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Buonsenso D, Tomà P, Scateni S, Curatola A, Morello R, Valentini P, Ferro V, D'Andrea ML, Pirozzi N, Musolino AM. Lung ultrasound findings in pediatric community-acquired pneumonia requiring surgical procedures: a two-center prospective study. Pediatr Radiol 2020; 50:1560-1569. [PMID: 32821992 DOI: 10.1007/s00247-020-04750-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/14/2020] [Accepted: 06/02/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Lung ultrasound (US) in the evaluation of suspected pediatric pneumonia is increasingly used and has a recognized role in evaluating pleural effusions, although there are no detailed studies specifically addressing its use in the pediatric population. OBJECTIVES To define lung US findings of severe pediatric community-acquired pneumonia that required surgical procedures during admission. MATERIALS AND METHODS Our prospective case-control study compared lung US findings in patients ages 1 month to 17 years admitted with community-acquired pneumonia that required surgical procedures from findings those who did not. Lung US was performed at admission and always before surgical procedures. Medical treatment, laboratory and microbiological findings, chest X-ray, computed tomography scan and surgical procedures are described. RESULTS One hundred twenty-one children with community-acquired pneumonia were included; of these, 23 underwent surgical intervention. Compared with the control group, children requiring a surgical procedure had a significantly higher rate of large consolidations (52.2%; 95% confidence interval [CI]: 30.6% to 73.2%), larger and complicated pleural effusions (100%; 95% CI: 85.2% to 100%), and both liquid and air bronchograms (73.9%; 95% CI: 51.6% to 89.8%). CONCLUSION Larger consolidations, larger and more complicated pleural effusions, and liquid and air bronchograms were associated with surgical treatment.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
- Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Paolo Tomà
- Department of Radiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Simona Scateni
- Emergency Department, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Antonietta Curatola
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Pediatrics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy
| | - Valentina Ferro
- Emergency Department, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | | | - Nicola Pirozzi
- Emergency Department, Ospedale Pediatrico Bambino Gesù, Rome, Italy
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Ko Y, Tobino K, Yasuda Y, Sueyasu T, Nishizawa S, Yoshimine K, Munechika M, Asaji M, Yamaji Y, Tsuruno K, Miyajima H, Mukasa Y, Ebi N. A Community-acquired Lung Abscess Attributable to Streptococcus pneumoniae which Extended Directly into the Chest Wall. Intern Med 2017; 56:109-113. [PMID: 28049987 PMCID: PMC5313435 DOI: 10.2169/internalmedicine.56.7398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We herein report the case of 75-year-old Japanese female with a community-acquired lung abscess attributable to Streptococcus pneumoniae (S. penumoniae) which extended into the chest wall. The patient was admitted to our hospital with a painful mass on the left anterior chest wall. A contrast-enhanced chest computed tomography scan showed a lung abscess in the left upper lobe which extended into the chest wall. Surgical debridement of the chest wall abscess and percutaneous transthoracic tube drainage of the lung abscess were performed. A culture of the drainage specimen yielded S. pneumoniae. The patient showed a remarkable improvement after the initiation of intravenous antibiotic therapy.
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Affiliation(s)
- Yuki Ko
- Department of Respiratory Medicine, Iizuka Hospital, Japan
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3
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Revoredo Rego F, Huamán Egoávil E, Zegarra Cavani S, Auris Mora H, Valderrama Barrientos R. [Microbiological and resistance profiles of community acquired and nosocomial intra abdominal infections in surgery of National Hospital Guillermo Almenara, Lima, Peru]. Rev Gastroenterol Peru 2016; 36:115-122. [PMID: 27409087] [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: 06/06/2023]
Abstract
OBJECTIVE To determine the microbiological and resistance profiles of community acquired and nosocomial intra abdominal infections (IAIs) at the Surgery Service of Emergency and surgery critical care units from the Hospital Nacional Guillermo Almenara Irigoyen. MATERIAL AND METHODS From August 1st, 2013 till July 31st, 2014, patients undergoing surgery/interventional drainage for IAIs were included. RESULTS The suitable cultures for the analysis were 169 (74 bile and 95 no bile cultures; 142 community acquired and 27 nosocomials). The microorganims more frequently isolated were E. coli (63.3%), K. pneumoniae (12%) and Enterococcus spp. (10%). The 43.5% of E. coli and the 21.23% of Klebsiella were ESBL producers. The carbapenems were the most active agents in vitro (100%), while the quinolones showed high resistance (>50%). CONCLUSIONS E. coli was the most common microorganism in the IAIs. Because of the quinolone’s high “in vitro†resistance, they should not be recommended as initial empirical therapy.
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Affiliation(s)
- Fernando Revoredo Rego
- Servicio de Cirugía de Páncreas, Bazo y Retroperitoneo, Departamento De Cirugía General, Hospital Nacional Guillermo Almenara Irigoyen. Lima, Perú
| | - Eduardo Huamán Egoávil
- Servicio de Cirugía de Emergencia y Cuidados Críticos Quirúrgicos, Departamento de Cirugía General, Hospital Nacional Guillermo Almenara Irigoyen. Lima, Perú
| | - Sergio Zegarra Cavani
- Servicio de Cirugía de Emergencia y Cuidados Críticos Quirúrgicos, Departamento de Cirugía General, Hospital Nacional Guillermo Almenara Irigoyen. Lima, Perú
| | - Hugo Auris Mora
- Servicio de Cirugía de Emergencia y Cuidados Críticos Quirúrgicos, Departamento de Cirugía General, Hospital Nacional Guillermo Almenara Irigoyen. Lima, Perú
| | - Roberto Valderrama Barrientos
- Servicio de Cirugía de Emergencia y Cuidados Críticos Quirúrgicos, Departamento de Cirugía General, Hospital Nacional Guillermo Almenara Irigoyen. Lima, Perú
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4
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Sopena Bert E, Cortiella Masdeu A, Qanneta R, Moltó Llarena E. [Soft tissue infection by probable community-acquired methicillin-resistant Staphylococcus aureus]. Rev Argent Microbiol 2013; 45:61. [PMID: 23560792] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
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McNamara WF, Hartin CW, Escobar MA, Yamout SZ, Lau ST, Lee YH. An alternative to open incision and drainage for community-acquired soft tissue abscesses in children. J Pediatr Surg 2011; 46:502-6. [PMID: 21376200 DOI: 10.1016/j.jpedsurg.2010.08.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2010] [Revised: 08/10/2010] [Accepted: 08/11/2010] [Indexed: 01/22/2023]
Abstract
BACKGROUND The continually rising incidence of soft tissue abscesses in children has prompted us to seek an alternative to the traditional open incision and drainage (I&D) that would minimize the pain associated with packing during dressing changes and eliminate the need for home nursing care. STUDY DESIGN A retrospective review of all patients with soft tissue abscesses from November 2007 to June 2008 was conducted after institutional review board approval. Patients who were treated with open I&D were compared to those treated with placement of subcutaneous drains through the abscess cavities. Both groups received equivalent antibiotic treatment, and all patients were followed in outpatient clinics until infection resolved. The demographics, presenting temperature, culture results, and outcomes were compared between these 2 groups. RESULTS A total of 219 patients were identified; 134 of them underwent open I&D, whereas 85 were treated with subcutaneous drains. The demographics, anatomical location of the abscesses, and bacteriology were comparable between the 2 groups. There were equal number of patients in each group who presented with fever initially. Of those treated with open I&D, 4 had metachronous recurring abscesses within the same anatomical region and 1 patient required an additional procedure because of incomplete drainage. There were no recurrences or incomplete drainages in the subcutaneous drain group. The cosmetic appearance of the healed wound from subcutaneous drain placement during the immediate follow-up period is better than that of an open I&D. CONCLUSIONS Placement of a subcutaneous drain for community-acquired soft tissue abscesses in children is a safe and equally effective alternative to the traditional I&D.
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Affiliation(s)
- William F McNamara
- Department of Surgery, State University of New York at Buffalo, Buffalo, NY 14222, USA
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6
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Lalich IJ, Sam-Agudu NA. Community-acquired methicillin-resistant Staphylococcus aureus necrotizing fasciitis in a healthy adolescent male. Minn Med 2010; 93:44-46. [PMID: 20957926] [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: 05/30/2023]
Abstract
Recently, the rate of severe, invasive community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection has been increasing in healthy children. The single most common cause of necrotizing fasciitis in children is group A Streptococcus. Empiric therapy is usually targeted at this organism, which is uniformly sensitive to penicillin. Necrotizing fasciitis caused by CA-MRSA is a potentially life-threatening infection that has not been extensively reported in the U.S. pediatric population. The limited literature includes reports of neonatal cases and reports of pediatric cases embedded in articles about adults with underlying risk factors. We present a case of CA-MRSA necrotizing fasciitis in a previously healthy 11-year-old male with no risk factors.
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Affiliation(s)
- Ian J Lalich
- University of North Dakota School of Medicine and Health Sciences, Grand Forks, USA
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Gómez CH, Perilla AM, González C, Valderrama SL, Vanegas N, Chavarro B, Triana LC, Támara JR, Alvarez CA. [Necrotizing pneumonia by community-acquired, methicillin-resistant Staphylococcus aureus in Colombia]. Biomedica 2009; 29:523-530. [PMID: 20440450] [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] [Received: 11/26/2008] [Accepted: 07/01/2009] [Indexed: 05/29/2023]
Abstract
The emergence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) as a cause of severe infections has been described in the recent years. In 2006, the first report of skin and soft tissue infection by CA-MRSA was published in Colombia. Herein, two additional cases of CA-MRSA are reported with a clinical course characterized by rapid progression, prolonged stay in the intensive care unit and complication of pneumonia with the onset of empyema. Both adult patients developed acute renal failure, and were treated with linezolide; the subsequent clinical response showed adequate treatment response. Molecular characterization of the isolates indicated the presence of the mecA gene carrying the cassette SCCmec type IV and the production of the toxin panton-valentine leukocidin.
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MESH Headings
- Acetamides/therapeutic use
- Adult
- Anti-Bacterial Agents/therapeutic use
- Colombia/epidemiology
- Combined Modality Therapy
- Community-Acquired Infections/diagnostic imaging
- Community-Acquired Infections/drug therapy
- Community-Acquired Infections/epidemiology
- Community-Acquired Infections/microbiology
- Community-Acquired Infections/surgery
- Drainage
- Endocarditis, Bacterial/drug therapy
- Endocarditis, Bacterial/etiology
- Endocarditis, Bacterial/microbiology
- Female
- Humans
- Immunocompromised Host
- Kidney Transplantation
- Linezolid
- Lupus Nephritis/surgery
- Male
- Methicillin-Resistant Staphylococcus aureus/isolation & purification
- Middle Aged
- Necrosis
- Oxazolidinones/therapeutic use
- Pneumonia, Staphylococcal/diagnostic imaging
- Pneumonia, Staphylococcal/drug therapy
- Pneumonia, Staphylococcal/epidemiology
- Pneumonia, Staphylococcal/microbiology
- Pneumonia, Staphylococcal/surgery
- Postoperative Complications/microbiology
- Respiration, Artificial
- Shock, Septic/etiology
- Thoracostomy
- Tomography, X-Ray Computed
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Affiliation(s)
- Carlos Hernando Gómez
- Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, D.C, Colombia.
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8
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Contreras GA, Pérez N, Murphy JR, Cleary TG, Heresi GP. Empyema necessitans and acute osteomyelitis associated with community-acquired methicillin-resistant Staphylococcus aureus in an infant. Biomedica 2009; 29:506-512. [PMID: 20440448] [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] [Received: 10/07/2008] [Accepted: 05/18/2009] [Indexed: 05/29/2023]
Abstract
Staphylococcus aureus is a well recognized pathogen with global distribution. In recent years community-associated, methicillin-resistant S. aureus has emerged as an increasing cause of severe infections among adults and children. Herein, a case is reported of a previously healthy, 19-month-old male, who presented with empyema necessitans and acute osteomyelitis due to a community-associated, methicillin-resistant, S. aureus strain. This report highlights the evolving epidemiology of S. aureus, as important pathogen in the community as well as the hospital setting, and the importance of establishing appropriate guidelines for diagnosis, management and surveillance of this public health problem.
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Affiliation(s)
- Germán A Contreras
- Division of Pediatrics Infectious Diseases, Department of Pediatrics, University of Texas Medical School at Houston, Houston, TX, USA
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9
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Solomkin J, Zhao YP, Ma EL, Chen MJ, Hampel B. Moxifloxacin is non-inferior to combination therapy with ceftriaxone plus metronidazole in patients with community-origin complicated intra-abdominal infections. Int J Antimicrob Agents 2009; 34:439-45. [PMID: 19692210 DOI: 10.1016/j.ijantimicag.2009.06.022] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2009] [Revised: 06/23/2009] [Accepted: 06/26/2009] [Indexed: 11/18/2022]
Abstract
Management of community-origin complicated intra-abdominal infections (cIAIs) requires surgical intervention and antimicrobial therapy. This multinational, randomised, double-blind clinical trial carried out in Asia compared the efficacy and safety of moxifloxacin monotherapy and ceftriaxone/metronidazole combination therapy in adults with confirmed or suspected cIAI. Patients received surgical intervention and either intravenous (i.v.) moxifloxacin 400 mg once daily or i.v. ceftriaxone 2 g once daily plus i.v. metronidazole 500 mg twice daily. A total of 364 patients were randomised [intent-to-treat (ITT), moxifloxacin N=180, comparator N=181; per-protocol (PP), moxifloxacin N=174, comparator N=171]. The most common cIAI diagnosis was complicated appendicitis. Moxifloxacin was non-inferior to ceftriaxone/metronidazole in terms of clinical response at test-of-cure in the PP population [clinical cure, 90.2% for moxifloxacin vs. 96.5% for ceftriaxone/metronidazole; 95% confidence interval (CI) of the difference -11.7 to -1.7] and in the ITT population (87.2% for moxifloxacin vs. 91.2% for ceftriaxone/metronidazole; 95% CI -10.7 to 1.9). Bacteriological cure rates in the microbiologically evaluable population support the clinical results (89.4% for moxifloxacin vs. 95.9% for ceftriaxone/metronidazole; 95% CI -13.3 to -0.6). The incidence of treatment-emergent adverse events was similar for both treatment groups (moxifloxacin 31.7% vs. comparator 24.3%). These results confirm previous findings that moxifloxacin plus adequate source control is an appropriate treatment of cIAI.
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Affiliation(s)
- Joseph Solomkin
- Division of Trauma/Critical Care, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0558, USA.
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10
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Bockeria LA, Muratov RM, Shamsiev GA. ICVTS on-line discussion A. Active infective endocarditis-predictability surgical results. Interact Cardiovasc Thorac Surg 2007; 6:358. [PMID: 17669865 DOI: 10.1510/icvts.2007.151621a] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Leo A Bockeria
- Bakoulev Center for Cardiovascular Surgery, Moscow 121552, Russia
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11
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12
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Alvarez CA, Barrientes OJ, Leal AL, Contreras GA, Barrero L, Rincón S, Diaz L, Vanegas N, Arias CA. Community-associated methicillin-resistant Staphylococcus aureus, Colombia. Emerg Infect Dis 2007; 12:2000-1. [PMID: 17354345 PMCID: PMC3291372 DOI: 10.3201/eid1212.060814] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Carlos A. Alvarez
- Hospital Simón Bolívar, Bogotá D.C., Colombia
- Universidad Nacional, Bogotá D.C., Colombia
| | | | | | | | | | | | - Lorena Diaz
- Universidad El Bosque, Bogotá D.C., Colombia
| | | | - Cesar A. Arias
- Universidad El Bosque, Bogotá D.C., Colombia
- University of Texas Medical School at Houston, Houston, Texas, USA
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Shibata T, Sasaki Y, Hirai H, Fukui T, Hosono M, Suehiro S. Early surgery for hospital-acquired and community-acquired active infective endocarditis. Interact Cardiovasc Thorac Surg 2007; 6:354-7. [PMID: 17669864 DOI: 10.1510/icvts.2007.151621] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Active infective endocarditis (IE) is classified into two groups; hospital acquired IE (HIE) and IE other than HIE, which was defined as community-acquired IE (CIE). Eighty-two patients underwent surgical treatment for active IE. Seventy-one cases were CIE group and eleven were HIE. There were six patients with native valve endocarditis and five cases of prosthetic valve endocarditis in the HIE group. We compared the surgical outcome of both types of active IE retrospectively. The preoperative status of the patients in the HIE group was more critical than that in the CIE group. Streptococcus spp. were the major micro-organisms in the CIE group (39%), while 82% of the HIE cases were caused by Staphylococcus spp. All Staphylococcus organisms in the HIE group were methicillin resistant. There were 10 hospital deaths, three in the CIE group and seven in the HIE group. Operative mortality in the HIE group was significantly higher than in the CIE group (63.6% vs. 4.2%, P<0.001). The outcome of early operation was satisfactory for active CIE, but poor for HIE. These types of active IE should be considered separately.
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Affiliation(s)
- Toshihiko Shibata
- Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno, Osaka, 545-8585, Japan.
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14
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Affiliation(s)
- Mark Chong Lee
- Brown Medical School and Hasbro Children's Hospital, Providence, RI 02905, USA
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15
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Smith BM, Zyromski NJ, Allison DC. Community-acquired methicillin-resistant Staphylococcus aureus liver abscess requiring resection. Surgery 2007; 141:110-1. [PMID: 17188175 DOI: 10.1016/j.surg.2006.05.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2005] [Revised: 05/04/2006] [Accepted: 05/07/2006] [Indexed: 10/23/2022]
Affiliation(s)
- Brian M Smith
- Department of Surgery, University of Toledo College of Medicine, Toledo, OH 43614, USA.
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Kodsi S. Community-acquired methicillin-resistant Staphylococcus aureus in association with chronic dacryocystitis secondary to congenital nasolacrimal duct obstruction. J AAPOS 2006; 10:583-4. [PMID: 17189157 DOI: 10.1016/j.jaapos.2006.08.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2006] [Accepted: 08/28/2006] [Indexed: 11/18/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as an important pathogen responsible for serious ocular and systemic disease. MRSA has been reported to occur in dacryocystitis in the adult population. This is the first case report of community-acquired MRSA in the pediatric population in association with chronic dacryocystitis secondary to congenital nasolacrimal duct obstruction in an infant.
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Affiliation(s)
- Sylvia Kodsi
- Department of Ophthalmology, North Shore University-Long Island Jewish Department of Ophthalmology, Great Neck, New York 11021, USA.
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Alfageme I, Aspa J, Bello S, Blanquer J, Blanquer R, Borderías L, Bravo C, de Celis R, de Gracia X, Dorca J, Gallardo J, Gallego M, Menéndez R, Molinos L, Paredes C, Rajas O, Rello J, Rodríguez de Castro F, Roig J, Sánchez-Gascón F, Torres A, Zalacaín R. [Guidelines for the diagnosis and management of community-acquired pneumonia. Spanish Society of Pulmonology and Thoracic Surgery (SEPAR)]. Arch Bronconeumol 2005. [PMID: 15919009 PMCID: PMC7131668 DOI: 10.1157/13074594] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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18
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Baker SD, Horger DC, Keane TE. Community-acquired methicillin-resistant Staphylococcus aureus prostatic abscess. Urology 2005; 64:808-10. [PMID: 15491738 DOI: 10.1016/j.urology.2004.05.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2004] [Revised: 05/06/2004] [Accepted: 05/06/2004] [Indexed: 11/30/2022]
Abstract
We present a 43-year-old man with a history of intravenous drug abuse who presented to the emergency department with a 5-week history of lower urinary tract symptoms. On digital rectal examination, a firm prostate with exquisite tenderness was noted. Computed tomography scan of the pelvis with contrast demonstrated a 4.4 by 2.7-cm prostatic abscess in the right lobe. Suppurative fluid was expressed from the right prostatic lobe during transurethral resection of the prostate. Cultures of blood and suppurative prostatic fluid grew methicillin-resistant Staphylococcus aureus.
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Affiliation(s)
- Scott D Baker
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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Krobot K, Yin D, Zhang Q, Sen S, Altendorf-Hofmann A, Scheele J, Sendt W. Effect of inappropriate initial empiric antibiotic therapy on outcome of patients with community-acquired intra-abdominal infections requiring surgery. Eur J Clin Microbiol Infect Dis 2004; 23:682-7. [PMID: 15322931 DOI: 10.1007/s10096-004-1199-0] [Citation(s) in RCA: 121] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
To assess the significance of initial empiric parenteral antibiotic therapy in patients requiring surgery for community-acquired secondary peritonitis, 425 patients hospitalized between January 1999 and September 2001 in 20 clinics across Germany were followed for a total of 6,521 patient days. Perforated appendix (38%), colon (27%), or gastroduodenum (22%) were the most common sites of infection. Escherichia coli was the most common pathogen. A total of 54 (13%) patients received inappropriate initial parenteral therapy not covering all bacteria isolated, or not covering both aerobes and anaerobes in the absence of culture results. Clinical success, predefined as the infection resolving with initial or step-down therapy after primary surgery, was achieved in 322 patients (75.7%; 95% confidence interval (CI), 70.6-81.2). Patients were more likely to have clinical success if initial antibiotic therapy was appropriate (78.6%; 95% CI, 73.6-83.9) rather than inappropriate (53.4%; 95% CI, 41.1-69.3). Patients having clinical success were estimated to stay 13.9 days in hospital (95% CI, 13.1-14.7), while those who had clinical failure stayed 19.8 days (95% CI, 17.3-22.3). In conclusion, appropriateness of initial parenteral antibiotic therapy was a predictor of clinical success, which in turn was associated with length of stay.
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Affiliation(s)
- K Krobot
- Outcomes Research, MSD Sharp & Dohme GmbH, Lindenplatz, Haar, Germany.
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20
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Management of community-acquired peritonitis. Short text. Ann Fr Anesth Reanim 2001; 20 Suppl 2:368s-73s. [PMID: 11797518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
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[Management of community-acquired peritonitis. Long text]. Ann Fr Anesth Reanim 2001; 20 Suppl 2:350s-67s. [PMID: 11797517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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Becmeur F. [Methods of surgical management of community-acquired peritonitis in children]. Ann Fr Anesth Reanim 2001; 20 Suppl 2:403s-410s. [PMID: 11797523] [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: 02/23/2023]
Affiliation(s)
- F Becmeur
- Hôpitaux Universitaires de Strasbourg, 67098 Strasbourg, France
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Veber B. [What should be the therapeutic follow-up of a community-acquired peritonitis in the case of a favorable outcome?]. Ann Fr Anesth Reanim 2001; 20 Suppl 2:454s-459s. [PMID: 11797528] [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: 02/23/2023]
Affiliation(s)
- B Veber
- Service d'anesthésie-réanimation, CHU, hôpital Charles Nicolle, 76031 Rouen, France
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Becmeur F, Bientz J. [Surgical management of community-acquired peritonitis in children. Analysis of a survey]. J Chir (Paris) 2000; 137:349-54. [PMID: 11119031] [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: 04/15/2023]
Abstract
The purpose of this work was to determine current practices of pediatric surgeons in the management of community peritonitis, excepting antibiotic use and resuscitation car. A questionnaire was sent to 63 French pediatric surgeons in France. Forty-six answers concerning appendicular peritonitis were analyzed. Laparoscopy was a good indication for 40 surgeons. A sample for bacteriological examination was never ordered. Conditions for washing and drainage were detailed. Treatment to prevent postoperative pain was used by all.
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Affiliation(s)
- F Becmeur
- Hôpitaux Universitaires de Strasbourg - Strasbourg.
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Ewig S, Ruiz M, Mensa J, Marcos MA, Martinez JA, Arancibia F, Niederman MS, Torres A. Severe community-acquired pneumonia. Assessment of severity criteria. Am J Respir Crit Care Med 1998; 158:1102-8. [PMID: 9769267 DOI: 10.1164/ajrccm.158.4.9803114] [Citation(s) in RCA: 256] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of the study was to validate the criteria used in the guidelines of the American Thoracic Society (ATS) for severe community-acquired pneumonia (CAP). Severe pneumonia was defined as admission to the intensive care unit (ICU). Overall 331 nonsevere (84%) and 64 severe cases (16%) of CAP were prospectively studied. Mortality was 19 of 395 (5%) and 19 of 64 (30%), respectively. Single severity criteria as well as the ATS definition of severe pneumonia were assessed calculating the operative indices. A modified prediction rule including minor (baseline) and major (baseline or evolutionary) criteria was derived. Single minor criteria at admission had a low sensitivity and positive predictive value. Defining severe pneumonia according to the ATS guidelines had a high sensitivity (98%). However, specificity and positive predictive value were low (32% and 24%, respectively). A modified prediction rule (presence of two or three minor criteria [systolic blood pressure < 90 mm Hg, multilobar involvement, PaO2/FIO2 < 250] or one of two major criteria [requirement of mechanical ventilation, presence of septic shock]) had a sensitivity of 78%, a specificity of 94%, a positive predictive value of 75%, and a negative predictive value of 95%. The ATS definition of severe pneumonia was highly sensitive but insufficiently specific and had a low positive predictive value. Our suggested modified rule had a more balanced performance and, if validated in an independent population, may represent a more accurate definition of severe CAP.
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Affiliation(s)
- S Ewig
- Servei de Pneumologia i Al.lèrgia Respiratoria, Servei de Malalties Infeccioces, Servei de Microbiologia, Hospital Clinic, Universitat de Barcelona, Spain
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Abstract
Staphylococcus lugdunensis is a recently described coagulase-negative staphylococcus that has been associated with human infections, including nine reported cases of infective endocarditis. The present study describes 11 other cases of infective endocarditis caused by this organism. The infection occurred in patients whose mean age was 61 years and was community-acquired in most cases. A preexisting cardiac abnormality was present in eight patients. Three of the 11 infections involved prosthetic valves. Ten strains were susceptible to penicillin. The destructive course of the infection, the need for valve replacement, and the high mortality suggest that S. lugdunensis causes a virulent form of endocarditis.
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Affiliation(s)
- F Vandenesch
- Laboratoire de Bactériologie, Hôpital Louis Pradel, Lyon, France
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