Christopher L. Emery

Regional Occurrence of Plasmid-Mediated SHV-7, an Extended-Spectrum β-Lactamase, in Enterobacter cloacae in Philadelphia Teaching Hospitals

Although the production of extended-spectrum beta-lactamases (ESBLs) by Klebsiella pneumoniae and Escherichia coli is an emerging problem, limited data are available regarding the frequency of ESBL production in other organisms. We provide the only description of regional occurrence of SHV-7 in Enterobacteriaceae other than E. coli or K. pneumoniae in the United States, and we emphasize that, among Enterobacter cloacae strains, not all resistance to extended-spectrum cephalosporins is the result of hyperproduction of AmpC beta-lactamase.

Misidentification of Mycobacterium peregrinum, the Causal Organism of a Case of Bacteremia and Automatic Implantable Cardioverter Defibrillator-Associated Infection, Due to Its Unusual Acid-Fast Staining Characteristics

ABSTRACT We report an unusual case of Mycobacterium peregrinum bacteremia and infection of an automatic implantable cardioverter defibrillator that was originally misidentified as a Nocardia sp. due, in part, to its partially acid-fast staining characteristic, morphology, and odor. The misdiagnosis had a direct effect on patient care, though the patient was subsequently successfully treated.

Occurrence of and risk factors for methicillin-resistant Staphylococcus aureus at a teaching hospital in Philadelphia

Manual medical record mining and data analysis were performed at a tertiary care university teaching hospital to establish the rate of occurrence of and risk factors for infection with methicillin-resistant Staphylococcus aureus (MRSA). Patients with surgical site infections had the highest rate of MRSA infection, representing 59% of the MRSA infections recorded. The mortality rate in patients with relapsed MRSA was 45% (13 of 30), compared with no deaths in 149 new MRSA cases. The majority of deaths in patients with relapsed MRSA occurred in the intensive care unit.