and the American Thoracic Society recommended that a 7-day course of antibiotics is sufficient (Kalil et al., 2016). Therapy may be prolonged on an individual basis for patients developing non-fermenting Gram-negative bacillus infections (Chastre et al., 2003), or for patients who are severely ill or immunocompromised. A low or decreasing procalcitonin level in patients who have demonstrated good clinical response may support discontinuation of therapy. Failure to respond by 72 hours should prompt a thorough search for complications of VAP (such as abscess or empyema) and a comprehensive reassessment of the differential diagnosis (different pathogens, different septic foci, or non-infectious issues).
Infantile orbital abscess: clinical presentation, microbiological profile, and management outcomes
Published in Orbit, 2022
Andrea Tongbram, Shahid Alam, Sumita Agarkar, Bipasha Mukherjee
The aspirate after abscess drainage in patients #8 and #9 was subjected to both microbiology and histopathology examination. In patient #8, the culture results initially reported Bacillus cereus as the causative organism, but histopathological examination suggested fungus as the organism. Repeat culture showed Entomophthorales fungi as the causative organism and Bacillus was reported as a contaminant. Bacillus cereus has been reported to be a frequent contaminant, and a single positive culture should not be considered diagnostic.23 Fungal infections of the orbit usually arise from the paranasal sinuses. Yet, our patient did not have any sinus involvement. Entomophthorales, primarily a pathogen of sinuses and the respiratory tract, spreads locally in the subcutaneous plane. Patients typically present with facial swelling.23 Orbital infection is described as an “atypical form” of this disease and is associated with poor prognosis. Diagnosis can be challenging as KOH stains are usually negative and cultures may show positivity only in 50% of cases.24–26 Diagnosis is based on a combination of microbiological as well as histopathological evidence of fungal infection. Histopathology in these cases shows granulomatous inflammation with the typical “Splendore Hoeppli phenomenon.”27 All these features were seen in our patient. To the best of our knowledge, this is only the second case of Rhinoentomophthoramycosis reported in an infant. In the previous case report, the lesion resolved completely with oral potassium iodide.28
Adjunctive probiotics after periodontal debridement versus placebo: a systematic review and meta-analysis
Published in Acta Odontologica Scandinavica, 2022
Ethan Ng, John Rong Hao Tay, Seyed Ehsan Saffari, Lum Peng Lim, Kong Mun Chung, Marianne Meng Ann Ong
Probiotics may also act via signaling interference. Quorum sensing is the process by which bacteria produce and detect signal molecules to coordinate their behavior [21]. An example is the accessory gene regulator (agr) quorum sensing system used by Staphylococcus aureus which is important for up-regulation of virulence factors during infection and the development of acute disease [22]. An in vitro study demonstrated that signaling molecules produced by Lactobacillus reuteri have the potential to interfere with this quorum-sensing system within S. aureus, resulting in decreased production of virulence factors [23]. More recently, a human study demonstrated that probiotic Bacillus was able to block this signaling system, thus reducing the infectivity of S. aureus infections [24]. While these actions have not yet been described in the dental literature, quorum-sensing regulation appears to be a valid mechanism for further research.
Microbial Contamination of Rigid Gas Permeable (RGP) Trial Lenses and Lens Cases in China
Published in Current Eye Research, 2020
Xiaojun Hu, Guangsen Shi, Hong Liu, Xiaofei Jiang, Jiaojiao Deng, Chengcheng Zhu, Ying Yuan, Bilian Ke
Isolated contaminants in our study included common ocular pathogenic microorganisms, such as Serratia spp., Staphylococcus aureus, Streptococcus spp. and Pseudomonas spp., and normal flora of the ocular surface, oral cavity, skin, gastrointestinal tract and environment. In terms of the profiles of microorganisms recovered, gram-negative bacteria were the major components of contaminants. The most frequently recovered bacterium from all three sites was Serratia marcescens, one of the microorganisms most frequently reported in contact lens-associated corneal infiltrates or keratitis,21–24 which are of great concern. S. marcescens is frequently found in damp, wet environments and on the skin, which might be introduced into cases or lenses when taking out or depositing RGP contact lenses. It was also isolated in previous studies on contact lens contamination.18,19,25–28 The predominant gram-positive bacteria isolated were Bacillus spp., which were mostly found in lens cases. Bacillus spp. are also considered opportunistic pathogens of keratitis.29 We isolated potential pathogens of keratitis from our sampled lenses and cases, which represents a potential threat to the safe use of RGP trial contact lenses.