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Saba O, Benylles Y, Howe M, Inkster T, Hooker E. Infection prevention and control factors associated with post-cataract surgery endophthalmitis - a review of the literature from 2010 - 2023. Infect Prev Pract 2024; 6:100387. [PMID: 39188789 PMCID: PMC11345623 DOI: 10.1016/j.infpip.2024.100387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 07/16/2024] [Indexed: 08/28/2024] Open
Abstract
Patients undergoing cataract surgery are at risk of post-cataract surgery endophthalmitis (PCSE), a sight-threatening complication. Cataract surgery is a relatively straightforward and quick procedure often performed under local anaesthetic. It is therefore simple to scale up to reduce the currently long waiting times, but it is important to maintain patient safety when considering high throughput surgery. This literature review aimed to identify appropriate infection prevention and control (IPC) measures to support increased throughput of cataract surgery in Scotland. Database searches were conducted using Medline and Embase from 2010 to 2023. Further hand-searching was also performed. The organisms associated with PCSE and IPC factors relevant to PCSE were analyzed. A range of microorganisms was associated with PCSE, where outbreak reports were most associated with Gram-negative bacteria and fungi, whereas retrospective chart reviews were most associated with Gram-positive bacteria. IPC risk factors identified were related to the built environment and issues with sterilization. Specifically, the sources of outbreaks included failures in the ventilation system, as well as contaminated ophthalmic solutions, surgical instruments, and medications. The factors identified in this review should be considered when implementing high throughput cataract surgery to ensure that patient safety is maintained.
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Affiliation(s)
- O.A. Saba
- Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) Scotland, NHS National Services Scotland, Glasgow, United Kingdom
| | - Y. Benylles
- Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) Scotland, NHS National Services Scotland, Glasgow, United Kingdom
| | - M.H. Howe
- Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) Scotland, NHS National Services Scotland, Glasgow, United Kingdom
| | - T. Inkster
- Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) Scotland, NHS National Services Scotland, Glasgow, United Kingdom
| | - E.L. Hooker
- Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) Scotland, NHS National Services Scotland, Glasgow, United Kingdom
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Liu L, Wang C, Xu H, Hou L, Huang R, Shi X, Jia H. Ochrobactrum anthropi infection following corneal transplantation -a case report and review of literature. BMC Ophthalmol 2024; 24:234. [PMID: 38831303 PMCID: PMC11145840 DOI: 10.1186/s12886-024-03472-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/29/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Ochrobactrum anthropi is widely distributed and primarily infects patients with compromised immune functions . Historically, O. anthropi has been considered to possess low toxicity and pathogenicity; however, recent studies suggest that it may in fact cause severe purulent infections. In this case study, we examine a case of O. anthropi infection following corneal transplantation, exploring the occurrence and outcomes of such post-operative infections. CASE PRESENTATION A retrospective analysis of cases involved examinations, genetic testing for diagnosis, and subsequent treatment. In patients undergoing partial penetrating keratoplasty with a fungal corneal ulcer perforation, anterior chamber exudation and purulence were observed post-surgery. Despite antifungal treatment, genetic testing of the anterior chamber fluid and purulent material confirmed O. anthropi infection. The use of antimicrobial treatment specifically targeting O. anthropi was found to be effective in treating the infection. CONCLUSION Inflammatory reactions following corneal transplantation should be should be monitored for the presence of other infections. Genetic testing has significant implications for clinical diagnosis and treatment.
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Affiliation(s)
- Lei Liu
- Department of ophthalmology, The first hospital of Jilin University, Changchun, 130021, China
| | - Chunmei Wang
- Department of ophthalmology, The first hospital of Jilin University, Changchun, 130021, China
| | - Hui Xu
- Department of ophthalmology, The first hospital of Jilin University, Changchun, 130021, China
| | - Lulu Hou
- Department of ophthalmology, The first hospital of Jilin University, Changchun, 130021, China
| | - Rong Huang
- Department of ophthalmology, The first hospital of Jilin University, Changchun, 130021, China
| | - Xiaoru Shi
- Department of ophthalmology, The first hospital of Jilin University, Changchun, 130021, China.
| | - Hui Jia
- Department of ophthalmology, The first hospital of Jilin University, Changchun, 130021, China.
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Zaher S, Rodriguez-Villalobos H. Triple Gram-negative bacterial endophthalmitis following intravitreal injection. J Ophthalmic Inflamm Infect 2024; 14:9. [PMID: 38334879 PMCID: PMC10857997 DOI: 10.1186/s12348-023-00376-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 11/23/2023] [Indexed: 02/10/2024] Open
Abstract
PURPOSE To describe a puzzling case of endophthalmitis caused by three unusual bacteria after intravitreal injection, its outcome, and underlying questions. FINDINGS A 70-year-old female patient was diagnosed with acute endophthalmitis following intravitreal aflibercept injection for age-related macular degeneration. A standard tap and inject procedure was performed. Microbiological analyses on the anterior chamber and vitreous samples yielded the presence of three non-fermenting Gram-negative rods: Pseudomonas stutzeri, Stenotrophomonas maltophilia, and Ochrobactrum anthropi. The outcome was favorable after intravitreal injections of vancomycin and ceftazidime, with an almost complete recovery of the visual acuity to its baseline level. No potential source of infection was identified. CONCLUSION Endophthalmitis following intravitreal injection can be caused by a wide variety of bacteria, including some rare Gram-negative species. They can sometimes co-exist in a single patient, but their virulence may vary greatly. Due to the variable antibiotic susceptibility and frequent multiresistance associated with non-fermenting Gram-negative rods, a prompt microbiological approach is required. Favorable outcome can be achieved with standard management.
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Affiliation(s)
- Samy Zaher
- Department of Ophthalmology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
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Kannan NB, Kohli P, Shekhar M, Sen S, Lalitha P, Pai A, Ramasamy K. Ochrobactrum anthropi: A Rare Cause of Culture-Proven Acute Post-Operative Cluster Endophthalmitis. Ocul Immunol Inflamm 2022; 30:1756-1762. [PMID: 34213986 DOI: 10.1080/09273948.2021.1945636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
AIM To report the clinical presentation and management outcomes of an outbreak of culture-proven post-operative endophthalmitis (POE) secondary to Ochrobactrum anthropi. METHODS This study was conducted at a tertiary-care eye hospital in South India. RESULTS Fifty-five patients underwent cataract surgery by six surgeons on three consecutive days in the same surgical facility in September 2020. Four patients developed POE after a mean interval of 12.0 ± 4.8 days and underwent immediate vitreous tap and intravitreal antibiotic injections (Vancomycin and Ceftazidime). All patients required a core vitrectomy (culture positive, n = 4/4). Two patients underwent an additional intraocular lens explantation, 2 and 4 months after presentation. All the four patients showed good anatomical and functional recoveries (mean follow-up, 5.75 ± 1.5 months). Two other patients had an exaggerated post-operative inflammation, which was successfully treated with topical medications. CONCLUSIONS O. anthropi is a rare cause of acute POE. Although the isolated organism was multi-drug resistant, the outcome was good in all the patients.
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Affiliation(s)
- Naresh Babu Kannan
- Department of Vitreo-retinal Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, India
| | - Piyush Kohli
- Department of Vitreo-retinal Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, India
| | - Madhu Shekhar
- Department of Cataract and IOL Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, India
| | - Sagnik Sen
- Department of Vitreo-retinal Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, India
| | - Prajna Lalitha
- Department of Microbiology, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, India
| | - Aruna Pai
- Department of Cataract and IOL Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, India
| | - Kim Ramasamy
- Department of Vitreo-retinal Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, India
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Park J, Popovic MM, Balas M, El-Defrawy SR, Alaei R, Kertes PJ. Clinical features of endophthalmitis clusters after cataract surgery and practical recommendations to mitigate risk: systematic review. J Cataract Refract Surg 2022; 48:100-112. [PMID: 34538777 DOI: 10.1097/j.jcrs.0000000000000756] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/20/2021] [Indexed: 11/26/2022]
Abstract
Intraocular transmission of exogenous pathogens in cataract surgery can lead to endophthalmitis. This review evaluates the features of endophthalmitis clusters secondary to pathogen transmission in cataract surgery. Articles reporting on pathogen transmission in cataract surgery were identified via searches of Ovid MEDLINE, EMBASE, and Cochrane CENTRAL, and a total of 268 eyes from 24 studies were included. The most common source of infectious transmission was attributed to a contaminated intraocular solution (ie, irrigation solution, viscoelastic, or diluted antibiotic; n = 10). Visual acuity at presentation with infectious features was 1.89 logMAR (range: 1.35 to 2.58; ∼counting fingers) and 1.33 logMAR (range: 0.04 to 3.00; Snellen: ∼20/430) at last follow-up. Patients with diabetes had worse outcomes compared with patients without diabetes. The most frequently isolated pathogen from the infectious sources was Pseudomonas sp. (50.0%). This review highlights the various routes of pathogen transmission during cataract surgery and summarizes recommendations for the detection, prevention, and management of endophthalmitis clusters.
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Affiliation(s)
- Jeff Park
- From the Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Park, Balas); Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada (Popovic, El-Defrawy, Kertes); Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada (Alaei); Kensington Eye Institute, Toronto, Ontario, Canada (El-Defrawy); John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre, Toronto, Canada (Kertes)
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Li SY, Huang YE, Chen JY, Lai CH, Mao YC, Huang YT, Liu PY. Genomics of Ochrobactrum pseudogrignonense (newly named Brucella pseudogrignonensis) reveals a new blaOXA subgroup. Microb Genom 2021; 7:000626. [PMID: 34448692 PMCID: PMC8549353 DOI: 10.1099/mgen.0.000626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/08/2021] [Indexed: 11/18/2022] Open
Abstract
Ochrobactrum pseudogrignonense (newly named Brucella pseudogrignonensis) is an emerging pathogen in immunodeficient and immunocompetent patients. Most documented cases associated with Ochrobactrum are frequently catheter-related and exhibit wide-spectrum β-lactam resistance. Misidentification of this pathogen using commercial bacterial identification kits is common. We identified a case of O. pseudogrignonense infection associated with cholelithiasis. The O. pseudogrignonense genome was sequenced and reconstructed using a Nanopore and Illumina hybrid strategy. A novel blaOXA-919 divergent from existing OXA members was identified and subsequent analysis revealed its existence in all available O. pseudogrignonense genomes, which forms a new phylogenetic subgroup distinct from other OXA clusters. Further analysis demonstrated the presence of the novel blaOXA-919 in the chromosome of several other Ochrobactrum species. Our study indicated that Ochrobactrum chromosomes may be a reservoir of blaOXA-919 β-lactamases.
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Affiliation(s)
- Shu-Yuan Li
- Division of Infectious Diseases, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
| | - Yin-En Huang
- Department of Computer Science and Information Engineering, National Chung Cheng University, Chia-Yi, Taiwan, ROC
| | - Jhih-Yang Chen
- Department of Computer Science and Information Engineering, National Chung Cheng University, Chia-Yi, Taiwan, ROC
| | - Chung-Hsu Lai
- Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan, ROC
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan, ROC
| | - Yan-Chiao Mao
- Department of Emergency Medicine, Division of Clinical Toxicology, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Yao-Ting Huang
- Department of Computer Science and Information Engineering, National Chung Cheng University, Chia-Yi, Taiwan, ROC
| | - Po-Yu Liu
- Division of Infectious Diseases, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
- Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan, ROC
- Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan, ROC
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7
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Ochrobactrum anthropi Keratitis in a Boston Type 1 Keratoprosthesis Recipient. Cornea 2020; 40:662-663. [PMID: 33252382 DOI: 10.1097/ico.0000000000002571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 09/06/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To report a case of Ochrobactrum anthropi keratitis in an eye with a Boston type 1 keratoprosthesis. METHODS This is a case report and review of the literature. RESULTS A 78-year-old man with a history of implantation of a Boston type 1 keratoprosthesis in the left eye presented for a routine follow-up with no acute complaints. In the left eye, visual acuity was 20/60 and slit-lamp examination revealed a 1.5-mm inferotemporal corneal infiltrate adjacent to the optic stem. Corneal cultures grew abundant O. anthropi. After 7 weeks of topical antimicrobial therapy and placement of a temporary tarsorrhaphy, the keratitis resolved. CONCLUSIONS Ochrobactrum anthropi is an organism associated with indwelling medical devices and can be pathogenic in eyes with implanted keratoprostheses.
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Ryan MP, Pembroke JT. The Genus Ochrobactrum as Major Opportunistic Pathogens. Microorganisms 2020; 8:E1797. [PMID: 33207839 PMCID: PMC7696743 DOI: 10.3390/microorganisms8111797] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/10/2020] [Accepted: 11/13/2020] [Indexed: 12/20/2022] Open
Abstract
Ochrobactrum species are non-enteric, Gram-negative organisms that are closely related to the genus Brucella. Since the designation of the genus in 1988, several distinct species have now been characterised and implicated as opportunistic pathogens in multiple outbreaks. Here, we examine the genus, its members, diagnostic tools used for identification, data from recent Ochrobactrum whole genome sequencing and the pathogenicity associated with reported Ochrobactrum infections. This review identified 128 instances of Ochrobactrum spp. infections that have been discussed in the literature. These findings indicate that infection review programs should consider investigation of possible Ochrobactrum spp. outbreaks if these bacteria are clinically isolated in more than one patient and that Ochrobactrum spp. are more important pathogens than previously thought.
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Affiliation(s)
- Michael P. Ryan
- Department of Applied Sciences, Limerick Institute of Technology, Moylish V94 EC5T, Limerick, Ireland;
- Molecular Biochemistry Laboratory, Department of Chemical Sciences, School of Natural Sciences, Bernal Institute, University of Limerick, Limerick V94 T9PX2, Ireland
| | - J. Tony Pembroke
- Molecular Biochemistry Laboratory, Department of Chemical Sciences, School of Natural Sciences, Bernal Institute, University of Limerick, Limerick V94 T9PX2, Ireland
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Genomic Characterization of Antimicrobial Resistance, Virulence, and Phylogeny of the Genus Ochrobactrum. Antibiotics (Basel) 2020; 9:antibiotics9040177. [PMID: 32294990 PMCID: PMC7235858 DOI: 10.3390/antibiotics9040177] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/04/2020] [Accepted: 04/09/2020] [Indexed: 01/27/2023] Open
Abstract
Ochrobactrum is a ubiquitous Gram-negative microorganism, mostly found in the environment, which can cause opportunistic infections in humans. It is almost uniformly resistant to penicillins and cephalosporins through an AmpC-like β-lactamase enzyme class (OCH). We studied 130 assembled genomes, of which 5 were animal-derived isolates recovered in Israel, and 125 publicly available genomes. Our analysis focused on antimicrobial resistance (AMR) genes, virulence genes, and whole-genome phylogeny. We found that 76% of Ochrobactrum genomes harbored a blaOCH β-lactamase gene variant, while 7% harbored another AmpC-like gene. No virulence genes other than lipopolysaccharide-associated genes were found. Core genome multilocus sequence typing clustered most samples to known species, but neither geographical clustering nor isolation source clustering were evident. When analyzing the distribution of different blaOCH variants as well as of the blaOCH-deficient samples, a clear phylogenomic clustering was apparent for specific species. The current analysis of the largest collection to date of Ochrobactrum genomes sheds light on the resistome, virulome, phylogeny, and species classification of this increasingly reported human pathogen. Our findings also suggest that Ochrobactrum deserves further characterization to underpin its evolution, taxonomy, and antimicrobial resistance.
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Machado TMD, Santana RF, Vaqueiro RD, Santos CTBD, Alfradique de Souza P. Telephone follow-up of the elderly after cataract surgery. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2019. [DOI: 10.1177/0264619619874825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Study’s purpose:To analyze the effectiveness of telephone intervention for the nursing diagnosis of delayed surgical recovery in older persons who have undergone cataract surgery.Design:Blinded, randomized, and controlled trial. A total of 95 patients of both sexes who were over 60 years old and had undergone cataract surgery were divided into an intervention group (48 patients) and a control group (47 patients), allocated using BioEstat 5.3 Software.Results:The intervention included postoperative follow-up recovery of cataracts and prevention of complications performed on the 1st, 4th, 10th, and 20th postoperative days. After the intervention, the intervention group had a decrease in the length of surgical recovery ( p = .000). The occurrence in the intervention group was 6.3%, while in the control group, it was 36.2% (odds ratio (OR) = 0.118; confidence interval (CI) = 1.02, 10.23). The number of nursing interventions nevertheless decreased during the telephone follow-up.Conclusion:For older persons, the telephone guidelines increase adherence to treatment, promote clinical improvement, promote surgical recovery over time, and improve independence and autonomy.
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Montaña S, Fernandez JS, Barenboim M, Hernandez M, Kayriyama C, Carulla M, Iriarte A, Ramirez MS, Almuzara M. Whole-genome analysis and description of an outbreak due to carbapenem-resistant Ochrobactrum anthropi causing pseudo-bacteraemias. New Microbes New Infect 2018; 26:100-106. [PMID: 30345061 PMCID: PMC6191975 DOI: 10.1016/j.nmni.2018.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/04/2018] [Accepted: 09/04/2018] [Indexed: 11/24/2022] Open
Abstract
Ochrobactrum anthropi, a rare human pathogen, has been isolated predominantly from patients with catheter-related bacteraemia and rarely from other infections. In 2016, six cases of pseudo-bacteraemia caused by carbapenem-resistant O. anthropi isolates were recovered from an Argentinian hospital. The resistant phenotype exposed by the isolates caught our attention and led to an extensive epidemiologic investigation. Here we describe the characterization of a carbapenem-resistant O. anthropi outbreak whose probable cause was by contaminated collection tubes. The genome analysis of one strain revealed the presence of various resistant determinants. Among them, a metal-dependent hydrolase of the β-lactamase superfamily I, phnP, was found. Lately the recovery of unusual multidrug-resistant pathogens in the clinical setting has increased, thus emphasizing the need to implement standardized infection control practice and epidemiologic investigation to identify the real cause of hospital outbreaks.
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Affiliation(s)
- S Montaña
- Instituto de Microbiología y Parasitología Médica (IMPaM, UBA-CONICET), Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - J S Fernandez
- Center for Applied Biotechnology Studies, Department of Biological Science, California State University Fullerton, Fullerton, CA, USA
| | - M Barenboim
- Laboratorio de Bacteriologia, Hospital Interzonal de Agudos Eva Perón, San Martín, Provincia de Buenos Aires, Argentina
| | - M Hernandez
- Center for Applied Biotechnology Studies, Department of Biological Science, California State University Fullerton, Fullerton, CA, USA
| | - C Kayriyama
- Laboratorio de Bacteriologia, Hospital Interzonal de Agudos Eva Perón, San Martín, Provincia de Buenos Aires, Argentina
| | - M Carulla
- Laboratorio de Bacteriologia, Hospital Interzonal de Agudos Eva Perón, San Martín, Provincia de Buenos Aires, Argentina
| | - A Iriarte
- Laboratorio de Biología Computacional, Dpto de Desarrollo Biotecnológico, Instituto de Higiene, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - M S Ramirez
- Center for Applied Biotechnology Studies, Department of Biological Science, California State University Fullerton, Fullerton, CA, USA
| | - M Almuzara
- Laboratorio de Bacteriologia, Hospital Interzonal de Agudos Eva Perón, San Martín, Provincia de Buenos Aires, Argentina
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Abstract
Advances in genomics have the potential to revolutionize clinical diagnostics. Here, we examine the microbiome of vitreous (intraocular body fluid) from patients who developed endophthalmitis following cataract surgery or intravitreal injection. Endophthalmitis is an inflammation of the intraocular cavity and can lead to a permanent loss of vision. As controls, we included vitreous from endophthalmitis-negative patients, balanced salt solution used during vitrectomy and DNA extraction blanks. We compared two DNA isolation procedures and found that an ultraclean production of reagents appeared to reduce background DNA in these low microbial biomass samples. We created a curated microbial genome database (>5700 genomes) and designed a metagenomics workflow with filtering steps to reduce DNA sequences originating from: (i) human hosts, (ii) ambiguousness/contaminants in public microbial reference genomes and (iii) the environment. Our metagenomic read classification revealed in nearly all cases the same microorganism that was determined in cultivation- and mass spectrometry-based analyses. For some patients, we identified the sequence type of the microorganism and antibiotic resistance genes through analyses of whole genome sequence (WGS) assemblies of isolates and metagenomic assemblies. Together, we conclude that genomics-based analyses of human ocular body fluid specimens can provide actionable information relevant to infectious disease management.
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Haviari S, Cassier P, Dananché C, Hulin M, Dauwalder O, Rouvière O, Bertrand X, Perraud M, Bénet T, Vanhems P. Outbreak of Achromobacter xylosoxidans and Ochrobactrum anthropi Infections after Prostate Biopsies, France, 2014. Emerg Infect Dis 2018; 22:1412-9. [PMID: 27434277 PMCID: PMC4982167 DOI: 10.3201/eid2208.151423] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report an outbreak of healthcare-associated prostatitis involving rare environmental pathogens in immunocompetent patients undergoing transrectal prostate biopsies at Hôpital Édouard Herriot (Lyon, France) during August 13-October 10, 2014. Despite a fluoroquinolone-based prophylaxis, 5 patients were infected with Achromobacter xylosoxidans and 3 with Ochrobactrum anthropi, which has not been reported as pathogenic in nonimmunocompromised persons. All patients recovered fully. Analysis of the outbreak included case investigation, case-control study, biopsy procedure review, microbiologic testing of environmental and clinical samples, and retrospective review of hospital records for 4 years before the outbreak. The cases resulted from asepsis errors during preparation of materials for the biopsies. A low-level outbreak involving environmental bacteria was likely present for years, masked by antimicrobial drug prophylaxis and a low number of cases. Healthcare personnel should promptly report unusual pathogens in immunocompetent patients to infection control units, and guidelines should explicitly mention asepsis during materials preparation.
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Ochrobactrum anthropi Keratitis with Focal Descemet's Membrane Detachment and Intracorneal Hypopyon. Case Rep Ophthalmol Med 2016; 2016:4502105. [PMID: 27777806 PMCID: PMC5061942 DOI: 10.1155/2016/4502105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 09/07/2016] [Indexed: 12/03/2022] Open
Abstract
Purpose. To describe a unique case of O. anthropi keratitis associated with a rare manifestation of Descemet's membrane detachment and intracorneal hypopyon and to discuss challenges in diagnosis and management. Methods. Best-corrected visual acuity was measured with Snellen letters. Corneal scrapings were performed and aerobic, viral, herpetic, acid-fast bacilli, Acanthamoeba, and fungal stains and cultures were obtained. Following evisceration, tissue was evaluated for histologic features and again stained for bacteria, mycobacteria, Acanthamoeba, fungi, and viral particles. Results. Initial presentation to our institute was notable for a corneal ulcer, focal Descemet's membrane detachment, and intracorneal hypopyon. Speciation of initial corneal scrapes revealed Ochrobactrum anthropi and initial management included fortified tobramycin. Despite medical therapy, the patient developed a corneal perforation and required subsequent evisceration. Conclusion. O. anthropi is an emerging ocular pathogen that has not been previously reported in cases of keratitis. As this pathogen becomes increasingly recognized as a source of ocular infections, it is important to identify and treat aggressively to avoid vision-threatening disease.
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15
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Kanjee R, Koreishi AF, Tanna AP, Goldstein DA. Chronic postoperative endophthalmitis after cataract surgery secondary to vancomycin-resistant Ochrobactrum anthropi: case report and literature review. J Ophthalmic Inflamm Infect 2016; 6:25. [PMID: 27421273 PMCID: PMC4947067 DOI: 10.1186/s12348-016-0094-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 06/28/2016] [Indexed: 11/27/2022] Open
Abstract
Background The aim of this study was to report an unusual case of chronic postoperative endophthalmitis following cataract surgery, secondary to Ochrobactrum anthropi that was found to be resistant to vancomycin. Findings Anterior chamber paracentesis cultures grew gram negative bacilli Ochrobactrum anthropi. The patient was treated with a series of intracameral injections of moxifloxacin, with adjuvant oral moxifloxacin. Posterior sub-Tenon and oral corticosteroids were used to treat cystoid macular edema. Explantation of the intraocular lens (IOL)-capsular bag complex was avoided. Conclusions Chronic postoperative endophthalmitis is a rare entity, often due to indolent pathogens that sequester in the capsular bag. Aggressive surgical intervention may be avoided with the use of adequate intraocular antibiotic, provided that the offending organism demonstrates appropriate antibiotic susceptibilities.
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Affiliation(s)
- Raageen Kanjee
- Department of Ophthalmology, Max Rady College of Medicine, University of Manitoba, M264-99 Cornish Ave., Winnipeg, MB, R3C 1A2, Canada
| | - Anjum F Koreishi
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, 645 North Michigan Avenue, Suite 440, Chicago, IL, 60611, USA
| | - Angelo P Tanna
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, 645 North Michigan Avenue, Suite 440, Chicago, IL, 60611, USA
| | - Debra A Goldstein
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, 645 North Michigan Avenue, Suite 440, Chicago, IL, 60611, USA.
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Hirai J, Yamagishi Y, Sakanashi D, Koizumi Y, Suematsu H, Mikamo H. [A Case of Bacteremia Caused by Ochrobacterium intermedium]. ACTA ACUST UNITED AC 2016; 90:129-33. [PMID: 27197440 DOI: 10.11150/kansenshogakuzasshi.90.129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We report herein on a case of bacteremia caused by Ochrobactrum intermedium (O. intermedium) identified with biotyper matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). An 86-year-old man was admitted to our hospital with paralysis of the right side of the body and dysphagia. He was diagnosed as having a pontine infarction based on the brain MRI findings and was admitted to hospital to have anti-platelet therapy. Three days after admission, he had a fever. Although he had redness and swelling at the peripheral venous catheter insertion site, he was diagnosed as having aspiration pneumonia, since he had fine crackles on auscultation. Soon after taking two sets of blood cultures and removal of the peripheral venous catheter, sulbactam/ampicillin (SBT/ABPC) was administrated. Fifty three hours after incubation, gram-negative bacilli was detected from an aerobic bottle and identified as O. intermedium with MALDI-TOF MS (Bruker MS). Antimicrobial chemotherapy was changed to meropenem (MEPM). He was treated for a total of seven days, and recovered without relapse. Infection caused by O. intermedium has been very uncommon, however, O. intermedium has been recognized as an emerging pathogen in immunodeficient and immunocompetent patients. Since identification of Ochrobactrum species by biochemical methods could be difficult, MALDI-TOF MS might be helpful to clarify Ochrobactrum species just as in the present case.
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Poroyko V, Meng F, Meliton A, Afonyushkin T, Ulanov A, Semenyuk E, Latif O, Tesic V, Birukova AA, Birukov KG. Alterations of lung microbiota in a mouse model of LPS-induced lung injury. Am J Physiol Lung Cell Mol Physiol 2015; 309:L76-83. [PMID: 25957290 DOI: 10.1152/ajplung.00061.2014] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 05/12/2015] [Indexed: 02/06/2023] Open
Abstract
Acute lung injury (ALI) and the more severe acute respiratory distress syndrome are common responses to a variety of infectious and noninfectious insults. We used a mouse model of ALI induced by intratracheal administration of sterile bacterial wall lipopolysaccharide (LPS) to investigate the changes in innate lung microbiota and study microbial community reaction to lung inflammation and barrier dysfunction induced by endotoxin insult. One group of C57BL/6J mice received LPS via intratracheal injection (n = 6), and another received sterile water (n = 7). Bronchoalveolar lavage (BAL) was performed at 72 h after treatment. Bacterial DNA was extracted and used for qPCR and 16S rRNA gene-tag (V3-V4) sequencing (Illumina). The bacterial load in BAL from ALI mice was increased fivefold (P = 0.03). The community complexity remained unchanged (Simpson index, P = 0.7); the Shannon diversity index indicated the increase of community evenness in response to ALI (P = 0.07). Principal coordinate analysis and analysis of similarity (ANOSIM) test (P = 0.005) revealed a significant difference between microbiota of control and ALI groups. Bacteria from families Xanthomonadaceae and Brucellaceae increased their abundance in the ALI group as determined by Metastats test (P < 0.02). In concordance with the 16s-tag data, Stenotrohomonas maltophilia (Xanthomonadaceae) and Ochrobactrum anthropi (Brucellaceae) were isolated from lungs of mice from both groups. Metabolic profiling of BAL detected the presence of bacterial substrates suitable for both isolates. Additionally, microbiota from LPS-treated mice intensified IL-6-induced lung inflammation in naive mice. We conclude that the morbid transformation of ALI microbiota was attributed to the set of inborn opportunistic pathogens thriving in the environment of inflamed lung, rather than the external infectious agents.
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Affiliation(s)
- Valeriy Poroyko
- Department of Pediatrics, The University of Chicago, Chicago, Illinois;
| | - Fanyong Meng
- Section of Pulmonary and Critical Medicine, Lung Injury Center, Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Angelo Meliton
- Section of Pulmonary and Critical Medicine, Lung Injury Center, Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Taras Afonyushkin
- Section of Pulmonary and Critical Medicine, Lung Injury Center, Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Alexander Ulanov
- Roy J. Carver Biotechnology Center, University of Illinois at Urbana-Champaign
| | - Ekaterina Semenyuk
- Department of Microbiology and Immunology, Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois
| | - Omar Latif
- Department of Medicine, The University of Chicago, Chicago, Illinois; and
| | - Vera Tesic
- Department of Pathology, University of Chicago, Chicago, Illinois
| | - Anna A Birukova
- Section of Pulmonary and Critical Medicine, Lung Injury Center, Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Konstantin G Birukov
- Section of Pulmonary and Critical Medicine, Lung Injury Center, Department of Medicine, The University of Chicago, Chicago, Illinois
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Kocak I, Kocak F, Teker B, Aydin A, Kaya F, Baybora H. Evaluation of bacterial contamination rate of the anterior chamber during phacoemulsification surgery using an automated microbial detection system. Int J Ophthalmol 2014; 7:686-8. [PMID: 25161944 DOI: 10.3980/j.issn.2222-3959.2014.04.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Accepted: 09/09/2013] [Indexed: 11/02/2022] Open
Abstract
AIM To assess the incidence of anterior chamber bacterial contamination during phacoemulsification surgery using an automated microbial detection system (BacT/Alert). METHODS Sixty-nine eyes of 60 patients who had uneventful phacoemulsification surgery, enrolled in this prospective study. No prophylactic topical or systemic antibiotics were used before surgery. After antisepsis with povidone-iodine, two intraoperative anterior chamber aqueous samples were obtained, the first whilst entering anterior chamber, and the second at the end of surgery. BacT/Alert culture system was used to detect bacterial contamination in the aqueous samples. RESULTS Neither aqueous samples obtained at the beginning nor conclusion of the surgery was positive for microorganisms on BacT/Alert culture system. The rate of bacterial contamination during surgery was 0%. None of the eyes developed acute-onset endophthalmitis after surgery. CONCLUSION In this study, no bacterial contamination of anterior chamber was observed during cataract surgery. This result shows that meticulous surgical preparation and technique can prevent anterior chamber contamination during phacoemulsification cataract surgery.
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Affiliation(s)
- Ibrahim Kocak
- Nisa Hospital, Fatih cad, Cobancesme mah, Bahcelievler, Istanbul 34196, Turkey
| | - Funda Kocak
- Clinical Microbiology and Infectious Diseases, Basaksehir state hospital, Basaksehir, Istanbul 34306, Turkey
| | - Bahri Teker
- Nisa Hospital, Fatih cad, Cobancesme mah, Bahcelievler, Istanbul 34196, Turkey
| | - Ali Aydin
- Nisa Hospital, Fatih cad, Cobancesme mah, Bahcelievler, Istanbul 34196, Turkey ; Department of Ophthalmology, Medipol University Hospital, Bagcılar, Istanbul 34214, Turkey
| | - Faruk Kaya
- Nisa Hospital, Fatih cad, Cobancesme mah, Bahcelievler, Istanbul 34196, Turkey
| | - Hakan Baybora
- Nisa Hospital, Fatih cad, Cobancesme mah, Bahcelievler, Istanbul 34196, Turkey
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