Search

The increasing burden of invasive biofilm-related staphylococcal infections has led to a dire need for new agents to prevent biofilm formation. Bacteriophages may hypothetically alter a biofilm through several mechanisms, including induction of depolymerizing enzymes and lysis of persistent bacteria. We have assessed the influence of commercially available bacteriophage cocktails on Staphylococcus spp. clinical strains viability and biofilm formation. We analyzed 83 staphylococcal strains from patients consecutively admitted to a Romanian infection reference center from October 2014 through May 2015; the strains were characterized by phenotypic and genetic tools for their resistance and virulence features and for their phyliation. Experiments were performed in triplicate. Methicillin-susceptible strains were significantly more susceptible to all tested phages: 1.7-fold higher susceptibility for PYO, 1.4-fold for INTESTI, 2.9-fold for PHAGYO, 2.7-fold for PHAGESTI and 3.9-fold for STAPHYLOCOCCAL; t030 strains were significantly more susceptible to PYO and INTESTI compared with t127 strains. We identified a significant decrease in biofilm formation in the presence of both low and high PYO and INTESTI concentrations (P < 0.001). In conclusion, Staphylococcus strains from Romania displayed fairly good susceptibility to commercially available bacteriophages. We have also ascertained there is phage-driven in vitro inhibition of biofilm formation, the results potentially impacting prevention of prosthetic infections. [ABSTRACT FROM AUTHOR]

Kaposi's sarcoma (KS) is a malignancy caused by the human herpesvirus type 8 (HHV-8 or Kaposi's sarcoma associated herpesvirus - KSHV). In USA, approximately 15-20% of the HIV-negative and 40% o f the HIV-positive men who have sex with men have a serology for HHV8 positive. We present the case o f a 51 year-old male, with no significant medical history, who in January 2015 presented to the National Institute for Infectious Diseases "Prof. Dr. Matei Balş" for chills, fever (39.5°C), asthenia and 25 kilos weight loss. The symptoms started 3 months ago. The patient states bisexual status started 10 years ago and occasionally intravenous drug use habit stopped 5 years ago. He has hyperpigmented lesions on his legs and arms, old for 4 years. The diagnostic of our patient is C3 HIV infection due to advanced immunosuppression, weight lost, prolonged fever and Kaposi's sarcoma. The patient was started on anti-tuberculous therapy and in the next step antiretroviral therapy was added. After a month of treatment, the patient has no fever, good general condition and a higher number ofCD4 + cell count. The"late presenter" patients are not a casual story in medical practice for infectious diseases physicians, having high mortality and transmission rate. [ABSTRACT FROM AUTHOR]

Osteodisdtis is an infection of the spine and generally engages adjacent vertebral bodies and intervertebral disk. In most cases, the origin is hematogenous. We present the case of a 59 year-old female with a history of type 2 insulindependent diabetes and a surgery with radio-chemotherapy for breast cancer, who in June 2014 presented in our clinic for fever, left chest pain and productive cough started a month before. She had suffered on June 2013 a traumatic comminuted L1 fracture, with lumbar pain that progressed to left hip and thigh pain. An ultrasound scan was performed and revealed two massive retroperitoneal abscesses. So, the patient was started on empiric therapy with ertapenem, linezolid and anti-tuberculosis therapy. We performed a CTscan and a thoracolumbar spine MRI exam which described T12-L2 osteodisdtis with osteodiscal abscess and two massive retroperitoneal abscesses close to both ureters. In the neurosurgery department, aT12 hemilaminectomy was performed, and the cultures were positive for Serratia marcescens. The therapy was changed to tigecycline, according to the antibiogram. The size o f the retroperitoneal abscesses increased on serial ultrasound scans so the patient was transferred to a urology department. The antibiotic therapy was switched to oral therapy with ciprofloxacin and rifampin, the abscesses were drained and a drainage tube was placed. Cultures from the drainage tube identified Serratia marcescens resistant to ciprofloxacin, so the ciprofloxacin was changed to levofloxacin. The patient continued to be evaluated in our clinic with blood tests and seriates ultrasound scans. A month and a half after the treatment was stopped, the lab tests and the ultrasound scan were normal. Treatment of infections caused by Serratia marcescens can be quite long and difficult, and every effort should be made to control the spread of infection and a multidisciplinary team is needed to ensure the best management for the patient. [ABSTRACT FROM AUTHOR]

Introduction Antimicrobial resistance is a growing threat for all clinical branches. This phenomenon poses important challenges in controlling infectious diseases. However, multidrug resistance is not the only issue, as bacteria that are otherwise susceptible to common antibiotics express other patterns for evading antibiotherapy, for example they can aggregate within a self-produced matrix to form biofilm. Methods We intend to perform a prospective laboratory study of the germs isolated from different samples collected from patients admitted with infectious pathology in reference hospitals in Romania. We will perform antibiotic resistance testing as well as phage testing, both on solid and liquid growth medium, for Staphylococcus spp., Enterococcus spp., and Pseudomonas spp. We intend to collect data for 150 patients with different infections with these identified pathogens. Phage susceptibility testing will be performed using 5 types of strain-specific bacteriophage mixtures: PYO, INTESTI, STAPHYLOCOCCAL (Eliava BioPreparations, Tbilisi, Georgia), PHAGYO, PHAGESTI (JSC "Biochimpharm", Tbilisi, Georgia). For phage-susceptible strains, we will evaluate biofilm formation in the presence of phages, as well as phage effect on already formed biofilm. Expected results Through this study, we intend to provide the first set of results on bacteriophage-susceptibility of bacteria isolated from patients with hard to treat infections, from reference hospitals in Romania. By evaluating a large number of bacterial strains we aim to predict and project biofilm kinetics, while adding binary phage dilutions at key timepoints during biofilm formation. [ABSTRACT FROM AUTHOR]

Genus Acinetobacter belongs to the family Neisseriaceae. Acinetobacter spp. can be found in soil, water and in health care facilities, especially in the intensive care units (ICU). It is the most common Gram negative germ, found on the skin of hospital personnel. It could be recovered from patients on ventilator systems or with tracheostomy. Healthy people can have throat carriage. It has the ability to survive in various environmental conditions and it has multiple resistance mechanisms. As a hospital germ, it mainly affects patients in the ICU, especially those requiring mechanical ventilation or those from trauma or burn units. Patients with diabetes mellitus or chronic lung disease have a high risk of infection with A. baumannii. It is an opportunist found in hospitalized patients, causing pneumonia, skin and soft tissue infections, meningitis, urinary tract infections, bacteremia, endocarditis, intra-abdominal abscesses. It is the major pathogen in traumatic wounds, postoperative incisions, and burns. A. baumannii has different resistance mechanisms, like: plasmids, transposons, integrons, carbapenemase and ţ-lactamase synthesis, porins, efflux pumps. Its antibiotic susceptibility profile has changed over time, such that infections with A. baumannii are becoming a significant public health problem worldwide. [ABSTRACT FROM AUTHOR]