Objective: To analyze the clinical characteristics, pathogenic bacteria, complications and risk factors of prognosis of acute hematogenous osteomyelitis in children. Methods: The clinical manifestations, laboratorg tests, etiological charateristics and clinical data of 107 patients with acute hematogenous osteomyelitis admitted to Beijing Children's Hospital from January 2017 to December 2020 were retrospectively analyzed. According to the drug sensitivity results of Staphylococcus aureus, the group was divided into methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible Staphylococcus aureus (MSSA) group; according to the presence or absence of complications, the group was divided into the group with and without complications; according to the prognosis of the follow-up children, the group was divided into good prognosis and poor prognosis. The χ² test or Mann-Whitney U test used for comparison between groups, and Logistic regression was used to analyze the risk factors for complications and prognosis. Results: Of the 107 patients, 62 were males and 45 were females. The age of presentation was 5.6 (1.7, 10.0) years, including 5 patients (4.7%) age from >28 days to 3 months, 46 patients (43.0%) age from >3 months to 5 years, 43 patients (40.2%)>5-12 years of age, and 13 patients (12.1%)>12-18 years of age. The first symptoms were acute fever in 35 patients (32.7%), limb pain in 24 patients (22.4%), and fever with limb pain in 23 patients (21.5%). Pathogen culture was positive in 75 patients (70.1%), Streptococcus pyogenes, Salmonella enterica and Escherichia coli in 1 case (1.4%) each, and Staphylococcus aureus in 72 cases (96.0%), among them, 47 cases were MSSA, 22 cases were MRSA, and 3 cases had positive reports of Staphylococcus aureus from other hospitals without drug-sensitive tests. The proportion of infected children living in rural areas and receiving surgical treatment was higher in the MRSA group than in the MSSA group (14 cases (63.6%) vs. 18 cases (38.3%) and 21 cases (95.5%) vs. 33 cases (70.2%), χ²=3.87, 4.23, both P<0.05). Sixty-five children had no complications while 42 children (39.3%) suffered from complications. Common complications consisted of 19 cases (17.8%) of sepsis, 17 cases (15.9%) of septic arthritis, and 12 cases (11.2%) of venous thrombosis. The group with complications showed higher mental changes, decreased appetite and (or) weakness, positive pathogenic cultures, and time from admission to surgery than the group without complications (18 cases (42.9%) vs. 9 cases (13.8%), 20 cases (47.6%) vs. 12 cases (18.5%), 34 cases (81.0%) vs. 41 cases (63.1%), 3.5 (2.0, 6.0) vs. 2.0 (1.0, 4.0) d,χ²=11.38, 10.35, 3.89, Z=2.21, all P<0.05). The poor prognosis group had more comorbidities, combined local complications, and positive aureus than the good prognosis group (10/15 vs. 34.9% (30/86), 7/15 vs. 17.4% (15/86), 14/15 vs. 61.6% (53/86), χ²=5.39, 6.40, 4.42, all P<0.05). Multifactorial Logistic regression analysis showed that acute phase C-reactive protein (CRP) was both an independent risk factor for complications (OR=1.01, 95%CI 1.01-1.02) and an independent risk factor for poor prognosis (OR=1.01, 95%CI 1.00-1.02). Conclusions: The first symptoms of acute hematogenous osteomyelitis are acute fever, limb pain, and fever with limb pain are most common. Staphylococcus aureus is the most common pathogenic organism. Those with loss of appetite and (or) weakness, mental changes, positive pathogenic cultures, and longer time between admission and surgery are prone to complications. Those with complications, combined local complications, and positive for Staphylococcus aureus had a poor prognosis. Elevated CRP is an independent risk factor not only for complications but for poor prognosis as well.
Acute Disease ; Adolescent ; Anti-Bacterial Agents/therapeutic use* ; Child ; Female ; Fever/etiology* ; Humans ; Male ; Methicillin-Resistant Staphylococcus aureus ; Osteomyelitis/microbiology* ; Pain/drug therapy* ; Prognosis ; Retrospective Studies ; Staphylococcal Infections/diagnosis* ; Staphylococcus aureus

Child ; Community-Acquired Infections ; complications ; microbiology ; Epidural Abscess ; diagnostic imaging ; etiology ; microbiology ; Female ; Humans ; Magnetic Resonance Imaging ; Methicillin-Resistant Staphylococcus aureus ; pathogenicity ; Staphylococcal Infections ; complications ; microbiology

OBJECTIVE: To investigate the risk factors of methicillin-resistant Staphylococcus aureus(MRSA) enterocolitis after gastrointestinal surgery. METHODS: Clinical and pathological data of 17 cases with MRSA enteritis after gastrointestinal surgery from March 2015 to March 2017 at Department of General Surgery of Affiliated Drum Tower Hospital were retrospectively analyzed. INCLUSION CRITERIA: (1) age of 18 to 80 years;(2) with history of gastrointestinal surgery; (3) diarrhea symptoms within 7 days after gastrointestinal surgery; (4) use of antibiotics before diarrhea; (5) fecal smear showing a large number of gram positive cocci; (6) fecal culture suggested the presence of MRSA; (7) application of antibiotic therapy against MRSA was effective. EXCLUSION CRITERIA: (1)clostridium difficile toxin positive; (2) toxic shock syndrome caused by food poisoning. According to gender, age, and inpatient ward, 1:2 pairing was performed, and 34 patients with non-MRSA enteritis from the hospitalized cases in the same ward were selected as the control group for retrospective case-control study. There were no significant differences in the gender, age, and constitution index between two groups (all P>0.05), indicating that the two groups were comparable. The χ² test was used to perform univariate analysis on 11 factors, including the nature of the primary disease, colorectal surgery, emergency surgery, use of multiple antibiotics, preoperative bowel preparation, perioperative hormone, intraoperative intraperitoneal chemotherapy, perioperative nasogastric tube, diabetes history, intensive care unit stay, and previous infectious disease hospitalization, and then multivariate logistic regression analysis was performed. RESULTS: MRSA enteritis occurred 3 to 5 days after surgery in all the 17 cases, and 4 cases developed septic shock rapidly. Univariate analysis showed that the operation site (colorectal surgery) (χ²=4.747, P=0.029) and use of two antibiotics before MRSA enteritis (χ²=3.959, P=0.047) were associated with MRSA enteritis after gastrointestinal surgery. Multivariate logistic regression analysis revealed that colorectal surgery was the only independent risk factor for MRSA enteritis after gastrointestinal surgery(OR=5.526, 95%CI: 1.350-22.602,P=0.017), while the use of two antibiotics was not (OR=0.204, 95%CI:0.051-0.819, P=0.025). CONCLUSIONS MRSA enteritis has a rapid onset, and a high incidence of septic shock, which requires immediate attention. Colorectal surgery is an independent risk factor for MRSA enteritis.
Anti-Bacterial Agents ; Case-Control Studies ; Colorectal Surgery ; adverse effects ; Digestive System Surgical Procedures ; adverse effects ; Enterocolitis ; etiology ; microbiology ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Retrospective Studies ; Risk Factors ; Staphylococcal Infections ; etiology

The incidence and mortality of infective endocarditis (IE) in patients with severe burn remain high, which are attributed to invasive procedures, bacteremia, and wound infection after burns. Clinical clues for IE in burns are usually masked by burn-related manifestations, so the diagnosis of IE may be delayed or missed. For burned patients with persistent bacteremia of unknown source, especially Staphylococcus aureus-induced bacteremia, the diagnosis of IE should be considered according to the Duke criteria, and early echocardiography performance is particularly important. Antibiotic therapy is the mainstay initial management, and early surgical intervention is strongly recommended once IE is clearly diagnosed in patients with burns. In order to lower the incidence and mortality of IE in burns, it is very important to take prophylactic procedures along with the whole course of burn management.
Bacteremia ; epidemiology ; Burn Units ; Burns ; complications ; mortality ; surgery ; Endocarditis, Bacterial ; complications ; diagnosis ; microbiology ; mortality ; Humans ; Incidence ; Severity of Illness Index ; Staphylococcal Infections ; complications ; diagnosis ; Staphylococcus aureus ; isolation & purification ; Surgery, Plastic ; Wound Infection ; etiology ; mortality

Infections following anterior cruciate ligament reconstruction are rare, with no previous reports citing Mycobacterium abscessus as the culprit pathogen. A 22-year-old man presented twice over three years with a painful discharging sinus over his right tibia tunnel site necessitating repeated arthroscopy and washout, months of antibiotic therapy, and ultimately culminating in the removal of the implants. In both instances, M. abscessus was present in the wound cultures, along with a coinfection of Staphyloccocus aureus during the second presentation. Though rare, M. abscessus is an important pathogen to consider in postoperative wounds presenting with chronic discharging sinuses, even in healthy non-immunocompromised patients. This case illustrates how the organism can cause an indolent infection, and how the removal of implants can be necessary to prevent the persistence of infection. Coinfection with a second organism is not uncommon and necessitates a timely change in treatment regime as well.
Anterior Cruciate Ligament/injuries/surgery ; Anterior Cruciate Ligament Reconstruction/*adverse effects ; Anti-Bacterial Agents/administration & dosage ; Arthritis, Infectious/etiology/*microbiology ; Arthroscopy ; Coinfection ; Device Removal ; Humans ; Male ; Mycobacterium Infections, Nontuberculous/*microbiology ; Recurrence ; Reoperation ; Staphylococcal Infections/*microbiology ; *Staphylococcus aureus ; Therapeutic Irrigation ; Young Adult

No abstract available.
Adult ; Embolism/*complications/diagnosis/microbiology ; Eye Infections, Bacterial/*complications/diagnosis/microbiology ; Fluorescein Angiography ; Fundus Oculi ; Humans ; Macula Lutea/drug effects/*pathology ; Male ; Retinal Perforations/diagnosis/*etiology ; Sepsis/*complications/diagnosis ; Staphylococcal Infections/*complications/diagnosis ; Staphylococcus aureus/isolation & purification

No abstract available.
Anti-Bacterial Agents/therapeutic use ; Cardiac Tamponade/etiology ; Drainage ; Empyema, Pleural/diagnosis/*etiology/microbiology/therapy ; Heart Diseases/diagnosis/*etiology/microbiology/therapy ; Humans ; Kidney Failure, Chronic/*therapy ; Male ; Methicillin-Resistant Staphylococcus aureus/isolation & purification ; Middle Aged ; Pericardial Effusion/etiology ; Pericardial Window Techniques ; Pericardiocentesis ; Peritoneal Dialysis, Continuous Ambulatory/*adverse effects ; Peritonitis/diagnosis/drug therapy/*etiology/microbiology ; Pleural Effusion/etiology ; Staphylococcal Infections/diagnosis/drug therapy/*etiology/microbiology ; Tomography, X-Ray Computed ; Treatment Outcome

Panton-Valentine leukocidin (PVL)-positive USA300 clone has been the most successful community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) clone spreading in North America. In contrast, PVL-negative ST72-CA-MRSA has been predominant in Korea, and there has been no report of infections by the USA300 strain except only one case report of perianal infection. Here, we describe the first case of pneumonia caused by the USA300 strain following pandemic influenza A (H1N1) in Korea. A 50-year-old man was admitted with fever and cough and chest radiograph showed pneumonic consolidation at the right lower lung zone. He received a ventilator support because of respiratory failure. PCR for pandemic influenza A (H1N1) in nasopharyngeal swab was positive, and culture of sputum and endotracheal aspirate grew MRSA. Typing of the isolate revealed that it was PVL-positive, ST 8-MRSA-SCCmec type IV. The analysis of the PFGE patterns showed that this isolate was the same pulsotype as the USA300 strain.
Community-Acquired Infections/*etiology/microbiology ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human/*complications ; Male ; *Methicillin-Resistant Staphylococcus aureus/classification/isolation & purification ; Middle Aged ; Pneumonia, Staphylococcal/*etiology/microbiology ; Republic of Korea ; Staphylococcal Infections/*etiology/microbiology

OBJECTIVE: To study the risk factors and interaction of nasal septal perforation (NSP) in rats. METHOD: Animals (n=120) that underwent unilateral nasal obstruction using Merocel nasal packing or gelfoam with/without standard staphylococcus aureus inoculation were observed for the formation of NSP at 2, 3, 5, and 7 days after operation by endoscope system. Following sacrifice at 7 days, the obtained nasal secretions were prepared for bacterial culture. Experimental interventions were compared with normal controls (n=10). RESULT: Perforation of nasal septum was observed in 80% of the animals accepted nasal obstruction using Merocel nasal packing with standard staphylococcus aureus inoculation in 3 days (P < 0.01), while in 70% of those using abacterial Merocel nasal packing in 5 days (P < 0.05) and no significant difference than that of before (P > 0.05). There was a weak region in anteroinferior nasal septum in rats, which the almost NSPs located in. The position of NSP does not overlap Merocel. CONCLUSION The interaction of risk factors contributes to NSP. The occurrence of NSP mainly depends on the construction of nasal septum, while dysaemia is also necessary. Obstruction of nasal drainage and infection promote the development of NSP.
Animals ; Causality ; Disease Models, Animal ; Male ; Nasal Obstruction ; microbiology ; pathology ; Nasal Septal Perforation ; etiology ; Nasal Septum ; anatomy & histology ; Rats ; Rats, Sprague-Dawley ; Risk Factors ; Staphylococcal Infections ; pathology

OBJECTIVE: To analyze the factors and biological characteristics of infection after cochlear implantation so as to control the risk factors and improve the treatment of postoperative infection. METHOD: A retrospective study was conducted to analyze the clinical data of 316 patients receiving cochlear implantation from July 2001 to October 2011. RESULT: Postoperative infection was found in five of the 316 cases and one transferred case. The six cases recovered after clinical therapy without explantation. One case underwent explantation due to recurrent meningitis after implantation of 8 years later. CONCLUSION The pathogens of infection after cochlear implantation are staphylococcus aureus, pseudomonas aeruginosa, etc. The key infectious factor is the formation of bacterial biofilm, which can be removal by chemical agents to control the postoperative infection, especially the flap infection. It is not necessary to remove the artificial cochlea when the postoperative infection occurs. Positive perioperative interventions and postoperative infection control can improve the outcome of cochlear implantation.
Adolescent ; Aged ; Biofilms ; growth & development ; Cochlea ; Cochlear Implantation ; adverse effects ; Humans ; Postoperative Complications ; microbiology ; Pseudomonas Infections ; etiology ; Pseudomonas aeruginosa ; physiology ; Retrospective Studies ; Risk Factors ; Staphylococcal Infections ; etiology ; Staphylococcus aureus ; physiology