No abstract available.
Gram-Positive Cocci*

No abstract available.
Gram-Positive Cocci* ; Imipenem* ; Ofloxacin*

Four Gram-positive cocci were isolated from the cerebrospinal fluid or blood of four different patients, but they could not be identified by an automated conventional identification system, so they were identified using cellular fatty acid (CFA) composition analysis and 16S rRNA gene sequencing analysis. Of these, two strains (SMC-A2662 and SMC-A5889), which were previously supposed to be Rothia dentocariosa according to the API Coryne system, were identified as Rothia aeria by the 16S rRNA gene analysis. SMC-A608, which was unidentified by both the VITEK2 and API Coryne systems, was identified as Rothia mucilaginosa. The one remaining SMC-2244T was distinguished from the other Rothia species by its biochemical profile, its CFA composition and its 16S rRNA gene sequence. Phylogenetic analysis showed that it was closely related to Rothia nasimurium but the 16S rRNA gene sequence dissimilarity of 1.8% was enough to differentiate it from R. nasimurium. Based on both the phenotypic and phylogenetic evidence, we propose a new species name for this bacterium, Rothia arfidiae sp. nov. The results of this study show that several Rothia species were isolated from human and we have identified them using 16S rRNA gene sequences.
Genes, rRNA ; Gram-Positive Cocci ; Humans

A case of gallbladder empyema caused by Pediococcus pentosaceus is discussed. This appears to be the first reported case of gallbladder empyema caused by this organism. The laboratory method to identify this vancomycin-resistant gram-positive cocci and antimicrobial susceptibility of this organism are described.
Cholecystitis* ; Gallbladder* ; Gram-Positive Cocci ; Pediococcus*

BACKGROUND: Catheter-related bloodstream infection (CRBSI) is one of the leading types of infection, with a significant morbidity and mortality rate. We evaluated the differential time to positivity (DTP) and semi-quantitative culture of catheter segments (SQCC) as a method for diagnosing CRBSI. METHODS: From January 2010 to August 2011, 155 positive paired blood cultures which had the same organism isolated from blood cultures drawn simultaneously through the central venous catheter (CVC) and the peripheral vein were included. Positive DTP represents a DTP of least 120 min earlier for the time to detection of CVC draw than that of a peripheral vein draw. We evaluated the clinical utility of DTP and SQCC for diagnosing CRBSIs, which were further divided into two groups: confirmed (either by DTP or SQCC) and non-confirmed CRBSIs (neither DTP nor SQCC positive). RESULTS: Sixty-five percent (100/155) of episodes were confirmed to CRBSIs. In CRBSIs, Gram-positive cocci accounted for 61% of cases, non-fermenting Gram-negative bacilli represented 10%, Enterobacteriaceae for 10%, yeasts for 15%, and others for 4%. Among the confirmed CRBSI cases, 22 were both positive with DTP and SQCC, 30 cases were positive with DTP only, 12 cases were positive with SQCC only, and 36 cases which did not undergo SQCC analysis were DTP positive. The sensitivities of the DTP and SQCC techniques were 88.0% (88/100) and 53.1% (34/64), respectively. CONCLUSION: The differential time to positivity was more sensitive than the semi-quantitative culture of catheter segments for the diagnosis of CRBSIs. DTP is useful for diagnosing CRBSIs without removal of the catheter.
Catheters ; Central Venous Catheters ; Enterobacteriaceae ; Gram-Positive Cocci ; Veins ; Yeasts

BACKGROUND: Continuous monitoring blood culture systems (CMBCS) reduce the time and false negative rates of bacterial growth compared with the traditional manual blood culture systems which have been used in many hospitals yet. The purpose of this study is to evaluate the terminal subcultures monitored by Vital system compared with the manual system and to determine the guideline of terminal subcultures. METHODS: A retrospective study was conducted over a period of one year (from January to December 1995) with manual blood culture system and and sixteen months (from February 1996 to May 1997) with Vital system. All of the positive and negative blood bottles were done Gram staining and subcultured aerobically and anaerobically with 7-day terminal subculture protocol. All of the isolates were identified with API systems or ATB systems. RESULTS: Among 3,344 cases with the manual system, 305 cases (9.1%) were declared positive and 424 cases (8.8%) out of 4,822 cases with Vital system were positve. The terminal subcultures detected 48 cases (1.44%) in manual system and 9 cases (0.19%) in Vital system according to 7-day protocol. No statistical differences were observed in results among 5 day, 7 day and terminal subcultures. Those of false negative organisms were gram positive cocci (22 cases), Enterobacteriaceae (13 cases), non-fermenters (12 cases) and gram positive rod (1 case) with the manual system and gram positive cocci (4 cases), Entrobacteriaceae (1 case), non-fermenter (1 case) and yeasts (3 cases) with Vital system. CONCLUSIONS: These results suggest that terminal subculture of Vital systemnegative blood culture bottles is not necessary except S. aureus and fungus bacteremia on the basis of clinical situation.
Bacteremia ; Enterobacteriaceae ; Fungi ; Gram-Positive Cocci ; Retrospective Studies ; Yeasts

BACKGROUND: Blood culture is the definitive method for the diagnosis and treatment of bacteremia and fungemia. Analysis of blood cultures positive for pathogenic species and trends in antimicrobial susceptibility can help delineate appropriate and experimental treatment strategies. In this study, we investigated the incidence of pathogenic species and trends in antimicrobial susceptibility in blood cultures collected from 2003 to 2007 to help clinicians to determine the best methods of diagnosis and treatment. Changes between previously published analyses and this study were also investigated. METHODS: Five-year blood culture results obtained at Kyung Hee University Hospital between 2003 and 2007 were analyzed to determine the bacterial and fungal species present and the antimicrobial susceptibility of the isolates. Antimicrobial susceptibility was tested by the broth microdilution method and the CLSI disk diffusion method. RESULTS: Among the 66,437 blood cultures, 5,645 were positive. Of the positive blood cultures, 59.8% were positive for aerobic and facultative anaerobic gram-positive cocci. Coagulase-negative staphylococci (CoNS) were frequently isolated. The numbers of anaerobic species and fungi decreased over the years. CONCLUSION: CoNS were the microorganisms most commonly isolated from blood cultures at Kyung Hee University Hospital. The number of cultures positive for fungi was higher than that reported in previous studies, but the absolute isolation rate over five years decreased. Anaerobic species were much less frequently isolated than reported for other hospitals.
Bacteremia ; Diffusion ; Fungemia ; Fungi ; Gram-Positive Cocci ; Humans ; Incidence

BACKGROUND: An evaluation was performed to assess the performance of continuously monitoring VITAL automated blood culture system (bio-Merieux, Marcy-l'Etoile, France) and to investigate the value of performing final subcultures at the end of the protocol. METHODS: A retrospective study was conducted over a period of one year (October 1996 to September 1997) with 7,078 blood culture bottles sent to Microbiology Department of Korea Veterans Hospital. Not only VITAL positive bottles but also all the VITAL negative bottles were observed under a microscope after Gram staining and subcultured aerobically and anaerobically at the end of 5-day protocol. All isolates were identified by the conventional method and ATB system. RESULTS: Among total 7,078 bottles, 688 bottles (9.72%) were declared positive by the system, of which 68 (0.96%) proved to be false positive. The final blind subculture permitted the detection of 96 falsely negative bottles (1.38%). The average time to detection was 38h 08, and 20% of 444 samples having microorganisms were detected during the first 12 h, 45% during the first 24 h, 63% within 48 h, and 87% within 120 h. 58 samples (13%), which contained 20 cases of Gram positive cocci and 20 cases of yeasts- especially 65% of C. parapsilosis, were declared negative by the system but gave a positive subculture. Among the positive bottles, 86.3% were detected by the slope algorithm, 10.6% by the delta algorithm, and 3.1% by the threshold algorithm. CONCLUSIONS: I conclude that the VITAL system must be modified to improve the detection of staphylococci and yeasts and a more sensitive computer algorithm may be required so that the terminal subcultures will not be necessary. Each laboratory must decide the value of terminal blind subcultures on the basis of patient population and the microorganisms that are most frequently isolated in their institution.
Gram-Positive Cocci ; Hospitals, Veterans ; Humans ; Korea ; Retrospective Studies ; Yeasts

Treatment of diabetic foot infection remains a challenging issue to be solved. Bacterial species complicating diabetic foot ulcer differ from those of non-diabetic patients. Empirical antibiotic regimens are selected based on the severity and type of infection (acute infection versus chronic infection), which should always include coverage for aerobic Gram-positive cocci, especially Staphylococcus aureus. Narrow-spectrum antibiotic agents are considered for mild-to-moderate, recent infections, while broad-spectrum agents are usually required for severe, chronic infections, targeting both Gram-positive cocci and Gram-negative bacilli.
Diabetic Foot ; Gram-Positive Cocci ; Humans ; Staphylococcus aureus ; Ulcer

Gemellae is a gram positive cocci that forms part of the oropharyngeal microflora in humans and is anaerobic to aerotolerant. Unlike the other members of the same genus, G. morbillorum rarely causes human infections. Recently, we experienced a case of tubo-ovarian abscess caused by G. morbillorum which was initially suspected to be actinomycosis associated with intrauterine device. This is the first case in the world on tubo-ovarian abscess with G. morbillorum as the culprit.
Abscess ; Actinomycosis ; Gemella ; Gram-Positive Cocci ; Humans ; Intrauterine Devices