Lublin, Poland
Lublin, Poland

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Bogut A.,Medical University of Lublin | Niedzwiadek J.,Medical University of Lublin | Koziol-Montewka M.,Medical University of Lublin | Strzelec-Nowak D.,Medical University of Lublin | And 4 more authors.
Journal of Medical Microbiology | Year: 2014

We determined the frequency of isolation of staphylococcal small-colony variants (SCVs) from 31 culture-positive patients undergoing revision of total hip prosthesis for aseptic loosening or presumed prosthetic-joint infection (PJI). We analysed auxotrophy of cultured SCVs, their antimicrobial susceptibility profiles and their biofilm-forming capacity. Eight SCV strains were cultivated from six (19%) patients. All SCVs were coagulase-negative staphylococci (CNS) with Staphylococcus epidermidis as the predominant species; there was also one Staphylococcus warneri SCV. The SCVs were auxotrophic for haemin, with one strain additionally auxotrophic for menadione. We noted the presence of two phenotypically (differences concerning antimicrobial susceptibility) and genetically distinct SCV strains in one patient, as well as the growth of two genetically related SCVs that differed in terms of their morphology and the type of auxotrophy in another. Seven out of eight SCVs were resistant to meticillin and gentamicin. In addition, antibiotic sensitivity testing revealed three multidrug-resistant SCV-normal-morphology isolate pairs. One S. epidermidis SCV harboured icaADBC genes and was found to be a proficient biofilm producer. This paper highlights the involvement of CNS SCVs in the aetiology of PJIs, including what is believed to be the first report of a S. warneri SCV. These subpopulations must be actively sought in the routine diagnosis of implant-associated infections. Moreover, in view of the phenotypic and genetic diversity of some SCV pairs, particular attention should be paid to the investigation of all types of observed colony morphologies, and isolates should be subjected to antimicrobial susceptibility testing. © 2014 SGM.

Bogut A.,Medical University of Lublin | Niedz'wiadek J.,Medical University of Lublin | Strzelec-Nowak D.,Medical University of Lublin | Blacha J.,Clinical Hospital No 4 | And 3 more authors.
New Microbiologica | Year: 2014

Reliable microbiological diagnosis along with surgery and prolonged antibiotic therapy are key elements in the management of prosthetic-joint infections (PJIs). The purpose of this study was to characterize antibiotic resistance profiles of bacteria involved in the aetiology of PJIs. A total of 33 bacterial isolates cultured from 31 patients undergoing exchange of total hip prostheses were analyzed. The diagnostic approach toward isolation of prosthesis- associated microorganisms included sonication of retrieved implants and conventional cultures of periprosthetic tissues and synovial fluid. The in vitro resistance profiles of bacterial isolates were determined in relation to antibiotics recommended for the therapy of PJIs using the disc diffusion method, E-tests® and broth microdilution system. Coagulase-negative staphylococci (CNS) were predominant microorganisms followed by Staphylococcus aureus, Enterobacter cloacae, Streptococcus mitis, and Propionibacterium acnes. Twenty out of 30 and 12 out of 30 staphylococcal isolates were methicillin- and multi-drug resistant, respectively. Only two isolates were rifampicinresistant. All staphylococci were susceptible to glycopeptides and linezolid. This paper stresses the pathogenic role of staphylococci in patients suffering from implant loosening and reports high methicillin- and multidrug-resistance rates in these bacteria. Hence, antimicrobial susceptibility tests of individual bacterial isolates must always be performed to guide selection of the optimal therapeutic option.

Sojka M.,Medical University of Lublin | Sojka M.,CNRS Laboratory of Plant Reproduction and Development | Jargiello T.,Medical University of Lublin | Jargiello T.,CNRS Laboratory of Plant Reproduction and Development | And 9 more authors.
Acta Angiologica | Year: 2011

Background. Visceral artery aneurysms (VAAs) are intra-abdominal aneurysms that occur in the coeliac trunk and the superior and inferior mesenteric arteries or their branches. They are uncommon vascular anomalies but can be life-threatening, with mortality ranging from 10 to 25% and up to 75% in pregnant women. Currently available treatment options include transcatheter embolisation, percutaneous implantation of covered stent, or surgical resection. The aim of our study was to demonstrate methods of minimally invasive endovascular treatment of visceral artery aneurysms and to assess their applicability and efficacy. Material and methods. Between January 2000 and September 2009, 34 patients with VAAs (aged 23-79 years) underwent endovascular treatment. Different techniques were used: 14 aneurysms were embolised with coils, covered stents were implanted in 12 patients, and in 8 cases transcatheter direct thrombin injection into the sack of the aneurysm was implemented. Results. Almost all aneurysms (33/34) were successfully excluded from the circulation. Follow-up examinations with Doppler USG or angio-CT were performed in 31 patients between 3 and 18 months after treatment. No reperfusion of aneurysmal sac was observed in any of the followed-up patients. Satisfactory results were observed in all 31 examined patients. Conclusions. Our experience shows that percutaneous treatment of visceral artery aneurysms is both safe and effective. Endovascular treatment of these lesions should be considered as the primary treatment option. Good treatment results depend on proper assessment of the aneurysm's morphology by means of angio-CT or angiography as well as on selection of the appropriate vascular approach and endovascular technique. Copyright © 2011 Via Medica.

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