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Fox-Lewis S, Muttaiyah S, Roberts S. Increasing isolation of non-toxigenic Corynebacterium diphtheriae in Aotearoa New Zealand. N Z Med J 2023; 136:112-115. [PMID: 37956362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Affiliation(s)
- Shivani Fox-Lewis
- Clinical Microbiology registrar, Microbiology, LabPLUS, Auckland City Hospital, Auckland, New Zealand
| | - Sharmini Muttaiyah
- Clinical Microbiologist, LabPLUS, Auckland City Hospital, Auckland, New Zealand
| | - Sally Roberts
- Clinical Microbiologist, Head of Department Microbiology, LabPLUS, Auckland City Hospital, Auckland, New Zealand
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Yap A, Muttaiyah S, Welch S, Niederer RL. Role of Antimicrobial Resistance in Outcomes of Acute Endophthalmitis. Antibiotics (Basel) 2023; 12:1246. [PMID: 37627666 PMCID: PMC10451699 DOI: 10.3390/antibiotics12081246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/27/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND This study explores local trends in antimicrobial resistance and its influence on long-term visual outcomes following treatment with broad-spectrum empiric intravitreal antibiotics. METHODS All patients undergoing intraocular sampling for endophthalmitis from Auckland between January 2006-May 2023 were included. The impact of antimicrobial resistance on the final visual outcome was analysed using logistic regression models. RESULTS 389 cases of endophthalmitis were included, and 207 eyes (53.2%) were culture positive. When tested, all Gram-positive microorganisms were fully susceptible to Vancomycin, and all Gram-negative microorganisms demonstrated full or intermediate susceptibility to Ceftazidime. Resistance to at least one antimicrobial agent was present in 89 culture results (43.0%), and multidrug resistance (resistant to ≥3 antimicrobials) in 23 results (11.1%). No increase in resistance was observed over time. The primary procedure was a tap and inject in 251 eyes (64.5%), and early vitrectomy was performed in 196 eyes (50.3%). Severe vision loss (≤20/200) occurred in 167 eyes (42.9%). Antimicrobial resistance was associated with an increased risk of retinal detachment (OR 2.455 p = 0.048) but not vision loss (p = 0.288). CONCLUSION High sensitivity to Vancomycin and Ceftazidime was present in our population, reinforcing their role as first-line empiric treatments. Resistant microorganisms were associated with an increased risk of retinal detachment but no alteration in final visual outcome.
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Affiliation(s)
- Aaron Yap
- Department of Ophthalmology, University of Auckland, Auckland 1142, New Zealand;
- Department of Ophthalmology, Te Whatu Ora Te Toka Tumai, Auckland 1051, New Zealand;
| | - Sharmini Muttaiyah
- Department of Microbiology, Te Whatu Ora Te Toka Tumai, Auckland 1023, New Zealand;
| | - Sarah Welch
- Department of Ophthalmology, Te Whatu Ora Te Toka Tumai, Auckland 1051, New Zealand;
| | - Rachael L. Niederer
- Department of Ophthalmology, University of Auckland, Auckland 1142, New Zealand;
- Department of Ophthalmology, Te Whatu Ora Te Toka Tumai, Auckland 1051, New Zealand;
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Basu I, Nagappan R, Fox-Lewis S, Muttaiyah S, McAuliffe G. Evaluation of extraction and amplification assays for the detection of SARS-CoV-2 at Auckland Hospital laboratory during the COVID-19 outbreak in New Zealand. J Virol Methods 2020; 289:114042. [PMID: 33345831 PMCID: PMC7837327 DOI: 10.1016/j.jviromet.2020.114042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 11/24/2022]
Abstract
MagNAPure 96, Panther Fusion, EpMotion 5075 tested for SARS-CoV2 RNA extraction. Panther, LC 480, A* Fortitude, Viasure, and GenePro kits tested for SARS-CoV2 RT-PCR. Same sets of specimen positives for COVID-19 used across platforms for comparison. Median Ct values, ΔCt values and IQR used for comparison of their performance. Comparison provided wider options as SARS-CoV-2 PCR testing soared in New Zealand.
Utilising diverse molecular platforms has formed a solid foundation in New Zealand’s COVID-19 response. We evaluated multiple extraction and PCR assays for the detection of SARS-CoV-2. We included 65 positive samples which were run on the Panther Fusion using a laboratory developed test (LDT, E gene target). Where viral RNA was extracted by MagNA Pure (MP) 96 extraction platform or EpMotion 5075/Geneaid extraction kit, SARS-CoV-2 detection was performed on Light Cycler (LC) 480 using a LDT (E gene) or 3 commercial assays; Certest Viasure (Orf1ab, N genes) GenePro (E, RdRp genes) and A* Star Fortitude (proprietary target). Median Cts on LC 480 LDT for specimens (n = 9) extracted on MP 96 (26.6) were lower than on EpMotion (31.6) whereas median Cts for specimens (n = 10) extracted on the Panther Fusion LDT (23.1) were comparable with MP 96 /LC480 LDT (23.6). Specimens tested on Panther Fusion LDT (n = 28), extracted by MP 96, and amplified using commercial assays showed good concordance with a few exceptions; lower median Ct values were seen for 2 targets on GenePro (16.9, 21.5) and Viasure (19.5, 21.1) than for the Panther Fusion LDT (24.2) and A* Star Fortitude (25.6). Specimens tested on MP 96 (n = 18) had comparable results using commercial assays, with lower median Cts for Viasure (22.2, 23.7) compared with the LC 480 LDT (24.7), GenePro (24.7,25.7) and A*Fortitude (25.1) assays. The study provides an early assessment of the performance characteristics of 3 extraction methods for viral RNA and 5 PCR assays for the detection of SARS-CoV-2.
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Affiliation(s)
- Indira Basu
- Department of Microbiology, LabPLUS, Auckland City Hospital, New Zealand.
| | - Radhika Nagappan
- Department of Virology, LabPLUS, Auckland City Hospital, New Zealand.
| | - Shivani Fox-Lewis
- Department of Virology, LabPLUS, Auckland City Hospital, New Zealand.
| | - Sharmini Muttaiyah
- Department of Microbiology, LabPLUS, Auckland City Hospital, New Zealand.
| | - Gary McAuliffe
- Department of Virology, LabPLUS, Auckland City Hospital, New Zealand.
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Forde BM, Henderson A, Playford EG, Looke D, Henderson BC, Watson C, Steen JA, Sidjabat HE, Laurie G, Muttaiyah S, Nimmo GR, Lampe G, Smith H, Jennison AV, McCall B, Carroll H, Cooper MA, Paterson DL, Beatson SA. Fatal respiratory diphtheria caused by β-lactam-resistant Corynebacterium diphtheriae. Clin Infect Dis 2020; 73:e4531-e4538. [PMID: 32772111 DOI: 10.1093/cid/ciaa1147] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 08/03/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Diphtheria is a potentially fatal respiratory disease caused by toxigenic Corynebacterium diphtheriae. Although resistance to erythromycin has been recognised, β-lactam resistance in toxigenic diphtheria has not been described. Here, we report a case of fatal respiratory diphtheria caused by toxigenic C. diphtheriae resistant to penicillin and all other β-lactam antibiotics and describe a novel mechanism of inducible carbapenem resistance associated with the acquisition of a mobile resistance element. METHODS Long-read whole genome sequencing was performed using Pacific Biosciences SMRT sequencing to determine the genome sequence of C. diphtheriae BQ11 and mechanism of β-lactam resistance. To investigate phenotypic inducibility of meropenem resistance, short read sequencing was performed using an Illumina NextSeq500 sequencer on the strain with and without exposure to meropenem. RESULTS BQ11 demonstrated high-level resistance to penicillin (benzylpenicillin MIC ≥ 256 μg/ml), β-lactam/β-lactamase inhibitors and cephalosporins (amoxicillin/clavulanic acid MIC ≥ 256 μg/mL; ceftriaxone MIC ≥ 8 μg/L). Genomic analysis of BQ11 identified acquisition of a novel transposon carrying the penicillin binding protein Pbp2c, responsible for resistance to penicillin and cephalosporins. When strain BQ11 was exposed to meropenem, selective pressure drove amplification of the transposon in a tandem array and led to a corresponding change from a low level to high level meropenem resistant phenotype. CONCLUSIONS We have identified a novel mechanism of inducible antibiotic resistance whereby isolates that appear to be carbapenem susceptible on initial testing can develop in vivo resistance to carbapenems with repeated exposure. This phenomenon could have significant implications for treatment of C. diphtheriae infection and may lead to clinical failure.
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Affiliation(s)
- Brian M Forde
- School of Chemistry and Molecular Biosciences, University of Queensland, QLD, Australia.,Australian Infectious Diseases Research Centre, University of Queensland, QLD, Australia.,Australian Centre for Ecogenomics, University of Queensland, QLD, Australia
| | - Andrew Henderson
- University of Queensland Centre For Clinical Research, University of Queensland, QLD, Australia.,Infection Management Services, Princess Alexandra Hospital, QLD, Australia
| | - Elliott G Playford
- Infection Management Services, Princess Alexandra Hospital, QLD, Australia.,School of Medicine, University of Queensland, QLD, Australia
| | - David Looke
- Infection Management Services, Princess Alexandra Hospital, QLD, Australia.,School of Medicine, University of Queensland, QLD, Australia
| | | | - Catherine Watson
- Infection Management Services, Princess Alexandra Hospital, QLD, Australia
| | - Jason A Steen
- Institute for Molecular Biosciences, University of Queensland, QLD, Australia
| | - Hanna E Sidjabat
- Australian Infectious Diseases Research Centre, University of Queensland, QLD, Australia.,University of Queensland Centre For Clinical Research, University of Queensland, QLD, Australia
| | - Gordon Laurie
- Intensive Care Unit, Princess Alexandra Hospital, QLD, Australia
| | | | - Graeme R Nimmo
- Department of Microbiology, Pathology Queensland, QLD, Australia
| | - Guy Lampe
- Department of Anatomical Pathology, Pathology Queensland, QLD, Australia
| | - Helen Smith
- Public Health Microbiology, Forensic and Scientific Services, Queensland Health
| | - Amy V Jennison
- Public Health Microbiology, Forensic and Scientific Services, Queensland Health
| | - Brad McCall
- Metro South Public Health Unit, Metro South Health, Brisbane, QLD, Australia
| | - Heidi Carroll
- Communicable Diseases Branch, Prevention Division, Department of Health, Queensland Health, QLD, Australia
| | - Matthew A Cooper
- Institute for Molecular Biosciences, University of Queensland, QLD, Australia
| | - David L Paterson
- Australian Infectious Diseases Research Centre, University of Queensland, QLD, Australia.,University of Queensland Centre For Clinical Research, University of Queensland, QLD, Australia
| | - Scott A Beatson
- School of Chemistry and Molecular Biosciences, University of Queensland, QLD, Australia.,Australian Infectious Diseases Research Centre, University of Queensland, QLD, Australia.,Australian Centre for Ecogenomics, University of Queensland, QLD, Australia
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Chhibber AV, Muttaiyah S, McAuliffe G, Fox-Lewis S, De Almeida M, Blakiston M, Playle V, Fox-Lewis A, Roberts S. Age-related differences in SARS-CoV-2 testing in the Northern Region of New Zealand. N Z Med J 2020; 133:89-94. [PMID: 32777799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
AIM There is concern the low incidence of coronavirus disease 2019 (COVID-19) in children reflects under-testing in this population. This study sought to describe the age-distribution of SARS-CoV-2 testing in the Northern Region of New Zealand. METHODS A retrospective single-centre review of all SARS-CoV-2 tests performed at LabPLUS, Auckland City Hospital, between 12 February and 18 April 2020. RESULTS A total of 22,333 tests were performed, with 313 (1.40%) positive results. The age-adjusted SARS-CoV-2 testing rate was three times higher in adults than in children. The overall proportion of positive tests was lower in children (0.86%) than adults (1.45%). However, within the paediatric population the proportion of tests positive differed significantly between those <10 years old (0.08%) and those 10-14 years old (2.6%). CONCLUSION The lower proportion of tests positive in children <10 years of age suggests they are appropriately tested relative to their rates of disease. A large high school-associated cluster makes the higher proportion of tests positive in children 10-14 years old difficult to interpret. Older children may have a higher risk of infection and increasing testing in intermediate and high school aged children may be indicated.
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Affiliation(s)
- Aakash V Chhibber
- Registrar, Department of Microbiology, LabPLUS, Auckland City Hospital, Auckland District Health Board, Auckland
| | - Sharmini Muttaiyah
- Clinical Microbiologist, Department of Microbiology, LabPLUS, Auckland City Hospital, Auckland District Health Board, Auckland
| | - Gary McAuliffe
- Clinical Microbiologist, Department of Microbiology, LabPLUS, Auckland City Hospital, Auckland District Health Board, Auckland
| | - Shivani Fox-Lewis
- Registrar, Department of Microbiology, LabPLUS, Auckland City Hospital, Auckland District Health Board, Auckland
| | - Mary De Almeida
- Clinical Microbiologist, Department of Microbiology, LabPLUS, Auckland City Hospital, Auckland District Health Board, Auckland
| | - Matthew Blakiston
- Clinical Microbiologist, Department of Microbiology, LabPLUS, Auckland City Hospital, Auckland District Health Board, Auckland
| | - Veronica Playle
- Clinical Microbiologist, Department of Microbiology, LabPLUS, Auckland City Hospital, Auckland District Health Board, Auckland
| | - Andrew Fox-Lewis
- Registrar, Department of Microbiology, LabPLUS, Auckland City Hospital, Auckland District Health Board, Auckland
| | - Sally Roberts
- Clinical Microbiologist and Clinical Head, Department of Microbiology, LabPLUS, Auckland City Hospital, Auckland District Health Board, Auckland
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Fox-Lewis S, Muttaiyah S, Rahnama F, McAuliffe G, Roberts S. An understanding of discordant SARS-CoV-2 test results: an examination of the data from a central Auckland laboratory. N Z Med J 2020; 133:81-88. [PMID: 32777798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
AIM The diagnostic sensitivity of the SARS-CoV-2 real time reverse transcription polymerase chain reaction (RT-PCR) test has not been determined. This has led to a degree of uncertainty in the interpretation of results, particularly in patients tested repeatedly. The aim of this study was to explore the characteristics of patients who initially tested negative, and subsequently tested positive for SARS-CoV-2. METHODS This retrospective observational study utilised data from the LabPlus Virology laboratory, Auckland City Hospital, to identify cases (hospital and community) with initial negative and subsequent positive SARS-CoV-2 RT-PCR results. Their clinical and laboratory characteristics were summarised. RESULTS From 1 February to 13 April a total of 20,089 samples were received for SARS-CoV-2 testing. Of 2,011 samples from patients with multiple tests, 25 samples were positive. Nine samples were from patients who initially tested negative then tested positive. Reasons for the initial negative test results, which were all from upper respiratory tract samples, included pre-symptomatic presentation or late presentation. All patients had significant risk factors and ongoing or evolving symptoms, which warranted repeat testing. CONCLUSION Few patients had discordant test results for SARS-CoV-2 RT-PCR. For patients who have a significant risk factor and a negative test result, repeat testing should be performed.
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Affiliation(s)
- Shivani Fox-Lewis
- Clinical Virology Registrar, Virology Department, LabPlus, Auckland City Hospital, Auckland
| | - Sharmini Muttaiyah
- Clinical Microbiologist, Microbiology Department, LabPlus, Auckland City Hospital, Auckland
| | - Fahimeh Rahnama
- Section Leader of Molecular Diagnostics, Virology Department, LabPlus, Auckland City Hospital, Auckland
| | - Gary McAuliffe
- Clinical Microbiologist, Microbiology Department, LabPlus, Auckland City Hospital, Auckland
| | - Sally Roberts
- Clinical Microbiologist, Microbiology Department, LabPlus, Auckland City Hospital, Auckland; Clinical Head of Microbiology, Microbiology Department, LabPlus, Auckland City Hospital, Auckland
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Roberts S, Grae N, Muttaiyah S, Morris AJ. Healthcare-associated Staphylococcus aureus bacteraemia: time to reduce the harm caused by a largely preventable event. N Z Med J 2020; 133:58-64. [PMID: 32027639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Staphylococcus aureus disease is associated with significant morbidity and mortality and of concern, it disproportionally affects Māori and Pacific Peoples. New Zealand has high rates of skin and soft tissue infection caused by S. aureus. Healthcare-associated S. aureus bacteraemia (HA-SAB) accounts for a significant proportion of all S. aureus bacteraemia events. Measurement of HA-SAB has been reported in New Zealand for over 20 years but it has not been linked to quality improvement interventions to reduce the rate. It has been used as an outcome measure for the Hand Hygiene New Zealand programme; however, a recent review of submitted data questioned the accuracy of it. This has been addressed. National programmes such as the Health Quality & Safety Commissions Hand Hygiene New Zealand and the Surgical Site Infection Improvement programme have led to reduced harm from healthcare-associated infections. Interventions targeted at reducing the HA-SAB rate, such as bundles of care for insertion and maintenance of vascular access devices and skin and nasal decolonisation of staphylococci prior to surgery, are urgently required.
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Affiliation(s)
- Sally Roberts
- Microbiology, LabPlus, Auckland District Health Board, Auckland
| | - Nikki Grae
- Infection Prevention and Control Programme, Health Quality and Safety Commission, Wellington
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Abstract
Background Aerococcus urinae is a Gram-positive coccus that is increasingly recognized as a urinary pathogen since the introduction of mass spectrometry for identification of bacteria. We report a case of abdominal aortitis (with aneurysm) caused by A urinae in a male with recurrent urinary tract infections and recently treated A urinae bacteremia. A 63-year-old gentleman with a history of A urinae urosepsis 7 weeks prior, presented to the Emergency Department with thoracolumbar back pain radiating bilaterally into the groin. Radiological and surgical findings were consistent with infective infrarenal aortitis with aneurysm. Methods The patient successfully underwent open surgical debridement and reconstruction of the infrarenal aorta with autologous vein graft. Results Aerococcus urinae was isolated from excised tissue. The patient completed a 4-week course of intravenous antimicrobial therapy. Conclusions Aurinae is a urinary pathogen with the ability to cause severe invasive disease including endovascular infections.
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Affiliation(s)
- Aakash Varun Chhibber
- Department of Microbiology, LabPLUS, Auckland District Health Board, Auckland, New Zealand
| | - Sharmini Muttaiyah
- Department of Microbiology, LabPLUS, Auckland District Health Board, Auckland, New Zealand
| | - Andrew A Hill
- Department of Vascular Surgery, Auckland City Hospital, Auckland District Health Board, Auckland, New Zealand
| | - Sally A Roberts
- Department of Microbiology, LabPLUS, Auckland District Health Board, Auckland, New Zealand
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Muttaiyah S, Best E, Freeman J, Taylor S, Morris A, Roberts S. Corynebacterium diphtheriae endocarditis: a case series and review of the treatment approach. Int J Infect Dis 2011; 15:e584-8. [DOI: 10.1016/j.ijid.2011.04.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Revised: 03/14/2011] [Accepted: 04/16/2011] [Indexed: 10/18/2022] Open
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Muttaiyah S, Ritchie S, Upton A, Roberts S. Clinical parameters do not predict infection in patients with external ventricular drains: a retrospective observational study of daily cerebrospinal fluid analysis. J Med Microbiol 2008; 57:207-209. [DOI: 10.1099/jmm.0.47518-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A retrospective review was conducted of patients with external ventricular drains (EVDs) in situ in order to ascertain the utility of daily cerebrospinal fluid (CSF) analysis in such patients. All laboratory requests for CSF analysis, which were sent to the Microbiology Department, Auckland City Hospital, New Zealand, were reviewed to identify patients with EVDs in situ. The patients' clinical records were reviewed and information was obtained regarding their age, ethnicity, indication for EVD, duration of EVD, CSF analysis results, daily temperatures, Glasgow Coma Scale (GCS) and the presence of other infections. For CSF samples that grew organisms, the patients' notes were reviewed to ascertain whether the organism was a contaminant or was representative of EVD-associated ventriculitis. A total of 454 CSF specimens from 60 patients were reviewed. Of the 56 CSF specimens that were culture-positive, 40 (71 %) were found to reflect clinical infection. Routine CSF analysis identified nine episodes of EVD-associated ventriculitis. Coagulase-negative staphylococci and Staphylococcus epidermidis were the most common isolates and were associated with ventriculitis approximately half of the time. Gram-negative isolates were less frequently isolated, but, when present, were always associated with ventriculitis. This study found that patient temperature and GCS did not allow early prediction of EVD-associated ventriculitis.
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Affiliation(s)
- Sharmini Muttaiyah
- Department of Microbiology, Auckland City Hospital, Auckland, New Zealand
| | - Stephen Ritchie
- Department of Infectious Diseases, Auckland City Hospital, Auckland, New Zealand
| | - Arlo Upton
- Department of Microbiology, Auckland City Hospital, Auckland, New Zealand
| | - Sally Roberts
- Department of Microbiology, Auckland City Hospital, Auckland, New Zealand
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Muttaiyah S, Paviour S, Buckwell L, Roberts SA. Anaerobic bacteraemia in patients admitted to Auckland City Hospital: its clinical significance. N Z Med J 2007; 120:U2809. [PMID: 18264176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
AIM To determine the clinical significance and outcomes for patients with anaerobic bacteraemia at our institution over a 2-year period. METHOD The isolates were identified from the laboratory database and patient information obtained from clinical records. RESULTS Anaerobes were isolated from 140 blood culture sets taken from 114 patients. For 59 patients, the isolates were considered to be contaminants. Of note, all Propionibacterium spp. were considered contaminants. For the patients with true bacteraemias, the most likely source of infection was intra-abdominal, 26 (50%), mucositis associated with neutropaenia contributed to by cytotoxic therapy, 11 (19%), skin and soft tissue, 4 (8%), pelvic, 5 (9%) and oropharyngeal, 4 (8%). Thirty-five patients were on appropriate therapy prior to the availability culture results. Five patients died but only one death was directly attributable to anaerobic bacteraemia. CONCLUSION At our institution, anaerobes accounted for 2.3% of all positive blood cultures. Excluding Propionibacterium spp., most isolates were considered clinically significant. The most common source for the bacteraemia was intra-abdominal infection, followed by mucositis in neutropaenic patients. Empiric antimicrobial therapy provided appropriate cover for two-thirds of the patients. One death was directly attributable to anaerobic bacteraemia.
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Fu J, Muttaiyah S, Pandey S, Thomas M. Two cases of endocarditis due to Bartonella henselae. N Z Med J 2007; 120:U2558. [PMID: 17546106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Affiliation(s)
- James Fu
- Department of Infectious Diseases and Microbiology Laboratory, Auckland City Hospital, Auckland
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