Clinical significance of multidrug-resistant Acinetobacter baumannii isolated from central venous catheter tip cultures in patients without concomitant bacteremia.

Background: The purpose of this study was to examine the clinical implications of a positive central venous catheter (CVC) tip culture with multidrug-resistant Acinetobacter baumannii (MRAB) in patients without concurrent bacteremia.

Methods: This retrospective, multicenter study was conducted in 9 teaching hospitals in the Republic of Korea from May 2008 to April 2012. Study subjects included adult patients (aged ≥ 18 y) who yielded an MRAB-positive CVC tip culture without concurrent MRAB bacteremia.

Vancomycin-resistant Enterococcus faecium outbreak caused by patient transfer in 2 separate intensive care units.

This report describes an outbreak involving vancomycin-resistant Enterococcus faecium colonization in 2 separate intensive care units (ICUs). Outbreak investigation including pulsed-field gel electrophoresis demonstrated that transfer of a vancomycin-resistant Enterococcus faecium colonized patient between ICUs contributed to the outbreaks that occurred simultaneously in 2 separate ICUs.

A case of primary infective endocarditis caused by community-associated methicillin-resistant Staphylococcus aureus in a healthy individual and colonization in the family.

Primary community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) endocarditis has rarely been reported in healthy individuals without risk factors, such as skin and soft tissue infections, and intravenous drug abuse. We describe a case of infective endocarditis by CA-MRSA (ST72-PVL negative-SCCmec IVA) in previously healthy individuals with no underlying medical condition and CA-MRSA colonization in the family.

Pseudooutbreak of Stenotrophomonas maltophilia bacteremia in a general ward.

Background: Stenotrophomonas maltophilia is a significant nosocomial pathogen and is commonly isolated in the hospital environment. We investigated the risk factors for a bloodstream pseudooutbreak of S maltophilia in a general ward.

Methods: On November 24 and 25, 2005, 7 patients without evidence of sepsis were reported as positive for blood culture with S maltophilia from blood samples collected on November 21 and 22, 2005.

Reduced use of third-generation cephalosporins decreases the acquisition of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae.

Objectives: To identify risk factors for the respiratory acquisition of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae among patients admitted to a neurosurgical intensive care unit (NSICU) and to modify them without changing general infection control measures.

Design: Nested case-control and intervention study.

Setting: A 1,200-bed, tertiary-care teaching hospital with a 17-bed NSICU.

Comparison of trends of resistance rates over 3 years calculated from results for all isolates and for the first isolate of a given species from a patient.

We compared trends of annual resistance rates calculated from results for all isolates and for the first isolate of Staphylococcus aureus, Klebsiella pneumoniae, and Acinetobacter baumannii per patient over a 3-year period from 2001 through 2003. Antimicrobial susceptibility results of inpatients were extracted from a computerized database. Annual resistance rates of a species were calculated by two methods: (i) from results for all isolates, even those from patients with multiple isolates in a given year and (ii) from results for the first isolate from a patient in a given year, regardless of susceptibility profile or specimen type.

Brain abscess due to Gemella haemolysans.

We present a case of brain abscess due to Gemella haemolysans and Bacteroides species in a 60-year-old-immunocompetent man who underwent dental procedures. The patient completely recovered following intravenous therapy with ampicillin and metronidazole for 6 weeks.