Pharyngeal Swab Culture Research Articles

Management and outcome of cutaneous diphtheria in adolescent refugees in Germany, June 2022 - October 2023.

From September 2022 an increase in Corynebacterium diphtheriae (C. diphtheriae)infections was reported in Europe. Our study focuses on 31 adolescent and young adult refugees with cutaneous C. diphtheriae infections detected in Germany. We examined treatment regimens and outcomes to provide targeted insights into the management of this infection. We distributed a standardized survey, focused on children and adolescents presenting to paediatric clinics through the German Paediatric Infectious Diseases Society (DGPI) and additional professional contacts in Germany. Data were extracted from routine medical documentation and reported anonymously. A total of 31 individuals with cutaneous C. diphtheriae infection were reported by 9 centres. Two of these showed diphtheria toxin (DT) related systemic symptoms and four exhibited systemic inflammation requiring complex management. The remaining 25 cases, with exclusively cutaneous manifestations, were afebrile. Treatment with topical antiseptics and systemic antibiotics, mainly aminopenicillin/beta-lactamase inhibitors (BLI) (35%) or clindamycin (25%), achieved eradication in all but two cases treated with aminopenicillin/BLI. Treatment duration varied between 5 and 17 days. In refugees presenting with chronic skin wounds, C. diphtheriae should be included into the differential diagnosis. Fever seems to be a valuable marker to differentiate severe cases with potentially DT-mediated sequelae from exclusively cutaneous diphtheria (CD). For afebrile CD, topical antiseptics and oral antibiotic therapy with clindamycin for 7 days, followed by clinical surveillance appears to be a safe treatment regimen. Patients with CD who present with fever or pharyngitis should be thoroughly investigated including blood and pharyngeal swab cultures.

Risk factors for carriage of meningococcus in third-level students in Ireland: an unsupervised machine learning approach

ABSTRACT The aim of this study was to examine the risk factors for pharyngeal carriage of meningococci in third-level students using an unsupervised machine learning approach. Data were gathered as part of meningococcal prevalence studies conducted by the Irish Meningitis and Sepsis Reference Laboratory (IMSRL). Pharyngeal swab cultures for meningococcal carriage were taken from each student once they had completed a single-page anonymous questionnaire addressing basic demographics, social behaviors, living arrangements, vaccination, and antibiotic history. Data were analyzed using multiple correspondence analysis through a machine learning approach. In total, 16,285 students who had a pharyngeal throat swab taken returned a fully completed questionnaire. Overall, meningococcal carriage rate was 20.6%, and the carriage of MenW was 1.9% (n = 323). Young Irish adults aged under 20 years and immunized with the meningococcal C vaccine had a higher MenW colonization rate (n = 171/1260, 13.5%) compared with non-Irish adults aged 20 years or older without the MenC vaccine (n = 5/81, 6%, chi-square = 3.6, p = .05). Unsupervised machine learning provides a useful technique to explore meningococcal carriage risk factors. The issue is very complex, and asked risk factors only explain a small proportion of the carriage. This technique could be used on other conditions to explore reasons for carriage.

Application effects of modified oral nursing in patients with dysphagia after brain injury

Objective To compare the effects of cleaning oral among different nursing methods for patients with dysphagia after brain injury who take food by gastric tube as well as by mouth. Methods A total of 59 patients with dysphagia after brain injury were divided into research group (29 cases, mouth nursing by modified method of brushing their teeth and irrigation) and control group (30 cases, mouth nursing by traditional oral care routine) according to the random number table method from October 2012 to May 2014. Results were observed by comparing oral condition, indexes of pharyngeal swab culture and water-swallowing test. Results Incidence rates of halitosis and unclean mouth were all 13.8% in the research group which were lower than those (73.3%, 63.3%) in the control group with statistically significant differences (χ2=21.208, 15.214; P 0.05). The abnormity rate in the research group was lower than that in the control group at 4th week (χ2=8.958, P 0.05). The rate of oral mucosa bleeding was 3.4% in the research group and 6.7% in the control with no statistically significant difference (χ2=0.316, P>0.05), but there was no mechanical injury of oral mucosa in two groups. There was no statistically significant difference in index of water-swallowing test between two groups before interventions (P>0.05), with significant difference at 4th week (P<0.01). Conclusions The implementation of mouth nursing by modified method of brushing their teeth and irrigation not only can achieve the purpose to clean oral effectively, but also can reduce oral bacteria and promote the recovery of swallowing function. Key words: Brain injuries; Dysphagia; Oral nursing

Influenza A (H1N1)-induced ischemic stroke in a child: case report and review of the literature

Ischemic stroke is an important cause of death and long term morbidity in children. Viral respiratory infections are emerging as important risk factors responsible for ischemic stroke in this age group. The direct action of virus against cerebral vessels, autoimmune reactivity, and increased production of cytokines are advocated as the main factors for causing ischemic stro-ke. This study can be useful for clarifying some molecular aspects of H1N1 virus infection in children.We report on the case of a H1N1-induced ischemic stroke in a Caucasian 2 year-old female. The cerebrospinal fluid samples showed the positivity of polymerase chain reaction for influenza A (H1N1) infection, confirmed also by pharyngeal swab culture. Increased levels of cerebrospinal fluid interleukin 6 and interleukin 1β were also detected.&nbsp;&nbsp;H1N1 virus infection has been identified as an important cause of neurological involvement in children. The findings of increased levels of Interleukin 6 and interleukin 1β in the cerebrospinal fluid of this child with H1N1 induced-ischemic stroke seems to validate the role of pro-inflammatory cytokines as crucial mediators of cerebral thrombus formation.&nbsp;&nbsp

Appropriate Sampling Sites for the Surveillance of Multidrug-Resistant Pseudomonas aeruginosa Colonization

This study aimed at evaluating the effectiveness of testing multiple samples (urine, stool, and pharyngeal swabs) for accurate screening of multidrug-resistant (MDR) Pseudomonas aeruginosa. Of a total of 641 patients, 16 (2.5%) were confirmed for MDR P. aeruginosa carriage at any site (urine and/or stool and/or pharyngeal swab). Notably, of the 3 sample sites, urine culture had the highest rate of positive surveillance for MDR P. aeruginosa. Seven (43.8%) of the 16 cases of MDR P. aeruginosa were detected by urine culture alone. Eleven (91.7%) of the 12 MDR P. aeruginosa carriers detected by urine culture had an indwelling urinary catheter. Our data suggest that urine culture was the most effective in detecting MDR P. aeruginosa carriage, particularly for patients with an indwelling urinary catheter. However, sample cultures from all 3 sites increased the detection rate of MDR P. aeruginosa carriage. Therefore, we recommend the use of a urine culture in combination with either a stool and/or a pharyngeal swab culture to increase the accuracy of MDR P. aeruginosa carriage detection.

P3.152 Prevalence of Neisseria Gonorrhoeae Infection in Two Distinct Men-Who-Have-Sex-With-Men (MSM) Populations in Slovenia in 2012

ObjectivesInfection with Neisseria gonorrhoeae represents a serious public health problem. According to the national reported incidence surveillance system in Slovenia, gonorrhoea is disproportionately more common in the MSM population. However,...

Purulent keratoconjunctivitis due to Neisseria gonorrhoeae and Chlamydia trachomatis coinfection

Gonococcal conjunctivitis is a rare infection induced by Neisseria gonorrhoeae and it usually manifests as a hyperacute purulent conjunctivitis. Ocular access of the infectious secretion during sexual intercourse is the way of transmission among adults. Inclusion conjunctivitis caused by the serovars D-K of Chlamydia trachomatis also affects the sexually active population. Authors present a case of a 33-year-old homosexual man who was treated for late latent syphilis formerly. Clinical symptoms were yellow purulent discharge for 3 weeks without any urological or upper respiratory tract symptoms. Conjunctival Neisseria gonorrhoeae and Chlamydia trachomatis infection was identified using cultures and polymerase chain reaction; pharyngeal swab culture and polymerase chain reaction showed positive results for both pathogens. The patient was probably under influence of party drugs at the time of sexual abuse when he became infected. After parenteral and oral cephalosporin and azithromycin therapy the patient had complete recovery within three weeks.

Letter to the editor

Letter to the editor We would like to applaud the authors of the article "The worldwide epidemiology of acute rheumatic fever (ARF) and rheumatic heart disease (RHD)"¹ for highlighting this important disease which continues needlessly to kill people living in poverty while being largely ignored by the developed world.² We would however like to address some key issues.The authors state that: the evidence of serologic infection is based on one of "a pharyngeal swab culture positive for GABHS, positive rapid GABHS antigen test or rising serologic antibody titers". Very few countries in highly affected regions of the world utilize routine rapid antigen or microbiological testing due to the cost involved. Furthermore, the delay involved in repeat serological testing before a diagnosis can be made, will result in missed diagnoses and tragic consequences. We recommend therefore that elevated serological markers of previous GABHS infection, together with major and minor criteria, are sufficient for a diagnosis of ARF.

Staphylococcal scalded skin syndrome in a neonate

Staphylococcal scalded skin syndrome (SSSS) manifests acute exfoliation of skin following a staphylococcal infection. We report a case of SSSS with pneumonia, an unusual combination in neonates. A full term, 3 kg, boy presented on the 18th day of life with erythematous, bullous skin lesions over face, back & extremities. Baby was irritable on admission. Perinatal period was uneventful. There was no family history of similar skin lesions. On admission, Nikolsky sign was positive. No systemic involvement was noted. Blood culture, gastric aspirate and pharyngeal swab cultures were done. With clinical suspicion of SSSS (Fig. 1) intravenous amoxicillin and clavulinic acid combination alongwith amikacin was initiated. Appropriate skin care was initiated. Desquamation stopped within 24 hours. On the second day, scaling lesions spread all over body. On the third day baby developed respiratory distress with bilateral crepitations. Chest roentgenogram showed right lung consolidation. Intravenous vancomycin was initiated. Respiratory distress settled over next two days. Blood culture was sterile. Pharyngeal swab and gastric aspirate cultures were positive for Staphylococcus aureus. Skin lesions healed without scarring. Staphylococcal Scalded Skin Syndrome in a Neonate

Clinical predictors of childhood streptococcal pharyngitis

Background Antibiotic prescription for the management of all acutepharyngitis seems to be increasing recently. Streptococcal pharyngitisis the one that has strong indication for antibiotic prescription. Itis quiet hard to distinguish the clinical features of streptococcalpharyngitis from non-streptococcal one.Objective To determine specifically clinical features of streptococcalpharyngitis and distinguish them from non-streptococcal one.Methods We conducted a cross-sectional study on children withacute pharyngitis at Pediatric Outpatient Department Dr. M.Djamil Hospital, Padang from November 2006 until March 2007.Data on clinical features and pharyngeal swab culture results wereanalyzed using chi-square test for clinical predictors. All were thenreanalyzed using multivariate logistic regression.Results Ninety-five children aged 3-13 years were enrolled andpharyngeal swab culture was performed. Group A β -haemolyticusstreptococcus was found in 13 children (14%). Absence of cough,sore throat, tonsillar exudates and tender anterior cervicaladenopathy were the clinical predictors for streptococcalpharyngitis and the last two shared highest risk (OR 55.05;31.82). Combination of tonsillar exudates, tender anterior cervicaladenopathy and absence of cough contributed 99,3% probability.Conclusions Streptococcal pharyngitis includes a small part of allchildhood with acute pharyngitis. High grade fever, sore throat,absence of cough, tonsiller excudates and tender anterior cervicaladenopathy were considered as clinical predictors for childhoodstreptococcal pharygitis. Combination of some clinical predictorswill strengthen the probability of streptococcal pharyngitis.

Eficacia de un filtro antibacteriano en la prevención de la contaminación de equipos de exploración funcional respiratoria

Devices to assess lung function are a potential source of nosocomial infection. Our aims in this study were: 1) to determine the efficacy of an antimicrobial filter to prevent contamination of a multifunctional device; 2) to assess the ability of the filter to prevent cross contamination of individuals being tested; and 3) to evaluate the efficacy of the recommendations of the Spanish Society of Respiratory Diseases and Thoracic Surgery for disinfecting lung function equipment. In this prospective, randomized study in two phases we used filters in phase 1 but not in phase 2. A pharyngeal swab culture was started within 7 days of a patient's lung function test. Swab samples for culturing were taken from three different places in the equipment at the beginning and end of each working day. Sixty-five patients (31 in phase 1 and 34 in phase 2) were studied. Thirty-two (49.2%) were men and the mean age was 49.4 15.7 years. Significantly less equipment contamination was found in phase 1 (4.2%) than in phase 2 (21%). We detected no cases of cross contamination using the criteria in this study. No cultures from any of the samples taken before exploration were positive. a) The antimicrobial filter used is effective for preventing the contamination of lung function testing equipment, b) throughout both phases of the study, we observed no cross contamination of patients tested, such that we cannot conclude that the antimicrobial filter is effective for preventing possible nosocomial infections, c) the recommendations of SEPAR for disinfecting lung function equipment are effective.

Methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa isolation from pharyngeal swab cultures among the Japanese elderly at admission to a geriatric hospital

The isolation rate of Methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa from pharyngeal swab cultures in the Japanese elderly was studied at admission to a geriatric hospital which had long-term care units. The subjects were 233 consecutive patients who were admitted to K Hospital in the time period April 1994 to March 1996. The isolation rate of MRSA and of Pseudomonas aeruginosa was 10.3% and 8.2% respectively. The proportions of the patients with severely to moderately limited Activities of Daily Living (ADL) (ADL score = 0–1) ( P < 0.01), those with fever ( P < ;0.01), those with CRP positive ( P = 0.04) and those with hypoalbuminemia (serum albumin<3.5 g/dl) ( P < 0.01) were higher in the MRSA positive patients than in the negative patients while the proportion of the patients with fever was higher in the Pseudomonas aeruginosa positive patients than in the negative patients ( P < 0.02). In the multiple logistic regression analysis, the limitation of ADL (ADL score 0–1 vs 2–3, OR = 1.54, 95% CI = 1.02–2.33) and fever (with vs without, OR = 1.77, 95% CI = 1.18–2.66) remained as risk factors for the isolation of MRSA while only fever (with vs without, OR = 1.67, 95% CI = 1.11–2.53) remained as a risk factor for the isolation of Pseudomonas aeruginosa.

Methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa isolation from pharyngeal swab cultures among the Japanese elderly at admission to a geriatric hospital

Objective : The purpose of this study was to describe: (a) the prevalence and content of policies on euthanasia or assisted suicide (EAS) in three different types of nursing homes; (b) specific content items of written guidelines for EAS; and (c) the prevalence of guidelines on withholding or withdrawing treatment from severely demented patients and patients in a persistent vegetative state in the nursing homes. Design : Descriptive, cross-sectional. Methods : We have used a postal survey among directors of patient care of all ( n = 304) Dutch somatic nursing homes (meant for physically handicapped patients), psychogeriatric nursing homes (meant for patients suffering from dementia) and combined nursing homes. Data were collected from October 1994 through January 1995. Results : Results indicate that psychogeriatric nursing homes less often had a written EAS policy than somatic and combined nursing homes (62, 68 and 80% respectively). The most frequently reported aspects in the EAS guidelines, by the nursing homes with guidelines based on a policy that EAS was accepted under certain conditions; were consultation of another physician (97%), referral to another physician if the attending physician had in-principle objections (82%), and the involvement of the nurse in the decision-making procedure (82%). Of the nursing homes, 9% reported having specific written procedures concerning withholding or withdrawing treatment from severely demented patients. Conclusion : Guidelines in the nursing homes on euthanasia and assisted suicide might be improved. Especially with regard to withholding or withdrawing treatment from incompetent patients, more guidelines should be developed.

Perception of body weight and self-reported eating and exercise behaviour among obese and non-obese women in Saudi Arabia

The isolation rate of Methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa from pharyngeal swab cultures in the Japanese elderly was studied at admission to a geriatric hospital which had long-term care units. The subjects were 233 consecutive patients who were admitted to K Hospital in the time period April 1994 to March 1996. The isolation rate of MRSA and of Pseudomonas aeruginosa was 10.3% and 8.2% respectively. The proportions of the patients with severely to moderately limited Activities of Daily Living (ADL) (ADL score = 0–1) ( P < 0.01), those with fever ( P < ;0.01), those with CRP positive ( P = 0.04) and those with hypoalbuminemia (serum albumin<3.5 g/dl) ( P < 0.01) were higher in the MRSA positive patients than in the negative patients while the proportion of the patients with fever was higher in the Pseudomonas aeruginosa positive patients than in the negative patients ( P < 0.02). In the multiple logistic regression analysis, the limitation of ADL (ADL score 0–1 vs 2–3, OR = 1.54, 95% CI = 1.02–2.33) and fever (with vs without, OR = 1.77, 95% CI = 1.18–2.66) remained as risk factors for the isolation of MRSA while only fever (with vs without, OR = 1.67, 95% CI = 1.11–2.53) remained as a risk factor for the isolation of Pseudomonas aeruginosa .

Methicillin-resistant Staphylococcus aureus (MRSA) isolation from pharyngeal swab cultures of Japanese elderly at admission to a geriatric hospital.

The isolation rate of the methicillin-resistant Staphylococcus aureus(MRSA) from pharyngeal swab cultures in Japanese elderly was studied at admission to a geriatric hospital. The subjects were 233 consecutive patients admitted to Kitakyushu Tsuyazaki Hospital from April 1994 to March 1996. The isolation rate of MRSA was 3.0% in the patients admitted from their own homes, 9.7% in those transferred from nursing homes and 14.0% in those transferred from other hospitals. The patients from their own homes were younger than those from nursing homes, the latter being older than those transferring from other hospitals. The patients from their own homes had better activities of daily living(ADL), higher levels of hemoglobin and serum albumin than those from nursing homes or other hospitals. The white blood cell counts, and the proportion of patients with positive c-reactive protein or with fever did not differ among the three groups. Multiple logistic regression analysis revealed that fever and ADL disability were independent risk factors for the isolation of MRSA, and hypoalbuminemia was a risk factor for MRSA isolation in the model using serum albumin instead of ADL score. These results suggest that the lower isolation rate MRSA among patients from their own homes may be partly due to better ADL and nutritional status compared with those from nursing homes or other hospitals.

Bacterial colonization as a potential source of nosocomial respiratory infections in two types of spirometer.

The potential risk of spirometers in the transmission of respiratory infections has not been yet established. We performed a prospective cross-sectional study to determine the rate of colonization of a water-sealed spirometer and a pneumotachograph, and the potential risk of cross-transmission of microorganisms to patients using each of these devices. Fifty four patients (aged 51 +/- 18 (mean +/- SD) yrs) were included in the study. All of them had undergone forced spirometry with bronchodilator response by means of the water-sealed spirometer (n = 36) or the pneumotachograph (n = 18). None had a clinically apparent respiratory infection at the time of the study. Routine hygiene measures for respiratory equipment were performed before the study protocol. Samples for microbiological cultures of different parts both of the water-sealed spirometer (proximal and distal tubing, bell and water-bell) and pneumotachograph (proximal and distal tubing) were taken daily before and after the usual series of lung function tests during a 5 day period. Pharyngeal swab cultures were obtained before spirometry and 7 days later in each subject. Thirty six out of a total of 40 (90%) culture samples from the water-sealed spirometer showed microbial growth compared to 4 out of 30 (13%) samples obtained from the pneumotachograph (p < 0.0001). Significant colonization of the water-sealed spirometer was apparent after the third day of the study. The microorganisms most frequently isolated were penicillium sp. (62%), Pseudomonas fluorescens (32%), and Burkholderia cepacea (48%). Distal tubing, water and water-bell were the parts of the water-sealed spirometer that showed higher colonization counts (> or = 10(4) colony-forming units (cfu).mL-1). No transmission sequence of potentially pathogenic microorganisms from equipment to patients or vice versa could be demonstrated. In summary, the water-sealed spirometer frequently became colonized by microorganisms. The potential hazard of such equipment as reservoirs of microorganisms suggests a need for the implementation of new hygiene measures for their maintenance.

Bacteriology of tonsil surface and core in children.

The tonsils of 97 children undergoing tonsillectomy were studied to determine the correlation between surface culture swab and culture of tonsillar core. In many cases, pathogenic organisms were found in the tonsil core, despite the fact that surface cultures revealed only normal respiratory flora. The tonsil core cultures showed a high incidence of Hemophilus influenzae and Staphylococcus aureus, which was rarely reflected on surface culture. The study indicates that pharyngeal swab cultures do not reliably reflect the presence of pathogens in the tonsil core. The value of parameters such as history of recurrent bouts of tonsillitis and presence of erythema or cryptic debris on physical examination for predicting the differential bacteriology of the tonsil is studied. The implications for treatment of children with adenotonsillar hypertrophy are discussed.

最近猩紅熱患者から分離した溶連菌の薬剤感受性特にエリスロマイシン耐性菌の出現について

On 163 streptococcus heamolyticus (SH) strains isolated by pharyngeal swab culture from patients of scarlet fever admitted to Tokyo Metropolitan Bokuto Hospital between June, 1970 and June, 1971, sensitivity to various antibiotics was measured.Through the whole period, 2 strains of A group SH resistant to EM were isolated. Special attention should be drawn to these isolations in the light of the fact thatthere had been no report of EM-resistant SH in this country until 1970. Increase of such strains in the future is feared.The number of CP-resistant SH found in this series was two, all belonging to A group. These were resistant only to TC among the rest. As to the incidence of TC-resistant. A group SH, yearly increase has been seen since 1967, 43.2% being the reach in 1971. There encountered none of PC-G-resistant strain.