Streptococcus parasanguis peritonitis: report of a case and review of the literature

Streptococcus parasanguinis: An emerging pathogen causing neonatal endocarditis: A case report

Background. The microbial infection of the endocardium, popularly known as Infective Endocarditis (IE), is typically classified on the basis of anatomy, valve nativity and its associated microbiology. As per the associated microbiology, Staphylococcus aureus is the most common microorganism responsible for the cause of IE. Even though, the Streptococcus group accounts for a smaller percentage of IE, however this doesn't give us the liberty of ignoring the high mortality and morbidity associated with this pathogen. Case presentation. We report an unusual case of neonatal sepsis, complicated with endocarditis, caused by penicillin resistant Streptococcus parasanguinis . The neonate however died of the same despite all efforts. The said baby was given birth by a mother with gestational diabetes mellitus.

Conclusion

High index of clinical suspicion and prompt diagnosis are the most important factors of patient management, especially in cases of life threatening neonatal infections. In such conditions a coordinated interdepartmental approach is very much needed.

Diagnosis based on electromagnetic navigational bronchoscopy-guided biopsied peripheral lung lesions in a 10-year-old girl: A case report

BACKGROUND

Electromagnetic navigational bronchoscopy (ENB) is an emerging diagnostic tool that enables practitioners to biopsy peripheral lung tissues that were previously only accessible under computed tomography (CT) guidance. However, few studies have investigated ENB use in children. Here, we report a case of a 10-year-old girl with peripheral lung lesions who complained of a 7-d persistent fever. She was diagnosed with Streptococcus parasanguinis infection based on findings obtained using ENB-guided transbronchial lung biopsy (TBLB).

CASE SUMMARY

A 10-year-old girl presented with constitutional symptoms of cough and fever of 7 days’ duration. Chest CT scans detected peripheral lung lesions and no endobronchial lesions. TBLB performed under the guidance of an ENB Lungpro navigation system was safe, well-tolerated, and effective for biopsying peripheral lung lesions. Examination of biopsied samples indicated the patient had a pulmonary Streptococcus parasanguinis infection, which was treated with antibiotics instead of more invasive treatment interventions. The patient’s symptoms resolved after she received a 3-wk course of oral linezolid. Comparisons of pre-treatment and post-treatment CT scans revealed absorption of some lung lesions within 7 mo of hospital discharge.

CONCLUSION

ENB-guided TBLB biopsying of peripheral lung lesions in this child is a safe, well-tolerated, and effective alternative to conventional interventions.

Microbiological Evaluation of Water Used in Dental Units

In modern dentistry, dental units are used for the treatment of patients’ teeth, and they need water to operate. Water circulates in a closed vessel system and finally reaches the mucous membranes of the patient as well as the dentist themselves. Therefore, the microbiological safety of this water should be a priority for physicians. This study aims to identify and determine the microbial count, expressed in CFU/mL, in water samples from various parts of the dental unit that are in direct contact with the patient. Thirty-four dental units located in dentistry rooms were analysed. The dentistry rooms were divided into three categories: surgical, conservative, and periodontal. It was found that in surgical rooms, the bacterial count was 1464.76 CFU/mL, and the most common bacterium was Staphylococcus pasteuri—23.88% of the total bacteria identified. In dentistry rooms where conservative treatments were applied, the average bacterial concentration was 8208.35 CFU/mL, and the most common bacterium was Ralsonia pickettii (26.31%). The periodontal rooms were also dominated by R. pickettii (45.13%), and the average bacterial concentration was 8743.08 CFU/mL. Fungi were also detected. Rhodotorula spp., Alternaria spp., and Candida parapsilosis were found to be the most common bacteria which are potentially harmful. This study indicates the need for effective decontamination of the water that is used in dental units and for constant monitoring of the level of contaminants present in the closed vessel system.

Microbial contamination profile change over a 4-year period in nonoperated cleft soft palate

AIMS

Surgical site infection is a major concern in cleft soft palate. Knowledge of the type, number and antimicrobial resistance of pathogens present preoperatively contribute to treatment success. The aim of this study is to determine whether or not the microbial contamination (diversity) preoperatively has changed since 2015.

METHODS AND RESULTS

Swabs were taken from the surgical site in 103 consecutive patients who presented for primary repair of the soft palate cleft. These were sent for microscopy, culture and sensitivity testing. Swabs were taken before disinfecting the site. Results were tabled and compared with two previous studies from the same facility. Out of 103 patients, 100 patients showed positive cultures with 42 different pathogenic micro-organisms identified. Most dominant pathogen was Klebsiella pneumoniae, 45.6%, increased by 28% from the previous two studies, with 93.6% of these pathogens resistant to one or more antimicrobials. Most of the other identified pathogens showed an alarming increase in occurrence, with a wide resistance to antimicrobials.

CONCLUSIONS

The increase in number and diversity of microbial contamination as well as their resistance to antimicrobials is a real concern. Ways of preventing postoperative infection in a natural way need to be explored.

SIGNIFICANCE

Surgeons need to be aware of constant changes in micro-organisms.

Viridans streptococci in peritoneal dialysis peritonitis: clinical courses and long-term outcomes

BACKGROUND

The clinical courses and long-term outcomes of viridans streptococcus (VS) peritoneal dialysis (PD) peritonitis remain unclear.

METHODS

We conducted a retrospective analysis of all PD patients in a single center with gram-positive cocci (GPC) peritonitis between 2005 and 2011, and divided them into 3 groups: VS, other streptococci and other GPC (apart from VS). Clinical characteristics and outcomes of the VS group were compared with the other streptococci and other GPC groups, with prognostic factors determined.

RESULTS

A total of 140 patients with 168 episodes of GPC peritonitis (44% of all peritonitis) were identified over 7 years. Among these, 18 patients (13%) developed VS peritonitis, while 14 patients (10%) developed other streptococcal peritonitis. Patients with VS peritonitis had a high cure rate by antibiotic alone (94%), despite a high polymicrobial yield frequency (28%). We found that VS peritonitis carried a lower risk of Tenckhoff catheter removal and relapsing episodes than other GPC peritonitis (6% vs 11%), and a lower mortality than other streptococci peritonitis (0% vs 7%). However, after the index peritonitis episodes, VS, other streptococci, and other GPC group had a significantly increased peritonitis incidence compared with the period before the index peritonitis (all p < 0.01). Patients with VS peritonitis had a significantly higher incidence of refractory peritonitis compared with other streptococci or other GPC peritonitis in the long term (both p < 0.01).

CONCLUSIONS

VS poses a higher risk of subsequent refractory peritonitis after the index episode as compared with other streptococcal or GPC peritonitis. It might be prudent to monitor the technique of these patients with VS peritonitis closely to avoid further peritonitis episodes.