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Winkler WL, George IA, Gandra S, Baker JC, Tomasian A, Northrup B, Velde TLV, Hillen TJ, Luo C, Imaoka R, Dettorre GM, Jennings JW. Diagnostic efficacy and clinical impact of image-guided core needle biopsy of suspected vertebral osteomyelitis. Int J Infect Dis 2024; 144:107027. [PMID: 38670483 DOI: 10.1016/j.ijid.2024.107027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 03/17/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
OBJECTIVES The diagnostic yield and clinical impact of image-guided core needle biopsy (ICNB) of suspected vertebral osteomyelitis in adults is heterogenous in published studies owing to small sample sizes, indicating the need for large cohort studies. METHODS A retrospective analysis of ICNBs was performed from 2010 to 2021 for patients with imaging findings consistent with vertebral osteomyelitis. For each biopsy, a series of factors were analyzed, as well as if histopathology was diagnostic of osteomyelitis and if microbiological cultures were positive. In addition, it was recorded in what way biopsy influenced clinical management regarding antimicrobial treatment. A multivariate statistical analysis was performed to evaluate the factors associated with yield. RESULTS A total of 570 biopsies performed on 527 patients were included. A histopathologic diagnosis of osteomyelitis was made in 68.4% (359 of 525) of biopsies, and microbiological cultures were positive in 29.6% (169 of 570). Elevated erythrocyte sedimentation rate was positively associated with a histopathologic diagnosis of osteomyelitis (odds ratio [OR] =1.96, P = 0.007) and positive cultures from bone cores (OR = 1.02, P ≤0.001) and aspirate (OR = 1.02, P ≤0.001). Increased total core length was positively associated with a histopathologic diagnosis of osteomyelitis (OR = 1.81, P = 0.013) and positive cultures from bone cores (OR = 1.65, P = 0.049). Clinical management was affected by ICNB in 37.5% (214 of 570) of cases. CONCLUSIONS In this large cohort, ICNB yielded approximately 30% positive cultures and changed clinical management in over one-third of the patients.
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Affiliation(s)
- Winston L Winkler
- Department of Radiology, Section of Musculoskeletal Radiology, Mallinckrodt Institute of Radiology, St. Louis, USA.
| | - Ige A George
- John T. Milliken Department of Internal Medicine, Division of Infectious Disease, St. Louis, USA
| | - Sumanth Gandra
- John T. Milliken Department of Internal Medicine, Division of Infectious Disease, St. Louis, USA
| | - Jonathan C Baker
- Department of Radiology, Section of Musculoskeletal Radiology, Mallinckrodt Institute of Radiology, St. Louis, USA
| | - Anderanik Tomasian
- Department of Radiology, Section of Musculoskeletal Radiology, University of Southern California, Los Angeles, USA
| | - Benjamin Northrup
- Department of Radiology, Section of Musculoskeletal Radiology, Mallinckrodt Institute of Radiology, St. Louis, USA
| | - Theodore L Vander Velde
- Department of Radiology, Section of Musculoskeletal Radiology, Mallinckrodt Institute of Radiology, St. Louis, USA
| | - Travis J Hillen
- Department of Radiology, Section of Musculoskeletal Radiology, Mallinckrodt Institute of Radiology, St. Louis, USA
| | - Chongliang Luo
- Division of Public Health Sciences, Washington University School of Medicine in St. Louis, St. Louis, USA
| | - Resten Imaoka
- Department of Radiology, Section of Musculoskeletal Radiology, Mallinckrodt Institute of Radiology, St. Louis, USA
| | - Gino M Dettorre
- Department of Radiology, Section of Musculoskeletal Radiology, Mallinckrodt Institute of Radiology, St. Louis, USA
| | - Jack W Jennings
- Department of Radiology, Section of Musculoskeletal Radiology, Mallinckrodt Institute of Radiology, St. Louis, USA
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Vázquez-López R, Hernández-Martínez T, Larios-Fernández SI, Piña-Leyva C, Lara-Lozano M, Guerrero-González T, Martínez-Bautista J, Gómez-Conde E, González-Barrios JA. Characterization of Beta-Lactam Resistome of Escherichia coli Causing Nosocomial Infections. Antibiotics (Basel) 2023; 12:1355. [PMID: 37760652 PMCID: PMC10525731 DOI: 10.3390/antibiotics12091355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 09/29/2023] Open
Abstract
Nosocomial infections caused by Escherichia coli pose significant therapeutic challenges due to the high expression of genes encoding antimicrobial drug resistance. In this study, we investigated the conformation of the beta-lactam resistome responsible for the specific pattern of resistance against beta-lactam antibiotics. A total of 218 Escherichia coli strains were isolated from in-hospital patients diagnosed with nosocomial infections, obtained from various sources such as urine (n = 49, 22.48%), vaginal discharge (n = 46, 21.10%), catheter tips (n = 14, 6.42%), blood (n = 13, 5.96%), feces (n = 12, 5.50%), sputum (n = 11, 5.05%), biopsies (n = 8, 3.67%), cerebrospinal fluid (n = 2, 0.92%) and other unspecified discharges (n = 63, 28.90%). To characterize the beta-lactam resistome, all strains were subjected to antibiotic dilution tests and grown in beta-lactam antibiotics supplemented with Luria culture medium. Subsequently, multiplex PCR and next-generation sequencing were conducted. The results show a multi-drug-resistance phenotype, particularly against beta-lactam drugs. The primary determinant of this resistance was the expression of the blaTEM gene family, with 209 positive strains (95.87%) expressing it as a single gene (n = 47, 21.6%) or in combination with other genes. Common combinations included blaTEM + blaCTX (n = 42, 19.3%), blaTEM + blaCTX + blaSHV (n = 13, 6%) and blaTEM + blaCTX + blaBIL (n = 12, 5.5%), among others. The beta-lactam resistome of nosocomial Escherichia coli strains isolated from inpatients at the "October first" Regional Hospital of ISSSTE was predominantly composed of members of the blaTEM gene family, expressed in various configurations along with different members of other beta-lactamase gene families.
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Affiliation(s)
- Rosalino Vázquez-López
- Departamento de Microbiología, Centro de Investigación en Ciencias de la Salud (CICSA), Facultad de Ciencias de la Salud Universidad Anáhuac México Norte, Huixquilucan 52786, Mexico;
| | - Tanya Hernández-Martínez
- Laboratorio de Medicina Genómica, Hospital Regional “Primero de Octubre”, ISSSTE, Av. Instituto Politécnico Nacional 1669, Lindavista, Gustavo A. Madero, Ciudad de México 07300, Mexico; (T.H.-M.); (S.I.L.-F.); (C.P.-L.); (M.L.-L.); (T.G.-G.)
| | - Selene Ivonne Larios-Fernández
- Laboratorio de Medicina Genómica, Hospital Regional “Primero de Octubre”, ISSSTE, Av. Instituto Politécnico Nacional 1669, Lindavista, Gustavo A. Madero, Ciudad de México 07300, Mexico; (T.H.-M.); (S.I.L.-F.); (C.P.-L.); (M.L.-L.); (T.G.-G.)
| | - Celia Piña-Leyva
- Laboratorio de Medicina Genómica, Hospital Regional “Primero de Octubre”, ISSSTE, Av. Instituto Politécnico Nacional 1669, Lindavista, Gustavo A. Madero, Ciudad de México 07300, Mexico; (T.H.-M.); (S.I.L.-F.); (C.P.-L.); (M.L.-L.); (T.G.-G.)
| | - Manuel Lara-Lozano
- Laboratorio de Medicina Genómica, Hospital Regional “Primero de Octubre”, ISSSTE, Av. Instituto Politécnico Nacional 1669, Lindavista, Gustavo A. Madero, Ciudad de México 07300, Mexico; (T.H.-M.); (S.I.L.-F.); (C.P.-L.); (M.L.-L.); (T.G.-G.)
| | - Tayde Guerrero-González
- Laboratorio de Medicina Genómica, Hospital Regional “Primero de Octubre”, ISSSTE, Av. Instituto Politécnico Nacional 1669, Lindavista, Gustavo A. Madero, Ciudad de México 07300, Mexico; (T.H.-M.); (S.I.L.-F.); (C.P.-L.); (M.L.-L.); (T.G.-G.)
| | - Javier Martínez-Bautista
- Laboratorio de Microbiología, Hospital Regional “Primero de Octubre”, ISSSTE, Av. Instituto Politécnico Nacional 1669, Lindavista, Gustavo A. Madero, Ciudad de México 07300, Mexico;
| | - Eduardo Gómez-Conde
- Departamento de Inmunobiología, Facultad de Medicina, Benemérita Universidad Autónoma de Puebla (BUAP), Puebla 72420, Mexico;
| | - Juan Antonio González-Barrios
- Laboratorio de Medicina Genómica, Hospital Regional “Primero de Octubre”, ISSSTE, Av. Instituto Politécnico Nacional 1669, Lindavista, Gustavo A. Madero, Ciudad de México 07300, Mexico; (T.H.-M.); (S.I.L.-F.); (C.P.-L.); (M.L.-L.); (T.G.-G.)
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Surgical Management of Thoracic Osteomyelitis due to Escherichia Coli Sepsis. Case Rep Orthop 2020; 2020:8847504. [PMID: 32908751 PMCID: PMC7474348 DOI: 10.1155/2020/8847504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 08/20/2020] [Indexed: 11/25/2022] Open
Abstract
Case Report. Escherichia coli is a rare cause of vertebral osteomyelitis. It is more common in adults and males. We present a case of an immunocompetent adult male presenting with a several month history of progressive systemic symptoms and subsequent neurologic compromise. We discuss the neurosurgical evaluation of a patient with a progressive vertebral osteomyelitis and treatment options. Surgical debridement and spinal stabilization were performed and confirmed the diagnosis. The patient successfully completed a prolonged antimicrobial therapy course. The patient made a complete neurologic recovery. We discuss the presentation of a patient with Escherichia coli vertebral osteomyelitis and the successful surgical management.
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Bergallo M, Loiacono E, Rizzo G, Caiazzo M, Palladino G, Amore A. Development of a degenerated TaqMan real-time Q-PCR for detection of bacteria-free DNA in dialysis fluid. Biotechnol Appl Biochem 2016; 64:443-448. [PMID: 27067406 PMCID: PMC7161787 DOI: 10.1002/bab.1498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 03/30/2016] [Indexed: 11/05/2022]
Abstract
Bacterial-derived DNA fragments (BDNAs) have been shown to be present in a dialysis fluid, to pass through dialyzer membranes, and to induce interleukin 6 (IL-6) in mononuclear cells. DNA fragments are thought to be derived from microorganisms inhabiting hemodialysis water and fluid. The primary aim of the present study was to develop two degenerated TaqMan real-time quantitative-PCR (Q-PCR) for detection of a broad range of bacterial DNA that specifically detect 16S ribosomal DNA (rDNA) (862 and 241 bp) and evaluate the efficiency of the Bellco Selecta resin to capture the BDNAs in the dialysis fluid. For this purpose, we decided to compare measurements of unfragmented samples (9.8 × 105 Escherichia coli genome) with artificially fragmented DNA samples. We assessed two broad-range real-time PCR targeting bacterial 16S rRNA genes for detection of fragmented and unfragmented bacterial DNA in the dialytic fluid and demonstrated that Bellco Selecta resin is capable of retaining these types of bacterial DNA.
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Affiliation(s)
- Massimiliano Bergallo
- Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Scuola di Medicina, Università di Torino, Torino, Italy.,Laboratorio di Citoimmunodiagnostica, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Elisa Loiacono
- SC Nefrologia-Dialisi e Trapianto Pediatrico, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Giovanna Rizzo
- Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Scuola di Medicina, Università di Torino, Torino, Italy
| | | | | | - Alessandro Amore
- SC Nefrologia-Dialisi e Trapianto Pediatrico, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
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