Browsing by Author "Garcia, Patricia"

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    Actinomycotic mycetoma due to Actinomadura madurae
    (SOC CHILENA INFECTOLOGIA, 2012) Jerez, Richard; Schafer, Fabiola; Fich, Felix; Garcia, Patricia; Leon, Pilar; Gonzalez, Sergio
    Mycetoma is a chronic, granulomatous, subcutaneous, inflammatory lesion caused by true fungi (eumycetoma) or filamentous bacteria (actinomycetoma). Mycetoma commonly affects young people between 20 and 40 years old. The most common affected site is the foot. The characteristic clinical triad is tumefaction, draining sinuses and discharging grains. We report a healthy 31-year-old male, with a 6-year history of a progressive inflammatory tumor associated with sinus tracts and granules on his left sole. Actinomycetoma was suspected. The clinical diagnosis was confirmed by microbiological and histopathological study. Polymerase chain reaction and DNA sequencing identified Actinomadura madurae. To our knowledge, this is the second case of mycetoma reported in Chile. Our report emphasizes the need to consider this diagnosis in patients with chronic granulomatous disease associated with sinus tracts, fistulas and grains.
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    An Emergent Change in Epidemiologic and Microbiological Characteristics of Bloodstream Infections in Adults With Febrile Neutropenia Resulting From Chemotherapy for Acute Leukemia and Lymphoma at Reference Centers in Chile, Ecuador, and Peru
    (2024) Rabagliati, Ricardo; Salazar, Grace; Perez-Lazo, Giancarlo; Iturrieta, Maria Paz; Portillo, Diana; Soria-Segarra, Carmen; Ojeda, Maria Jose; Flores, Jimena; Galarza, Margarita; Sandoval-Ahumada, Roxana; Cartes Aguilera, Pablo; Dimitrakis, Lady; Reinoso, Fabiola Avelga; Garcia, Patricia
    Background Febrile neutropenia is a life-threatening condition commonly observed in patients with hematologic malignancies. The aim of this article is to provide updated knowledge about bloodstream infections in febrile neutropenia episodes within the Andean region of Latin America.Method This retrospective study was based in 6 hospitals in Chile, Ecuador, and Peru and included adult patients with acute leukemia or lymphoma and febrile neutropenia between January 2019 and December 2020.Results Of the 416 febrile neutropenia episodes, 38.7% had a bloodstream infection, 86% of which were caused by gram-negative rods, with Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa being the most frequently identified bacteria. K pneumoniae isolates were more frequently resistant than E coli to cefotaxime (65% vs 39.6%), piperacillin-tazobactam (56.7% vs 27.1%), and imipenem (35% vs 2.1%) and were more frequently multidrug resistant (61.7% vs 12.5%). Among P aeruginosa, 26.7% were resistant to ceftazidime, piperacillin-tazobactam, and imipenem, and 23.3% were multidrug resistant. Overall 30-day mortality was 19.8%, being higher with vs without a bloodstream infection (26.7% vs 15.3%, P = .005). Fever duration was also significantly longer, as well as periods of neutropenia and length of hospital stay for patients with bloodstream infection. Additionally, the 30-day mortality rate was higher for episodes with inappropriate vs appropriate empirical antibiotic therapy (41.2% vs 26.6%, P = .139).Conclusions Considering the high rates of bacteria-resistant infection and 30-day mortality, it is imperative to establish strategies that reduce the frequency of bloodstream infections, increasing early identification of patients at higher risks of multidrug bacteria resistance, and updating existing empirical antibiotic recommendations.
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    An Open One-Step RT-qPCR for SARS-CoV-2 detection
    (2024) Cerda, Ariel; Rivera, Maira; Armijo, Grace; Ibarra-Henriquez, Catalina; Reyes, Javiera; Blazquez-Sanchez, Paula; Aviles, Javiera; Arce, Anibal; Seguel, Aldo; Brown, Alexander J.; Vasquez, Yesseny; Cortez-San Martin, Marcelo; Cubillos, Francisco A.; Garcia, Patricia; Ferres, Marcela; Ramirez-Sarmiento, Cesar A.; Federici, Fernan; Gutierrez, Rodrigo A.
    The COVID-19 pandemic has resulted in millions of deaths globally, and while several diagnostic systems were proposed, real-time reverse transcription polymerase chain reaction (RT-PCR) remains the gold standard. However, diagnostic reagents, including enzymes used in RT-PCR, are subject to centralized production models and intellectual property restrictions, which present a challenge for less developed countries. With the aim of generating a standardized One-Step open RT-qPCR protocol to detect SARS-CoV-2 RNA in clinical samples, we purified and tested recombinant enzymes and a non-proprietary buffer. The protocol utilized M-MLV RT and Taq DNA pol enzymes to perform a Taqman probe-based assay. Synthetic RNA samples were used to validate the One-Step RT-qPCR components, demonstrating sensitivity comparable to a commercial kit routinely employed in clinical settings for patient diagnosis. Further evaluation on 40 clinical samples (20 positive and 20 negative) confirmed its comparable diagnostic accuracy. This study represents a proof of concept for an open approach to developing diagnostic kits for viral infections and diseases, which could provide a cost-effective and accessible solution for less developed countries.
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    Antibiotic Consumption During the Coronavirus Disease 2019 Pandemic and Emergence of Carbapenemase-Producing Klebsiella pneumoniae Lineages Among Inpatients in a Chilean Hospital: A Time-Series Study and Phylogenomic Analysis
    (2023) Allel, Kasim; Peters, Anne; Conejeros, Jose; Martinez, Jose R. W.; Spencer-Sandino, Maria; Riquelme-Neira, Roberto; Rivas, Lina; Rojas, Pamela; Orellana Chea, Cristian; Garcia, Patricia; Araos, Rafael; McGovern, Olivia; Patel, Twisha S.; Arias, Cesar A.; Lessa, Fernanda C.; Undurraga, Eduardo A.; Munita, Jose M.
    The increased usage of carbapenems and broad-spectrum & beta;-lactams during the COVID-19 pandemic was associated with a higher prevalence of carbapenemase-producing Klebsiella pneumoniae in a public hospital in Chile. We observed emergence and spread of bla(NDM) ST45 during the pandemic.
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    Antimicrobial Resistance and Extended-Spectrum Beta-Lactamase Genes in Enterobacterales, Pseudomonas and Acinetobacter Isolates from the Uterus of Healthy Mares
    (2023) Thomson, Pamela; Garcia, Patricia; del Rio, Camila; Castro, Rodrigo; Nunez, Andrea; Miranda, Carolina
    Antibiotic-resistant bacteria are a growing concern for human and animal health. The objective of this study was to determine the antimicrobial resistance and extended-spectrum beta-lactamase genes in Enterobacterales, Pseudomonas spp. and Acinetobacter spp. isolates from the uterus of healthy mares. For this purpose, 21 mares were swabbed for samples, which were later seeded on blood agar and MacConkey agar. The isolates were identified using MALDI-TOF and the antimicrobial susceptibility test was performed using the Kirby-Bauer technique. To characterize the resistance genes, a polymerase chain reaction (PCR) scheme was performed. Of the isolates identified as Gram-negative, 68.8% were Enterobacterales, represented by E. coli, Enterobacter cloacae, Citrobacter spp., and Klebsiella pneumoniae; 28.1% belonged to the genus Acinetobacter spp.; and 3.1% to Pseudomonas aeruginosa. A 9.3% of the isolates were multidrug-resistant (MDR), presenting resistance to antibiotics from three different classes, while 18.8% presented resistance to two or more classes of different antibiotics. The diversity of three genes that code for ESBL (bla(TEM), bla(CTX-M) and bla(SHV)) was detected in 12.5% of the strains. The most frequent was bla(SHV), while bla(TEM) and bla(CTX-M) were present in Citrobacter spp. and Klebsiella pneumoniae. These results are an alarm call for veterinarians and their environment and suggest taking measures to prevent the spread of these microorganisms.
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    Bacterial identification based on protein mass spectrometry: A new insight at the microbiology of the 21st century
    (SOC CHILENA INFECTOLOGIA, 2012) Garcia, Patricia; Allende, Fidel; Legarraga, Paulette; Huilcaman, Marcos; Solari, Sandra
    Bacterial identification is important for the proper treatment of infected patients hospitalized with serious infections especially in critical care units. Identification by conventional methods used in microbiology laboratories takes at least 16 hours since a culture is positive. The introduction of mass spectrometry, specifically MALDI-TOF MS (matrix-assisted laser desorption/ionization time-of-flight mass spectrometer) in the microbiology laboratory could mean a radical change in the identification accuracy, turn around time (6 minutes per bacteria) and cost (about 5 times cheaper than conventional identification). Since its introduction in clinical microbiology laboratories in 2008, many reports about its usefulness in identifying microorganisms from colonies, as well as directly from positive blood cultures and urine samples have been published. This review describes MALDI-TOF MS methodology, its identification performance for bacteria (aerobic and anaerobic), mycobacterium and yeasts, its future applications in microbiology and its main disadvantages.
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    Catheter-associated bloodstream infection caused by Leifsonia aquatica in a haemodialysis patient: a case report
    (SOC GENERAL MICROBIOLOGY, 2012) Porte, Lorena; Soto, Andres; Andrighetti, Daniela; Dabanch, Jeannette; Braun, Stephanie; Saldivia, Alejandra; Carlos Flores, Juan; Wozniak, Aniela; Garcia, Patricia; Weitzel, Thomas
    Leifsonia aquatica is an aquatic coryneform rod that is capable of forming biofilms in environmental water sources. It has rarely been associated with human infections and its pathogenicity and clinical significance are uncertain. We describe a case of catheter-related bloodstream infection in a haemodialysis patient. The isolate grew on conventional media as a yellow-pigmented colony, but identification required molecular methods. Although the strain displayed reduced sensitivity to vancomycin, the clinical outcome was favourable after catheter removal and intravenous treatment with this antibiotic. Our report gives further evidence of the capability of this aquatic bacterium to cause human infection.
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    Clinical and epidemiological changes of candidemia among adult patients from 2000 to 2013
    (SOC CHILENA INFECTOLOGIA, 2017) Siri, Leonardo; Legarraga, Paulette; Garcia, Patricia; Gonzalez, Tamara; Rabagliati, Ricardo
    Background: Invasive Candida spp. infections have been described more frequently. Aim: To characterize the epidemiological data of candidemia in recent years. Methods: A retrospective study of adult patients in a University Hospital in Santiago, Chile, with 1 or more documented episodes of candidemia, from January 2000 to December 2013. Results: One hundred and twenty episodes of candidemia were identified in 120 patients, annual incidence of 0.4 cases per 1000 discharges, 53.3% were male patients, 58.3%> 60 years, 77,5% had at least one co-morbidity. Candida albicans was the species most frequently identified 55%, followed by C. glabrata 18.3%, C. tropicalis 11.7% and C. parapsilosis 9.2%. Comparing 2000-2006 vs 2007-2013, increased the frequency of C. parapsilosis among non-albicans and echinocandins prescription. Patients with C. albicans showed higher APACHE-II, more requirement for invasive mechanical ventilation, greater association with CVC, and shorter incubation time compared with non-albicans species. The 30-day mortality was 31.7%. Conclusions: During this 14-years period we observed that C. albicans was the predominant specie and more recently a change among C. non-albicans increasing C. parapsilosis and decreasing C. glabrata 30-days and attributable mortality decreased together with more echinocandins prescription.
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    COVID-19-Associated Mold Infection in Critically Ill Patients, Chile
    (2021) Rabagliati, Ricardo; Rodriguez, Nicolas; Nunez, Carolina; Huete, Alvaro; Bravo, Sebastian; Garcia, Patricia
    Patients with severe coronavirus disease (COVID-19) may have COVID-19-associated invasive mold infection (CAIMI) develop. We report 16 cases of CAIMI among 146 nonimmunocompromised patients with severe COVID-19 at an academic hospital in Santiago, Chile. These rates correspond to a CAIMI incidence of 11%; the mortality rate for these patients was 31.2%.
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    Creation of the first national biorepository of multi-resistant bacteria available for the study of bacterial resistance in Chile
    (2022) Garcia, Patricia; Rivas, Lina; Peters, Anne; Henriquez, Paola; Castillo, Loriana; Illesca, Vijna; Maripani, Andrea; Moreno, Juan; Muhlhauser, Margareta; Porte, Lorena; Rioseco, Maria Luisa; Rojas, Pamela; Silva, Francisco; Suazo, Patricio; Munita, Jose M.
    The availability of bacterial strains for the study of bacterial resis-tance is key to advances in basic and clinical research. There are few biobanks of bacteria with known resistance mechanisms, isolated from clinically significant infections. A review of the literature reveals that only in the United States of America is there a biobank of resistant isolates. This publication shows the creation of the first biorepository of resistant bacteria Chile associated with the MICROB-R Laboratory Network, with the participation of 11 centers distributed throughout the country, which to date has more than 3,500 bacterial isolates studied phenotypically and genotypically, available to the Chilean scientific community.
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    Daptomycin: pharmacological characteristics and its role in the treatment of gram positive infections
    (SOC CHILENA INFECTOLOGIA, 2012) Araos, Rafael; Garcia, Patricia; Chanqueo, Leonardo; Labarca, Jaime
    Daptomycin recently made available in Chile, belongs to a new family of antimicrobials known as lypopeptides. Daptomycin has a unique mechanism of action and a potent bactericidal activity over susceptible agents. It is active against a number of clinically significant Gram positive cocci, including strains of Staphylococcus aureus and Enterococcus spp., both susceptible and resistant to classic antimicrobials. Daptomycin has been approved for clinical use in skin and soft tissue infections, and for S. aureus bacteremia in adult patients. Ongoing trials suggest that daptomycin is also useful in the treatment of other infections such as osteomyelitis, biofilm producing infections, and in immunocompromised patients, particularly onco-hematologic patients. The main adverse reaction associated with daptomycin use is myopathy, usually mild and reversible.
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    Does a clinical prediction rule anticipate the diagnosis for streptococcal pharyngitis in children aged 2 to 15?
    (SOC CHILENA INFECTOLOGIA, 2018) Katzulovic, Lorena; Garcia, Patricia; Wozniak, Aniela; Villarroel, Luis; Hirsch, Tamara; Concha, Ida; Catalan, Silvia; Cifuentes, Lorena
    Background: The etiology of a streptococcal pharyngitis must be documented by laboratory techniques to avoid unnecessary antimicrobial treatment, but this strategy increases cost for the patient. Available scores applied in children or adults are imperfect. Aim: To develop a clinical prediction rule to aid the diagnostic process of streptococcal pharyngitis (SP) in children in a low-resource setting. Methods: Three hundred and eighteen patients aged 2 to 15 years who were evaluated for suspected SP at the Pediatric Emergency Department and the Pediatric Ambulatory Unit of Red Salud UC-Christus entered the study. A throat culture and a rapid antigen detection test for Streptococcus pyogenes were obtained from each patient. Data were analyzed for possible clinical predictors of SP with univariate and multiple regression analyses. Results: Seventy-three cases of SP were diagnosed (23.9%). In the univariate analysis, fever was inversely associated with SP (p = 0.002). Odynophagia, palatal petechiae, and season of the year (autumn and winter) were positively associated with SP (p = 0.007, p < 0.001 and p = 0.03 respectively). In multiple regression analysis the models did not have sufficient power to predict streptococcal etiology. Conclusion: Clinical predictors, even those systematically included in clinical prediction rules, did not show sufficient predictive power to safely include or exclude SP in this setting, and thus, it is necessary to improve access to confirmatory tests.
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    Dynamics of the MRSA Population in a Chilean Hospital: a Phylogenomic Analysis (2000-2016)
    (2023) Martinez, Jose R. W.; Planet, Paul J.; Spencer-Sandino, Maria; Rivas, Lina; Diaz, Lorena; Moustafa, Ahmed M.; Quesille-Villalobos, Ana; Riquelme-Neira, Roberto; Alcalde-Rico, Manuel; Hanson, Blake; Carvajal, Lina P.; Rincon, Sandra; Reyes, Jinnethe; Lam, Marusella; Calderon, Juan F.; Araos, Rafael; Garcia, Patricia; Arias, Cesar A.; Munita, Jose M.
    Methicillin-resistant Staphylococcus aureus (MRSA) is a major public health pathogen that disseminates through the emergence of successful dominant clones in specific geographic regions. Knowledge of the dissemination and molecular epidemiology of MRSA in Latin America is scarce and is largely based on small studies or more limited typing techniques that lack the resolution to represent an accurate description of the genomic landscape.
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    Effects of c-FLIPL Knockdown in Cervical Uterine Carcinoma Cell Lines
    (2015) Ili, Carmen G.; Brebi, Priscilla; Garcia, Patricia; Leal, Pamela; Lopez, Jaime; Tapia, Oscar; Letelier, Pablo; Weber, Helga; Castillo, Jonathan; Roa, Juan C.
    Overexpression of Short and Raji variants of Cellular FLICE-like inhibitory protein (c-FLIP) is capable of inhibiting apoptosis, while the function of the Long isoform depends of c-FLIPL concentration in cells. The aim of this study was to determine the effects of c-FLIPL knockdown in cervical cell lines. SiHa, C-4I and C-33A cervical cancer cell lines were analyzed. c-FLIPL level expression was determined by quantitative real-time PCR and western blotting. c-FLIPL was transiently downregulated by siRNA. The effects of knockdown of c-FLIPL on cell viability, proliferation and apoptosis were assessed by comparing with scrambled siRNA-transfected cells. SiHa and C-4I c-FLIPL knockdown cells showed increased viability compared with scrambled siRNA-transfected cells (P<0.05), while C-33A cells did not show significant differences. Ki-67 and PCNA immunocytochemistry was performed to evaluate proliferation on these cervical cancer cell lines. SiHa cells with c-FLIPL knockdown showed elevated expression of Ki-67 protein compared with their scrambled counterparts (P<0.0001), while C-33A c-FLIPL knockdown cells showed a significantly lower in PCNA expression (P<0.01) compared with control. All three c-FLIP-transfected cell lines showed a higher level of apoptosis compared with their scrambled controls. Our results suggest that c-FLIPL could have effects in proliferation and apoptosis in cervical cancer cell lines.
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    First isolation of kpc in Chile: from Italy to a public hospital in Santiago
    (SOC CHILENA INFECTOLOGIA, 2012) Cifuentes, Marcela; Garcia, Patricia; San Martin, Paola; Silva, Francisco; Zuniga, Jennifer; Reyes, Sergio; Rojas, Rodrigo; Ponce, Rodrigo; Quintanilla, Raul; Delpiano, Luis; Wolff, Marcelo
    Carbapenem resistance in Enterobacteriaceae is an emerging problem worldwide. Among the mechanisms involved are the production of ESBLs or AmpC associated with porins loss or the presence of carbapenemases. Among these, the KPC betalactamase has become especially relevant given its rapid spread.In this article we present the first case of isolation of a strain of KPC producer Klebsiella pneumoniae at a hospital in Santiago, in a patient coming from Italy, with a history of multiple hospitalizations for treatment of non-Hodgkin lymphoma and subjected to several cycles of chemotherapy and hemodialysis. The strain was isolated from a urine culture on the seventh day of the patient's arrival to Chile. The isolate was resistant to quinolones, aminoglycosides, cephalosporins and carbapenems, retaining only susceptibility to tigecycline and colistin. In phenotypic test it was found to have positive Hodge test and positive synergy with carbapenems/boronic acid. Polymerase chain reaction demonstrated the presence of beta-lactamases TEM, SHV and KPC-2. None other Class A serine-carbapenemase or metallo-bectalactamases were present.
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    Gallbladder cancer
    (2022) Roa, Juan C.; Garcia, Patricia; Kapoor, Vinay K.; Maithel, Shishir K.; Javle, Milind; Koshiol, Jill
    Gallbladder cancer is the most common cancer of the biliary tract and often has a very poor prognosis. This Primer by Roa and colleagues summarizes the epidemiology, mechanisms, diagnosis and treatment of gallbladder cancer, and discusses patient quality of life and open research questions for this disease.
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    Genomic Analysis of Carbapenem-Resistant Acinetobacter baumannii Strains Recovered from Chilean Hospitals Reveals Lineages Specific to South America and Multiple Routes for Acquisition of Antibiotic Resistance Genes
    (2022) Brito, Barbara P.; Koong, Jonathan; Wozniak Banchero, Aniela; Opazo-Capurro, Andres; To, Joyce; Garcia, Patricia; Hamidian, Mehrad
    Carbapenem-resistant Acinetobacter baumannii (CRAb) is a public health threat accounting for a significant number of hospital-acquired infections. Despite the importance of this pathogen, there is scarce literature on A. baumannii molecular epidemiology and evolutionary pathways relevant to resistance emergence in South American strains. We analyzed the genomic context of 34 CRAb isolates recovered from clinical samples between 2010 and 2013 from two hospitals in Santiago, Chile, using whole-genome sequencing. Several Institut Pasteur scheme sequence types (STs) were identified among the 34 genomes studied here, including ST1, ST15, ST79, ST162, and ST109. No ST2 (the most widespread sequence type) strain was detected. Chilean isolates were phylogenetically closely related, forming lineages specific to South America (e.g., ST1, ST79, and ST15). The genomic contexts of the resistance genes were diverse: while genes were present in a plasmid in ST15 strains, all genes were chromosomal in ST79 strains. Different variants of a small Rep_3 plasmid played a central role in the acquisition of the oxa58 carbapenem and aacC2 aminoglycoside resistance genes in ST1, ST15, and ST79 strains. The aacC2 gene along with blaTEM were found in a novel transposon named Tn6925 here. Variants of Tn7 were also found to play an important role in the acquisition of the aadA1 and dfrA1 genes. This work draws a detailed picture of the genetic context of antibiotic resistance genes in a set of carbapenem-resistant A. baumannii strains recovered from two Chilean hospitals and reveals a complex evolutionary picture of antibiotic resistance gene acquisition events via multiple routes involving several mobile genetic elements.
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    Genomic characterisation of the population structure and antibiotic resistance of Salmonella enterica serovar Infantis in Chile, 2009-2022
    (2024) Pina-Iturbe, Alejandro; Diaz-Gavidia, Constanza; Alvarez, Francisca P.; Barron-Montenegro, Rocio; Alvarez-Espejo, Diana M.; Garcia, Patricia; Solis, Doina; Constenla-Albornoz, Rodrigo; Toro, Magaly; Olivares-Pacheco, Jorge; Reyes-Jara, Angelica; Meng, Jianghong; Bell, Rebecca L.; Moreno-Switt, Andrea I.
    Background Multidrug-resistant (MDR) Salmonella Infantis has disseminated worldwide, mainly linked to the consumption of poultry products. Evidence shows dissemination of this pathogen in Chile; however, studies are primarily limited to phenotypic data or involve few isolates. As human cases of Salmonella Infantis infections have substantially increased in recent years, this study aimed to characterise the genomic epidemiology and antimicrobialresistance profiles of isolates obtained from different sources, aiming to inform effective surveillance and control measures. Methods We sequenced 396 Salmonella Infantis genomes and analysed them with all publicly available genomes of this pathogen from Chile (440 genomes in total), representing isolates from environmental, food, animal, and human sources obtained from 2009 to 2022. Based on bioinformatic and phenotypic methods, we assessed the population structure, dissemination among different niches, and antimicrobial resistance (AMR) profiles of Salmonella Infantis in the country. Findings The genomic and phylogenetic analyses showed that Salmonella Infantis from Chile comprised several clusters of highly related isolates dominated by sequence type 32. The HC20_343 cluster grouped an important proportion of all isolates. This was the only cluster associated with pESI-like megaplasmids, and up to 12 acquired AMR genes/mutations predicted to result in an MDR phenotype. Accordingly, antimicrobial -susceptibility testing revealed a strong concordance between the AMR genetic determinants and their matching phenotypic expression, indicating that a significant proportion of HC20_343 isolates produce extended -spectrum beta-lactamases and have intermediate fluoroquinolone resistance. HC20_343 Salmonella Infantis were spread among environmental, animal, food, and human niches, showing a close relationship between isolates from different years and sources, and a low intra-source genomic diversity. Interpretation Our findings show a widespread dissemination of MDR Salmonella Infantis from the HC20_343 cluster in Chile. The high proportion of isolates with resistance to first -line antibiotics and the evidence of active transmission between the environment, animals, food, and humans highlight the urgency of improved surveillance and control measures in the country. As HC20_343 isolates predominate in the Americas, our results suggest a high prevalence of ESBL-producing Salmonella Infantis with intermediate fluoroquinolone resistance in the continent.
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    HACEK Infective Endocarditis: Characteristics and Outcomes from a Large, Multi-National Cohort
    (2013) Chambers, Stephen T.; Murdoch, David; Morris, Arthur; Holland, David; Pappas, Paul; Almela, Manel; Fernandez-Hidalgo, Nuria; Almirante, Benito; Bouza, Emilio; Forno, Davide; del Rio, Ana; Hannan, Margaret M.; Harkness, John; Kanafani, Zeina A.; Lalani, Tahaniyat; Lang, Selwyn; Raymond, Nigel; Read, Kerry; Vinogradova, Tatiana; Woods, Christopher W.; Wray, Dannah; Corey, G. Ralph; Chu, Vivian H.; Clara, Liliana; Sanchez, Marisa; Nacinovich, Francisco; Fernandez Oses, Pablo; Ronderos, Ricardo; Sucari, Adriana; Thierer, Jorge; Casabe, Jose; Cortes, Claudia; Altclas, Javier; Kogan, Silvia; Spelman, Denis; Athan, Eugene; Harris, Owen; Kennedy, Karina; Tan, Ren; Gordon, David; Papanicolas, Lito; Eisen, Damon; Grigg, Leeanne; Street, Alan; Korman, Tony; Kotsanas, Despina; Dever, Robyn; Jones, Phillip; Konecny, Pam; Lawrence, Richard; Rees, David; Ryan, Suzanne; Feneley, Michael P.; Harkness, John; Jones, Phillip; Ryan, Suzanne; Jones, Phillip; Ryan, Suzanne; Jones, Phillip; Post, Jeffrey; Reinbott, Porl; Ryan, Suzanne; Gattringer, Rainer; Wiesbauer, Franz; Andrade, Adriana Ribas; Passos de Brito, Ana Claudia; Guimaraes, Armenio Costa; Grinberg, Max; Mansur, Alfredo Jose; Siciliano, Rinaldo Focaccia; Varejao Strabelli, Tania Mara; Campos Vieira, Marcelo Luiz; de Medeiros Tranchesi, Regina Aparecida; Paiva, Marcelo Goulart; Fortes, Claudio Querido; Ramos, Auristela de Oliveira; Ferraiuoli, Giovanna; Golebiovski, Wilma; Lamas, Cristiane; Santos, Marisa; Weksler, Clara; Karlowsky, James A.; Keynan, Yoav; Morris, Andrew M.; Rubinstein, Ethan; Jones, Sandra Braun; Garcia, Patricia; Cereceda, M.; Fica, Alberto; Mella, Rodrigo Montagna; Barsic, Bruno; Bukovski, Suzana; Krajinovic, Vladimir; Pangercic, Ana; Rudez, Igor; Vincelj, Josip; Freiberger, Tomas; Pol, Jiri; Zaloudikova, Barbora; Ashour, Zainab; El Kholy, Amani; Mishaal, Marwa; Rizk, Hussien; Aissa, Neijla; Alauzet, Corentine; Alla, Francois; Campagnac, Catherine; Doco-Lecompte, Thanh; Selton-Suty, Christine; Casalta, Jean-Paul; Fournier, Pierre-Edouard; Habib, Gilbert; Raoult, Didier; Thuny, Franck; Delahaye, Francois; Delahaye, Armelle; Vandenesch, Francois; Donal, Erwan; Donnio, Pierre Yves; Michelet, Christian; Revest, Matthieu; Tattevin, Pierre; Violette, Jeremie; Chevalier, Florent; Jeu, Antoine; Dan; Rusinaru; Sorel, Claire; Tribouilloy, Christophe; Bernard, Yvette; Chirouze, Catherine; Hoen, Bruno; Leroy, Joel; Plesiat, Patrick; Naber, Christoph; Neuerburg, Carl; Mazaheri, Bahram; Naber, Christoph; Neuerburg, Carl; Athanasia, Sofia; Giannitsioti, Efthymia; Mylona, Elena; Paniara, Olga; Papanicolaou, Konstantinos; Pyros, John; Skoutelis, Athanasios; Sharma, Gautam; Francis, Johnson; Nair, Lathi; Thomas, Vinod; Venugopal, Krishnan; Hannan, Margaret; Hurley, John; Gilon, Dan; Israel, Sarah; Korem, Maya; Strahilevitz, Jacob; Rubinstein, Ethan; Strahilevitz, Jacob; Tripodi, Marie Francoise; Casillo, Roberta; Cuccurullo, Susanna; Dialetto, Giovanni; Durante-Mangoni, Emanuele; Irene, Mattucci; Ragone, Enrico; Utili, Riccardo; Cecchi, Enrico; De Rosa, Francesco; Forno, Davide; Imazio, Massimo; Trinchero, Rita; Tebini, Alessandro; Grossi, Paolo; Lattanzio, Mariangela; Toniolo, Antonio; Goglio, Antonio; Raglio, Annibale; Ravasio, Veronica; Rizzi, Marco; Suter, Fredy; Carosi, Giampiero; Magri, Silvia; Signorini, Liana; Baban, Tania; Kanafani, Zeina; Kanj, Souha S.; Sfeir, Jad; Yasmine, Mohamad; Abidin, Imran; Tamin, Syahidah Syed; Martinez, Eduardo Rivera; Nieto, Gabriel Israel Soto; van der Meer, Jan T. M.; Chambers, Stephen; Holland, David; Morris, Arthur; Raymond, Nigel; Read, Kerry; Murdoch, David R.; Dragulescu, Stefan; Ionac, Adina; Mornos, Cristian; Butkevich, O. M.; Chipigina, Natalia; Kirill, Ozerecky; Vadim, Kulichenko; Vinogradova, Tatiana; Edathodu, Jameela; Halim, Magid; Lum, Luh-Nah; Tan, Ru-San; Lejko-Zupanc, Tatjana; Logar, Mateja; Mueller-Premru, Manica; Commerford, Patrick; Commerford, Anita; Deetlefs, Eduan; Hansa, Cass; Ntsekhe, Mpiko; Almela, Manuel; Armero, Yolanda; Azqueta, Manuel; Castaneda, Ximena; Cervera, Carlos; del Rio, Ana; Falces, Carlos; Garcia-de-la-Maria, Cristina; Fita, Guillermina; Gatell, Jose M.; Marco, Francesc; Mestres, Carlos A.; Miro, Jose M.; Moreno, Asuncion; Ninot, Salvador; Pare, Carlos; Pericas, Joan; Ramirez, Jose; Rovira, Irene; Sitges, Marta; Anguera, Ignasi; Font, Bernat; Guma, Joan Raimon; Bermejo, Javier; Bouza, Emilio; Garcia Fernandez, Miguel Angel; Gonzalez-Ramallo, Victor; Marin, Mercedes; Munoz, Patricia; Pedromingo, Miguel; Roda, Jorge; Rodriguez-Creixems, Marta; Solis, Jorge; Almirante, Benito; Fernandez-Hidalgo, Nuria; Tornos, Pilar; de Alarcon, Aristides; Parra, Ricardo; Alestig, Eric; Johansson, Magnus; Olaison, Lars; Snygg-Martin, Ulrika; Pachirat, Orathai; Pachirat, Pimchitra; Pussadhamma, Burabha; Senthong, Vichai; Casey, Anna; Elliott, Tom; Lambert, Peter; Watkin, Richard; Eyton, Christina; Klein, John L.; Bradley, Suzanne; Kauffman, Carol; Bedimo, Roger; Chu, Vivian H.; Corey, G. Ralph; Crowley, Anna Lisa; Douglas, Pamela; Drew, Laura; Fowler, Vance G.; Holland, Thomas; Lalani, Tahaniyat; Mudrick, Daniel; Samad, Zaniab; Sexton, Daniel; Stryjewski, Martin; Wang, Andrew; Woods, Christopher W.; Lerakis, Stamatios; Cantey, Robert; Steed, Lisa; Wray, Dannah; Dickerman, Stuart A.; Bonilla, Hector; DiPersio, Joseph; Salstrom, Sara-Jane; Baddley, John; Patel, Mukesh; Peterson, Gail; Stancoven, Amy; Afonso, Luis; Kulman, Theresa; Levine, Donald; Rybak, Michael; Cabell, Christopher H.; Baloch, Khaula; Chu, Vivian H.; Corey, G. Ralph; Dixon, Christy C.; Fowler, Vance G.; Harding, Tina; Jones-Richmond, Marian; Pappas, Paul; Park, Lawrence P.; Redick, Thomas; Stafford, Judy; Anstrom, Kevin; Athan, Eugene; Bayer, Arnold S.; Cabell, Christopher H.; Chu, Vivian H.; Corey, G. Ralph; Fowler, Vance G.; Hoen, Bruno; Karchmer, A. W.; Miro, Jose M.; Murdoch, David R.; Sexton, Daniel J.; Wang, Andrew; Bayer, Arnold S.; Cabell, Christopher H.; Chu, Vivian; Corey, G. Ralph; Durack, David T.; Phil, D.; Eykyn, Susannah; Fowler, Vance G.; Hoen, Bruno; Miro, Jose M.; Moreillon, Phillipe; Olaison, Lars; Raoult, Didier; Rubinstein, Ethan; Sexton, Daniel J.
    The HACEK organisms (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species) are rare causes of infective endocarditis (IE). The objective of this study is to describe the clinical characteristics and outcomes of patients with HACEK endocarditis (HE) in a large multi-national cohort. Patients hospitalized with definite or possible infective endocarditis by the International Collaboration on Endocarditis Prospective Cohort Study in 64 hospitals from 28 countries were included and characteristics of HE patients compared with IE due to other pathogens. Of 5591 patients enrolled, 77 (1.4%) had HE. HE was associated with a younger age (47 vs. 61 years; p < 0.001), a higher prevalence of immunologic/vascular manifestations (32% vs. 20%; p < 0.008) and stroke (25% vs. 17% p = 0.05) but a lower prevalence of congestive heart failure (15% vs. 30%; p = 0.004), death in-hospital (4% vs. 18%; p = 0.001) or after 1 year follow-up (6% vs. 20%; p = 0.01) than IE due to other pathogens (n = 5514). On multivariable analysis, stroke was associated with mitral valve vegetations (OR 3.60; CI 1.34-9.65; p < 0.01) and younger age (OR 0.62; CI 0.49-0.90; p < 0.01). The overall outcome of HE was excellent with the in-hospital mortality (4%) significantly better than for non-HE (18%; p < 0.001). Prosthetic valve endocarditis was more common in HE (35%) than non-HE (24%). The outcome of prosthetic valve and native valve HE was excellent whether treated medically or with surgery. Current treatment is very successful for the management of both native valve prosthetic valve HE but further studies are needed to determine why HE has a predilection for younger people and to cause stroke. The small number of patients and observational design limit inferences on treatment strategies. Self selection of study sites limits epidemiological inferences.
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    Isolation and Identification of Staphylococcus Species Obtained from Healthy Companion Animals and Humans
    (2022) Thomson, Pamela; Garcia, Patricia; Miles, Jorge; Isla, David; Yanez, Camilo; Santibanez, Rodrigo; Nunez, Andrea; Flores-Yanez, Carla; del Rio, Camila; Cuadra, Francoise
    The close contact between people and their pets has generated the exchange of skin microbiota, accompanied by bacteria that present resistance to antibiotics. Staphylococcus spp., opportunistic pathogens present in the skin and mucosa of mammals, have had their importance recognized in human and veterinary medicine. The objectives of this study were to identify Staphylococcus spp. present in isolates from the nostrils of healthy humans, dogs and cats as well as to determine their phenotype of resistance to methicillin. Strain identification was performed by MALDI-TOF mass spectrometry and antimicrobial susceptibility was determined using a disk diffusion assay for 12 antibiotics. Sixty humans (veterinary and technicians), sixty dogs and sixty cats were sampled; of them, 61.6%, 56.6% and 46.6%, respectively, carried Staphylococcus spp. in their nostrils, and only two people carried two different species of Staphylococcus in the only anatomical site sampled. A methicillin-resistant phenotype was present in 48.7% of the humans, 26.5% of the dogs and 57.1% of the cats, and sampled. These results demonstrate the presence of Staphylococcus spp. strains resistant to methicillin in personnel who work in contact with animals, as well as in dogs and cats that entered the same hospital or veterinary clinic, which alerts us to the potential transfer of these strains to or between people, dogs and/or cats.