Sphingomonas paucimobilis outbreak in a dialysis room: Case report and literature review of an emerging healthcare associated infection

Evaluation of the safety and quality of Brazil nuts (Bertholletia excelsa) using the tools of dna sequencing technology and aflatoxin profile

Introduction

Brazil nuts (BNs) result from sustainable extraction and are widely exploited in the Amazon region. Due to the production characteristics in the forest and the nutritional characteristics of these nuts, the occurrence of fungal contamination and the presence of aflatoxins are extensively discussed in the literature as a great aspect of interest and concern. This study aims to evaluate the microbial profile through DNA sequencing and amplification of 16S and ITS genes for bacterial and fungal analysis, respectively, and the presence of mycotoxins using high-performance liquid chromatography with fluorescence detection (HPLC-FD) from different fractions of the nuts processed.

Methods

The BN samples, harvest A (HA) and harvest B (HB), from two different harvests were collected in an extractive cooperative in the Amazon region for microbiological analysis (from DNA extraction and amplification of 16S genes, bacteria analysis, and ITS for fungi) and mycotoxins (aflatoxins AFB1, AFB2, AFG1, and AFG2) using HPLC-FD/KobraCell®.

Results and discussion

The samples showed a very different microbiome and aflatoxin profile. Genera such as Rothia (HA) and Cronobacter (HB) were abundant during the analysis of bacteria; as for fungi, the genera Aspergillus, Fusarium, Penicillium, and Alternaria were also considered prevalent in these samples. Soil microorganisms, including those pathogenic and related to inadequate hygienic-sanitary production practices, as well as aflatoxins, were found in the samples. However, they were within the established limits permitted by Brazilian legislation. Nuts have a diverse microbiota and are not restricted to fungi of the genus Aspergillus. The microbiological and toxicological profile can vary significantly within the same nut in the same extraction region and can be exacerbated by global climate changes. Therefore, it is necessary to advance sanitary educational actions by applying good production practices and inspection programs to ensure the sustainability and quality of the BN production chain.

Draft genome of heterotrophic bacteria Sphingomonas sp. 2R-10 isolated from water treatment plant in South Africa

The availability of clean drinking water is crucial for human well-being, necessitating the monitoring and characterization of microorganisms in water sources. In this study, we present the draft genome of a heterotrophic bacterium, Sphingomonas sp. 2R-10, isolated from the untreated raw water of a drinking water source in South Africa.

Isolation of Sphingomonas paucimobilis from an ocular infection and identification using ribosomal RNA gene: First case report from Iran

Key Clinical Message

Sphingomonas paucimobilis can cause infection in healthy people. As this bacterium is slow-growing, special attention should be paid to the timely diagnosis and control of its antibiotic resistance to prevent the spread of resistant strains.

Abstract

This study reports a case of ocular infection caused by Sphingomonas paucimobilis and its treatment with various antibiotics. A middle-aged woman with prolonged purulent eye discharge was admitted to an ophthalmology clinic in Qazvin, Iran. A strain of S. paucimobilis was isolated from the patient. The sample was identified by Sanger sequencing of the 16s rRNA gene, and an antibiogram test was performed to determine its resistance profile. The patient was treated with ceftazidime and levofloxacin eye drops. The bacterial culture was negative 18 days after starting ceftazidime and levofloxacin treatment. The antibiogram results showed that the isolated bacterium was resistant to aminoglycosides and colistin. This study highlights that S. paucimobilis can cause disease even in immunocompetent individuals. Due to the different resistance profiles of this bacterium, treatment should be based on antibiogram results.

Lacrimal Drainage Infections with Sphingomonas paucimobilis: Clinical Presentations, Complications and Outcomes

PURPOSE

To report the clinical presentations, complications, and outcomes of Sphingomonas paucimobilis-specific lacrimal drainage infections.

METHODS

A retrospective chart review of all patients diagnosed with Sphingomonas paucimobilis lacrimal infections and managed at a tertiary care Dacryology Service from November 2015 to May 2022 over a 6.5-year period were recruited and analyzed. Data collected include demographic details, clinical presentation, microbiological diagnosis, antibiotic susceptibility profiles, management, complications, and outcomes. The microbiological techniques employed were aerobic and anaerobic cultures, phenotypic identification with VITEK 2^R system, polymerase chain reaction, antibiotic sensitivity profile and minimal inhibitory concentration.

RESULTS

Twelve Sphingomonas-specific lacrimal drainage infections of 11 patients were identified. Of these five were canaliculitis and seven were acute dacryocystitis. All the seven acute dacryocystitis presented in an advanced stage; five were with lacrimal abscess and two with orbital cellulitis. The antibiotic susceptibility profile of canaliculitis and acute dacryocystitis were comparable and the organism was sensitive to several classes of antibiotics. The outcomes of punctal dilatation and nonincisional curettage were effective for canaliculitis. Patients with acute dacryocystitis had advanced clinical stage at presentation but responded well to intensive systemic management and had excellent anatomical and functional outcomes with dacryocystorhinostomy.

CONCLUSION

Sphingomonas-specific lacrimal sac infections can have aggressive clinical presentations and need early and intensive therapy. The outcomes are excellent with multimodal management.

Multidisciplinary approach to the study of large-format oil paintings

Cultural heritage has become a keystone for comprehending our society, as it represents and reflects our origins, passions, beliefs and traditions. Furthermore, it provides fundamental information about specific temporary spaces, materials' availability, technology, artist's intention, and site weather conditions. Our aim was to develop a multidisciplinary approach with a main focus on investigating two Italian large-format paintings located in highly diverse environments such as the National Theater of Costa Rica. We monitored environmental conditions and quantified fungal aerial spores. Then, we determined regions of possible biodeterioration with the software MicroorganismPattern and used the software PigmentArrangement to elucidate the apparent colour of the paintings based on distribution and arrangement of the pigment crystals. Finally, we characterized eight genera of calcareous nannofossils found in the ground layers of the artwork. The former Men's Canteen at the National Theater of Costa Rica presented a mean air temperature of 23.5 [Formula: see text]C, a relative humidity of 72.7% and a concentration of CO[Formula: see text] of 570 ppm. The fungal aerial concentration was 1776 spores/m[Formula: see text]. The software MicroorganismPattern identified 32 sampling regions, out of which 11 were positive for microbial contamination. The software PigmentArrangement determined that the blue crystals (ultramarine pigment) had the shortest distances between themselves (29 [Formula: see text]m). Finally, the nanofossils identified enabled us to restrict the age of the material to a biostratigraphic interval ranging from Coniacian to Maastricthian ages. By using a multidisciplinary approach we were able to explore the diptych, suggest a set of minimally invasive perspectives in tropical environments to be used worldwide and obtain key information about the artist's artistic process, materials used along with better understand its state of conservation.

Sphingomonas paucimobilis native valve endocarditis and mycotic cerebral aneurysm in a patient with Crohn's disease: Case report and review of literature

This report describes a case of Sphingomonas paucimobilis bacteremia and infective endocarditis with a mycotic aneurysm in a young patient with Crohn's disease. Our patient reported prolonged intermittent fever followed by sudden hemiparesis and a tonic clonic convulsion. His blood cultures showed growth of Sphingomonas paucimobilis, and further cardiac imaging revealed the presence of a vegetation with severe valvular regurgitation. Cerebral angiography showed middle cerebral artery occlusion and aneurysm. The patient was treated with meropenem for 6 weeks, coupled with aortic valve replacement, and coiling of the aneurysm. Our patient recovered with good results. S. paucimobilis is an opportunistic gram-negative pathogen of growing importance in the clinical setting.

Sphingomonas paucimobilis Bacteremia in a Patient With Retropharyngeal Abscess

Sphingomonas paucimobilis is a nonfermenting gram-negative bacillus that is widely distributed in both community environments and hospitals. Various infections have been identified in humans, but most have been limited to case reports. When reported, it is most commonly nosocomial infections associated with contaminated hospital equipment such as indwelling catheters, ventilators, hemodialysis devices, and very rarely upper respiratory tract infections. We report an unusual presentation of S. paucimobilis infection. This case report describes a 59-year-old immunocompetent man who presented with a retropharyngeal abscess. Blood culture was positive for S. paucimobilis. The patient was treated for a total of 21 days of intravenous (IV) cefepime and oral (PO) metronidazole. He showed significant improvement and was discharged home with no medical sequelae.

Recurrent neurosurgical site infection by extensively drug-resistant P. aeruginosa treated with cefiderocol: a case report and literature review

INTRODUCTION

Cefiderocol is a new siderophore cephalosporin designed to be active against extensively resistant Gram-negative bacteria; however, clinical studies are limited to complicated urinary tract infections, pneumonia, and intra-abdominal infections. To date, no data are available on neurosurgical site infections.

CASE PRESENTATION

We present a case of a patient successfully cured with Cefiderocol for a neurosurgical site infection due to extensively resistant P. aeruginosa, who had failed a previous treatment based on combined antimicrobial therapy and right parietal bone excision.

CONCLUSIONS

Cefiderocol is a promising antibiotic for complicated infections due to multidrug resistant gram-negative bacteria.

Italian young doctors' knowledge, attitudes and practices on antibiotic use and resistance: A national cross-sectional survey

OBJECTIVES

Antimicrobial resistance (AMR) is one of the major health issues worldwide. Clinicians should play a central role to fight AMR, and medical training is a pivotal issue to combat it; therefore, assessing levels of knowledge, attitudes and practices among young doctors is essential for future antimicrobial stewardship (AMS) programmes.

METHODS

A nationwide, cross-sectional, multicentre survey was conducted in Italy. A descriptive analysis of knowledge and attitudes was performed, along with a univariate and multivariate analysis of their determinants.

RESULTS

Overall, 1179 young doctors accessed the survey and 1055 (89.5%) completed all sections. Regarding the knowledge section of the questionnaire, almost all participants declared to know the different species of bacteria proposed, however the percentage of participants who correctly responded to clinical quizzes was 23% for the question on vancomycin-resistant enterococci (VRE), 42% on carbapenem-resistant Enterobacteriaceae (CRE), 32% on extended-spectrum β-lactamase-producing enterobacteria (ESBL) and 27% on methicillin-resistantStaphylococcus aureus (MRSA). Similarly, 81% of participants disagreed in stating that AMR was adequately addressed during their medical training and 71% disagreed that they received the right example from their tutors. Finally, a high rate of agreement with the proposed actions to combat AMR was documented; in particular, the percentage agreement was 76% for respondents who agreed to be part of an active surveillance system or AMS programme.

CONCLUSIONS

Tackling AMR should be a priority for politicians and for all health workers. Inclusion of competencies in antibiotic use in all specialty curricula is urgently needed.