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Teoh Z, Ankrum AL, Meinzen-Derr J, Weingartner M, Goebel MJ, Scaggs Huang F, Schaffzin JK. An outbreak of Burkholderia contaminans at a quaternary children's hospital linked to equipment reprocessing. Infect Control Hosp Epidemiol 2023; 44:1267-1273. [PMID: 36102334 PMCID: PMC11151214 DOI: 10.1017/ice.2022.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Burkholderia cepacia complex (BCC) has been increasingly implicated in local and multistate outbreaks in both adult and pediatric healthcare settings. However, a lack of source identification may be common for BCC outbreak investigations. We describe, in detail, the investigation of an outbreak of BCC (B. contaminans) among pediatric patients at a large quaternary-care children's hospital and our system-level changes and outcomes.
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Affiliation(s)
- Zheyi Teoh
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Andrea L Ankrum
- Department of Infection Prevention & Control, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Jareen Meinzen-Derr
- Department of Pediatrics, University of Cincinnati Medical Center, Cincinnati, Ohio
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - MaryAnn Weingartner
- Department of Infection Prevention & Control, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Mary Jo Goebel
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Felicia Scaggs Huang
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Infection Prevention & Control, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati Medical Center, Cincinnati, Ohio
| | - Joshua K Schaffzin
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Infection Prevention & Control, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati Medical Center, Cincinnati, Ohio
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2
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Khan U, Pandey E, Gandham N, Das N, Mukhida S, Kannuri S, Bhaumik S, Mirza S. A case series and literature review of infections due to Myroides spp.: identification of contributing factors and emerging antibiotic susceptibility trends. Access Microbiol 2023; 5:acmi000549.v2. [PMID: 37323940 PMCID: PMC10267660 DOI: 10.1099/acmi.0.000549.v2] [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: 12/20/2022] [Accepted: 03/09/2023] [Indexed: 06/17/2023] Open
Abstract
Introduction Infections forby Myroides spp. can lead to significant morbidity and mortality, particularly in immunocompromised patients with underlying co-morbidities. Recent reports have highlighted its intrinsic and acquired drug resistance, making it a particularly challenging infectious agent to combat. Methods Myroides spp. isolated and reported in clinically significant urine samples were considered for the study. Identification of the organism was done via the VITEK 2C system. Antibiotic susceptibility testing was done using both manual and automated methods following Clinical and Laboratory Standards Institute (CLSI) guidelines. Existing literature was searched on MEDLINE using PubMed. Results We present a series of five catheter-associated urinary tract infections due to Myroides odoratimimus , with sensitivity to only minocycline. This is the first case from Western India, and the third case in the existing literature that shows Myroides sensitivity only to minocycline. Our literature review is the first to systematically describe contributory factors to infection, allowing us to devise a clinically relevant tool that delineates contributory factors and efficacious drugs in Myroides spp. infection. Conclusion Myroides spp. infections, previously considered rare and opportunistic, need cognizance and diagnostic suspicion especially in particular associated conditions.
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Affiliation(s)
- Uzair Khan
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Ellora Pandey
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Nageswari Gandham
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Nikunja Das
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Sahjid Mukhida
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Sriram Kannuri
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Shalini Bhaumik
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Shahzad Mirza
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, India
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3
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Liu S, Zhang L, Feng C, Zhu J, Li A, Zhao J, Zhang Y, Gao M, Shi W, Li Q, Zhang X, Zhang H, Xu T, Lu J, Bao Q. Characterization and Identification of a novel chromosome-encoded metallo-β-lactamase WUS-1 in Myroides albus P34. Front Microbiol 2022; 13:1059997. [PMID: 36532482 PMCID: PMC9751785 DOI: 10.3389/fmicb.2022.1059997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 11/14/2022] [Indexed: 01/12/2024] Open
Abstract
In this study, we identified and characterized a novel chromosomally-encoded class B metallo-β-lactamase (MBL) gene designated bla WUS-1 in a carbapenem-resistant isolate Myroides albus P34 isolated from sewage discharged from an animal farm. Comparative analysis of the deduced amino acid sequence revealed that WUS-1 shares the highest amino acid similarities with the function-characterized MBLs MUS-1 (AAN63647.1; 70.73%) and TUS-1 (AAN63648.1; 70.32%). The recombinant carrying bla WUS-1 exhibited increased MICs levels against a number of β-lactam antimicrobials such as carbenicillin, ampicillin and imipenem, and β-lactamase inhibitors (clavulanic acid and tazobactam). The metallo-β-lactamase WUS-1 could also hydrolyze these antimicrobials and the hydrolytic activities could be inhibited by EDTA. Genetic context analysis of bla WUS-1 revealed that no mobile genetic element was found in its surrounding region. The plasmid pMA84474 of Myroides albus P34 harbored 6 resistance genes (bla OXA-347, aadS, bla MYO-1, ereD, sul2 and ermF) within an approximately 17 kb multidrug resistance (MDR) region. These genes, however, were all related to mobile genetic elements.
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Affiliation(s)
- Shuang Liu
- The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China
- Key Laboratory of Medical Genetics of Zhejiang Province, Key Laboratory of Laboratory Medicine, Ministry of Education, China, School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Lei Zhang
- The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China
- Key Laboratory of Medical Genetics of Zhejiang Province, Key Laboratory of Laboratory Medicine, Ministry of Education, China, School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Chunlin Feng
- Key Laboratory of Medical Genetics of Zhejiang Province, Key Laboratory of Laboratory Medicine, Ministry of Education, China, School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Jin Zhu
- Department of Laboratory Medicine, Quzhou People's Hospital, Quzhou, China
| | - Anqi Li
- Key Laboratory of Medical Genetics of Zhejiang Province, Key Laboratory of Laboratory Medicine, Ministry of Education, China, School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Jingxuan Zhao
- Key Laboratory of Medical Genetics of Zhejiang Province, Key Laboratory of Laboratory Medicine, Ministry of Education, China, School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Yuan Zhang
- Key Laboratory of Medical Genetics of Zhejiang Province, Key Laboratory of Laboratory Medicine, Ministry of Education, China, School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Mengdi Gao
- The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China
- Key Laboratory of Medical Genetics of Zhejiang Province, Key Laboratory of Laboratory Medicine, Ministry of Education, China, School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Weina Shi
- Key Laboratory of Medical Genetics of Zhejiang Province, Key Laboratory of Laboratory Medicine, Ministry of Education, China, School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Qiaoling Li
- The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China
- Key Laboratory of Medical Genetics of Zhejiang Province, Key Laboratory of Laboratory Medicine, Ministry of Education, China, School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Xueya Zhang
- The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China
- Key Laboratory of Medical Genetics of Zhejiang Province, Key Laboratory of Laboratory Medicine, Ministry of Education, China, School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Hailin Zhang
- The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China
| | - Teng Xu
- Institute of Translational Medicine, Baotou Central Hospital, Baotou, China
| | - Junwan Lu
- Medical Molecular Biology Laboratory, School of Medicine, Jinhua Polytechnic, Jinhua, China
| | - Qiyu Bao
- The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China
- Key Laboratory of Medical Genetics of Zhejiang Province, Key Laboratory of Laboratory Medicine, Ministry of Education, China, School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
- Medical Molecular Biology Laboratory, School of Medicine, Jinhua Polytechnic, Jinhua, China
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4
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Extensively Drug-Resistant Myroides odoratus in Critically Ill Patients: A Case Series and Literature Review. Case Rep Infect Dis 2022; 2022:6422861. [PMID: 35873406 PMCID: PMC9303506 DOI: 10.1155/2022/6422861] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 07/01/2022] [Indexed: 11/18/2022] Open
Abstract
The bacterial genus Myroides, like other members of the Flavobacteriaceae family, consists of aerobic, non-motile, Gram-negative bacilli. Myroides spp. is considered predominantly opportunistic pathogens as, historically, most documented infections have been in immunocompromised individuals. Along with advancements in molecular assay testing, there are growing reports of clinically relevant Myroides spp. infections in immunocompetent individuals. These organisms display broad antimicrobial resistance, and while research into their mechanisms of resistance is progressing, genetic testing has revealed metallo-β-lactamases present in their genome. The sporadic identification of Myroides spp. and ongoing clarification of resistance patterns make empiric treatment difficult. This report documents two cases of extensively drug-resistant Myroides odoratus isolated from critically ill but otherwise immunocompetent patients followed by a review of available literature on Myroides spp. antibiotic sensitivities. Our findings indicate that minocycline and moxifloxacin have the highest documented in vitro activity against Myroides spp.
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5
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Lu Y, Xia W, Zhang X, Ni F, Mei Y. A Confirmed Catheter-Related Blood Stream Infection (CRBSI) in an Immunocompetent Patient Due to Myroides odoratimimus: Case Report and Literature Review. Infect Drug Resist 2020; 13:139-144. [PMID: 32021328 PMCID: PMC6959507 DOI: 10.2147/idr.s234778] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 12/17/2019] [Indexed: 01/12/2023] Open
Abstract
The genus Myroides are gram-negative bacilli which are completely aerobic, non-motile, non-fermenting and yellow-pigmented with a characteristic fruity odor. Myroides species are widely found in the environment, especially in water and soil, and are considered as low-grade opportunistic pathogens for humans. Myroides infections are most commonly seen in immunocompromised patients and only rarely occur in immunocompetent patients. We here report the first confirmed catheter-related bloodstream infection (CRBSI) due to Myroides odoratimimus in an immunocompetent patient. We also review the literature related to Myroides infections.
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Affiliation(s)
- Yanfei Lu
- Department of Laboratory Medicine, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, People's Republic of China.,National Key Clinical Department of Laboratory Medicine, Nanjing, People's Republic of China
| | - Wenying Xia
- Department of Laboratory Medicine, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, People's Republic of China.,National Key Clinical Department of Laboratory Medicine, Nanjing, People's Republic of China
| | - Xiaohui Zhang
- Department of Laboratory Medicine, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, People's Republic of China.,National Key Clinical Department of Laboratory Medicine, Nanjing, People's Republic of China
| | - Fang Ni
- Department of Laboratory Medicine, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, People's Republic of China.,National Key Clinical Department of Laboratory Medicine, Nanjing, People's Republic of China
| | - Yaning Mei
- Department of Laboratory Medicine, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, People's Republic of China.,National Key Clinical Department of Laboratory Medicine, Nanjing, People's Republic of China
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6
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Pérez-Lazo G, Morales-Moreno A, Soto-Febres F, Jove-Químper H, Morales-Castillo L, Palomares-Reyes C, Del Valle-Mendoza J, Aguilar-Luis M, Silva-Caso W. First report of Myroides phaeus bacteraemia identified by Polymerase chain reaction and genetic sequencing. IDCases 2020; 19:e00695. [PMID: 32021799 PMCID: PMC6994844 DOI: 10.1016/j.idcr.2020.e00695] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/31/2019] [Accepted: 01/01/2020] [Indexed: 11/15/2022] Open
Abstract
We report the first case of Myroides phaeus isolated from blood, causing bacteremia in an immunocompromised patient. The relevance of this species is that most strains are resistant to multiple drugs. For identification it was used MicroScan Panel in addition to PCR – genetic sequencing.
We report the first case of Myroides phaeus isolated from blood, causing bacteremia in an immunocompromised patient using the automated MicroScan Walk Away 96 system, followed by bacterial identification by amplification-sequencing of the 16S rDNA. The sequences obtained were compared with the reference sequence of the BLAST ® platform - National Library of Medicine, USA, and the isolation was identified as Myroides phaeus strain with 99.67 % identity in Blast report. In the literature we did not find previous reported cases of infections by this bacterium, however its pathogenic role is still controversial; therefore, this isolation alerts us to carry out an exhaustive surveillance of other possible acquisition routes.
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Affiliation(s)
- G Pérez-Lazo
- Unidad de Infectología, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
| | - A Morales-Moreno
- Unidad de Infectología, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
| | - F Soto-Febres
- Unidad de Infectología, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
| | - H Jove-Químper
- Servicio de Microbiología, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
| | - L Morales-Castillo
- Servicio de Microbiología, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
| | - C Palomares-Reyes
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Av. San Marcos cuadra 2, Chorrillos, Lima, Peru.,Instituto de Investigación Nutricional, Lima, Peru
| | - J Del Valle-Mendoza
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Av. San Marcos cuadra 2, Chorrillos, Lima, Peru.,Instituto de Investigación Nutricional, Lima, Peru
| | - M Aguilar-Luis
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Av. San Marcos cuadra 2, Chorrillos, Lima, Peru.,Instituto de Investigación Nutricional, Lima, Peru
| | - W Silva-Caso
- Facultad de Ciencias de la Salud, Universidad Tecnológica del Perú, Lima, Peru
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7
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Prävention von Gefäßkatheter-assoziierten Infektionen bei Früh- und Neugeborenen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 61:608-626. [PMID: 29671025 DOI: 10.1007/s00103-018-2718-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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8
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Myroides Soft Tissue Infections. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2018. [DOI: 10.1097/ipc.0000000000000510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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9
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Pompilio A, Galardi G, Verginelli F, Muzzi M, Di Giulio A, Di Bonaventura G. Myroides odoratimimus Forms Structurally Complex and Inherently Antibiotic-Resistant Biofilm in a Wound-Like in vitro Model. Front Microbiol 2017; 8:2591. [PMID: 29312264 PMCID: PMC5744432 DOI: 10.3389/fmicb.2017.02591] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 12/12/2017] [Indexed: 12/12/2022] Open
Abstract
Myroides odoratimimus is an aerobic, non-fermenting Gram-negative multidrug-resistant bacterium widely distributed in nature that rarely causes infections in immunocompromised patients. We recently described in a diabetic patient a case of recurrent calcaneal ulcer infection caused by a M. odoratimimus strain showing potential for biofilm formation. For the first time, we therefore evaluated the ability of M. odoratimimus to form biofilm under different pH values and glucose concentrations using an in vitro “skin-like” model, and its susceptibility to levofloxacin, meropenem, and tigecycline. The expression of some antibiotic-resistance related genes was also monitored by RT-PCR during planktonic-to-biofilm transition. Our results indicated that M. odoratimimus can produce relevant amounts of biofilm biomass, in a time-dependent manner, especially at acidic pH and regardless of glucose concentration tested. The comparative analysis of MIC and MBC values between planktonic and sessile cells showed that resistance to antibiotics increased during the planktonic-to-biofilm transition. Viable cell count indicated that none of the tested antibiotics were able to completely eradicate preformed biofilms, although meropenem and levofloxacin were the most active causing a significant, dose-independent, reduction of biofilm's viability, as also confirmed by microscopic analysis. RT-PCR showed that antibiotic-resistance related gyrA and acrB genes are over-expressed during the transition from planktonic to sessile (biofilm) lifestyle. Overall, our findings showed that M. odoratimimus can form relevant amounts of inherently antibiotic-resistant biofilm under conditions relevant to wound site, therefore suggesting a role in the pathogenesis of chronic ulcer infections.
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Affiliation(s)
- Arianna Pompilio
- Department of Medical, Oral & Biotechnological Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Aging Research Center and Translational Medicine, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Giuseppe Galardi
- Department of Medical, Oral & Biotechnological Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Aging Research Center and Translational Medicine, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Fabio Verginelli
- Aging Research Center and Translational Medicine, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Department of Pharmacy, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Maurizio Muzzi
- Department of Science, LIME, University of Roma Tre, Rome, Italy
| | - Andrea Di Giulio
- Department of Science, LIME, University of Roma Tre, Rome, Italy
| | - Giovanni Di Bonaventura
- Department of Medical, Oral & Biotechnological Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Aging Research Center and Translational Medicine, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
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10
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Infection of recurrent calcaneal ulcer caused by a biofilm-producer Myroides odoratimimus strain. Folia Microbiol (Praha) 2017; 63:203-207. [PMID: 28956275 DOI: 10.1007/s12223-017-0552-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 09/19/2017] [Indexed: 10/18/2022]
Abstract
We report a case of recurrent post-traumatic ulcer infection due to Myroides odoratimimus in an immunocompromised male. We have also reviewed the medical literature on isolated M. odoratimimus infections. The strain, isolated from ulcer discharge, was multidrug-resistant and treatment with meropenem, based on susceptibility testing, led to resolution of infection. The strain was also able to form a relevant amount of biofilm over time, thus suggesting a possible role of sessile communities in the chronicization of infection. To our knowledge, this is the first description of recurrent ulcer infection caused by a biofilm-producer M. odoratimimus strain. This case reminds us of the need to consider uncommon pathogens as etiology of skin and soft tissue infections, especially in immunocompromised patients. Further, since the treatment of infections due to M. odoratimimus is often difficult both due to multidrug resistance and scarce clinical experience, antibiotic therapy should be adapted to in vitro susceptibility testing.
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11
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Prävention von Infektionen, die von Gefäßkathetern ausgehen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017; 60:171-206. [DOI: 10.1007/s00103-016-2487-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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12
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Paul LM, Hegde A, Pai T, Shetty S, Baliga S, Shenoy S. An Outbreak of Burkholderia cepacia Bacteremia in a Neonatal Intensive Care Unit. Indian J Pediatr 2016; 83:285-8. [PMID: 26264633 DOI: 10.1007/s12098-015-1855-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 07/16/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To identify the source of infection, to study the clinical profile and outcomes of neonates with Burkholderia septicemia and to determine the antimicrobial susceptibility patterns of the isolates. METHODS The authors describe a 3 mo outbreak of nosocomial Burkholderia cepacia bacteremia involving 12 neonates. During the outbreak, ventilator humidifier water, intravenous solutions and other possible sources were taken from the concerned neonatal intensive care units (NICUs); cultured and isolates identified by standard microbiological techniques and VITEK system. Clinical details of affected babies were also obtained to ascertain the clinical significance of the isolates. RESULTS All neonates had clinical and biochemical evidence of sepsis and the source could be tracked to intravenous solutions of 5% dextrose, normal saline (opened bottles) and continuous positive airway pressure humidifier water. Strain relatedness of the environmental isolates with the clinical isolates is likely as antibiotic susceptibility patterns were similar. CONCLUSIONS The investigations revealed the source of the nosocomial outbreak which is crucial for initiating appropriate control measures.
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Affiliation(s)
- Liz Mary Paul
- Department of Microbiology, Kasturba Medical College, Manipal University, Mangalore, India
| | - Ashwini Hegde
- Department of Microbiology, Kasturba Medical College, Manipal University, Mangalore, India.
| | - Tanvi Pai
- Department of Pediatrics, Kasturba Medical College, Manipal University, Mangalore, India
| | - Subodh Shetty
- Department of Pediatrics, Kasturba Medical College, Manipal University, Mangalore, India
| | - Shrikala Baliga
- Department of Microbiology, Kasturba Medical College, Manipal University, Mangalore, India
| | - Suchitra Shenoy
- Department of Microbiology, Kasturba Medical College, Manipal University, Mangalore, India
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13
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Singhal T, Shah S, Naik R. Outbreak of Burkholderia cepacia complex bacteremia in a chemotherapy day care unit due to intrinsic contamination of an antiemetic drug. Indian J Med Microbiol 2016; 33:117-9. [PMID: 25560013 DOI: 10.4103/0255-0857.148405] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND In the end of 2009, a large number of patients with cancer undergoing chemotherapy at the day care unit of a private hospital in Mumbai, India developed Burkholderia cepacia complex (BCC) blood stream infection (BSI). OBJECTIVE The objectives were to identify the source of the outbreak and terminate the outbreak as rapidly as possible. MATERIALS AND METHODS All infection control protocols and processes were reviewed. Intensive training was started for all nursing staff involved in patient care. Cultures were sent from the environment (surfaces, water, air), intravenous fluids, disinfectants and antiseptics and opened/unopened medication. RESULTS A total of 13 patients with cancer with tunneled catheters were affected with BCC BSI. The isolates were of similar antimicrobial sensitivity. No significant breach of infection control protocols could be identified. Cultures from the prepared intravenous medication bags grew BCC. Subsequently, culture from unused vials of the antiemetic granisetron grew BCC, whereas those from the unopened IV fluid bag and chemotherapy medication were negative. On review, it was discovered that the outbreak started when a new brand of granisetron was introduced. The result was communicated to the manufacturer and the brand was withdrawn. There were no further cases. CONCLUSIONS This outbreak was thus linked to intrinsic contamination of medication vials. We acknowledge a delay in identifying the source as we were concentrating more on human errors in medication preparation and less on intrinsic contamination. We recommend that in an event of an outbreak, unopened vials be cultured at the outset.
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Affiliation(s)
- T Singhal
- Department of Infection Control, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, Maharashtra, India
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14
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Liu H, Iwase H, Wijkstrom M, Singh J, Klein E, Wagner R, Humar A, Pasculle W, Cooper DKC. MYROIDES INFECTION IN A BABOON AFTER PROLONGED PIG KIDNEY GRAFT SURVIVAL. Transplant Direct 2015; 1:1-5. [PMID: 26146660 PMCID: PMC4486305 DOI: 10.1097/txd.0000000000000523] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 04/13/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Immunosuppressed patients and experimental nonhuman primates are at risk of opportunistic infection. We report a Myroides spp infection in an immunosuppressed baboon that had received a life-supporting kidney from a genetically-engineered pig. CASE REPORT The baboon received a costimulation blockade-based immunosuppressive regimen as well as two anti-inflammatory agents (tocilizumab and etanercept). Although the pig kidney functioned well, approximately four months after the transplant the baboon became less active and ate and drank poorly. On day 136, it collapsed and died despite inotropic and fluid support. A blood culture drawn before death grew Myroides spp. DISCUSSION AND CONCLUSIONS To our knowledge, Myroides spp has not been reported as a cause of opportunistic infection in either patients with organ allotransplants or experimental animals. We summarize what is known about this rare organism, and suggest it should be considered in any immunocompromised patient or animal. In the present case, we suggest the baboon died of circulatory shock following infection through an indwelling intravenous catheter.
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Affiliation(s)
- Hong Liu
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, USA ; Department of General Surgery, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Hayato Iwase
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, USA
| | - Martin Wijkstrom
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, USA
| | - Jagjit Singh
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, USA
| | - Edwin Klein
- Division of Laboratory Animal Resources, University of Pittsburgh, PA, USA
| | - Robert Wagner
- Division of Laboratory Animal Resources, University of Pittsburgh, PA, USA
| | - Abhinav Humar
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, USA
| | - William Pasculle
- Department of Microbiology, University of Pittsburgh, Pittsburgh, USA
| | - David K C Cooper
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, USA
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15
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Zurita J, Mejia L, Zapata S, Trueba G, Vargas AC, Aguirre S, Falconi G. Healthcare-associated respiratory tract infection and colonization in an intensive care unit caused by Burkholderia cepacia isolated in mouthwash. Int J Infect Dis 2014; 29:96-9. [PMID: 25449242 DOI: 10.1016/j.ijid.2014.07.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 07/08/2014] [Accepted: 07/21/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Burkholderia cepacia has been linked to healthcare-associated infections and colonization caused by contamination of alcohol-free mouthwash used in patients undergoing mechanical ventilation. The purpose of our study was to establish the source of a clustering of healthcare-associated B. cepacia isolates in patients on mechanical ventilation in the intensive care unit (ICU). METHODS During April 2012 the Infection Control Committee became concerned when B. cepacia was isolated from tracheal aspirate cultures of three ICU patients. The medical records for the years 2011 and 2012 were reviewed to identify further cases. Cultures of potential reservoirs were done. Isolates from patients and an alcohol-free mouthwash were submitted to multilocus sequence typing (MLST) analysis and antimicrobial resistance testing. RESULTS Four patients with positive cultures for B. cepacia were identified before the review of the medical records for the years 2011 and 2012. Nine further cases were identified in the review, defined as a patient with pneumonia who had a culture of respiratory secretions that was positive for B. cepacia. Three were cases of infection and 10 were colonizations. All of the isolates from patients (J, K, L, and M) and mouthwash samples (B19, B20, and B21) were genetically identical by MLST analysis. CONCLUSIONS Our findings strongly suggest that alcohol-free mouthwash solution intrinsically contaminated with B. cepacia was the source of these colonizations and infections involving adults in the ICU.
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Affiliation(s)
- Jeannete Zurita
- Servicio de Microbiología y Tuberculosis, Hospital Vozandes, Villalengua Oe2-37, Quito, Ecuador; Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador; Unidad de Investigaciones en Biomedicina, Zurita & Zurita Laboratorios, Quito, Ecuador.
| | - Lorena Mejia
- Instituto de Microbiología, Universidad San Francisco de Quito, Cumbayá, Quito, Ecuador
| | - Sonia Zapata
- Instituto de Microbiología, Universidad San Francisco de Quito, Cumbayá, Quito, Ecuador
| | - Gabriel Trueba
- Instituto de Microbiología, Universidad San Francisco de Quito, Cumbayá, Quito, Ecuador
| | - Ana Cecilia Vargas
- Servicio de Microbiología y Tuberculosis, Hospital Vozandes, Villalengua Oe2-37, Quito, Ecuador
| | - Samanta Aguirre
- Unidad de Cuidados Intensivos, Hospital Vozandes, Quito, Ecuador
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16
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Ferranti G, Marchesi I, Favale M, Borella P, Bargellini A. Aetiology, source and prevention of waterborne healthcare-associated infections: a review. J Med Microbiol 2014; 63:1247-1259. [DOI: 10.1099/jmm.0.075713-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The purpose of this review is to discuss the scientific literature on waterborne healthcare-associated infections (HCAIs) published from 1990 to 2012. The review focuses on aquatic bacteria and describes both outbreaks and single cases in relation to patient characteristics, the settings and contaminated sources. An overview of diagnostic methods and environmental investigations is summarized in order to provide guidance for future case investigations. Lastly, on the basis of the prevention and control measures adopted, information and recommendations are given. A total of 125 reports were included, 41 describing hospitalized children. All cases were sustained by opportunistic pathogens, mainly Legionellaceae, Pseudomonadaceae and Burkholderiaceae. Hot-water distribution systems were the primary source of legionnaires’ disease, bottled water was mainly colonized by Pseudomonaceae, and Burkholderiaceae were the leading cause of distilled and sterile water contamination. The intensive care unit was the most frequently involved setting, but patient characteristics were the main risk factor, independent of the ward. As it is difficult to avoid water contamination by microbes and disinfection treatments may be insufficient to control the risk of infection, a proactive preventive plan should be put in place. Nursing staff should pay special attention to children and immunosuppressed patients in terms of tap-water exposure and also their personal hygiene, and should regularly use sterile water for rinsing/cleaning devices.
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Affiliation(s)
- Greta Ferranti
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Isabella Marchesi
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Marcella Favale
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Paola Borella
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Annalisa Bargellini
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
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17
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Crum-Cianflone NF, Matson RW, Ballon-Landa G. Fatal case of necrotizing fasciitis due to Myroides odoratus. Infection 2014; 42:931-5. [PMID: 24806817 DOI: 10.1007/s15010-014-0626-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 04/21/2014] [Indexed: 10/25/2022]
Abstract
Myroides sp., previously known as Flavobacterium odoratum, is a relatively unknown organism with unclear human pathogenicity. While Myroides sp. has been implicated in human infections, many reports have described the organism as a relatively avirulent opportunistic pathogen. We present an unusual case of rapidly fatal necrotizing fasciitis and septic shock due to Myroides odoratus. Our case demonstrates the pathogenicity of Myroides, and highlights potential risk factors for infection including underlying liver disease and open wounds. The recognition of Myroides is of particular importance given its resistance to multiple antibiotics. We review the literature on Myroides sp. skin and soft tissue infections, including necrotizing forms, and discuss the clinical presentation and management of this potentially emerging pathogen.
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18
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Boszczowski I, do Prado GVB, Dalben MF, Telles RCP, Freire MP, Guimarães T, Oliveira MS, Rosa JF, Soares RE, Llacer PED, Dulley FL, Costa SF, Levin AS. Polyclonal outbreak of bloodstream infections caused by Burkholderia cepacia complex in hematology and bone marrow transplant outpatient units. Rev Inst Med Trop Sao Paulo 2014; 56:71-6. [PMID: 24553612 PMCID: PMC4085834 DOI: 10.1590/s0036-46652014000100011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 05/23/2013] [Indexed: 11/22/2022] Open
Abstract
Aim: The objective was to describe an outbreak of bloodstream infections
by Burkholderia cepacia complex (Bcc) in bone marrow transplant and
hematology outpatients. Methods: On February 15, 2008 a Bcc outbreak was suspected. 24 cases
were identified. Demographic and clinical data were evaluated. Environment and
healthcare workers' (HCW) hands were cultured. Species were determined and typed.
Reinforcement of hand hygiene, central venous catheter (CVC) care, infusion therapy,
and maintenance of laminar flow cabinet were undertaken. 16 different HCWs had cared
for the CVCs. Multi-dose heparin and saline were prepared on counter common to both
units. Findings: 14 patients had B. multivorans (one patient
had also B. cenopacia), six non-multivorans Bcc and
one did not belong to Bcc. Clone A B. multivorans occurred in 12
patients (from Hematology); in 10 their CVC had been used on February 11/12.
Environmental and HCW cultures were negative. All patients were treated with
meropenem, and ceftazidime lock-therapy. Eight patients (30%) were hospitalized. No
deaths occurred. After control measures (multidose vial for single patient; CVC lock
with ceftazidime; cleaning of laminar flow cabinet; hand hygiene improvement; use of
cabinet to store prepared medication), no new cases occurred. Conclusions: This polyclonal outbreak may be explained by a common
source containing multiple species of Bcc, maybe the laminar flow cabinet common to
both units. There may have been contamination by B. multivorans
(clone A) of multi-dose vials.
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Affiliation(s)
- Icaro Boszczowski
- Infection Control Department, Hospital das Clinicas, Universidade de São Paulo, SP, Brazil, Infection Control Department, Hospital das Clinicas, Universidade de São Paulo, SP, Brazil
| | - Gladys Villas Boas do Prado
- Infection Control Department, Hospital das Clinicas, Universidade de São Paulo, SP, Brazil, Infection Control Department, Hospital das Clinicas, Universidade de São Paulo, SP, Brazil
| | - Mirian F Dalben
- Infection Control Department, Hospital das Clinicas, Universidade de São Paulo, SP, Brazil, Infection Control Department, Hospital das Clinicas, Universidade de São Paulo, SP, Brazil
| | - Roberto C P Telles
- Department of Infectious Diseases and LIM-54, University of São Paulo, São PauloSP, Brazil, Department of Infectious Diseases and LIM-54, University of São Paulo, São Paulo, SP, Brazil
| | - Maristela Pinheiro Freire
- Infection Control Department, Hospital das Clinicas, Universidade de São Paulo, SP, Brazil, Infection Control Department, Hospital das Clinicas, Universidade de São Paulo, SP, Brazil
| | - Thaís Guimarães
- Infection Control Department, Hospital das Clinicas, Universidade de São Paulo, SP, Brazil, Infection Control Department, Hospital das Clinicas, Universidade de São Paulo, SP, Brazil
| | - Maura S Oliveira
- Infection Control Department, Hospital das Clinicas, Universidade de São Paulo, SP, Brazil, Infection Control Department, Hospital das Clinicas, Universidade de São Paulo, SP, Brazil
| | - Juliana F Rosa
- Department of Infectious Diseases and LIM-54, University of São Paulo, São PauloSP, Brazil, Department of Infectious Diseases and LIM-54, University of São Paulo, São Paulo, SP, Brazil
| | - Robson E Soares
- Department of Infectious Diseases and LIM-54, University of São Paulo, São PauloSP, Brazil, Department of Infectious Diseases and LIM-54, University of São Paulo, São Paulo, SP, Brazil
| | - Pedro Enrique Dorlhiac Llacer
- Hematology Unit, Hospital das Clínicas, University of São Paulo, São PauloSP, Brazil, Hematology Unit, Hospital das Clínicas, University of São Paulo, São Paulo, SP, Brazil
| | - Frederico Luiz Dulley
- Chief of Bone Marrow Transplant Unit, Hospital das Clínicas, University of São Paulo, São PauloSP, Brazil, Chief of Bone Marrow Transplant Unit, Hospital das Clínicas, University of São Paulo, São Paulo, SP, Brazil
| | - Silvia F Costa
- Department of Infectious Diseases and LIM-54, University of São Paulo, São PauloSP, Brazil, Department of Infectious Diseases and LIM-54, University of São Paulo, São Paulo, SP, Brazil
| | - Anna S Levin
- Infection Control Department, Hospital das Clinicas, Universidade de São Paulo, SP, Brazil, Infection Control Department, Hospital das Clinicas, Universidade de São Paulo, SP, Brazil
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19
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Papp-Wallace KM, Taracila MA, Gatta JA, Ohuchi N, Bonomo RA, Nukaga M. Insights into β-lactamases from Burkholderia species, two phylogenetically related yet distinct resistance determinants. J Biol Chem 2013; 288:19090-102. [PMID: 23658015 DOI: 10.1074/jbc.m113.458315] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Burkholderia cepacia complex and Burkholderia pseudomallei are opportunistic human pathogens. Resistance to β-lactams among Burkholderia spp. is attributable to expression of β-lactamases (e.g. PenA in B. cepacia complex and PenI in B. pseudomallei). Phylogenetic comparisons reveal that PenA and PenI are highly related. However, the analyses presented here reveal that PenA is an inhibitor-resistant carbapenemase, most similar to KPC-2 (the most clinically significant serine carbapenemase), whereas PenI is an extended spectrum β-lactamase. PenA hydrolyzes β-lactams with k(cat) values ranging from 0.38 ± 0.04 to 460 ± 46 s(-1) and possesses high k(cat)/k(inact) values of 2000, 1500, and 75 for β-lactamase inhibitors. PenI demonstrates the highest kcat value for cefotaxime of 9.0 ± 0.9 s(-1). Crystal structure determination of PenA and PenI reveals important differences that aid in understanding their contrasting phenotypes. Changes in the positioning of conserved catalytic residues (e.g. Lys-73, Ser-130, and Tyr-105) as well as altered anchoring and decreased occupancy of the deacylation water explain the lower k(cat) values of PenI. The crystal structure of PenA with imipenem docked into the active site suggests why this carbapenem is hydrolyzed and the important role of Arg-220, which was functionally confirmed by mutagenesis and biochemical characterization. Conversely, the conformation of Tyr-105 hindered docking of imipenem into the active site of PenI. The structural and biochemical analyses of PenA and PenI provide key insights into the hydrolytic mechanisms of β-lactamases, which can lead to the rational design of novel agents against these pathogens.
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Affiliation(s)
- Krisztina M Papp-Wallace
- Research Service, Louis Stokes Cleveland Department of Veterans Affairs, Cleveland, Ohio 44106, USA
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20
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Maraki S, Sarchianaki E, Barbagadakis S. Myroides odoratimimus soft tissue infection in an immunocompetent child following a pig bite: case report and literature review. Braz J Infect Dis 2013; 16:390-2. [PMID: 22846131 DOI: 10.1016/j.bjid.2012.06.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 03/26/2012] [Indexed: 11/17/2022] Open
Abstract
Members of the genus Myroides are aerobic Gram-negative bacteria that are common in environmental sources, but are not components of the normal human microflora. Myroides organisms behave as low-grade opportunistic pathogens, causing infections in severely immunocompromised patients and rarely, in immunocompetent hosts. A case of Myroides odoratimimus cellulitis following a pig bite in an immunocompetent child is presented, and the medical literature on Myroides spp. soft tissue infections is reviewed.
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Affiliation(s)
- Sofia Maraki
- Department of Clinical Microbiology, Parasitology, Zoonoses, and Geographical Medicine, University Hospital of Heraklion, Crete, Greece.
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21
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Benedetti P, Rassu M, Pavan G, Sefton A, Pellizzer G. Septic shock, pneumonia, and soft tissue infection due to Myroides odoratimimus: report of a case and review of Myroides infections. Infection 2011; 39:161-5. [PMID: 21246247 DOI: 10.1007/s15010-010-0077-1] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Accepted: 12/13/2010] [Indexed: 11/26/2022]
Abstract
The genus Myroides comprises aerobic, yellow-pigmented, non-motile, non-fermenting gram-negative rods formerly classified as Flavobacterium odoratum. Members of the genus are widely distributed in the environment, especially in water, and usually behave as low-grade opportunistic pathogens, having been found to cause urinary tract infection, endocarditis, ventriculitis, and cutaneous infections in severely immunocompromised patients. We report a case of soft tissue infection, septic shock, and pneumonia due to M. odoratimimus in an immunocompetent male. To our knowledge, this is the first description of life-threatening infection caused by this organism in an immunocompetent host. We have also reviewed the medical literature on the genus Myroides.
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Affiliation(s)
- P Benedetti
- Unità Operativa di Malattie Infettive e Tropicali, Ospedale S. Bortolo, Viale F. Rodolfi, 37, 36100, Vicenza, Italy.
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22
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Hospital-wide outbreak of Burkholderia contaminans caused by prefabricated moist washcloths. J Hosp Infect 2011; 77:267-70. [PMID: 21216034 DOI: 10.1016/j.jhin.2010.10.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Accepted: 10/07/2010] [Indexed: 11/22/2022]
Abstract
We experienced a hospital outbreak of Burkholderia contaminans (Burkholderia cepacia Group K) in a German university hospital with two campuses. Cases were defined as the microbiological detection of B. cepacia complex (BCC) in any clinical specimen sent to the laboratory during 30 June to 21 October 2008. Species identification of BCC was performed by recA gene sequencing, followed by pulsed-field gel electrophoresis (PFGE; SpeI digest) for clonal identity. In total, 61 BCC-positive cases were diagnosed at the two campuses. At least nine patients contracted a ventilator-associated pneumonia with BCC. One patient suffered an infection of a pacing wire insertion site and four patients had septicaemia. Sixteen patients died in hospital, none thought to be due to the outbreak strain. BCC was eventually found in packages of moist prefabricated washcloths used for intensive care patients. German healthcare authorities were informed and a Europe-wide alarm (RAPEX) was initiated through the systems to prevent infections in other hospitals. PFGE proved clonal identity between isolates from clinical specimens and washcloths of both campuses. After elimination of the contaminated washcloths no further cases occurred. This example of a relatively newly introduced product raises the question of whether current regulations are adequate to protect consumers. For critically ill patients, care products should be carefully evaluated. In case of infections due to contaminated products, immediate communication to healthcare authorities is required, including RAPEX warning if products are sold across Europe.
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23
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Cho SH, Chae SH, Im WT, Kim SB. Myroides marinus sp. nov., a member of the family Flavobacteriaceae, isolated from seawater. Int J Syst Evol Microbiol 2010; 61:938-941. [PMID: 20495024 DOI: 10.1099/ijs.0.024067-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A Gram-negative, aerobic, non-motile, yellow-pigmented, rod-shaped bacterium (strain JS-08(T)) isolated from seawater was subjected to a polyphasic taxonomic study. 16S rRNA gene sequence analysis indicated that strain JS-08(T) belongs to the genus Myroides, a member of the phylum Bacteroidetes. Its closest phylogenetic relative was Myroides odoratimimus JCM 7460(T), with which it shared 97.0 % 16S RNA gene sequence similarity. Strain JS-08(T) contained menaquinone-6 (MK-6) as the predominant menaquinone, and the dominant fatty acids were iso-C(15 : 0), iso-C(17 : 0) 3-OH and a summed feature consisting of iso-C(15 : 0) 2-OH and/or C(16 : 1)ω7c. The DNA G+C content of strain JS-08(T) was 34.2 mol%. Based on phenotypic, genotypic and phylogenetic evidence, it is suggested that strain JS-08(T) represents a novel species of the genus Myroides, for which the name Myroides marinus sp. nov. is proposed. The type strain is JS-08(T) ( = KCTC 23023(T) = JCM 16529(T)).
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Affiliation(s)
- Sung-Heun Cho
- Department of Microbiology and Molecular Biology, School of Bioscience and Biotechnology, Chungnam National University, 220 Gung-dong, Yuseong, Daejeon 305-764, Republic of Korea
| | - Song-Hee Chae
- Department of Microbiology and Molecular Biology, School of Bioscience and Biotechnology, Chungnam National University, 220 Gung-dong, Yuseong, Daejeon 305-764, Republic of Korea
| | - Wan-Taek Im
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, 373-1 Guseong-dong, Yuseong-gu, Daejeon 305-701, Republic of Korea
| | - Seung Bum Kim
- Department of Microbiology and Molecular Biology, School of Bioscience and Biotechnology, Chungnam National University, 220 Gung-dong, Yuseong, Daejeon 305-764, Republic of Korea
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