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DRCOG MCQs for Circuit B Questions
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Asymptomatic bacteriuria in pregnancy may be associated with:Escherichia coli infection.> 100,000 bacteria ml-1 urine.30% risk of acute pyelonephritis in pregnancy.Preterm labour.Proteus mirabilis infection.
Urinary Tract Infections (UTI)
Published in Manit Arya, Taimur T. Shah, Jas S. Kalsi, Herman S. Fernando, Iqbal S. Shergill, Asif Muneer, Hashim U. Ahmed, MCQs for the FRCS(Urol) and Postgraduate Urology Examinations, 2020
Nish Bedi, Ali Omar, Jas S. Kalsi
Urea-splitting bacteria are Proteus, Klebsiella, Pseudomonas, Providencia, Serratia species, Staphylococcus aureus and Ureaplasma urealyticum. Proteus mirabilis accounts for more than half of all urease positive urinary infections [6]. Urea-splitting bacteria change the urine pH (>7.2) and allow easier precipitation of phosphate with several compounds, mainly ammonium and magnesium [7]. The result is struvite stones.
Interpreting Routine Microbiology Results for Patient Care
Published in Nancy Khardori, Bench to Bedside, 2018
A 72-year-old-woman is sent in from dialysis after she developed hypotension, chills and fever during her dialysis session. Due to the presence of her dialysis catheter, blood cultures are sent and she is started on Vancomycin to cover gram positive skin flora. Twelve hours later, blood culture gram stain shows a gram negative rod and Piperacillin-tazobactam is added to her regimen. Forty-eight hours later the bacteria is identified as Proteus mirabilis susceptible to multiple antibiotics. The positive gram stain allowed the clinician to add an appropriate antibiotic 48 hours before culture results were available.
An overview of cilastatin + imipenem + relebactam as a therapeutic option for hospital-acquired and ventilator-associated bacterial pneumonia: evidence to date
Published in Expert Opinion on Pharmacotherapy, 2021
Júlia Sellarès-Nadal, Simeón Eremiev, Joaquin Burgos, Benito Almirante
Specifically, isolates of Klebsiella pneumoniae, E. coli, Enterobacter spp. and Citrobacter spp. exhibit susceptibilities over 95% with imipenem-relebactam. In general, Proteus mirabilis and S. marcescens demonstrate lower susceptibility: 87% and 66% of isolates, respectively. CRE presents variable susceptibility rates. Based on different studies, IMI/REL exhibits activity against 100% of isolates of KPC-producing K. pneumoniae [31,39,40]. IMI/REL improves the activity of imipenem for Ambler class A ESBL-producing (2- to 16-fold MIC reduction) and KPC carbapenemase- producing (32- to 128-fold MIC reduction) Enterobacterales [38]. In contrast, the combination does not present activity against the Ambler class D carbapenemase OXA-48 [39–41] or against class B metallo-β-lactamases, such as VIM, IMP, and NDM [42,43].
In vitro activity of hyperthermia on swarming motility and antimicrobial susceptibility profiles of Proteus mirabilis isolates
Published in International Journal of Hyperthermia, 2021
Deniz Gazel, Hadiye Demirbakan, Mehmet Erinmez
Thirty-one Proteus mirabilis clinical isolates recovered from patients in a university hospital (Gaziantep, Turkey) between January 2019 and December 2020 were included in the study. Ethical approval and transfer documents have been obtained from the Gaziantep University Clinical Researches Ethical Committee with date and number: 2021/05. The isolates were obtained from cultures of urine (n = 13), wound (n = 7), tracheal aspirate (n = 6), blood (n = 2), cerebrospinal fluid (n = 1), catheter (n = 1) and sputum (n = 1) samples during routine microbiological examinations in the clinical microbiology laboratory of Sanko University Hospital. The study isolates were selected among imipenem non-susceptible strains in order to see the sensitization effect of hyperthermia on the antimicrobial resistance profiles of multi-drug resistant bacteria. Only one isolate per patient was included to avoid repeat samples. All bacterial isolates were stored at −80 °C until further testing. Deep frozen isolates were thawed and sub-cultured twice prior to testing. The identification and routine susceptibility testing of the isolates was performed using the Vitek2 automated bacterial identification and antibiogram system (bioMérieux, France) before the study [22].
Ecthyma gangrenosum associated with Proteus bacteremia
Published in Baylor University Medical Center Proceedings, 2018
Andrew Hawrylak, Susan Seago, Edana Stroberg, Richmond Hunt, Megan Greene Newman
The patient was admitted and antibiotic therapy was initiated with meropenem and linezolid. Initial urine and blood cultures grew Proteus mirabilis. Dermatology was consulted for further evaluation of her necrotic skin ulcers and a punch biopsy illustrated acute inflammation and necrosis with Gram-negative bacterial organisms (Figure 2). Body tissue cultures from the ulcer sites grew both Proteus mirabilis and Enterococcus faecalis, and pathology was consistent with a diagnosis of ecthyma gangrenosum. A transesophageal echocardiogram illustrated no focal vegetation. Two weeks of intravenous meropenem were given as definitive therapy. Urology was consulted for possible percutaneous nephrolithotomy; however, she was again deemed a poor operative candidate. Sepsis recurred without additional ulcerations, and the patient was ultimately transitioned to palliative care.