Endogenous fungal endophthalmitis caused by Cladophialophora devriesii: report of a case and literature review.

Purpose: To report a case of endogenous endophthalmitis caused by the dematiaceous fungus Cladophialophora devriesii.

Methods: Observational case report and literature review.

Case Presentation: A 73-year-old female with a history of chronic obstructive pulmonary disease presented with a red and painful left eye.

Case Report: Whole-Genome Sequencing of Serially Collected From a Patient With Common Variable Immunodeficiency Reveals Within-Host Evolution of Resistance to Trimethoprim-Sulfamethoxazole and Azithromycin After Prolonged Treatment With These Antibiotics.

We report within-host evolution of antibiotic resistance to trimethoprim-sulfamethoxazole and azithromycin in a nontypeable strain from a patient with common variable immunodeficiency (CVID), who received repeated or prolonged treatment with these antibiotics for recurrent respiratory tract infections. Whole-genome sequencing of three longitudinally collected sputum isolates during the period April 2016 to January 2018 revealed persistence of a strain of sequence type 2386. Reduced susceptibility to trimethoprim-sulfamethoxazole in the first two isolates was associated with mutations in genes encoding dihydrofolate reductase ( and its promotor region, dihydropteroate synthase (), and thymidylate synthase (), while subsequent substitution of a single amino acid in dihydropteroate synthase (G225A) rendered high-level resistance in the third isolate from 2018.

Consistent Biofilm Formation by Isolated From Patients With Necrotizing Soft Tissue Infections.

Objectives: Biofilm formation has been demonstrated in muscle and soft tissue samples from patients with necrotizing soft tissue infection (NSTI) caused by , but the clinical importance of this observation is not clear. Although M-protein has been shown to be important for biofilm formation in , the evidence for an association between type and biofilm forming capacity is conflicting. Here we characterize the biofilm forming capacity in a collection of isolates causing NSTI, and relate this to type of the isolates and clinical characteristics of the patients.

Identification of Streptococcus dysgalactiae using matrix-assisted laser desorption/ionization-time of flight mass spectrometry; refining the database for improved identification.

Matrix-assisted laser desorption/ionization time of flight (MALDI-ToF) has revolutionized bacterial identification. However, the phylogenetic resolution is still insufficient for discerning several β-haemolytic streptococcal species. We aimed to improve the diagnostic performance of MALDI-ToF through manual curation of the reference spectra in Brukers Compass Library DB-7854.

Emerging Threat of Antimicrobial Resistance in β-Hemolytic Streptococci.

Highly variable resistance rates to erythromycin and clindamycin have been reported in the β-hemolytic streptococcal species , , and , depending on geographic and temporal context. In the present study we aimed to examine the longitudinal trends of antimicrobial resistance in these three species in a northern European setting. Furthermore, we used whole genome sequencing to identify resistance determinants and the mobile genetic elements involved in their dissemination, as well as elucidate phylogenetic relationships.

Role of Horizontal Gene Transfer in the Development of Multidrug Resistance in Haemophilus influenzae.

colonizes the respiratory tract in humans and causes both invasive and noninvasive infections. Resistance to extended-spectrum cephalosporins in is rare in Europe. In this study, we defined acquired resistance gene loci and mutations in multidrug-resistant (MDR) and/or PBP3-mediated beta-lactam-resistant (rPBP3) strains, intending to understand the mode of spread of antibiotic resistance determinants in this species.

The impact of age on risk assessment, therapeutic practice and outcome in candidemia.

Background: In Norway, the epidemiological situation of candidemia is followed closely. We have previously demonstrated the highest incidence of candidemia in elderly >65 years of age. However, knowledge of other aspects of this infection is lacking.

Exploring the arthritogenicity of Streptococcus dysgalactiae subspecies equisimilis.

Background: During the past decades, Streptococcus dysgalactiae subspecies equisimilis (SDSE) has been increasingly recognized as an important human pathogen. Osteoarticular infections is one of the predominant disease manifestations of SDSE, but the pathogenetic rationale for its arthritogenicity has yet to be unravelled. We aimed to explore if the rising incidence of osteoarticular infections caused by this pathogen in our region emanated from clonal expansion of strains with enhanced tropism for bone and joint tissue components or orthopaedic implants.

An Estimate of the Burden of Fungal Disease in Norway.

The aim of this study was to examine the burden of fungal disease in Norway, contributing to a worldwide effort to improve awareness of the needs for better diagnosis and treatment of such infections. We used national registers and actual data from the Departments of Microbiology from 2015 and estimated the incidence and/or prevalence of superficial, allergic and invasive fungal disease using published reports on specific populations at risk. One in 6 Norwegians suffered from fungal disease: Superficial skin infections (14.

Emergence of a Streptococcus dysgalactiae subspecies equisimilis stG62647-lineage associated with severe clinical manifestations.

Increasing incidence rates of invasive Streptococcus dysgalactiae subspecies equisimilis (SDSE) infections have been reported worldwide, but the evolutionary mechanisms underlying this development remain elusive. Through prospective surveillance of invasive SDSE infections in western Norway, we observed the emergence of a novel and virulent SDSE genotype, stG62647. This emm-type, rarely encountered as a cause of invasive disease during 1999-2012, emerged in 2013 as the predominant SDSE-genotype.

Clinical and molecular characteristics of infective β-hemolytic streptococcal endocarditis.

Streptococcus pyogenes (S. pyogenes) and Streptococcus dysgalactiae subspecies equisimilis (SDSE) cause considerable morbidity and mortality, and show similarities in disease manifestations and pathogenic mechanisms. Their involvement in infective endocarditis, however, has not been well described.

Aetiology and clinical features of facial cellulitis: a prospective study.

Background: In the early 20th century, the face was the predominant site of cellulitis. Despite a relative decrease in the incidence of facial cellulitis, it is still common. There are few studies on this condition during the last decades.

Extended spectrum cephalosporin resistance among clinical isolates of Enterobacteriaceae in West Norway during 2006-2013; a prospective surveillance study.

Routine surveillance of resistance to broad-spectrum cephalosporins in Enterobacteriaceae and phenotypic identification of underlying mechanisms using a simple strategy was commenced in 2006 at our laboratory, serving West Norway. This report focuses on the results until 2013. The classical plasmid-mediated extended spectrum beta-lactamase (ESBL ) among clinically relevant Escherichia coli isolates showed an increase from 0.

Temporal trends of β-haemolytic streptococcal osteoarticular infections in western Norway.

Background: Beta-haemolytic streptococci are important contributors to the global burden of osteoarticular infections (OAI). Knowledge on the disease traits specific for streptococcal OAI, however, remains scarce. We wished to explore temporal trends of OAI caused by Group A Streptococci (GAS), Group B Streptococci (GBS) and Group C and G Streptococci (GCGS), and furthermore, to describe the associated host and pathogen characteristics.

Etiology of Cellulitis and Clinical Prediction of Streptococcal Disease: A Prospective Study.

Background.  The importance of bacteria other than group A streptococci (GAS) in different clinical presentations of cellulitis is unclear, commonly leading to treatment with broad-spectrum antibiotics. The aim of this study was to describe the etiological and clinical spectrum of cellulitis and identify clinical features predicting streptococcal etiology.

Increased cytotoxicity and streptolysin O activity in group G streptococcal strains causing invasive tissue infections.

Streptococcus dysgalactiae subsp. equisimilis (SDSE) has emerged as an important cause of severe skin and soft tissue infections, but little is known of the pathogenic mechanisms underlying tissue pathology. Patient samples and a collection of invasive and non-invasive group G SDSE strains (n = 69) were analyzed with respect to virulence factor expression and cytotoxic or inflammatory effects on human cells and 3D skin tissue models.

Aminoglycoside resistance in clinical Escherichia coli and Klebsiella pneumoniae isolates from Western Norway.

Resistance to gentamicin in Escherichia coli from blood culture has shown an increase over the past decade in Norway. This study was done to investigate aminoglycoside resistance in Escherichia coli and Klebsiella pneumoniae in Western Norway. The material included 49 blood culture isolates which had shown aminoglycoside resistance collected during 2000-2009.

Proteomic analysis of a multi-resistant clinical Escherichia coli isolate of unknown genomic background.

Horizontal transfer of gene clusters occurs in Escherichia coli (E. coli), which could lead to evolution of new pathovars and improve survival fitness. However, this genetic event results in genomic plasticity which is a hindrance for proteomic characterization of strains with unknown genetic backgrounds.

Age specific aetiological agents of diarrhoea in hospitalized children aged less than five years in Dar es Salaam, Tanzania.

Background: This study aimed to determine the age-specific aetiologic agents of diarrhoea in children aged less than five years. The study also assessed the efficacy of the empiric treatment of childhood diarrhoea using Integrated Management of Childhood Illness (IMCI) guidelines.

Methods: This study included 280 children aged less than 5 years, admitted with diarrhoea to any of the four major hospitals in Dar es Salaam.

Clinical, microbiological and molecular characteristics of six cases of group A streptococcal meningitis in western Norway.

Meningitis is a rare clinical manifestation of invasive group A streptococcal (iGAS) disease. Clinical, microbiological and molecular characteristics of 6 consecutive cases of GAS meningitis treated in Haukeland University Hospital in the period 2004-2009 are described. All 6 patients had a primary upper respiratory tract infection, with subsequent mastoiditis in 5, subdural effusions in 2, and cerebral abscess in 1.

Two unusual cases of severe soft tissue infection caused by Streptococcus dysgalactiae subsp. equisimilis.

We present two cases of invasive infection caused by Streptococcus dysgalactiae subsp. equisimilis, one that showed rapidly developing necrotizing fasciitis in a previously healthy man and one that showed severe cellulitis and septic shock even though the bacterium possessed a mutated emm gene, predicted to encode a truncated M protein.