RESUMO
PURPOSE: To characterize the risk factors, clinical presentations, management choices, and outcomes of Proteus mirabilis keratitis. METHODS: In this retrospective study, 26 culture-proven cases of P. mirabilis infections were diagnosed and treated between 1998 and 2019 at the University of Pittsburgh Medical Center. Medical records were available for 14 keratitis cases and were reviewed for demographic information, ocular risk factors, and treatment outcomes. RESULTS: Sixteen eyes of 14 patients were included in the study. The average age was 47.8 ± 19.3 years, with a median follow-up time of 6 months. The most common ocular risk factors were poor ocular surface and contact lens use in 57.1% and 42.9% of cases, respectively. Eleven of the 14 patients (78.6%) had positive corneal cultures, and 13 of the 14 patients (92.9%) had positive conjunctiva or eyelid cultures. All isolates were susceptible to ciprofloxacin, ofloxacin, moxifloxacin, gatifloxacin, and cefazolin. Surgical intervention was required in 4 patients (28.6%). Average LogMAR visual acuity was 1.3 ± 1.0 at presentation and 0.9 6 ± 1.0 at the most recent follow-up visit. CONCLUSIONS: Proteus mirabilis is an uncommon cause of microbial keratitis. Patients with poor ocular surface and those who use contact lens are at increased risk for developing this cause of keratitis. Empiric treatment with fortified antibiotics or fluoroquinolones seemed to provide effective coverage for P. mirabilis.
Assuntos
Úlcera da Córnea/microbiologia , Infecções Oculares Bacterianas/microbiologia , Infecções por Proteus/microbiologia , Proteus mirabilis/isolamento & purificação , Adolescente , Adulto , Idoso , Antibacterianos/uso terapêutico , Pré-Escolar , Terapia Combinada , Úlcera da Córnea/epidemiologia , Úlcera da Córnea/terapia , Infecções Oculares Bacterianas/epidemiologia , Infecções Oculares Bacterianas/terapia , Feminino , Seguimentos , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Oftalmológicos , Infecções por Proteus/epidemiologia , Infecções por Proteus/terapia , Estudos Retrospectivos , Fatores de Risco , Resultado do TratamentoRESUMO
Gram-positive organisms are the most common infectious etiologic agents in skin abscesses. Empiric antimicrobial treatment choices are influenced by this knowledge. In this report, we describe a high prevalence of Proteus mirabilis, a Gram-negative bacillus, in skin abscesses of the axilla, which has potential implications for selection of antimicrobial therapy.
Assuntos
Abscesso/microbiologia , Infecções por Proteus/epidemiologia , Proteus mirabilis/isolamento & purificação , Dermatopatias Bacterianas/microbiologia , Abscesso/epidemiologia , Abscesso/terapia , Adolescente , Axila , Feminino , Humanos , Masculino , Prevalência , Infecções por Proteus/terapia , Dermatopatias Bacterianas/epidemiologia , Dermatopatias Bacterianas/terapiaRESUMO
Probiotics are increasingly being considered as non-pharmaceutical and safe potential alternatives for the treatment and prevention of a variety of pathologies including urinary tract infections. These are the most common infections in medical practice and are frequently treated with antibiotics, which have generated an intense selective pressure over bacterial populations. Proteus mirabilis is a common cause of urinary tract infections in catheterised patients and people with abnormalities of the urinary tract. In this work we isolated, identified and characterised an indigenous Lactobacillus murinus strain (LbO2) from the vaginal tract of a female mouse. In vitro characterisation of LbO2 included acid and bile salts tolerance, growth in urine, adherence to uroepithelial cells and in vitro antimicrobial activity. The selected strain showed interesting properties, suitable for its use as a probiotic. The ability of LbO2 to prevent and even treat ascending P. mirabilis urinary tract infection was assessed using an experimental model in the mouse. Kidney and bladder P. mirabilis counts were significantly lower in mice preventively treated with the probiotic than in non-treated mice. When LbO2 was used for therapeutic treatment, bladder counts of treated mice were significantly lower although no significant differences were detected in P. mirabilis kidney colonisation of treated and non-treated animals. These results are encouraging and prompt further research related to probiotic strains and the basis of their effects for their use in human and animal health.
Assuntos
Lactobacillus/patogenicidade , Probióticos/uso terapêutico , Infecções por Proteus/terapia , Proteus mirabilis/metabolismo , Infecções Urinárias/terapia , Animais , Anti-Infecciosos/uso terapêutico , Ácidos e Sais Biliares/química , Adesão Celular , Feminino , Humanos , Concentração de Íons de Hidrogênio , Rim/microbiologia , Lactobacillus/genética , Lactobacillus/metabolismo , Camundongos , Dados de Sequência Molecular , Infecções por Proteus/prevenção & controle , RNA Ribossômico 16S/análise , Infecções Urinárias/microbiologia , Infecções Urinárias/prevenção & controle , Urina/microbiologia , Urotélio/citologia , Urotélio/microbiologiaRESUMO
We report a case of renal abscess caused by gram negative pathogens, possibly Proteus mirabilis, that resolved with medical treatment. The infection was secondary to a purulent infection in the patient's left knee.