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Catheter-related bloodstream infection by Tsukamurella inchonensis in an immunocompromised patient.

ABSTRACT: We report a case of catheter-related bloodstream infection by Tsukamurella inchonensis, identified using 16S rRNA gene sequencing, in a patient with myelofibrosis who underwent a bone marrow transplant. Tsukamurella species infections are rare. To our knowledge, this is the first case of T. inchonensis bloodstream infection in an immunocompromised patient.

SUBMITTER: Takebe I

PROVIDER: S-EPMC4042780 | biostudies-literature | 2014 Jun

REPOSITORIES: biostudies-literature

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Catheter-related bloodstream infection by Tsukamurella inchonensis in an immunocompromised patient.

Takebe Isao I Sawabe Etsuko E Ohkusu Kiyofumi K Tojo Naoko N Tohda Shuji S

Journal of clinical microbiology 20140326 6

We report a case of catheter-related bloodstream infection by Tsukamurella inchonensis, identified using 16S rRNA gene sequencing, in a patient with myelofibrosis who underwent a bone marrow transplant. Tsukamurella species infections are rare. To our knowledge, this is the first case of T. inchonensis bloodstream infection in an immunocompromised patient. ...[more]

PMID: 24671800

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Project description:BackgroundTsukamurella spp. are obligate aerobic, gram-positive, non-motile, and slightly acid-fast bacilli belonging to the Actinomycetes family. They share many characteristics with Nocardia, Rhodococcus, Gordonia, and the rapidly growing Mycobacterium species. Therefore, standard testing may misidentify Tsukamurella spp. as another species. Accurate and rapid diagnosis is critical for proper infection management, but identification of this bacterium is difficult in the standard laboratory setting.Case presentationA bloodstream infection caused by a gram-positive bacterium and related to a central venous catheter was identified in an immunocompromised 2-year-old girl. Tsukamurella tyrosinosolvens was identified by modified secA1 sequencing. Antibiotic treatment and removal of the central venous catheter resolved the infection. Inappropriate management of the catheter during an overnight stay outside of the hospital was considered as a possible source of infection.ConclusionsSecA1 sequencing may be a useful diagnostic tool in the identification of T. tyrosinosolvens. Providing proper central venous catheter care instructions to patients, their families, and medical staff is important for infection prevention.

| S-EPMC10633952 | biostudies-literature

Project description:Mycobacterium brumae is a rapidly growing environmental mycobacterial species identified in 1993; so far, no infections by this organism have been reported. Here we present a catheter-related M. brumae bloodstream infection in a 54-year-old woman with breast cancer. The patient presented with high fever (39.7 degrees C), and >1,000 colonies of M. brumae grew from a quantitative culture of blood drawn through the catheter. A paired peripheral blood culture was negative, however, suggesting circulational control of the infection. The patient was treated empirically with meropenem and vancomycin, and the fever resolved within 24 h. The catheter was removed a week later, and from the tip M. brumae was isolated a second time, suggesting catheter colonization. The organism was identified by colonial morphology, sequence analysis of the 16S rRNA gene, and biochemical tests.

| S-EPMC525179 | biostudies-literature

Tsukamurella pulmonis bloodstream infection identified by secA1 gene sequencing.

Project description:Recurrent bloodstream infections caused by a Gram-positive bacterium affected an immunocompromised child. Tsukamurella pulmonis was the microorganism identified by secA1 gene sequencing. Antibiotic treatment in combination with removal of the subcutaneous port healed the patient.

| S-EPMC4298536 | biostudies-literature

Establishing catheter-related bloodstream infection surveillance to drive improvement.

Project description:BackgroundCatheter-related blood stream infections (CRBSI) are an important complication of central venous access devices but are often poorly measured. This article describes the journey of one hospital trust to set up a surveillance process for CRBSI across all specialties of the trust and to reduce CRBSI.MethodUsing a locally adapted CRBSI criteria and root cause analysis (RCA) for investigation we identified a number of opportunities for a quality improvement programme.FindingsOver a 5-year period we saw a significant and sustained reduction in the rate of CRBSI from 5 per 1000 catheter days to 0.23 per 1000 catheter days.ConclusionsThe surveillance enabled rates of CRBSI to be monitored across the trust and the success of our improvements to be measured.

| S-EPMC6039910 | biostudies-literature

Effect of sutureless securement on hemodialysis catheter-related bloodstream infection.

Project description:The use of sutureless securement devices during catheterization might reduce the risk of catheter-related bloodstream infection (CRBSI) by suppressing catheter-exit infection and catheter dislodgement. However, the effectiveness of these devices in reducing CRBSI risk when securing hemodialysis catheters has not been explored. This single-center retrospective observational study examined 211 non-tunneled hemodialysis catheters (NTHCs) from 110 hemodialysis inpatients, of which 121 were secured using conventional skin sutures (Suture group) and 90 with GRIP-LOK (GRIP-LOK group). The stabilized inverse probability of treatment (SIPT)-weighting method was used to generate a new population (SIPT-weighted model) without group differences for each of the 12 predictors of CRBSI development (i.e., age, sex, dialysis history, concomitant acute kidney injury or diabetes, concurrent use of immunosuppressant drugs or aspirin, NTHC insertion site, methicillin-resistant Staphylococcus aureus, carriage, bacteremia event within 3 months before catheterization, hemoglobin level, and serum albumin titer). The effect of GRIP-LOK compared with sutures on CRBSI in the SIPT-weighted model was evaluated using univariate SIPT-weighted Cox proportional regression analysis, which showed a significant CRBSI suppression effect of GRIP-LOK compared with sutures (hazard ratio: 0.17 [95% CI 0.04-0.78], p = 0.023).　GRIP-LOK affords a lower risk of CRBSI due to indwelling NTHCs than conventional securement using sutures.

| S-EPMC8571352 | biostudies-literature

Cluster-Randomized Trial of Devices to Prevent Catheter-Related Bloodstream Infection.

Project description:Central venous catheters (CVCs) contribute disproportionately to bloodstream infection (BSI) and, by extension, to infection-related hospitalization, mortality, and health care costs in patients undergoing dialysis. Recent product advancements may reduce BSIs, but a sufficiently powered comparative-effectiveness study is needed to facilitate evidence-based patient care decisions. In a 13-month, prospective, cluster-randomized, open-label trial, we compared BSI rates in facilities using ClearGuard HD antimicrobial barrier caps (ClearGuard group) with those in facilities using Tego hemodialysis connectors plus Curos disinfecting caps (Tego+Curos group). Forty DaVita dialysis facilities in the United States were pair-matched by BSI rate, number of patients using CVCs, and geographic location, and then cluster randomized 1:1. We enrolled all adult patients undergoing dialysis with CVCs at these facilities, except those allergic to heparin or chlorhexidine. Overall, 1671 patients participated in the study, accruing >183,000 CVC-days. The study outcome was positive blood culture (PBC) rate as an indicator of BSI rate. We calculated results at the cluster level and adjusted for the facility cluster effect. During a 3-month run-in period immediately before study interventions, the groups had similar BSI rates (P=0.8). During the 13-month intervention period that immediately followed, the ClearGuard group had a BSI rate significantly lower than that of the Tego+Curos group (0.28 versus 0.75 PBCs per 1000 CVC-days, respectively; P=0.001). No device-related adverse events were reported. In conclusion, compared with Tego connectors plus Curos caps, ClearGuard HD antimicrobial barrier caps significantly lowered the rate of catheter-related BSIs in patients undergoing hemodialysis using CVCs, representing an important advancement in hemodialysis patient care.

| S-EPMC5875956 | biostudies-literature

The first case of catheter-related bloodstream infection caused by Nocardia farcinica.

Project description:Nocardia farcinica is an emerging pathogen in immunocompromised hosts. Even though several species of Nocardia have been reported as causative pathogens of catheter-related blood stream infections (CRBSI), CRBSI caused by N. farcinica has not been reported. A 70-yr-old man with a tunneled central venous catheter (CVC) for home parenteral nutrition was admitted with fever for two days. Norcardia species was isolated from the blood through CVC and peripheral bloods and identified to N. farcinica by 16S rRNA and rpoB gene sequence analyses. This report emphasizes the rapid and correct identification of causative agents in infectious diseases in the selection of antimicrobial agents and the consideration of catheter removal.

| S-EPMC2967007 | biostudies-literature

Persistent bloodstream infection with Kocuria rhizophila related to a damaged central catheter.

Project description:A case of persistent bloodstream infection with Kocuria rhizophila related to a damaged central venous catheter in a 3-year-old girl with Hirschsprung's disease is reported. The strain was identified as K. rhizophila by 16S rRNA gene sequencing and matrix-assisted laser desorption ionization-time of flight mass spectrometry. Arbitrarily primed PCR analysis showed a clonal strain. The repeated septic episodes were resolved with the catheter repair.

| S-EPMC3318534 | biostudies-literature

Project description:Kodamaea ohmeri is a rare yeast pathogen that has recently emerged as an important cause of fungaemia in immunocompromised patients. In most cases, identification to the species level requires the adoption of new tools, including matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS) or DNA sequencing. As K. ohmeri is a teleomorph of Candida guilliermondii var. membranaefaciens and its susceptibility to fluconazole is variable, a rapid and accurate identification of this yeast is important. Echinocandins may be the first choice for empiric therapy for this pathogen. We report the case of a 25-year-old male patient from North China who developed a catheter-related bloodstream infection caused by K. ohmeri. He was treated with caspofungin in hospital. He improved after removal of the central venous catheter and use of caspofungin as therapy. The K. ohmeri strain was identified using a MALDI-TOF mass spectrometer and a Vitek 2YST card. Definitive identification was obtained by a sequencing test of the internal transcribed spacer regions of the rDNA. Our patient findings, the first reported in mainland China, highlighted the diagnostic challenges associated with catheter-related bloodstream infection caused by fungi.

| S-EPMC8336306 | biostudies-literature

Lower risk of peripheral venous catheter-related bloodstream infection by hand insertion.

Project description:IntroductionLittle is known about the bloodstream infection (BSI) risk associated with short-term peripheral venous catheters (PVCs) and no large study investigated the insertion site-related risk for PVC-BSI.MethodsWe performed a cohort study at the University of Geneva Hospitals using the prospective hospital-wide BSI surveillance database. We analyzed the association between insertion site and risk of PVC-BSI on the upper extremity using univariable and multivariable marginal Cox models.ResultsBetween 2016 and 2020, utilization of 403'206 peripheral venous catheters were prospectively recorded in a 2000-bed hospital consortium with ten sites. Twenty-seven percent of PVC (n = 109'686) were inserted in the hand. After adjustment for confounding factors, hand insertion was associated with a decreased PVC-BSI risk (adjusted hazard ratio [HR] 0.42, 95% CI 0.18-0.98, p = 0.046) compared to more proximal insertion sites. In a sensitivity analysis for PVCs with ≥ 3 days of dwell time, we confirmed a decreased PVC-BSI risk after hand insertion (HR 0.37, 95% CI 0.15-0.93, p = 0.035).ConclusionHand insertion should be considered for reducing PVC infections, especially for catheters with an expected dwell time of more than 2 days.

| S-EPMC9164319 | biostudies-literature

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