Aerococcus viridans, a catalase-negative gram-positive coccus rarely causing bacteremia, was isolated from blood cultures of a 52-yr-old man under the gran-ulocytopenic condition. The isolate showed the typical characteristics of A. viridans, i.e., tetrad arrangements in gram stain, positive pyrrolidonyl aminopeptidase (PYR) and negative leucine aminopeptidase (LAP) reactions, and no growth at 45 degrees C.The isolate was revealed to be highly resistant to penicillin, erythromycin, clindamycin, and ceftriaxone, although most strains of A. viridans isolated from the previously reported patients were susceptible to penicillin and other commonly used antibiotics. Even though A. viridans is rarely associated with human infections, it could be a potential causative agent of bacteremia, especially in immunocompromised patients.
Agranulocytosis/*complications/microbiology/physiopathology ; Bacteremia/*complications/microbiology/physiopathology ; Ceftriaxone/pharmacology ; Clindamycin/pharmacology ; *Drug Resistance, Multiple, Bacterial ; Erythromycin/pharmacology ; Gram-Positive Bacterial Infections/*complications/microbiology/physiopathology ; Humans ; Male ; Middle Aged ; Penicillins/*pharmacology ; Streptococcaceae/*drug effects/isolation & purification

OBJECTIVETo observe the effects of Gutuo Qingfu Decoction (GQD) via gastro-enteric perfusion on blood level of bacterial 16S rRNA gene in severe multi-traumatic (SMT) patients at early stage.

METHODSSixty SMT patients were assigned to two groups, the 33 in the treated group and the 27 in the control group. They were treated with the same conventional treatment, but different in the gastro-enteric infusion with GOD for the former and saline for the latter. Blood 16SrRNA gene, body temperature, leukocyte count, C-reactive protein (CRP), and blood bacterial culture positive rate on the 3, 6, 9 post-trauma days were detected, and incidences of infective complication and mortality were observed.

RESULTSBody temperature on day 9 in the treated group was significantly lower than in the control group (37.6 +/- 0.12 degrees C vs 38.1 +/- 0.15 degrees C, P < 0.05); so did the CRP level on day 6 (52.4 +/- 6.3 mg/L vs 104.3 +/- 20.1 mg/L, P < 0.05) and day 9 (42.9 + 7.5 mg/L vs 92.5 +/- 17.1 mg/L, P < 0.05), as well as the positive rates of blood 16SrRNA gene on day 6 and 9 (33.3% vs 59.3% and 30.3% vs 77.8%, P < 0.05 and P < 0.01, respectively). However, the positive rates of blood culture were insignificantly different between the two groups ( P > 0.05). Besides, incidence of infective complication in the treated group was significantly lower than in the control group (30.3% vs 59.3%, P < 0.05).

CONCLUSIONEarly stage gastrointestinal administration of GQD is likely to have benefits for the improvement of intestinal mucosa barrier and reduction of enteric bacterial translocation in SMT patients, and it may also reduce the incidence of infective complication in these patients.

Adolescent ; Adult ; Aged ; Bacteremia ; etiology ; microbiology ; Bacterial Translocation ; drug effects ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Intestinal Mucosa ; physiopathology ; Male ; Middle Aged ; Multiple Trauma ; complications ; drug therapy ; microbiology ; Phytotherapy ; RNA, Bacterial ; blood ; isolation & purification ; RNA, Ribosomal, 16S ; blood ; Wounds and Injuries ; blood ; drug therapy ; Young Adult