Shih-Ta Shang

Tri-Service General Hospital, T’ai-pei, Taipei, Taiwan

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Publications (7)15.08 Total impact

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    ABSTRACT: There are few reports of invasive infections caused by Brevundimonas vesicularis. We report two cases of B vesicularis bacteremia confirmed by culture and 16S rRNA sequence analysis with highly variable sensitivity to broad-spectrum antibiotics. Initial empiric therapy with anti-pseudomonal antibiotics plus trimethoprim-sulfamethoxazole for hospital-acquired B vesicularis infections should be considered.
    Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi 05/2012; 45(6). DOI:10.1016/j.jmii.2011.12.021 · 2.35 Impact Factor
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    ABSTRACT: Chryseobacterium indologenes is an uncommon pathogen of human disease and is usually associated with indwelling devices or immunocompromised hosts. We report here an unusual case of C. indologenes peritonitis in an oncological patient with malignant ascites. The patient was treated successfully by trimethoprim-sulfamethoxazole without removal of the catheter.
    International Medical Case Reports Journal 01/2011; 4(1):13-5. DOI:10.2147/IMCRJ.S16179
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    ABSTRACT: The number of community-onset bacteremic urinary tract infections (UTIs) caused by Escherichia coli and Klebsiella pneumoniae is increasing. However, the impact of extended-spectrum β-lactamase (ESBL)-producing E. coli and K. pneumoniae (ESBL-EK) on bacteremic UTI outcomes is unknown. The aim of this study was to retrospectively analyze the impact of ESBL-EK on community-onset bacteremic UTIs. Of the 58 patients enrolled, 12 suffered from ESBL-EK-caused community-onset bacteremic UTIs. Patients were categorized into ESBL (n=12) and non-ESBL (n=46) groups. Diagnosis was based on findings of concurrent bacteremia and bacteriuria caused by the same pathogen on admission. The ESBL group had significantly more male patients (66.7%vs. 23.9%; p=0.005), indwelling urinary catheters (41.7%vs. 6.5%; p=0.002), patients admitted from other healthcare facilities (50.0%vs. 8.7%; p=0.001), and patients with higher Acute Physiology and Chronic Health Evaluation II scores (23.3±7.1 vs. 15.9±6.3; p=0.001) and intensive care unit admissions (41.7%vs. 4.4%; p=0.003) than the non-ESBL group. Multiple logistic regression analysis revealed that male gender (odds ratio=9.2; 95%, confidence interval=1.7-50.6) and healthcare facility residency (odds ratio=15.5; 95% confidence interval=2.4-98.9) were independent risk factors for ESBL-producer infections among bacteremic UTIs. Although the mortality rate of both groups was similar (8.3%vs. 4.4%; p=0.403), the ESBL group had longer hospital stays (16.3±9.3 days vs. 7.9±5.2 days; p=0.010) and higher antibiotic costs (615.1±423.5 USD vs. 252.8±269.2 USD, p=0.014). Male gender and healthcare facility residency are risk factors for ESBL-producer infections among patients with community-onset bacteremic UTIs. Patients with bacteremic UTIs caused by ESBL-EK also have prolonged hospital stays and higher antibiotic costs. Early detection of ESBLs and appropriate antibiotic coverage are likely to shorten hospital stays and reduce medical costs.
    Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi 06/2010; 43(3):194-9. DOI:10.1016/S1684-1182(10)60031-X · 2.35 Impact Factor
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    ABSTRACT: The yeast Kodamaea ohmeri rarely causes life-threatening human infections. However, risk factors, laboratory diagnoses, and treatments for K. ohmeri infection have been limited, and the optimal therapy for K. ohmeri infection has not been identified. Twenty cases of K. ohmeri infection have been reported in the English medical literature. We present two new cases of K. ohmeri fungemia. We investigated the nature and treatment of K. ohmeri infections using minimum inhibitory concentrations of antifungal agents and by comparing the two cases with those described in the literature. From March 1998 to December 2008, a total of 22 patients with K. ohmeri infections were studied. Hematological malignancies and diabetes were the most common co-morbidities for K. ohmeri infections, with crude prevalence rates of 27.3% and 18.2%, respectively. The K. ohmeri isolates showed less susceptibility to fluconazole but greater susceptibility to amphotericin B [15/25 isolates (60%) vs. 25/25 isolates (100%), respectively]. Good outcomes (8/9 cases; 88.9%) were found following removal of indwelling catheters and implants. In addition, voriconazole and echinocandins, such as caspofungin and micafungin, also showed excellent minimum inhibitory concentrations against K. ohmeri. K. ohmeri should not be regarded as a contaminant of blood cultures. Favorable outcomes for this potentially life-threatening infection are promoted by the removal of indwelling catheters; furthermore, outcomes are associated with optimal antifungal regimens, especially voriconazole and echinocandins.
    Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi 06/2010; 43(3):200-6. DOI:10.1016/S1684-1182(10)60032-1 · 2.35 Impact Factor
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    ABSTRACT: We describe a case of ruptured cerebral mycotic aneurysm caused by Abiotrophia defectiva endocarditis in a previously healthy man. The patient underwent craniotomy with clipping of aneurysm and received antibiotic treatment for 6 weeks and survived.
    The American Journal of the Medical Sciences 02/2010; 339(2):190-1. DOI:10.1097/MAJ.0b013e3181be6586 · 1.39 Impact Factor
  • Shih-Ta Shang · Ya-Sung Yang · Ming-Yieh Peng ·
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    ABSTRACT: Trichosporon asahii (formerly known as T. beigelii) is an emerging, life-threatening opportunistic pathogen, especially in severely granulocytopenic patients with underlying hematological malignancies. Other reported predisposing factors for infection with this pathogen include organ transplantation, extensive burns, human immunodeficiency virus infection, corticosteroid therapy, prosthetic valve surgery, and peritoneal dialysis. We report a 53-year-old nongranulocytopenic female with secondary hemochromatosis, who developed nosocomial fungemia caused by T. asahii. This case suggests that clinicians should be aware that T. asahii fungemia can develop in nongranulocytopenic patients with secondary hemochromatosis.
    Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi 02/2010; 43(1):77-80. DOI:10.1016/S1684-1182(10)60012-6 · 2.35 Impact Factor
  • Chun-Hsiang Chiu · Ying-Chuan Wang · Shih-Ta Shang · Feng-Yee Chang ·

    International journal of antimicrobial agents 11/2009; 35(1):98-9. DOI:10.1016/j.ijantimicag.2009.09.010 · 4.30 Impact Factor