Clinical Infectious Diseases: Open Access

ISSN: 2684-4559

Open Access

Articles in press and Articles in process

    Case Report Pages: 1 - 3

    Elevation in International Normalized Ratio due to Administration of Cefoperazone in Valvular Patients on Warfarin Therapy: Series of Two Case Reports

    Anam Liaqat*, Muhammad Asad and Arif-Ullah Khan

    Warfarin is an oral anticoagulant, which is commonly prescribed in hospital settings in various thrombotic conditions. It is known to have had a broad range of interactions with other medicinal gents widely used during clinical settings, particularly antibiotics, resulting in altered coagulation parameters and bleeding in such patients. In this study, we intend to describe two such cases that developed excessive hypoprothombinemic response due to cefoperazone and improved after substituting cefoperazone with alternative antibiotic. While there is no conclusive proof of warfarin-cefaperazone interactions, it is recommended that healthcare providers explore alternate antibiotic use in warfarin therapy patients and allow careful surveillance of the coagulation profile for all those patients receiving warfarin and antibiotics in combination with warfarin dosage modification.

      Case Report Pages: 1 - 3

      Pneumothorax Aggravated Respiratory Failure in a Patient with SARS-CoV-2 Pneumonia

      Ting Li* and Gang Wu

      High-flow oxygen inhalation, noninvasive and invasive ventilation were used for a 68-year-old female with laboratory-confirmed SARS-CoV-2 pneumonia successively. Secondary-infection, injury of liver and kidney, respiratory acidosis and coagulation disorder were revealed by laboratory findings. Two weeks after admission, chest radiograph showed pneumothorax. She died of respiratory failure four days later.

        Review Article Pages: 1 - 6

        Small Colony Variants of Staphylococcus aureus and their Diagnostic Methods: A Narrative Review

        Esayas Tekle*, Yonas Adisu, Sisay Teferi and Gemechu Tiruneh

        DOI: 10.37421/2684-4559.2023.7.186

        One of the most well-known human pathogens, Staphylococcus aureus, causes infections ranging from life-threatening conditions including sepsis, necrotizing pneumonia and, endocarditis to benign superficial skin infections. It was formerly thought to be an extracellular bacterium. However, it has been demonstrated that this pathogen can live and dwell inside cells. These features allow the pathogen to survive periods of antibiotic treatment or pressure from the immune system of the host and further enable it to start the infection once again after the environmental stress declines. Such characteristics are considered properties of Staphylococcus aureus small colony variants. Staphylococcus aureus small colony variants are often difficult to recognize due to the fact that they are endowed with unusual metabolic, physiological, and morphological characteristics that will cause difficulties for the routine diagnostic laboratory. As a result, they are associated with persistent infections.

        Research Article Pages: 1 - 11

        Prevalence of Methicillin Resistant Staphylococcus aureus and Assessment of Associated Factors among Patients Admitted at Jimma Medical Center, Southwest Ethiopia

        Esayas Tekle*, Yonas Adisu, Zewdineh Sahlemariam, Yared Alemu, Sisay Teferi and Gemechu Tiruneh

        DOI: 10.37421/2684-4559.2023.7.187

        Background: Methicillin Resistant Staphylococcus aureus (MRSA) is one of the most important hospital associated pathogens whose emergence has created clinical difficulties for nosocomial infections. The extent of nasal colonization during hospitalization, however, has not been investigated. Therefore, this study aimed to assess the prevalence and associated factors of methicillin resistant Staphylococcus aureus nasal colonization in inpatient wards at an Ethiopian teaching hospital offering tertiary care for the prevention and control of its transmission.

        Methods: A hospital based prospective cross-sectional study was conducted among 388 admitted patients at Jimma medical center in Jimma town, southwest Ethiopia, from October 1 to December 30, 2020. Proportional stratification and systematic random sampling were employed to get a proportional number of participants and to recruit study participants from each ward. Socio-demographic data and data on associated factors were collected using a structured questionnaire. Two nasal swab samples were taken from each patient, the first within 48 hours of admission and the second at the time of discharge. The specimens were then inoculated on Mannitol salt agar and yellowish colonies were sub-cultured on nutrient agar. The isolate was further identified using gram reaction, catalase, and coagulase tests. The Cefoxitin disk was used for the detection of methicillin resistant Staphylococcus aureus. Multivariate logistic regression was employed for factors associated with Methicillin Resistant Staphylococcus aureus (MRSA) nasal colonization. A P-value <0.05 was defined as statistically significant for all results.

        Results: The overall prevalence of MRSA nasal colonization was 29.9%. The prevalence of MRSA at the time of admission was 23.7%. From the total (116) MRSA isolated, 20.69% of patients were newly colonized. The isolates showed the highest resistance to penicillin (97.9%). History of hospitalization, chronic wound infection, and diabetes mellitus were significantly associated with MRSA nasal colonization.

        Conclusion: The prevalence of MRSA was 29.9%. The isolated S. aureus showed the highest resistance to penicillin (97.9%) and the majority of the isolates were multidrug resistant. Having a history of hospitalization, chronic wound infection, and diabetes mellitus were significantly associated with MRSA nasal colonization. MRSA transmission in the hospital can be reduced by screening patients during their admission.

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