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A Fatal Bloodstream Infection by Staphylococcus pettenkoferi in an Intensive Care Unit Patient.

ABSTRACT: Coagulase negative staphylococci are increasingly recognized as leading pathogens in bacteremia, with incidence peaking in intensive care units. Interpretation of blood cultures that are positive for CoNS is often doubtful. We describe a fatal case of bacteremia by a newly recognized species of CoNS, Staphylococcus pettenkoferi, in an ICU patient.

SUBMITTER: Mammina C

PROVIDER: S-EPMC4010065 | biostudies-literature | 2011

REPOSITORIES: biostudies-literature

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A Fatal Bloodstream Infection by Staphylococcus pettenkoferi in an Intensive Care Unit Patient.

Mammina Caterina C Bonura Celestino C Verde Maria Stella MS Fasciana Teresa T Palma Daniela Maria DM

Case reports in critical care 20111020

Coagulase negative staphylococci are increasingly recognized as leading pathogens in bacteremia, with incidence peaking in intensive care units. Interpretation of blood cultures that are positive for CoNS is often doubtful. We describe a fatal case of bacteremia by a newly recognized species of CoNS, Staphylococcus pettenkoferi, in an ICU patient. ...[more]

PMID: 24826324

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intensive care unit

Project description:intensive care unit Raw sequence reads

| PRJNA561526 | ENA

Acquired bloodstream infection in the intensive care unit: incidence and attributable mortality.

Project description:IntroductionTo estimate the incidence of intensive care unit (ICU)-acquired bloodstream infection (BSI) and its independent effect on hospital mortality.MethodsWe retrospectively studied acquisition of BSI during admissions of >72 hours to adult ICUs from two university-affiliated hospitals. We obtained demographics, illness severity and co-morbidity data from ICU databases and microbiological diagnoses from departmental electronic records. We assessed survival at hospital discharge or at 90 days if still hospitalized.ResultsWe identified 6339 ICU admissions, 330 of which were complicated by BSI (5.2%). Median time to first positive culture was 7 days (IQR 5-12). Overall mortality was 23.5%, 41.2% in patients with BSI and 22.5% in those without. Patients who developed BSI had higher illness severity at ICU admission (median APACHE III score: 79 vs. 68, P < 0.001). After controlling for illness severity and baseline demographics by Cox proportional-hazard model, BSI remained independently associated with risk of death (hazard ratio from diagnosis 2.89; 95% confidence interval 2.41-3.46; P < 0.001). However, only 5% of the deaths in this model could be attributed to acquired-BSI, equivalent to an absolute decrease in survival of 1% of the total population. When analyzed by microbiological classification, Candida, Staphylococcus aureus and gram-negative bacilli infections were independently associated with increased risk of death. In a sub-group analysis intravascular catheter associated BSI remained associated with significant risk of death (hazard ratio 2.64; 95% confidence interval 1.44-4.83; P = 0.002).ConclusionsICU-acquired BSI is associated with greater in-hospital mortality, but complicates only 5% of ICU admissions and its absolute effect on population mortality is limited. These findings have implications for the design and interpretation of clinical trials.

| S-EPMC3219371 | biostudies-literature

Acinetobacter soli as a cause of bloodstream infection in a neonatal intensive care unit.

Project description:Acinetobacter soli is a new bacterial species described from forest soil. Five cases of bloodstream infection caused by A. soli clonal isolates are reported here for the first time. The patients were neonates admitted to an intensive care unit. This is a new neonatal pathogen with the potential to cause outbreaks.

| S-EPMC3122775 | biostudies-literature

Incidence, clinical characteristics and attributable mortality of persistent bloodstream infection in the neonatal intensive care unit.

Project description:An atypical pattern of neonatal sepsis, characterized by persistent positive blood culture despite effective antimicrobial therapy, has been correlated with adverse outcomes. However, previous studies focused only on coagulate-negative staphylococcus infection.All episodes of persistent bloodstream infection (BSI), defined as 3 or more consecutive positive blood cultures with the same bacterial species, at least two of them 48 hours apart, during a single sepsis episode, were enrolled over an 8-year period in a tertiary level neonatal intensive care unit. These cases were compared with all non-persistent BSI during the same period.We identified 81 episodes of persistent BSI (8.5% of all neonatal late-onset sepsis) in 74 infants, caused by gram-positive pathogens (n=38, 46.9%), gram-negative pathogens (n=21, 25.9%), fungus (n=20, 24.7%) and polymicrobial bacteremia (n=2, 2.5%). Persistent BSI does not differ from non-persistent BSI in most clinical characteristics and patient demographics, but tends to have a prolonged septic course, longer duration of feeding intolerance and more frequent requirement of blood transfusions. No difference was observed for death attributable to infection (9.8% vs. 6.5%), but neonates with persistent BSI had significantly higher rates of infectious complications (29.6% vs. 9.2%, P < 0.001), death from all causes (21.6% vs. 11.7%, P = 0.025), and duration of hospitalization among survivors [median (interquartile range): 80.0 (52.5-117.5) vs. 64.0 (40.0-96.0) days, P = 0.005] than those without persistent BSI.Although persistent BSI does not contribute directly to increased mortality, the associated morbidities, infectious complications and prolonged septic courses highlight the importance of aggressive treatment to optimize outcomes.

| S-EPMC4398497 | biostudies-other

Reductions in Methicillin-resistant Staphylococcus aureus, Clostridium difficile Infection and Intensive Care Unit-Acquired Bloodstream Infection Across the United Kingdom Following Implementation of a National Infection Control Campaign.

Project description:BackgroundMethicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile infections declined across the UK National Health Service in the decade that followed implementation of an infection control campaign. The national impact on intensive care unit (ICU)-acquired infections has not been documented.MethodsData on MRSA, C. difficile, vancomycin-resistant Enterococcus (VRE), and ICU-acquired bloodstream infections (UABSIs) for 1 189 142 patients from 2007 to 2016 were analyzed. Initial coverage was 139 ICUs increasing to 276 ICUs, representing 100% of general adult UK ICUs.ResultsICU MRSA and C. difficile acquisitions per 1000 patients decreased between 2007 and 2016 (MRSA acquisitions, 25.4 to 4.1; and C. difficile acquisitions, 11.1 to 3.5), whereas VRE acquisitions increased from 1.5 to 5.9. There were 13 114 UABSIs in 1.8% of patients who stayed longer than 48 hours on ICU. UABSIs fell from 7.3 (95% confidence interval [CI], 6.9-7.6) to 1.6 (95% CI, 1.5-1.7)/1000 bed days. Adjusting for patient factors, the incidence rate ratio was 0.21 (95% CI, 0.19-0.23, P < .001) from 2007 to 2016. The greatest reduction, comparing rates in 2007/08 and 2015/16, was for MRSA (97%), followed by P. aeruginosa (81%), S. aureus (79%) and Candida spp (72%), with lower reductions for the coliforms (E. coli 57% and Klebsiella 49%).ConclusionsLarge decreases in ICU-acquired infections occurred across the UK ICU network linked with the first few years of a national infection control campaign, but rates have since been static. Further reductions will likely require a new intervention framework.

| S-EPMC7286372 | biostudies-literature

Project description:BackgroundIn patients hospitalized in intensive care units (ICU), Candida infections are associated with increased morbidity, mortality and costs. However, previous studies reported confused risk factors for catheter-related Candida bloodstream infection (CRCBSI). The objective was to describe the risk factors, microbiology, management and outcomes of CRCBSI in the China-SCAN population.MethodsPatients with ≥1 Candida-positive peripheral blood culture were selected from the China-SCAN study. Peripheral and catheter blood samples were collected for Candida isolation. Patients with the same strain of Candida in peripheral and catheter blood samples were considered as being with CRCBSI, while patients with Candida-positive peripheral blood cultures only or different strains were considered as non-CRCBSI. Data were collected from the China-SCAN study.ResultsCRCBSI incidence in ICU was 0.03% (29/96,060), accounting for 9.86% of all candidemia observed in ICU (29/294). The proportion of CRCBSI due to Candida parapsilosis reached 33.3%, more than that of Candida albicans (28.6%). In univariate analyses, older age (P=0.028) and lower body weight (P=0.037) were associated with CRCBSI. Multivariate analysis showed that the sequential organ failure assessment (SOFA) score was independently associated with CRCBSI (odds ratio (OR)=1.142, 95% confidence interval = 1.049-1.244, P=0.002). Catheter removal and immune enhancement therapy were often used for CRCBSI treatment.ConclusionsIn China, CRCBSI was more likely to occur in old patients with low body weight. SOFA score was independently associated with CRCBSI. Candida parapsilosis accounted for a high proportion of CRCBSI, but the difference from non-CRCBSI was not significant.

| S-EPMC4234860 | biostudies-literature

intensive care unit shotgun raw sequences

Project description:intensive care unit shotgun raw sequences Metagenome

| PRJNA562118 | ENA

A Central Line Care Maintenance Bundle for the Prevention of Central Line-Associated Bloodstream Infection in Non-Intensive Care Unit Settings.

Project description:OBJECTIVE To evaluate a central line care maintenance bundle to reduce central line-associated bloodstream infection (CLABSI) in non-intensive care unit settings. DESIGN Before-after trial with 12-month follow-up period. SETTING A 1,250-bed teaching hospital. PARTICIPANTS Patients with central lines on 8 general medicine wards. Four wards received the intervention and 4 served as controls. INTERVENTION A multifaceted catheter care maintenance bundle consisting of educational programs for nurses, update of hospital policies, visual aids, a competency assessment, process monitoring, regular progress reports, and consolidation of supplies necessary for catheter maintenance. RESULTS Data were collected for 25,542 catheter-days including 43 CLABSI (rate, 1.68 per 1,000 catheter-days) and 4,012 catheter dressing observations. Following the intervention, a 2.5% monthly decrease in the CLABSI incidence density was observed on intervention floors but this was not statistically significant (95% CI, -5.3% to 0.4%). On control floors, there was a smaller but marginally significant decrease in CLABSI incidence during the study (change in monthly rate, -1.1%; 95% CI, -2.1% to -0.1%). Implementation of the bundle was associated with improvement in catheter dressing compliance on intervention wards (78.8% compliance before intervention vs 87.9% during intervention/follow-up; P<.001) but improvement was also observed on control wards (84.9% compliance before intervention vs 90.9% during intervention/follow-up; P=.001). CONCLUSIONS A multifaceted program to improve catheter care was associated with improvement in catheter dressing care but no change in CLABSI rates. Additional study is needed to determine strategies to prevent CLABSI in non-intensive care unit patients. Infect Control Hosp Epidemiol 2016;37:692-698.

| S-EPMC4874848 | biostudies-literature

Methicillin-sensitive Staphylococcus aureus CC398 in intensive care unit, France.

Project description:During testing for Staphylococcus aureus in an intensive care unit in France in 2011, we found that methicillin-sensitive S. aureus clonal complex 398 was the most frequent clone (29/125, 23.2%). It was isolated from patients (5/89, 5.6%), health care workers (2/63, 3.2%), and environmental sites (15/864, 1.7%). Results indicate emergence of this clone in a hospital setting.

| S-EPMC4178408 | biostudies-literature

Examination of 388 Staphylococcus aureus Isolates from Intensive Care Unit Patients.

Project description:We have examined the draft genomes of 388 methicillin-resistant Staphylococcus aureus isolates obtained from intensive care unit patients at three geographically distributed hospitals to determine genomic diversity associated with potential health care worker-associated transmission.

| S-EPMC6856284 | biostudies-literature

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