- Hello, Jeff - This is a very perplexing situation at
the Medical Center. It does sound as though Dr. Michael Gewitz is trying
to quell some culpability on the part of the medical center. He is attempting
to claim the infant deaths probably would have occurred anyway, even if
the babies were not infected.
-
- In the summer of 1983, the same neonatal intensive care
unit and the maternity floor had a problem with infection control and had
reoccurring Staph outbreaks throughout the summer. I had firsthand knowledge
of a patient and her newborn daughter who were infected with Staph that
summer. The hospitals answer to the second Staph outbreak was to send the
infected baby home as soon as possible and the severely ill Mom was transferred
to the Oncology floor. (She did not have cancer however the hospital transferred
her due to the Staph infection. The mother had gone into respiratory arrest
during the C-Section after given an overdose of anesthesia.)
-
- Hopefully, the hospital will find out HOW the bacteria
had infected the babies.
-
- Patricia Doyle
-
-
- http://www.wnbc.com/health/3596719/detail.html
-
-
-
- Uncommon Bacteria Found In 7 Babies, 4 Die
-
- UPDATED: 2:12 pm EDT July 30, 2004
-
- VALHALLA, N.Y. -- Seven premature
babies at a Westchester hospital tested positive for bacteria rarely found
in infants, and four of them have died.
-
- The extremely premature babies all suffered multiple
medical problems, and two who died were not expected to survive regardless
of the bacteria, Westchester Medical Center officials told The Journal
News. Some weighed less than a pound.
-
- Dr. Michael Gewitz, director of pediatrics, told the
newspaper it was nearly impossible to say whether the bacteria, acinetobacter,
contributed to the babies' deaths. He said some just had it on their skin,
not in their blood.
-
- The bacteria, which is not uncommon in ailing adult patients,
was identified by routine blood cultures about two weeks ago at Westchester
Medical Center in a baby who had been transferred from another hospital.
-
- Other babies were checked for the bacteria, and the six
who tested positive were isolated, Gewitz said. The surviving babies are
being treated with antibiotics.
-
- Twenty-nine other babies tested negative for the bacteria,
which spreads by contact. The hospital's neonatal intensive-care unit is
a regional center that typically treats the sickest premature infants in
the Hudson Valley region.
-
- Acinetobacter infections might cause a fever or other
symptoms in adults, but the babies showed no signs of the bacteria's presence,
Gewitz said in the newspaper's Friday report. Testing positive for acinetobacter
does not mean there is an infection.
-
- "In these babies, it's hard to make that call because
they have so many other serious problems associated with their basic illness
of being extremely premature," he said.
-
- © 2004 by The Associated Press. All rights reserved.
This material may not be published, broadcast, rewritten or redistributed.
-
-
- I sincerely apologize for adding the wrong file from
my notes. I was too hasty in clicking on my file which is in alphabetical
order of bacteria files in my computer and hit the wrong bacteria.
-
- Please forgive me for the error and I sincerely thank
Jeff Rense for posting the correct information.
-
- Sincerely,
- Patricia Doyle
-
- Correction: Acinetobacter
-
- ACINETOBACTER
- Acinetobacter species are oxidase-negative, non-motile
bacteria which appear as Gram-negative coccobacilli in pairs under the
microscope. Identifying the different species of this genus can be done
through the use of FLN (Flourescence-Lactose-Denitrification medium) acid
results which determines the amount of acid produced from metabolizing
glucose. Also, most members of Acinetobacter show good growth on MacConkey
agar with the exception of some A. lwoffii strains. Although many species
of Acinetobacter can cause infection, A. baumannii is the most frequently
encountered species in the clinical laboratory. Like Pseudomonas, A. baumannii
can be linked to many hospital acquired infections including skin and wound
infections, pneumonia, and meningitis. A. lwoffi, in particular, is responsible
for most cases of meningitis caused by Acinetobacter. Because most species
are resistant to penicillin and chloramphenicol, a combination of aminoglycoside
and ticarcillin is usually recommended for treatment.
-
- LABORATORY INDICATIONS:
- Oxidase -
- Non-motile
- Penicillin resistance (most strains)
-
- Also for more information:
-
- http://arch.rivm.nl/enemti/The%20genus%20Acinetobacter.htm
-
- The Acinetobacter Working Group
-
-
- Introduction
-
- Bacteria of the genus Acinetobacter are widespread in
nature, and can be recovered from water, soil and living organisms. They
are non-motile, coccobacillary, strictly aerobic and Gram-negative; they
can use a variety of carbon sources for growth, and can be cultured on
relatively simple media, including trypticase soya agar or nutrient agar.
Extensive reviews of the genus have been written by Juni (15) and by Bergogne-Bérézin
& Towner (1). Strains of A. baumannii, and the unnamed groups 3 and
13 TU are recovered predominantly from clinical specimens, with A. baumannii
being notorious for its capacity to colonise and infect severely ill, hospitalised
patients. Strains of this genomic species can persist in hospitals and
give rise to outbreaks; they are usually highly resistant to antibiotics,
which makes them difficult to eradicate.
-
- Two recently described species, A. ursingii ('phenon
1') and A. schindlerii ('phenon 2') (17, 18) are also associated with patients;
thus A. ursingii was cultured from the blood of severely ill hospitalised
patients, and A. schindlerii from non-sterile body sites of outpatients.
Most other (genomic) species of Acinetobacter have been found in different
environments, e.g. strains of A. calcoaceticus are isolated predominantly
from soil and A. johnsonii from activated sludge and frozen food, although
representatives of these and other species have also been recovered occasionally
from human specimens. Strains of A. venetianus, including the emulsan-producing
strain RAG-1, have been found in seawater and oil-degrading consortia (7,
22). Overall, the natural habitats of most Acinetobacter (genomic) species
have not been well-studied.
-
- Within the context of ENEMTI, the Acinetobacter Working
Group will seek to develop two different protocols that can be used for
the development of an interactive database for the exchange of microbial
typing database:-
-
- (i) a high-resolution typing method suitable for use
in reference laboratories: AFLP protocol
-
- (ii) a simpler rapid typing method for use in routine
hospital laboratories: RAPD method
-
- The ENEMTI initiative aims to harmonise typing methods
so that the fingerprints generated can be used to set up electronic databanks
by which the geographic spread of particular strains can be depicted and
monitored.
-
- ENEMTI participants have also collaborated with members
of the EU ARPAC Concerted Action ('Antibiotic Resistance Prevention and
Control') to develop an Acinetobacter database based on pulsed-field gel
electrophoresis (PFGE) fingerprint profiles. Click here [http://bioinformatics.phls.org.uk/acine/acinepfge.htm]
to enter the Acinetobacter PFGE database.
-
- More information on the genus Acinetobacter, a heterogeneous
group of organisms
-
- Taxonomy
-
- Currently, the genus Acinetobacter comprises at least
23 genomic species (DNA-DNA hybridisation groups; DNA groups), 10 of which
have been given species names; other DNA groups are designated by numbers
(for Table 1, see the original Word document). The numbers 13-15 have been
given to sets of strains in two independent studies (6, 20); DNA group
13 of Bouvet & Jeanjean (BJ) has been found to correspond to group
14 of Tjernberg & Ursing (TU), whereas no correlation was found for
the two other groups. Strains of A. calcoaceticus, A. baumannii, and the
unnamed groups 3 and 13TU are genetically closely related and difficult
to separate phenotypically, and are therefore sometimes unified in the
so-called A. calcoaceticus A. baumannii (Acb) complex (10). Apart from
the known genomic species, additional strains have been found, some of
which are closely related to the Acb complex (12), while the taxonomic
status of others has not yet been resolved.
-
- Genus identification
-
- Bacteria can be identified to the genus Acinetobacter
by the phenotypic criteria listed in Table 2 (see the original Word document).
A simple test for identification to the genus Acinetobacter is based on
the finding that DNA of organisms belonging to the genus can be used to
transform an auxotrophic Acinetobacter strain (BD413 trpE27) to prototrophy
(14).
-
- (Genomic) species identification
-
- DNA-DNA hybridisation is the gold standard for identification
of Acinetobacter strains, but this method is not applicable in most laboratories.
A phenotypic identification scheme, including enzymatic and nutritional
tests and growth at different temperatures, was devised by Bouvet &
Grimont (4, 5). Several studies have shown that some genomic species are
difficult to identify by phenotypic tests (10, 16). Similarly, commercial
phenotypic identification systems, such as API 20NE and Biolog, show only
moderate performance (2, 3). In particular, A. baumannii, DNA groups 3
and 13TU are difficult to differentiate by these systems.
-
- Several genotypic methods have been proposed for identifying
acinetobacters to the genomic species level, including ribotyping (11),
tDNA fingerprinting (9), amplified ribosomal DNA restriction analysis (ARDRA)
(8, 21), and AFLP (13). An overview of ARDRA patterns for species identification
can be found at http://allserv.rug.ac.be/~mvaneech/LBR.html.
-
- Despite the progress made in subdividing the genus Acinetobacter
and the efforts to develop easy identification methods, identification
to the genomic species level can still be problematic. This may be overcome
by using a combination of methods, which results in a so-called 'consensus
identification' (17).
-
- Typing of Acinetobacter strains
-
- Virtually all currently available typing methods have
been used for discrimination of acinetobacters below the species level.
Phenotypic methods, including biotyping, cell envelope protein electrophoresis,
and quantitative antibiogram typing were applied successfully in the 1980s
and 1990s. More recently, genotypic methods including plasmid typing (now
rarely used), ribotyping, pulsed-field gel electrophoresis (PFGE), PCR
fingerprinting and AFLP analysis have been used in numerous studies. In
general, a combination of typing methods is recommended for unambiguous
strain identification in local situations.
-
- References
-
-
-
- Bergogne-Bérézin E & Towner KJ (1996).
Acinetobacter spp. as nosocomial pathogens: microbiological, clinical,
and epidemiological features. Clin Microbiol Rev 9, 148-165.
- Bernards AT, Dijkshoorn L, van der Toorn J, Bochner BR
& van Boven CPA (1995). Phenotypic characterization of Acinetobacter
strains of 13 DNA-DNA hybridization groups by means of the Biolog system.
J Med Microbiol 42, 113-119.
- Bernards AT, van der Toorn J, van Boven CPA. & Dijkshoorn
L (1996). Evaluation of the ability of the API 20NE system to identify
Acinetobacter genomic species. Eur J Clin Microbiol Infect Dis 15, 303-308.
- Bouvet PJM & Grimont PAD (1986). Taxonomy of the
genus Acinetobacter with the recognition of Acinetobacter baumannii sp.
nov., Acinetobacter haemolyticus sp. nov., Acinetobacter johnsonii sp.
nov., and Acinetobacter junii sp. nov., and emended descriptions of Acinetobacter
calcoaceticus and Acinetobacter lwoffii. Int J Syst Bacteriol 36, 228-240.
- Bouvet PJM & Grimont PAD (1987). Identification and
biotyping of clinical isolates of Acinetobacter. Ann Inst Pasteur/Microbiol
138, 569-578.
- Bouvet PJM & Jeanjean S (1989). Delineation of new
proteolytic genomic species in the genus Acinetobacter. Res Microbiol 140,
291-299.
- DiCello F, Pepi M, Baldi F & Fani R (1997). Molecular
characterization of an n-alkane-degrading bacterial community and identification
of a new species, Acinetobacter venetianus. Res Microbiol 148, 237-249.
- Dijkshoorn L, van Harsselaar B, Tjernberg I, Bouvet PJM
& Vaneechoutte M (1998). Evaluation of amplified ribosomal DNA restriction
analysis for identification of Acinetobacter genomic species. Syst Appl
Microbiol 21, 33-39.
- Ehrenstein B, Bernards AT, Dijkshoorn L, Gerner-Smidt
P, Towner KJ, Bouvet PJ, Daschner FD & Grundmann H (1996). Acinetobacter
species identification by using tRNA spacer fingerprinting.J Clin Microbiol
34, 2414-2420.
- Gerner-Smidt P, Tjernberg I & Ursing J (1991). Reliability
of phenotypic tests for identification of Acinetobacter species. J Clin
Microbiol 29, 277-282.
- Gerner-Smidt P (1992). Ribotyping of the Acinetobacter
calcoaceticus-Acinetobacter baumannii complex. J Clin Microbiol 30, 2680-2685
- Gerner-Smidt P & Tjernberg I (1993). Acinetobacter
in Denmark: II. Molecular studies of the Acinetobacter calcoaceticus- Acinetobacter
baumannii complex. APMIS 101, 826-832.
- Janssen P, Maquelin K, Coopman R, Tjernberg I, Bouvet
P, Kersters K & Dijkshoorn L (1997). Discrimination of Acinetobacter
genomic species by AFLP fingerprinting. Int J Syst Bacteriol 47, 1179-1187.
- Juni E (1972). Interspecies transformation of Acinetobacter:
Genetic evidence for a ubiquitous genus. J Bacteriol 112, 917-931.
- Juni E (1984). Genus III Acinetobacter Brisou and Prévot
1954, 727 AL. In: Bergey,s Manual of Systematic Bacteriology vol. 1, Krieg,
N.R. (ed). Williams and Wilkins, Baltimore, pp 303-307.
- Kämpfer P, Tjernberg I & Ursing J (1993). Numerical
classification and identification of Acinetobacter genomic species. J Appl
Bacteriol 75, 259-268.
- Nemec A, Dijkshoorn L & Je°ek P (2000). Recognition
of two novel phenons of the genus Acinetobacter among glucose non-acidifying
isolates from human specimens. J Clin Microbiol 38, 3937-3941.
- Nemec A, De Baere T, Tjernberg I, Vaneechoutte M, van
der Reijden TJK & Dijkshoorn L (2001). Acinetobacter ursingii sp.nov.
and Acinetobacter schindleri sp. nov., isolated from human clinical specimens.
Int J Syst Evol Microbiol, in press.
- Nishimura Y, Ino T & Iizuka H (1988). Acinetobacter
radioresistens sp. nov. isolated from cotton and soil. Int J Syst Bacteriol
38, 209-211.
- Tjernberg I & Ursing J (1989). Clinical strains of
Acinetobacter classified by DNA-DNA hybridization. APMIS 97, 595-605.
- Vaneechoutte M, Dijkshoorn L, Tjernberg I, Elaichouni
A, de Vos P, Claeys G & Verschraegen G (1995). Identification of Acinetobacter
genomic species by amplified ribosomal DNA restriction analysis. J Clin
Microbiol 33, 11-15.
- Vaneechoutte M, Tjernberg I, Baldi F, Pepi M, Fani R,
Sullivan ER, van der Toorn J & Dijkshoorn L (1999). Oil-degrading Acinetobacter
strain RAG-1 and strains described as 'Acinetobacter venetianus' sp. nov.
belong to the same genomic species. Res Microbiol 150, 69-73.
-
-
-
- Patricia A. Doyle, PhD
- Please visit my "Emerging Diseases" message
board at: http://www.clickitnews.com/ubbthreads/postlist.php?Cat=&Board=emergingdiseases
- Zhan le Devlesa tai sastimasa
- Go with God and in Good Health
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