Departments of Community-acquired Listeria Monocytogenes Meningitis in Adults
نویسندگان
چکیده
ceftazidime, and imipenem (MIC, 132 mg/L); intermediate susceptibility to aztreonam; and susceptibility to piperacillin. Such a phenotype suggested MBL production, which was confirmed by the imipenem-EDTA double-disk synergy test [6]. The MBL determinant was subsequently identified as blaIMP-4 by molecular techniques [7]. The patient, who had just been transferred to the neurosurgery department, was moved to a single room, and contact barriers were implemented. Antibiotic treatment was discontinued, and invasive devices were removed as soon as possible to decrease the risk factors for P. aeruginosa infection. Forty days after admission, when discharge from the hospital was scheduled, a rectal swab was performed and determined to be negative for IMP-4–producing isolates. However, isolation measures were maintained until discharge, 20 days later. No further MBLproducing isolate has been identified in our hospital so far. MBL genes are widespread in some geographical areas, particularly Southeast Asia, whereas they remain uncommon in other countries [8]. So far, very few MBLs have been reported in France, and all of those that have been identified were Veronese imipenemase– type enzymes [9, 10]. Our report highlights the importance of an active surveillance strategy in countries where MBLs are absent or uncommon. Patients transferred from high-risk areas should be screened on admission, and isolation precautions should be implemented until culture results are available. Such measures are critical to prevent these enzymes from spreading worldwide, as occurred with extended-spectrum b-lactamases.
منابع مشابه
Community-acquired Listeria monocytogenes meningitis in adults.
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تاریخ انتشار 2010