We describe a case of septic shock due to Vibrio alginolyticus presenting with fever and bilateral leg pain. Despite intensive management with antibiotics and inotropic agents, the patient died from septic shock 1 day after hospitalization. V. alginolyticus was isolated from both leg wounds and a blood culture. To the best of our knowledge, this is the first reported case of V. alginolyticus bacteremia in Korea.
Bacteremia/etiology/pathology ; Humans ; Korea ; Male ; Middle Aged ; Shock, Septic/*etiology/pathology ; Vibrio Infections/*complications/pathology ; Vibrio alginolyticus/*isolation & purification

Adrenal Gland Diseases ; etiology ; surgery ; Aged ; Bacteremia ; microbiology ; Fatal Outcome ; Hemorrhage ; etiology ; pathology ; surgery ; Humans ; Lung Neoplasms ; complications ; diagnosis ; pathology ; Male ; Methicillin-Resistant Staphylococcus aureus ; Retroperitoneal Space ; Risk Factors

Objective: To explore the feasibility and effectiveness of "one-puncture one-needle" transrectal ultrasound (TRUS)-guided prostate biopsy in the prevention of postoperative infections. METHODS: We retrospectively analyzed the clinical data about "one-puncture one-needle" (the observation group) and "one-person one-needle" (the control group) TRUS-guided prostate biopsy performed in the Second People's Hospital of Guangdong Province from January 2005 to December 2015, and compared the incidence rates of puncture-related infection between the two strategies. By "one-puncture one-needle", one needle was used for one biopsy puncture, while by "one-person one-needle", one needle was used for all biopsy punctures in one patient and the needle was sterilized with iodophor after each puncture. RESULTS: Totally, 120 patients received 6+1-core or 12+1-core "one-person one-needle" and 466 underwent 12+1-core "one-puncture one-needle" TRUS-guided prostate biopsy. There were no statistically significant differences between the two groups of patients in age, the prostate volume, the serum PSA level, or the detection rate of prostate cancer (P >0.05). Compared with the control group, the observation group showed remarkably lower incidence rates of puncture-related urinary tract infection (7.5% vs 0.9%, P <0.05), fever (5.0% vs 1.1%, P <0.05), bacteriuria (2.5% vs 0.2%, P <0.05), and total infections (16.7% vs 2.6%, P<0.05) postoperatively. Two cases of bacteremia or sepsis were found in each of the groups, with no significant difference between the two. CONCLUSIONS "One-puncture one-needle" TRUS-guided prostate biopsy can effectively prevent puncture-related infections.
Bacteremia ; etiology ; Biopsy, Fine-Needle ; adverse effects ; instrumentation ; methods ; Case-Control Studies ; Feasibility Studies ; Humans ; Male ; Prostate ; pathology ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; blood ; pathology ; Retrospective Studies ; Sterilization ; methods ; Ultrasonography, Interventional ; Urinary Tract Infections ; prevention & control

We investigated the combined effect of glutamine (GLN) and growth hormone (GH) on bacterial translocation (BT) in sepsis. After single intraperitoneal injection of lipopolysaccharide (10 mg/kg), 48 rats were divided randomly into four groups of 12 animals each: the control group received chow orally; the GLN group received chow plus 10% GLN; GH group received chow plus GH; and the GLN/GH group received chow, 10% GLN, and GH. Twenty-four and 96 hr later, rats were sacrificed. Portal blood culture, bacterial colony counts of cultured mesenteric lymph nodes, mucosal thickness, malondialdehyde (MDA), and glutathione (GSH) levels in the gut mucosa were measured. There was no significant change of the rate of portal blood culture between all treatment groups at 24 and 96 hr. At 24 hr, the rats receiving combined treatment of GLN and GH showed lower bacterial colony counts and mucosal MDA levels than the control rats, and higher mucosal GSH levels than the control and GLN-treated rats. At 96 hr, rats treated with both GLN and GH exhibited lower bacterial colony counts and mucosal MDA levels, and higher mucosal thickness and GSH levels than control, GLN, or GH-treated rats. This study suggests that the combination of GLN and GH may synergistically reduce BT over time in sepsis.
Animals ; Bacteremia/etiology ; Bacteremia/microbiology ; Bacteremia/prevention & control ; Bacterial Translocation/drug effects* ; Comparative Study ; Drug Evaluation, Preclinical ; Drug Synergism ; Endotoxemia/drug therapy* ; Endotoxemia/microbiology ; Escherichia coli/isolation & purification* ; Glutamine/pharmacology* ; Glutamine/therapeutic use ; Glutathione/analysis ; Human Growth Hormone/pharmacology* ; Human Growth Hormone/therapeutic use ; Ileum/microbiology ; Ileum/pathology ; Intestinal Mucosa/microbiology ; Intestinal Mucosa/pathology ; Lipid Peroxidation/drug effects ; Lymph Nodes/microbiology ; Male ; Rats ; Rats, Sprague-Dawley ; Recombinant Proteins/pharmacology ; Recombinant Proteins/therapeutic use ; Sepsis/microbiology ; Sepsis/prevention & control* ; Specific Pathogen-Free Organisms

OBJECTIVETo clarify the value of endotoxin determination in evaluating the infection risk and antibiotic prophylaxis during transrectal biopsy of the prostate.

METHODSForty-eight patients were divided into four groups randomly. Group A (12 patients) were not treated before biopsy. Group B (13 patients) received antibiotic prophylaxis therapy. Group C (12 patients) underwent clusis. Group D (11 patients) received combined treatment. Urine and blood samples of the patients were obtained before and after prostatic biopsy. All samples were cultured for bacteria and investigated for endotoxin concentration by limulus quantitative azo color test.

RESULTSNo significant difference in either serum endotoxin or blood bacterial cultures was noted before and after prostatic biopsy (P < 0.05) in all the groups. A significant increase was observed in urine endotoxin after biopsy compared with that before biopsy in Groups A and B (P < 0.05). There was no significant increase in urine endotoxin after biopsy compared with that before biopsy in Group C and D. The positive incidence of urine bacterial culture was significantly increased (P < 0.05) in patients of Group A and B.

CONCLUSIONCirculation infection risk following prostatic biopsy was low. Changes of urinary infection were fewer in patients who had undergone clusis and/or antibiotic prophylaxis than in those who had received no or only antibiotic prophylaxis therapy. Endotoxin determination in urine is a reliable, sensitive and simple method for diagnosis of bacterial infection in patients undergoing transrectal biopsy of the prostate.

Aged ; Aged, 80 and over ; Antibiotic Prophylaxis ; Bacteremia ; microbiology ; Bacterial Infections ; etiology ; prevention & control ; Bacteriuria ; microbiology ; Biopsy, Needle ; adverse effects ; Endotoxins ; analysis ; blood ; urine ; Humans ; Male ; Middle Aged ; Prostate ; pathology

Sphingobacterium spiritivorum has been rarely isolated from clinical specimens of immunocompromised patients, and there have been no case reports of S. spiritivorum infection in Korea to our knowledge. We report a case of S. spiritivorum bacteremia in a 68-yr-old woman, who was diagnosed with acute myeloid leukemia and subsequently received chemotherapy. One day after chemotherapy ended, her body temperature increased to 38.3degrees C. A gram-negative bacillus was isolated in aerobic blood cultures and identified as S. spiritivorum by an automated biochemical system. A 16S rRNA sequencing analysis confirmed that the isolate was S. spiritivorum. The patient received antibiotic therapy for 11 days but died of septic shock. This is the first reported case of human S. spiritivorum infection in Korea. Although human infection is rare, S. spiritivorum can be a fatal opportunistic pathogen in immunocompromised patients.
Aged ; Anti-Bacterial Agents/therapeutic use ; Bacteremia/*complications/drug therapy/*microbiology ; Bone Marrow Cells/pathology ; Fatal Outcome ; Female ; Humans ; Immunocompromised Host ; Leukemia, Myeloid, Acute/*complications ; Phylogeny ; RNA, Ribosomal, 16S/genetics ; Sequence Analysis, DNA ; Shock, Septic/etiology/microbiology ; Sphingobacterium/classification/genetics/isolation & purification/*physiology