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Beta-hemolytic streptococci (BHS) are the most common causative agents of perianal streptococcal dermatitis (PSD). This study evaluates the distribution of BHS isolates in perianal bacterial cultures. We retrospectively reviewed microbiological results for perianal BHS that were isolated in our laboratory between 2006 and 2015. We identified a total of 105 BHS isolates from rectal swabs and swabs of clinically intact perianal skin. The majority of BHS were of group A (GABHS) (73/105; 69.5%), followed by group B BHS (GBBHS) (27/105; 25.7%), and non-group A or B BHS (5/105; 4.8%). The distribution of GABHS was age-specific, with the majority of GABHS obtained from young children. All BHS isolates were susceptible to penicillin. GABHS were universally susceptible to clindamycin, whereas 1.4% were resistant to erythromycin. GBBHS were resistant to erythromycin and clindamycin in 14.8% and 7.4% of cases. In addition, we wanted to emphasize the importance of correct diagnosis of PSD. Hence, we provide a review of protocols that can decrease the time to diagnosis and treatment of PSD, reduce patients' discomfort, and prevent unnecessary diagnostic procedures.

Early postoperative prosthetic valve endocarditis due to Stenotrophomonas maltophilia was diagnosed in seven patients (two men) aged from 68 to 84 years (mean age 78.1 years) over a three-year period. All patients had undergone aortic valve replacement. S. maltophilia was isolated from at least two blood cultures per patient. Four patients experienced CNS embolic complications. Three patients died. All patients were treated with ceftazidime, one in combination with amikacin, one with ciprofloxacin and one with levofloxacin. Because a common source of infection in the operating theater was suspected, 24 environmental samples were taken, of which two contained S. maltophilia. Six of the seven clinical isolates from the patients and two isolates from the environment were analyzed using molecular typing by pulsed-field gel electrophoresis (PFGE). The patients' isolates were resistant to gentamicin, ciprofloxacin, trimethoprim/sulfamethoxazole and, except in one case, to amikacin and piperacillin/tazobactam and susceptible to ceftazidime and levofloxacin. In contrast, the environmental isolates were resistant to ceftazidime, showed intermediate susceptibility to ciprofloxacin, and were susceptible to trimethoprim/sulfamethoxazole. PFGE demonstrated indistinguishable or closely related (1-3 band difference) PFGE patterns in isolates from the patients, but a different pattern in the environmental isolates. No common source of infection was found despite intensive investigation. Extensive cleaning and other measures of infection control were carried out and no new cases were recorded in the two year follow-up period.

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Staphylococcus aureus is among the most important human pathogens. It is associated with different infections and is a major cause of skin and soft tissue infections (SSTIs). The aim of our study was to compare S. aureus isolates associated with SSTIs with isolates obtained from healthy carriers in the Central Slovenia region in terms of antimicrobial susceptibility, genetic diversity by clonal complex (CC)/sequence type, spa type, and by toxin gene profiling. In total, 274 S. aureus isolates were collected prospectively by culturing wound samples from 461 SSTI patients and nasal samples from 451 healthy carriers. We have demonstrated high heterogeneity in terms of CCs and spa type in both groups of isolates. The main clone among SSTI strains was Panton-Valentine leukocidin gene (pvl) positive CC121, whereas the main clone among carrier strains was CC45 carrying a large range of toxin genes. The main spa type in both groups was t091. Pvl was more frequently present in SSTI strains (31.2% SSTI vs 3.6% carrier strains) and staphylococcal enterotoxin C was more frequently present in carrier strains (1.6% SSTI vs 17.0% carrier strains). We have also demonstrated that methicillin-resistant S. aureus was a rare cause (2.8%) of SSTIs in our region.