The Experts below are selected from a list of 588 Experts worldwide ranked by ideXlab platform

Poren Hsueh - One of the best experts on this subject based on the ideXlab platform.

  • role of vancomycin in the treatment of bacteraemia and meningitis caused by Elizabethkingia Meningoseptica
    International Journal of Antimicrobial Agents, 2017
    Co-Authors: Shio Shin Jean, Tai Chin Hsieh, Yong Zhong Ning, Poren Hsueh
    Abstract:

    Abstract Elizabethkingia Meningoseptica , a Gram-negative pathogen once deemed clinically insignificant, tends to cause infections among low-birth-weight infants and immunocompromised patients. Previously, vancomycin was reported to cure several patients with bacteraemia caused by E. Meningoseptica . Nevertheless, some laboratory investigations also showed considerable discordance between in vitro vancomycin susceptibility results obtained by the disk diffusion and broth microdilution methods against clinical E. Meningoseptica isolates as determined using the criteria for staphylococci recommended by the Clinical and Laboratory Standards Institute (CLSI). In this review, the PubMed database (1960–2017) was searched for studies that reported mainly cases with E. Meningoseptica bacteraemia or meningitis treated with vancomycin alone or with regimens that included vancomycin. In addition, the in vitro synergy between vancomycin and other agents against isolates of E. Meningoseptica was reviewed. Elizabethkingia Meningoseptica bacteraemia appears not to universally respond to intravenous (i.v.) vancomycin-only therapy, especially in patients who require haemodialysis. If i.v. vancomycin is the favoured therapy against E. Meningoseptica meningitis, the addition of ciprofloxacin, linezolid or rifampicin might be an option to effectively treat this difficult-to-treat infection. Further clinical studies are needed to determine the clinical efficacy of these combination regimens for the treatment of E. Meningoseptica meningitis.

  • Elizabethkingia Meningoseptica an important emerging pathogen causing healthcare associated infections
    Journal of Hospital Infection, 2014
    Co-Authors: Shio Shin Jean, Fulun Chen, Tsong Yih Ou, Poren Hsueh
    Abstract:

    Summary Elizabethkingia Meningoseptica has been deemed a potentially important threat to patients in critical care areas because of its multidrug-resistant phenotype and its ability to adapt to various environments. This review considers the incidence, factors which predispose to, and clinical features of, E. Meningoseptica sepsis, along with antimicrobial susceptibility patterns of clinical E. Meningoseptica isolates and reportedly successful measures for the prevention and control of infections caused by this bacterium. The English-language literature from the PubMed database was reviewed. The incidence of E. Meningoseptica bacteraemia has increased over the last decade. Patients at high risk of E. Meningoseptica infection include preterm children, the immunocompromised and those exposed to antibiotics in critical care units. Vancomycin, rifampicin, newer fluoroquinolones, piperacillin–tazobactam, minocycline and possibly tigecycline are preferred empirical choices for E. Meningoseptica infection according to in-vitro susceptibility data. Combination therapy has been used for infections not responding to single agents. Saline, lipid, and chlorhexidine gluconate solutions as well as contaminated sinks have been implicated as sources of infection following outbreak investigations. In addition to reinforcement of standard infection control measures, actions that have successfully terminated E. Meningoseptica outbreaks include pre-emptive contact isolation, systematic investigations to identify the source of the bacterium and thorough cleaning of equipment and environmental surfaces. As the clinical complexity and incidence of E. Meningoseptica infections increase, there is a need for heightened awareness of the potential for this bacterium to cause outbreaks. This will permit timely initiation of active surveillance for infected/colonized patients as well as investigations to identify the likely source of the bacterium, which will, in turn, allow implementation of appropriate infection control measures.

  • clinical features antimicrobial susceptibilities and outcomes of Elizabethkingia Meningoseptica chryseobacterium meningosepticum bacteremia at a medical center in taiwan 1999 2006
    European Journal of Clinical Microbiology & Infectious Diseases, 2011
    Co-Authors: Chunhsing Liao, Y.-t. Huang, Chiayu Yang, Poren Hsueh
    Abstract:

    A total of 118 patients with Elizabethkingia Meningoseptica bacteremia at a medical center in Taiwan from 1999 to 2006 were studied. Minimum inhibitory concentrations (MICs) of 99 preserved isolates were determined. The incidence (per 100,000 admissions) of E. Meningoseptica bacteremia increased from 7.5 in 1996 to 35.6 in 2006 (p = 0.006). Among them, 84% presented with fever, 86% had nosocomial infections, and 60% had acquired the infection in intensive care units (ICUs). The most common underlying diseases were malignancy (36%) and diabetes mellitus (25%). Seventy-eight percent of patients had primary bacteremia, followed by pneumonia (9%), soft tissue infection, and catheter-related bacteremia (6%). Forty-five patients (38%) had polymicrobial bacteremia. Overall, the 14-day mortality was 23.4%. Multivariate analysis revealed E. Meningoseptica bacteremia acquired in an ICU (p = 0.048, odds ratio [OR] 4.23) and presence of effective antibiotic treatment after the availability of culture results (p = 0.049, OR 0.31) were independent predictors of 14-day mortality. The 14-day mortality was higher among patients receiving carbapenems (p = 0.046) than fluoroquinolones or other antimicrobial agents. More than 80% of the isolates tested were susceptible to trimethoprim-sulfamethoxzole, moxifloxacin, and levofloxacin. The MIC50 and MIC90 of the isolates to tigecycline and doxycycline were both 4 μg/mL and 8 μg/ml, respectively.

J C Chan - One of the best experts on this subject based on the ideXlab platform.

  • invasive paediatric Elizabethkingia Meningoseptica infections are best treated with a combination of piperacillin tazobactam and trimethoprim sulfamethoxazole or fluoroquinolone
    Journal of Medical Microbiology, 2019
    Co-Authors: J C Chan, C Y Chong, K C Thoon, M Maiwald, R Bhattacharya, S Chandran
    Abstract:

    Objectives. Elizabethkingia Meningoseptica is a multi-drug-resistant organism that is associated with high mortality and morbidity in newborn and immunocompromised patients. This study aimed to identify the best antimicrobial therapy for treating this infection. Methods. A retrospective descriptive study was conducted from 2010 to 2017 in a tertiary paediatric hospital in Singapore. Paediatric patients aged 0 to 18 years old with a positive culture for E. Meningoseptica from any sterile site were identified from the hospital laboratory database. The data collected included clinical characteristics, antimicrobial susceptibility and treatment, and clinical outcomes. Results. Thirteen cases were identified in this study. Combination therapy with piperacillin/tazobactam and trimethoprim/sulfamethoxazole or a fluoroquinolone resulted in a cure rate of 81.8  %. The mortality rate was 15.4  % and neurological morbidity in patients with bacteraemia and meningitis remained high (75 %). Conclusions. Treatment with combination therapy of piperacillin/tazobactam and trimethoprim/sulfamethoxazole or a fluroquinolone was effective in this study, with low mortality rates being observed.

  • Invasive paediatric Elizabethkingia Meningoseptica infections are best treated with a combination of piperacillin/tazobactam and trimethoprim/sulfamethoxazole or fluoroquinolone.
    Journal of Medical Microbiology, 2019
    Co-Authors: J C Chan, C Y Chong, K C Thoon, M Maiwald, R Bhattacharya, S Chandran, Chee Fu Yung
    Abstract:

    Objectives. Elizabethkingia Meningoseptica is a multi-drug-resistant organism that is associated with high mortality and morbidity in newborn and immunocompromised patients. This study aimed to identify the best antimicrobial therapy for treating this infection. Methods. A retrospective descriptive study was conducted from 2010 to 2017 in a tertiary paediatric hospital in Singapore. Paediatric patients aged 0 to 18 years old with a positive culture for E. Meningoseptica from any sterile site were identified from the hospital laboratory database. The data collected included clinical characteristics, antimicrobial susceptibility and treatment, and clinical outcomes. Results. Thirteen cases were identified in this study. Combination therapy with piperacillin/tazobactam and trimethoprim/sulfamethoxazole or a fluoroquinolone resulted in a cure rate of 81.8  %. The mortality rate was 15.4  % and neurological morbidity in patients with bacteraemia and meningitis remained high (75 %). Conclusions. Treatment with combination therapy of piperacillin/tazobactam and trimethoprim/sulfamethoxazole or a fluroquinolone was effective in this study, with low mortality rates being observed.

Aruna Vyas - One of the best experts on this subject based on the ideXlab platform.

  • isolation of multidrug resistant Elizabethkingia Meningoseptica from an immune compromised patient
    International Journal of Research, 2016
    Co-Authors: S K Agarwal, Rajni Sharma, Aruna Vyas
    Abstract:

    Elizabethkingia Meningoseptica is an emerging pathogen known to cause meningitis, pneumonia, endocarditis, bacteremia, wound & soft tissue infection, abdominal, respiratory and ocular infections, dialysis associated peritonitis and prosthesis associated septic arthritis; especially in immunodeficient hosts. We are reporting an uncommon case of nosocomial septicemia due to Elizabethkingia Meningoseptica in a 56 year old male admitted with hypoglycemic encephalopathy. Patient had squamous cell carcinoma and was receiving chemotherapy. Using biochemical tests and VITEK 2 automated (Biomerieux) Identification and Antimicrobial Sensitivity Test (AST) system, the isolate was identified as Elizabethkingia Meningoseptica and was found sensitive to Trimethoprim-Sulfamethoxazole only. His condition improved gradually after starting Trimethoprim-Sulfamethoxazole and repeat blood culture was sterile. To our knowledge from literature review, this is the first reported case of multidrug resistant Elizabethkingia Meningoseptica septicemia from North India.

Vyoma Singh - One of the best experts on this subject based on the ideXlab platform.

  • successful control of Elizabethkingia Meningoseptica outbreak in a neuro surgical intensive care unit of a tertiary care hospital in north india
    International Journal of Infection Control, 2018
    Co-Authors: Namita Jaggi, Vyoma Singh
    Abstract:

    Elizabethkingia Meningoseptica has been found to be associated with a broad range of infectious etiologies, most notably outbreaks of neonatal meningitis. In adults, it can also cause pneumonia, endocarditis, bacteremia, meningitis and even skin and soft tissue infections, primarily in immunocompromised individuals. We report a cluster of 3 cases with E. Meningoseptica infection in an adult neurology critical care unit of a 400-bedded tertiary care hospital situated in Gurugram (Delhi-National Capital Region), India. Two patients were diagnosed with ventilator-associated-pneumonia (VAP) and one was a patient in whom the organism was isolated from a cerebrospinal fluid (CSF) sample. Clinical details were studied and outbreak investigation was carried out. We found the following common risk factors for infection: Prolonged ICU stay, exposure to multiple antibiotics, presence of underlying co-morbidities and insertion of multiple invasive medical devices. E. Meningoseptica was isolated from the catheter mount connected between endotracheal tube and ventilation circuit of one patient but clonality could not be studied. Strict infection control protocols and environmental cleaning procedures terminated the outbreak.

P.-r. Hsueh - One of the best experts on this subject based on the ideXlab platform.

  • Clinical features, antimicrobial susceptibilities, and outcomes of Elizabethkingia Meningoseptica (Chryseobacterium meningosepticum) bacteremia at a medical center in Taiwan, 1999–2006
    European Journal of Clinical Microbiology & Infectious Diseases, 2011
    Co-Authors: C.-h. Liao, Y.-t. Huang, C.-j. Yang, P.-r. Hsueh
    Abstract:

    A total of 118 patients with Elizabethkingia Meningoseptica bacteremia at a medical center in Taiwan from 1999 to 2006 were studied. Minimum inhibitory concentrations (MICs) of 99 preserved isolates were determined. The incidence (per 100,000 admissions) of E. Meningoseptica bacteremia increased from 7.5 in 1996 to 35.6 in 2006 ( p  = 0.006). Among them, 84% presented with fever, 86% had nosocomial infections, and 60% had acquired the infection in intensive care units (ICUs). The most common underlying diseases were malignancy (36%) and diabetes mellitus (25%). Seventy-eight percent of patients had primary bacteremia, followed by pneumonia (9%), soft tissue infection, and catheter-related bacteremia (6%). Forty-five patients (38%) had polymicrobial bacteremia. Overall, the 14-day mortality was 23.4%. Multivariate analysis revealed E. Meningoseptica bacteremia acquired in an ICU ( p  = 0.048, odds ratio [OR] 4.23) and presence of effective antibiotic treatment after the availability of culture results ( p  = 0.049, OR 0.31) were independent predictors of 14-day mortality. The 14-day mortality was higher among patients receiving carbapenems ( p  = 0.046) than fluoroquinolones or other antimicrobial agents. More than 80% of the isolates tested were susceptible to trimethoprim-sulfamethoxzole, moxifloxacin, and levofloxacin. The MIC_50 and MIC_90 of the isolates to tigecycline and doxycycline were both 4 μg/mL and 8 μg/ml, respectively.