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Mettler SK, Charoenngam N, Colgrove RC. Clinical differences between Raoultella spp. and Klebsiella oxytoca. Front Cell Infect Microbiol 2024; 14:1260212. [PMID: 38887491 PMCID: PMC11180880 DOI: 10.3389/fcimb.2024.1260212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 05/15/2024] [Indexed: 06/20/2024] Open
Abstract
Purpose Raoultella spp. is a genus of bacteria that is known to be closely related to Klebsiella. It has been debated whether Raoultella should be reclassified as a subgroup of Klebsiella. The aim of this study is to compare clinical aspects of Raoultella and Klebsiella oxytoca, a species of Klebsiella that is known to be bacteriologically similar to Raoultella spp. Methods Using data collected at a tertiary care hospital in the United States, we identified 43 patients with Raoultella infection and 1173 patients with Klebsiella oxytoca infection. We compared patient demographics (age and sex), hospitalization status, isolation sites and antibiotic resistance profiles between the two species. Results There was no significant difference in patient demographics between the two bacteria species. The proportions of intensive care unit (ICU) admission were higher among patients with Raoultella infection (p=0.008). The most common site of isolation was urine for both species (39.5% of all patients with Raoultella spp. vs. 59.3% for K. oxytoca). The second most common site of isolation was blood stream for Raoultella spp. (23.3%) and respiratory tract for K. oxytoca (10.8%). Except for the high proportion of resistant isolates of Raoultella spp. for Trimethoprim/sulfamethoxazole, the antibiotic susceptibility profiles were similar between the two bacteria species. Both were susceptible to ciprofloxacin and meropenem. Conclusion While there are no significant differences in the patient demographics and antibiotic susceptibility profiles between Raoultella spp. and K. oxytoca, Raoultella may cause more serious infection requiring ICU admissions. Also, Raoultella may cause blood stream infection more frequently than K. oxytoca.
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Affiliation(s)
- Sofia K. Mettler
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Medicine, Mount Auburn Hospital, Cambridge, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Nipith Charoenngam
- Department of Medicine, Mount Auburn Hospital, Cambridge, MA, United States
- Harvard Medical School, Boston, MA, United States
- Mahidol University, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
| | - Robert C. Colgrove
- Department of Medicine, Mount Auburn Hospital, Cambridge, MA, United States
- Harvard Medical School, Boston, MA, United States
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2
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Villacís JE, Castelán-Sánchez HG, Rojas-Vargas J, Rodríguez-Cruz UE, Albán V, Reyes JA, Meza-Rodríguez PM, Dávila-Ramos S, Villavicencio F, Galarza M, Gestal MC. Emergence of Raoultella ornithinolytica in human infections from different hospitals in Ecuador with OXA-48-producing resistance. Front Microbiol 2023; 14:1216008. [PMID: 37692398 PMCID: PMC10484340 DOI: 10.3389/fmicb.2023.1216008] [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: 05/03/2023] [Accepted: 08/01/2023] [Indexed: 09/12/2023] Open
Abstract
Purpose The purpose of this study was to highlight the clinical and molecular features of 13 Raoultella ornithinolytica strains isolated from clinical environments in Ecuador, and to perform comparative genomics with previously published genomes of Raoultella spp. As Raoultella is primarily found in environmental, clinical settings, we focused our work on identifying mechanisms of resistance that can provide this bacterium an advantage to establish and persist in hospital environments. Methods We analyzed 13 strains of Raoultella ornithinolytica isolated from patients with healthcare associated infections (HAI) in three hospitals in Quito and one in Santo Domingo de Los Tsáchilas, Ecuador, between November 2017 and April 2018. These isolates were subjected to phenotypic antimicrobial susceptibility testing, end-point polymerase chain reaction (PCR) to detect the presence of carbapenemases and whole-genome sequencing. Results Polymerase chain reaction revealed that seven isolates were positive isolates for blaOXA-48 and one for blaKPC-2 gene. Of the seven strains that presented the blaOXA-48 gene, six harbored it on an IncFII plasmid, one was inserted into the bacterial chromosome. The blaKPC gene was detected in an IncM2/IncR plasmid. From the bioinformatics analysis, nine genomes had the gene blaOXA-48, originating from Ecuador. Moreover, all R. ornithinolytica strains contained the ORN-1 gene, which confers resistance for β-lactams, such as penicillins and cephalosporins. Comparative genome analysis of the strains showed that the pangenome of R. ornithinolytica is considered an open pangenome, with 27.77% of core genes, which could be explained by the fact that the antibiotic resistance genes in the ancestral reconstruction are relatively new, suggesting that this genome is constantly incorporating new genes. Conclusion These results reveal the genome plasticity of R. ornithinolytica, particularly in acquiring antibiotic-resistance genes. The genomic surveillance and infectious control of these uncommon species are important since they may contribute to the burden of antimicrobial resistance and human health.
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Affiliation(s)
- José E. Villacís
- Centro de Investigación para la Salud en América Latina (CISeAL), Pontificia Universidad Católica del Ecuador, Quito, Ecuador
- Centro de Referencia Nacional de Resistencia a los Antimicrobianos, Instituto Nacional de Investigación en Salud Pública, “Leopoldo Izquieta Pérez,” Quito, Ecuador
| | - Hugo G. Castelán-Sánchez
- Programa Investigadoras e Investigadores por México, Grupo de Genómica y Dinámica Evolutiva de Microorganismos Emergentes, Consejo Nacional de Ciencia y Tecnología, México City, Mexico
- Centro de Investigación en Dinámica Celular, Instituto de Investigación en Ciencias Básicas y Aplicadas, Universidad Autónoma del Estado de Morelos, Cuernavaca, Mexico
| | - Jorge Rojas-Vargas
- Departamento de Microbiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca, Mexico
| | - Ulises E. Rodríguez-Cruz
- Departamento de Ecología Evolutiva, Instituto de Ecología, Universidad Nacional Autónoma de México, México City, Mexico
| | - Viviana Albán
- Centro de Referencia Nacional de Resistencia a los Antimicrobianos, Instituto Nacional de Investigación en Salud Pública, “Leopoldo Izquieta Pérez,” Quito, Ecuador
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, United States
| | - Jorge A. Reyes
- Facultad de Ciencias Químicas, Universidad Central del Ecuador, Quito, Ecuador
| | - Pablo M. Meza-Rodríguez
- Centro de Investigación en Dinámica Celular, Instituto de Investigación en Ciencias Básicas y Aplicadas, Universidad Autónoma del Estado de Morelos, Cuernavaca, Mexico
| | - Sonia Dávila-Ramos
- Centro de Investigación en Dinámica Celular, Instituto de Investigación en Ciencias Básicas y Aplicadas, Universidad Autónoma del Estado de Morelos, Cuernavaca, Mexico
| | - Fernando Villavicencio
- Centro de Referencia Nacional de Resistencia a los Antimicrobianos, Instituto Nacional de Investigación en Salud Pública, “Leopoldo Izquieta Pérez,” Quito, Ecuador
| | | | - Monica C. Gestal
- Department of Microbiology and Immunology, Louisiana State University (LSU), Health Science Center at Shreveport, Shreveport, LA, United States
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Etani T, Kondo S, Yanase T, Morikawa T, Aoki M, Gonda M, Tomiyama N, Nagai T, Iida K, Iwatsuki S, Taguchi K, Naiki T, Hamamoto S, Okada A, Kawai N, Nakamura A, Yasui T. Clinical characteristics of Raoultella ornithinolytica bacteremia and antimicrobial susceptibility of Raoultellaornithinolytica. J Infect Chemother 2023; 29:554-557. [PMID: 36738858 DOI: 10.1016/j.jiac.2023.01.023] [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: 12/03/2022] [Revised: 01/20/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
Raoultella ornithinolytica (R. ornithinolytica) is a gram-negative rod that was considered related to Klebsiella oxytoca and was classified as R. ornithinolytica in 2001. R. ornithinolytica is known as a histamine-producing bacterium that causes mackerel poisoning. Although only few clinical cases of R. ornithinolytica infection in humans have been reported, the number of diagnosed cases is expected to increase owing to the advancements in identification methods. In the present study, we performed a retrospective analysis of cases of R. ornithinolytica infection detected at our hospital. From September 2019 to July 2021, 62 specimens positive for R. ornithinolytica were obtained after removing duplicates. The clinical courses of these cases were investigated retrospectively based on electronic medical records. Of the 62 specimens, 24 were sputum, 19 were urine, three were stool, six were blood, four were bile, and six were other specimens. All the six blood culture specimens in which R. ornithinolytica was detected were from male patients, and the causative diseases were cholangitis in four cases and complicated pyelonephritis in two cases. Of these, two patients with cholangitis succumbed to death due to the worsening of underlying cancer. Identification of R. ornithinolytica is reportedly difficult, and some instruments may misidentify it as Klebsiella oxytoca. The prognosis of R. ornithinolytica infection has been reported to be good when susceptible drugs are used. However, high mortality rates were also reported despite the use of these drugs, suggesting the need for further investigation of clinical features of R. ornithinolytica infection.
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Affiliation(s)
- Toshiki Etani
- Department of Nephro-urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Shuhei Kondo
- Division of Infection Prevention & Control, Nagoya City University Hospital, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Takahiro Yanase
- Department of Nephro-urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Toshiharu Morikawa
- Department of Nephro-urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Maria Aoki
- Department of Nephro-urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Masakazu Gonda
- Department of Nephro-urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Nami Tomiyama
- Department of Nephro-urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Takashi Nagai
- Department of Nephro-urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Keitaro Iida
- Department of Nephro-urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Shoichiro Iwatsuki
- Department of Nephro-urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Kazumi Taguchi
- Department of Nephro-urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Taku Naiki
- Department of Nephro-urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Shuzo Hamamoto
- Department of Nephro-urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Atsushi Okada
- Department of Nephro-urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Noriyasu Kawai
- Department of Nephro-urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Atsushi Nakamura
- Division of Infection Prevention & Control, Nagoya City University Hospital, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Takahiro Yasui
- Department of Nephro-urology, Graduate School of Medical Sciences, Nagoya City University, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
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Graham GD, Jeray KJ. Posttraumatic Patellar Osteomyelitis due to Raoultella ornithinolytica: A Case Report. JBJS Case Connect 2023; 13:01709767-202303000-00039. [PMID: 36795860 DOI: 10.2106/jbjs.cc.22.00590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
CASE A 59-year-old woman sustained a comminuted patellar fracture after a fall from standing. The injury was treated with open reduction and internal fixation 7 days from initial injury. Seven weeks postoperatively, she developed a swollen, painful, and draining knee. Workup demonstrated Raoultella ornithinolytica. She underwent surgical debridement and antibiotic treatment. CONCLUSION This is an unusual presentation of patellar osteomyelitis with R. ornithinolytica. Early identification, treatment with appropriate antimicrobial therapy, and consideration of surgical debridement are important in patients presenting with pain, swelling, and erythema after surgery.
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Affiliation(s)
- George D Graham
- Department of Orthopaedic Surgery, Prisma Health - Upstate, Greenville, South Carolina
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5
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Nearly Complete Genome Sequence of Raoultella ornithinolytica Strain MQB_Silv_108, Carrying an Uncommon Extended-Spectrum-β-Lactamase-like blaBEL Gene. Microbiol Resour Announc 2022; 11:e0101222. [PMID: 36314936 PMCID: PMC9670947 DOI: 10.1128/mra.01012-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Raoultella ornithinolytica has become increasingly important in human diseases. Here, we report the nearly complete genome sequence of a multidrug-resistant strain, R. ornithinolytica MQB_Silv_108, which was isolated from the effluent from a domestic wastewater treatment plant in Spain. Therefore, its release into the environment poses a possible exposure risk for humans and animals.
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6
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Teixeira P, Pinto N, Henriques I, Tacão M. KPC-3-, GES-5-, and VIM-1-Producing Enterobacterales Isolated from Urban Ponds. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105848. [PMID: 35627386 PMCID: PMC9141432 DOI: 10.3390/ijerph19105848] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/05/2022] [Accepted: 05/07/2022] [Indexed: 01/27/2023]
Abstract
Carbapenems are antibiotics of pivotal importance in human medicine, the efficacy of which is threatened by the increasing prevalence of carbapenem-resistant Enterobacterales (CRE). Urban ponds may be reservoirs of CRE, although this hypothesis has been poorly explored. We assessed the proportion of CRE in urban ponds over a one-year period and retrieved 23 isolates. These were submitted to BOX-PCR, PFGE, 16S rDNA sequencing, antibiotic susceptibility tests, detection of carbapenemase-encoding genes, and conjugation assays. Isolates were affiliated with Klebsiella (n = 1), Raoultella (n = 11), Citrobacter (n = 8), and Enterobacter (n = 3). Carbapenemase-encoding genes were detected in 21 isolates: blaKPC (n = 20), blaGES-5 (n = 6), and blaVIM (n = 1), with 7 isolates carrying two carbapenemase genes. Clonal isolates were collected from different ponds and in different campaigns. Citrobacter F6, Raoultella N9, and Enterobacter N10 were predicted as pathogens from whole-genome sequence analysis, which also revealed the presence of several resistance genes and mobile genetic elements. We found that blaKPC-3 was located on Tn4401b (Citrobacter F6 and Enterobacter N10) or Tn4401d (Raoultella N9). The former was part of an IncFIA-FII pBK30683-like plasmid. In addition, blaGES-5 was in a class 3 integron, either chromosomal (Raoultella N9) or plasmidic (Enterobacter N10). Our findings confirmed the role of urban ponds as reservoirs and dispersal sites for CRE.
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Affiliation(s)
- Pedro Teixeira
- CESAM (Centre for Marine and Environmental Studies), University of Aveiro, 3810-193 Aveiro, Portugal; (P.T.); (M.T.)
- Biology Department, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Nuno Pinto
- Biology Department, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Isabel Henriques
- Centre for Functional Ecology, Department of Life Sciences, University of Coimbra, 3004-531 Coimbra, Portugal
- Correspondence:
| | - Marta Tacão
- CESAM (Centre for Marine and Environmental Studies), University of Aveiro, 3810-193 Aveiro, Portugal; (P.T.); (M.T.)
- Biology Department, University of Aveiro, 3810-193 Aveiro, Portugal;
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7
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Valiatti TB, Santos FF, Nunes PHS, Streling AP, Veiga R, Cayô R, Gales AC, Gomes TAT. Decreased susceptibility to imipenem and ceftazidime in early virulent Raoultella spp. strains retrieved from human intestinal infections. Braz J Microbiol 2022; 53:785-789. [PMID: 35138632 PMCID: PMC9151967 DOI: 10.1007/s42770-022-00699-0] [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: 07/20/2021] [Accepted: 02/01/2022] [Indexed: 02/01/2023] Open
Abstract
The genus Raoultella spp. is comprised of four species, namely, R. electrica, R. ornithinolytica, R. planticola, and R. terrigena, which are rarely reported to cause infections in humans. This study aimed to characterize six strains of Raoultella spp. isolated from stool samples from patients with diarrhea. The strains included in the study were previously identified by biochemical methods as K. pneumoniae, during a surveillance study conducted in 1987. In the present study, the strains were re-identified by MALDI TOF and 16S rRNA sequencing and subsequently subjected to virulence gene screening by PCR, hemolytic activity, biofilm formation, hypermucoviscosity phenotype, capacity to interact with Caco-2 cells, and antimicrobial susceptibility test. Our results revealed that, among the six strains, three were identified as R. ornithinolytica and three as R. planticola. The genes related to iron uptake systems (aero1, aero2, iutA, entB, and ybtS) and adhesin (mrkD) were found in all strains. Furthermore, all strains demonstrated the ability to interact in vitro with Caco-2 cells and form biofilms. In general, the strains studied were sensitive to the antimicrobials tested; however, it was possible to observe high MICs for imipenem compared to ertapenem and meropenem and high minimal inhibitory concentrations (MICs) for ceftazidime, except for one strain. Our results show the occurrence of virulent strains of Raoultella spp. with high MICs for imipenem and ceftazidime causing diarrhea. We hope that our findings can contribute to the understanding of the evolution of this species since, as far as we know, these are the oldest isolates reported so far.
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Affiliation(s)
- Tiago Barcelos Valiatti
- Laboratório Experimental de Patogenicidade de Enterobactérias (LEPE), Disciplina de Microbiologia, Departamento de Microbiologia, Imunologia e Parasitologia (DMIP), Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil. .,Laboratório Alerta, Division of Infectious Diseases, Department of Internal Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
| | - Fernanda Fernandes Santos
- Laboratório Experimental de Patogenicidade de Enterobactérias (LEPE), Disciplina de Microbiologia, Departamento de Microbiologia, Imunologia e Parasitologia (DMIP), Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP Brazil ,Present Address: Laboratório Alerta, Division of Infectious Diseases, Department of Internal Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP Brazil
| | - Pedro Henrique Soares Nunes
- Laboratório Experimental de Patogenicidade de Enterobactérias (LEPE), Disciplina de Microbiologia, Departamento de Microbiologia, Imunologia e Parasitologia (DMIP), Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP Brazil
| | - Ana Paula Streling
- Present Address: Laboratório Alerta, Division of Infectious Diseases, Department of Internal Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP Brazil
| | - Ruanita Veiga
- Present Address: Laboratório Alerta, Division of Infectious Diseases, Department of Internal Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP Brazil
| | - Rodrigo Cayô
- Present Address: Laboratório Alerta, Division of Infectious Diseases, Department of Internal Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP Brazil ,Laboratório de Imunologia e Microbiologia (LIB), Setor de Biologia Molecular, Microbiologia e Imunologia, Departamento de Ciências Biológicas (DCB), Instituto de Ciências Ambientais Químicas e Farmacêuticas (ICAQF), Universidade Federal de São Paulo (UNIFESP), Diadema, SP Brazil
| | - Ana Cristina Gales
- Present Address: Laboratório Alerta, Division of Infectious Diseases, Department of Internal Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP Brazil
| | - Tânia Aparecida Tardelli Gomes
- Laboratório Experimental de Patogenicidade de Enterobactérias (LEPE), Disciplina de Microbiologia, Departamento de Microbiologia, Imunologia e Parasitologia (DMIP), Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
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Neonatal Community-acquired Raoultella Ornithinolytica Septicemia: A Case Report and Review of the Literature. Pediatr Infect Dis J 2021; 40:e370-e373. [PMID: 34260488 DOI: 10.1097/inf.0000000000003197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Raoultella ornithinolytica is an opportunistic, aquaphilic and Gram-negative bacterium. Immune deficiency states and indwelling catheters provide a basis for most of the infections arising. R. ornithinolytica septicemia (ROS) is extremely rare in neonates but can be life threatening. Community-acquired ROS has not been described in neonates before. The diagnosis of neonatal septicemia is occasionally complicated by unusual clinical presentations. Pyloric stenosis is manifested by projectile, nonbilious vomiting and late findings, including weight loss, dehydration and electrolyte abnormalities beyond 4-6 weeks old. Community-acquired neonatal septicemia symptoms can sometimes be confused with symptoms of gastrointestinal obstructions in patients without risk factors for sepsis. Early diagnosis and appropriate antibiotics are essentials for a good prognosis in neonatal septicemia. Herein, we present a novel case of community-acquired ROS with an unusual presentation in a term infant and a review of the literature about ROS in the neonatal period.
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9
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Appel TM, Quijano-Martínez N, De La Cadena E, Mojica MF, Villegas MV. Microbiological and Clinical Aspects of Raoultella spp. Front Public Health 2021; 9:686789. [PMID: 34409007 PMCID: PMC8365188 DOI: 10.3389/fpubh.2021.686789] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 07/09/2021] [Indexed: 11/13/2022] Open
Abstract
The genus Raoultella was established in 2001. Species of Raoultella and Klebsiella share many ecological, biochemical, clinical, and microbiological features. Given the shortcomings of available technology for species identification in the clinical microbiology laboratory, are practically indistinguishable. Since the late 2000s there has been an increase in case reports of human Raoultella infections. Therefore, several authors are postulating that Raoultella spp. are rare and/or emerging pathogens. Conclusions:Raoultella spp. are very similar to Klebsiella spp. The epidemiology and the clinical relevance of the human Raoultella spp. infections is uncertain and further studies are required. The previous difficulties in the identification of Raoultella spp. and the introduction of more precise identification techniques may explain the recent increase in the number of case reports. Raoultella spp. might be rather underdiagnosed than rare or emerging pathogens.
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Affiliation(s)
- Tobias M Appel
- Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany.,Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Bogotá, Colombia
| | | | - Elsa De La Cadena
- Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Bogotá, Colombia
| | - María F Mojica
- Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Bogotá, Colombia
| | - María Virginia Villegas
- Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Bogotá, Colombia
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Abd El-Ghany WA. A spotlight on Raoultella ornithinolytica: A newly emerging life-threatening zoonotic pathogen. INTERNATIONAL JOURNAL OF ONE HEALTH 2021. [DOI: 10.14202/ijoh.2021.1-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The genus Raoultella contains Raoultella ornithinolytica (R. ornithinolytica), which was previously named as Klebsiella ornithinolytica. R. ornithinolytica is a Gram-negative bacillus that belongs to the family Enterobacteriaceae. This pathogen is normally present in aquaculture, and it has been isolated from fish, insects, and wild and domestic birds. Seafood and poultry products are incriminated as sources of R. ornithinolytica infection. Community-acquired human infection with R. ornithinolytica is common. This infection is commonly associated with sepsis, bacteremia, food poisoning, purities, and urinary and respiratory tracts' infections. Rapid acquired resistance of R. ornithinolytica strains is common, and it is related to the development of resistant genes. R. ornithinolytica is considered as a newly emerging life-threatening pathogen world-wide. Hence, it is very important to determine the role of animals and birds in the epidemiological situation of this pathogen as well as the detection of antibiotic resistance genes before treatment.
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Affiliation(s)
- Wafaa A. Abd El-Ghany
- Department of Poultry Diseases, Faculty of Veterinary Medicine, Cairo University, Egypt
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11
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El-Shannat SM, El-Tawab AAA, Hassan WMM. Emergence of Raoultella ornithinolytica isolated from chicken products in Alexandria, Egypt. Vet World 2020; 13:1473-1479. [PMID: 32848326 PMCID: PMC7429399 DOI: 10.14202/vetworld.2020.1473-1479] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 06/04/2020] [Indexed: 11/30/2022] Open
Abstract
Background and Aim: Raoultella ornithinolytica is one of the emerging gram-negative bacteria, which associated with foodborne illness. Researches affirmed that distinguish between R. ornithinolytica and Klebsiella oxytoca are difficult, as they are phylogenetic related. The evolution of multidrug resistance of Raoultella strains gained more concern for recognition of the pathogen which supports in controlling the disease and minify its threat. This study sought to find a reliable tool for the identification of Raoultella ornithinolytica, isolated from chicken product samples, and assessed the resistance profile of R. ornithinolytica using antibiogram sensitivity tests. Materials and Methods: Forty samples of chicken products were collected between January and September 2019 from different markets in Alexandria Governorate, Egypt. The products included nuggets, strips, burgers, luncheon meats, pane, frankfurters, and minced chicken meat. The samples were transferred to the Reference Laboratory. The samples were subjected to isolation, biochemical reaction testing, phenotypic system analytical profile index (API) E20, and a detection of antimicrobial susceptibility test. Phenotypic identification was confirmed through matrix-assisted laser-desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). Results: Thirty-three bacterial isolates (82.50%) out of 40 samples were isolated into pure cultures from the chicken samples. Three isolates (9.09%) were positive for R. ornithinolytica, while 30 isolates (90.91%) exhibited growth characters for different pathogens (Escherichia coli, Enterobacter aerogenes, Proteus vulgaris, R. ornithinolytica, and Klebsiella pneumoniae). The isolates of R. ornithinolytica were resistant to five types of antibiotics and sensitive to two types of antibiotics. Conclusion: This study reported the first case of R. ornithinolytica found in chicken products in Egypt. Phenotypic system API 20E and MALDI-TOF MS were found to be reliable tools for confirming the diagnosis of R. ornithinolytica. As it provides rapid identification with high sensitivity and specificity for R. ornithinolytica, which often do not require a molecular procedure for confirmation.
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Affiliation(s)
- Sara M El-Shannat
- Department of Microbiology, Animal Health Research Institute, Marsa Matruh, Egypt
| | - Ashraf A Abd El-Tawab
- Department of Bacteriology, Immunology, and Mycology, Faculty of Veterinary Medicine, Benha University, Banha, Egypt
| | - Wafaa M M Hassan
- The Reference Laboratory for Quality Control on Poultry Production, Animal Health Research Institute, Dokki, Giza, Egypt
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12
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Hajjar R, Ambaraghassi G, Sebajang H, Schwenter F, Su SH. Raoultella ornithinolytica: Emergence and Resistance. Infect Drug Resist 2020; 13:1091-1104. [PMID: 32346300 PMCID: PMC7167274 DOI: 10.2147/idr.s191387] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 12/13/2019] [Indexed: 11/23/2022] Open
Abstract
Raoultella ornithinolytica is an encapsulated Gram-negative, oxidase-negative, catalase-positive, aerobic, non-motile rod that belongs to the Enterobacteriaceae family. This bacterium was initially classified in the genus Klebsiella as Klebsiella ornithinolytica, until the creation of the genus Raoultella in 2001. R. ornithinolytica is usually found in water environments and soil, and due to its ability to convert histidine to histamine, it has been associated with histamine poisoning in humans. R. ornithinolytica is an emerging entity in human infections, with several reports of virulent infections in comorbid at-risk patients. Increasing reports are potentially due to better and more precise identification tools. The objective of this article is to provide a comprehensive review of reported cases of R. ornithinolytica infections, the emergent virulence of described multiresistant strains, and an overview of currently used identification methods.
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Affiliation(s)
- Roy Hajjar
- Digestive Surgery Service, Department of Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
| | - Georges Ambaraghassi
- Department of Medical Microbiology and Infectious Diseases, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
| | - Herawaty Sebajang
- Digestive Surgery Service, Department of Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
| | - Frank Schwenter
- Digestive Surgery Service, Department of Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
| | - Shih-Hann Su
- Department of Medical Microbiology and Infectious Diseases, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
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13
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Coexistence of the bla NDM-1-carrying plasmid pWLK-NDM and the bla KPC-2-carrying plasmid pWLK-KPC in a Raoultella ornithinolytica isolate. Sci Rep 2020; 10:2360. [PMID: 32047243 PMCID: PMC7012882 DOI: 10.1038/s41598-020-59341-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 01/23/2020] [Indexed: 01/13/2023] Open
Abstract
To date, blaNDM and blaKPC genes have been found predominantly in clinical settings around the world. In contrast, bacteria harbouring these two genes from natural environments are relatively less well studied compared to those found in clinical settings. In this study, a carbapenem-resistant Raoultella ornithinolytica strain, WLK218, was isolated from urban river sediment in Zhengzhou City, Henan Province, China. This isolate was subjected to PCR and antimicrobial susceptibility testing. PCR results showed that this isolate was positive for both the blaNDM-1 and blaKPC-2 genes. The antimicrobial susceptibility testing results showed that this isolate exhibited resistance or intermediate resistance to all the antibiotics tested except for streptomycin (susceptible) and cefepime (susceptible-dose dependent). The complete genome sequence of the WLK218 isolate was then determined by using a combination of the PacBio and Illumina sequencing technologies. The de novo assembly of the genome generated one chromosome and six plasmids. Among the six plasmids, the blaNDM-1 gene was carried on the IncX3 plasmid pWLK-NDM, while the blaKPC-2 gene was located on the untypeable plasmid pWLK-KPC. This is the first report of an environmental Raoultella ornithinolytica isolate co-harbouring the blaNDM-1 and blaKPC-2 genes.
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14
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Pi DD, Zhou F, Bai K, Liu C, Xu F, Li J. Raoultella ornithinolytica Infection in the Pediatric Population: A Retrospective Study. Front Pediatr 2020; 8:362. [PMID: 32754562 PMCID: PMC7366290 DOI: 10.3389/fped.2020.00362] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/29/2020] [Indexed: 11/17/2022] Open
Abstract
Raoultella ornithinolytica is a pathogen causing an increasing number of pediatric infections. The objective of this study was to investigate the clinical characteristics of R. ornithinolytica infections in children. As a retrospective analysis, clinical features and drug susceptibility data of the five cases were analyzed and related literature was reviewed. A total of 14 cases (eight females, six males) were analyzed: nine cases were retrieved from PubMed, Web of Science, and three domestic databases; five cases occurred in our hospital. The primary diseases of the older children were mainly of neoplastic and immune origin, while cases of infants and young children were mostly complicated by congenital malformation. Fever was the main symptom, and neonatal infection was mainly manifested by dyspnea and hypoxemia, with multiple skin flushes, systemic erythema, and leukocytosis. Of the 14 cases, six were ventilator-assisted, five had indwelling urethral catheters, three had surgical treatment or chemotherapy, and one had multiple rounds of continuous renal replacement therapy (CRRT). Blood infection is the main route of R. ornithinolytica infection in children. Skin flushing and systemic erythema might be positive clues for newborn infection. Patients with multiple congenital abnormalities are susceptible to infection. Tumors, immune deficiency, and invasive operations increase the risk of infection. Blood culture was the main method of disease identification. Based on the drug susceptibility results, the preferred antibiotics are third generations of cephalosporins, carbapenems, quinolone, and aminoglycoside. Lastly, patients with sepsis mostly have poor prognosis.
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Affiliation(s)
- Dan-Dan Pi
- Intensive Care Unit, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Fang Zhou
- Intensive Care Unit, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Ke Bai
- Intensive Care Unit, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Chengjun Liu
- Intensive Care Unit, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Feng Xu
- Intensive Care Unit, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Jing Li
- Intensive Care Unit, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
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15
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High-Level Carbapenem Resistance in OXA-232-Producing Raoultella ornithinolytica Triggered by Ertapenem Therapy. Antimicrob Agents Chemother 2019; 64:AAC.01335-19. [PMID: 31636064 DOI: 10.1128/aac.01335-19] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 10/14/2019] [Indexed: 11/20/2022] Open
Abstract
OXA-232 is an OXA-48-group class D β-lactamase that hydrolyzes expanded-spectrum cephalosporins and carbapenems at low levels. Clinical strains producing OXA-232 are sometimes susceptible to carbapenems, making it difficult to identify them in the clinical microbiology laboratory. We describe the development of carbapenem resistance in sequential clinical isolates of Raoultella ornithinolytica carrying bla OXA-232 in a hospitalized patient, where the ertapenem MIC increased from 0.5 μg/ml to 512 μg/ml and the meropenem MIC increased from 0.125 μg/ml to 32 μg/ml during the course of ertapenem therapy. Whole-genome sequencing (WGS) analysis identified loss-of-function mutations in ompC and ompF in carbapenem-resistant isolates that were not present in the initial carbapenem-susceptible isolate. Complementation of a carbapenem-resistant isolate with an intact ompF gene resulted in 16- to 32-fold reductions in carbapenem MICs, whereas complementation with intact ompC resulted in a 2-fold reduction in carbapenem MICs. Additionally, bla OXA-232 expression increased 2.9-fold in a carbapenem-resistant isolate. Rapid development of high-level carbapenem resistance in initially carbapenem-susceptible OXA-232-producing R. ornithinolytica under selective pressure from carbapenem therapy highlights the diagnostic challenges in detecting Enterobacteriaceae strains producing this inefficient carbapenemase.
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16
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Asif S, Abughanimeh OK, Husainat NM, Numan L. Maxillary Osteomyelitis with an Incidental Diagnosis of Maxillary Diffuse Large B-Cell Lymphoma: A Case Report. Cureus 2019; 11:e5238. [PMID: 31565636 PMCID: PMC6758960 DOI: 10.7759/cureus.5238] [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] [Indexed: 11/13/2022] Open
Abstract
Raoultella planticola osteomyelitis is rarely reported in the literature. The most likely source in our case is the oral microbiome secondary to the tooth extraction. Herein we present a case of Raoultella planticola osteomyelitis of the jaw that leads to the diagnosis of diffuse large B-cell lymphoma (DLBCL) of the jaw. A 75-year-old male with no significant medical history, presented to the emergency department with right upper jaw pain after he had a tooth extraction a week before his presentation. Computed tomography (CT) scan of the face showed concerns of right maxillary osteomyelitis with soft tissue swelling and prominent cervical lymph nodes. He underwent a bone biopsy of the maxilla and was started on intravenous ampicillin-sulbactam. His bone culture grew pan-sensitive Raoultella planticola. in addition to that, his bone biopsy revealed diffuse large B-cell lymphoma of the jaw. The patient underwent staging imaging, and he was found to have metastasis to the liver. He was started on chemotherapy and had a good response. In conclusion, Raoultella planticola osteomyelitis is extremely rare. The diagnosis of maxillary DLBCL can be a challenge. Fortunately, our patient had an infection at the same site that led to the diagnosis of DLBCL.
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Affiliation(s)
- Samia Asif
- Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, USA
| | | | - Nedaa M Husainat
- Kidney Institute, University of Kansas Hospital & Medical Center, Kansas City, USA
| | - Laith Numan
- Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, USA
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17
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de Alegría Puig CR, Torres MF, Marfil-Pérez E, Ferández MIR, Del Río MC, Balbín JA, Martínez-Martínez L. Comparison between Vitek MS, Bruker Biotyper, Vitek2, and API20E for differentiation of species of the genus Raoultella. Eur J Clin Microbiol Infect Dis 2019; 38:467-470. [PMID: 30684162 DOI: 10.1007/s10096-018-03444-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 11/29/2018] [Indexed: 10/27/2022]
Abstract
Rapid and reliable identification of microorganisms in the clinical laboratory is essential for an early and accurate diagnosis guiding timely therapy. However, conventional methods are sometimes unreliable and show controversial outcomes. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) has been reported as a rapid and reliable method for identification of bacteria and fungi isolated from clinical samples. Members of the genus Raoultella are increasingly recognized as clinically relevant. There are difficulties in their identification at the species level since sequencing the 16S rRNA or the rpoB genes does not show conclusive results. The aim of this study has been to compare two MALDI-TOF MS systems (Vitek MS and Bruker Biotyper) with Vitek2 and API20E systems for differentiation of Raoultella species. A collection of 97 clinical isolates of Raoultella species was identified with Vitek MS, in parallel with Vitek2 and API, and finally with Bruker Biotyper. Among the two most widely used MALDI-TOF MS platforms, results obtained with Vitek MS were slightly superior to those obtained with the Bruker Biotyper system, with sensitivities and specificities of 98.9/57.9% and 98.8/37.0%, respectively. The current commercial phenotypic identification systems are not optimized for the identification of Raoultella species. Our results indicate that MALDI-TOF-based identification is more accurate and sensitive than that provided by phenotypic methods.
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Affiliation(s)
| | | | - Eduardo Marfil-Pérez
- Clinical Unit, University Hospital Reina Sofía, Córdoba, Spain.,Maimónides Institute for Biomedical Research of Córdoba (IMIBIC), Córdoba, Spain
| | | | - Manuel Causse Del Río
- Clinical Unit, University Hospital Reina Sofía, Córdoba, Spain.,Maimónides Institute for Biomedical Research of Córdoba (IMIBIC), Córdoba, Spain
| | - Jesús Agüero Balbín
- Microbiology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.,Department of Molecular Biology, University of Cantabria, Santander, Spain
| | - Luis Martínez-Martínez
- Clinical Unit, University Hospital Reina Sofía, Córdoba, Spain.,Maimónides Institute for Biomedical Research of Córdoba (IMIBIC), Córdoba, Spain.,Department of Microbiology, University of Córdoba, Córdoba, Spain
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18
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Sekowska A, Mikucka A, Gospodarek-Komkowska E. Identification of Raoultella spp.: Comparison of three methods. Indian J Med Microbiol 2018; 36:197-200. [PMID: 30084410 DOI: 10.4103/ijmm.ijmm_17_99] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Raoultella is a Gram-negative bacteria, which commonly occur in the natural environment such as water, soil and on plants. In recent years, Raoultella spp. gained more interest. There is also an increasing number of publications describing mainly clinical cases involving these bacteria. Identification of Raoultella spp. is difficult due to a phylogenetic relationship with Klebsiella spp. Purpose Available biochemical tests do not always allow for their identification to species. Thus, the aim of this study was to evaluate selected methods of identification of Raoultella spp. and their differentiation from genus Klebsiella. Materials and Methods In this evaluation three methods were used such as manual test ID32E (bioMérieux), automatic test VITEK2 Compact (bioMérieux) and matrix-assisted laser desorption ionisation-time of flight mass spectrometry (MALDI-TOF MS) method (Bruker). Results Good identification of the species was obtained for 81.4% of the strains in the ID32E test, 93.3% in VITEK2 Compact test, and 97.4% in MALDI-TOF MS method, respectively. Conclusion It was established that MALDI-TOF MS method is reliable in identifying genus Raoultella.
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Affiliation(s)
- Alicja Sekowska
- Department of Microbiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Agnieszka Mikucka
- Department of Microbiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Eugenia Gospodarek-Komkowska
- Department of Microbiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
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19
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Genomic analysis of a Raoultella ornithinolytica strain causing prosthetic joint infection in an immunocompetent patient. Sci Rep 2018; 8:9462. [PMID: 29930334 PMCID: PMC6013458 DOI: 10.1038/s41598-018-27833-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 05/25/2018] [Indexed: 11/08/2022] Open
Abstract
We sequenced the genome of Raoultella ornithinolytica strain Marseille-P1025 that caused a rare case of prosthetic joint infection in a 67-year-old immunocompetent male. The 6.7-Mb genome exhibited a genomic island (RoGI) that was unique among R. ornithinolytica strains. RoGI was likely acquired by lateral gene transfer from a member of the Pectobacterium genus and coded for a type IVa secretion system found in other pathogenic bacteria and that may have conferred strain Marseille-P1025 an increased virulence. Strain Marseille-P1025 was also able to infect, multiply within, and kill Acanthamoaeba castellanii amoebae.
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20
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Ayoade F, Mada PK, Alam M. Fat necrosis and polymicrobial wound infection caused partly by Raoultella ornithinolytica after reduction mammoplasty. BMJ Case Rep 2018; 2018:bcr-2018-224234. [PMID: 29866679 DOI: 10.1136/bcr-2018-224234] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Raoultella ornithinolytica is a rare opportunistic aerobic gram-negative bacillus that naturally exists in soil, water and plants. The pathogen has been described in association with diabetic foot infections, biliary infections, bacteraemia and native and prosthetic joint infections. Fat necrosis and wound infection following breast reduction surgery or other plastic surgeries caused by this pathogen have not been previously described. We present a case of bilateral fat necrosis, wound infection and dehiscence in a 24-year-old woman with no significant past medical problems. She initially had an uneventful early postoperative course but 3 weeks after surgery noticed pain and discharge from both nipple/areola area of both breasts which later developed into full-thickness fat necrosis and complete destruction of the nipple areolar complex. R. ornithinolytica, Escherichia coli and Enterococcus faecalis were identified from wound exudate cultures. She was treated with surgical debridement and 2 weeks of appropriate antibiotics with a favourable outcome.
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Affiliation(s)
- Folusakin Ayoade
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Pradeep Kumar Mada
- Division of Infectious Diseases, Department of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
| | - Mohammad Alam
- Division of Infectious Diseases, Department of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
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21
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Susceptibility testing and detection of β-lactam resistance mechanisms in Enterobacteriaceae: a multicentre national proficiency study. Int J Antimicrob Agents 2018; 51:612-619. [DOI: 10.1016/j.ijantimicag.2017.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 12/13/2017] [Accepted: 12/16/2017] [Indexed: 11/23/2022]
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22
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Marietto-Gonçalves GA, Lima EL, Nagayoshi BA, Tonin AA, Knöbl T, Adreatti Filho RL. Raoultella ornithinolytica Isolation in Cloacal Microbiota of Tinamus solitarius: Preliminary Data. BRAZILIAN JOURNAL OF POULTRY SCIENCE 2018. [DOI: 10.1590/1806-9061-2017-0599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
| | | | | | - AA Tonin
- Instituto Federal de Ciências e Tecnologia do Amazonas, Brazil
| | - T Knöbl
- Universidade de São Paulo, Brazil
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23
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Abbas A, Ahmad I. First report of neonatal early-onset sepsis caused by multi-drug-resistant Raoultella ornithinolytica. Infection 2017; 46:275-277. [PMID: 29103080 DOI: 10.1007/s15010-017-1098-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 11/02/2017] [Indexed: 11/28/2022]
Abstract
Raoultella ornithinolytica is increasingly being isolated as a causative organism in human infections. Most of the infections caused by R. ornithinolytica are hospital acquired and occur in patients who are immunocompromised, had invasive procedures or have indwelling catheters. This is a first report of early onset neonatal sepsis caused by multi-drug-resistant R. ornithinolytica. The infection was not very severe and was characterised by generalized flushing of the skin. Patient made complete recovery once appropriate antibiotics were started.
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Affiliation(s)
- Asad Abbas
- District Early Intervention Centre, Jawaharlal Nehru Medical College, AMU, Aligarh, India.
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24
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Mahabeer Y, Singh-Moodley A, Mackanjee H, Perovic O, Mlisana KP. First report of neonatal bacteraemia caused by blaNDM-1Raoultella ornithinolytica. S Afr J Infect Dis 2017. [DOI: 10.1080/23120053.2016.1210939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Yesholata Mahabeer
- Department of Medical Microbiology, National Health Laboratory Services, Durban, South Africa
- School of Laboratory Medicine and Medical Sciences, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Ashika Singh-Moodley
- Centre for Opportunistic, Tropical and Hospital Infections, National Institute for Communicable Diseases, Johannesburg, South Africa
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Harshavadan Mackanjee
- Department of Paediatrics, Inkosi Albert Luthuli Central Hospital, Durban, South Africa
| | - Olga Perovic
- Centre for Opportunistic, Tropical and Hospital Infections, National Institute for Communicable Diseases, Johannesburg, South Africa
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Koleka P Mlisana
- Department of Medical Microbiology, National Health Laboratory Services, Durban, South Africa
- School of Laboratory Medicine and Medical Sciences, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
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25
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Seng P, Theron F, Honnorat E, Prost D, Fournier PE, Stein A. Raoultella ornithinolytica: An unusual pathogen for prosthetic joint infection. IDCases 2016; 5:46-8. [PMID: 27500082 PMCID: PMC4969086 DOI: 10.1016/j.idcr.2016.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 07/08/2016] [Accepted: 07/08/2016] [Indexed: 11/23/2022] Open
Abstract
We herein report the first case of a prosthetic joint infection caused by Raoultella ornithinolytica in an immunocompetent patient. The clinical outcome was favorable after a two-stage prosthetic exchange and a six-month course of antimicrobial therapy.
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Affiliation(s)
- Piseth Seng
- Centre de Référence des Infections Ostéo-Articulaires (CRIOA) Interrégional Sud-Méditerranée, Hôpital de la Conception, 147, boulevard Baille, Marseille, France
- Service des Maladies Infectieuses, Hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France
- Aix-Marseille Université, URMITE, UM 63, CNRS 7278-IRD 198, INSERM 1095, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille, France
| | - Françoise Theron
- Hôpital privé Résidence du Parc, 16 rue Gaston Berger, 13887 Marseille Cedex 10, France
| | - Estelle Honnorat
- Centre de Référence des Infections Ostéo-Articulaires (CRIOA) Interrégional Sud-Méditerranée, Hôpital de la Conception, 147, boulevard Baille, Marseille, France
- Service des Maladies Infectieuses, Hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France
| | - Didier Prost
- Hôpital privé Résidence du Parc, 16 rue Gaston Berger, 13887 Marseille Cedex 10, France
| | - Pierre-Edouard Fournier
- Centre de Référence des Infections Ostéo-Articulaires (CRIOA) Interrégional Sud-Méditerranée, Hôpital de la Conception, 147, boulevard Baille, Marseille, France
- Aix-Marseille Université, URMITE, UM 63, CNRS 7278-IRD 198, INSERM 1095, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille, France
| | - Andreas Stein
- Centre de Référence des Infections Ostéo-Articulaires (CRIOA) Interrégional Sud-Méditerranée, Hôpital de la Conception, 147, boulevard Baille, Marseille, France
- Service des Maladies Infectieuses, Hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France
- Aix-Marseille Université, URMITE, UM 63, CNRS 7278-IRD 198, INSERM 1095, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille, France
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Demiray T, Koroglu M, Ozbek A, Altindis M. A rare cause of infection, Raoultella planticola: emerging threat and new reservoir for carbapenem resistance. Infection 2016; 44:713-717. [PMID: 27147419 DOI: 10.1007/s15010-016-0900-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 04/20/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Severe cases of infections caused by Raoultella planticola are constantly being reported from all over the world with the increase in drug-resistance patterns. In this study, we retrospectively evaluated the clinical characteristics of R. planticola infections with patients' demographics and antimicrobial susceptibilities of the R. planticola isolates. METHODS R. planticola isolates were retrospectively evaluated. VITEK 2® automated system was used for identification and antimicrobial susceptibility testing. Verification of the low-discriminated isolates was analyzed with MALDI-TOF method using VITEK MS® system. Gene-Xpert® system was used for detection of bla IMP-1-, bla KPC-, bla NDM-1-, bla OXA-48- and bla VIM-type carbapenemases. The data of the patients with R. planticola infection were collected from hospital records. RESULT During the 4-year period, 42 episodes of R. planticola infections were detected. MALDI-TOF was used for 11 of the low-discriminated isolates, and 1 of which identified as R. terrigena was excluded. Carbapenems and aminoglycosides were the most effective antimicrobial agents. Extended spectrum beta-lactamases were detected in seven of the isolates. Three carbapenem-resistant isolates were detected as bla OXA-48-type carbapenemase carrier. Nosocomial R. planticola infections constituted 80.9 % (n = 34) of the infections. Most common infections related with R. planticola were blood stream infections (n = 24) (p < 0.005). The presence of indwelling catheter and intensive care unit stay were the most common detected risk factors (p < 0.005). Diabetes mellitus and chronic renal insufficiency commonly accompanied the infections (p > 0.005). CONCLUSIONS Challenging infections caused by Raoultella spp., like those of multidrug resistant Klebsiella spp., will probably become a concern for clinicians as well as microbiologists . In literature, there were few cases, but we believe that the incidence of Raoultella spp. infections, which may result from misidentification, are more common than expected , and it is not unlikely that there will be a gradual increase and spread in multidrug-resistant isolates.
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Affiliation(s)
- Tayfur Demiray
- Sakarya University Education and Research Hospital, Clinical Microbiology Laboratory, Sakarya, Turkey
| | - Mehmet Koroglu
- Department of Medical Microbiology, Sakarya University Faculty of Medicine, Sakarya, Turkey.
| | - Ahmet Ozbek
- Department of Medical Microbiology, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Mustafa Altindis
- Department of Medical Microbiology, Sakarya University Faculty of Medicine, Sakarya, Turkey
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Seng P, Boushab BM, Romain F, Gouriet F, Bruder N, Martin C, Paganelli F, Bernit E, Le Treut YP, Thomas P, Papazian L, Raoult D, Stein A. Emerging role of Raoultella ornithinolytica in human infections: a series of cases and review of the literature. Int J Infect Dis 2016; 45:65-71. [PMID: 26921549 DOI: 10.1016/j.ijid.2016.02.014] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 02/16/2016] [Accepted: 02/18/2016] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Raoultella ornithinolytica is known to inhabit aquatic environments. The clinical features and outcomes of human infections caused by R. ornithinolytica have been reported for only a limited number of cases. METHODS A retrospective study of cases of infection caused by R. ornithinolytica managed at four university hospital centres during the period before and after the introduction of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was performed. The aim was to describe the clinical and microbiological characteristics, treatments, and outcomes. RESULTS Among 187 R. ornithinolytica isolates identified for which clinical information was available, 71 were considered colonizers and 116 were pathogenic. A total of 112 cases of R. ornithinolytica infection were identified. Urinary tract infections, gastrointestinal infections, wound and skin infections, and bacteraemia were observed in 36%, 14%, 13%, and 5% of cases, respectively. Associated infections that have been poorly reported, such as respiratory infections, i.e. pneumonia and pleural effusion, were observed in 24% of cases. Additional diseases reported here for the first time included osteomyelitis, meningitis, cerebral abscess, mediastinitis, pericarditis, conjunctivitis, and otitis. The proportion of R. ornithinolytica isolates resistant to antibiotics was found to be relatively high: 4% of isolates were resistant to ceftriaxone, 6% to quinolones, and 13% to co-trimoxazole. The mortality rate related to infection was 5%. CONCLUSIONS R. ornithinolytica is an underreported, emerging hospital-acquired infection and is particularly associated with invasive procedures. R. ornithinolytica should never be considered simply a saprophytic bacterium that occasionally contaminates bronchial lavage or other deep respiratory samples or surgical sites. Physicians should be aware of the high rates of antimicrobial resistance of R. ornithinolytica isolates so that immediate broad-spectrum antibiotic treatment can be established before accurate microbiological results are obtained.
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Affiliation(s)
- Piseth Seng
- Centre de Référence des Infections Ostéo-Articulaires (CRIOAC) Interrégional Sud Méditerranée, Service des Maladies Infectieuses, Hôpital de la Conception, 147 boulevard Baille, 13005 Marseille, France; Aix-Marseille Université, Faculté de Médecine, Marseille, France.
| | - Boushab Mohamed Boushab
- Centre de Référence des Infections Ostéo-Articulaires (CRIOAC) Interrégional Sud Méditerranée, Service des Maladies Infectieuses, Hôpital de la Conception, 147 boulevard Baille, 13005 Marseille, France
| | - Fanny Romain
- Service d'Informatique Médicale, Hôpital de la Conception, Marseille, France
| | | | - Nicolas Bruder
- Département d'Anesthésie-réanimation et Soins Intensif, Hôpital de la Timone, Marseille, France
| | - Claude Martin
- Service d'Anesthésie et de Réanimation, Hôpital Nord, Marseille, France
| | | | - Emmanuelle Bernit
- Département de Médecine Interne, Hôpital de la Conception, Marseille, France
| | - Yves Patrice Le Treut
- Département de Chirurgie Digestive et Transplantation Hépatique, Hôpital de la Conception, Marseille, France
| | - Pascal Thomas
- Département de Chirurgie Thoracique, Transplantation Pulmonaire et Maladies Respiratoires, Hôpital Nord, Marseille, France
| | - Laurent Papazian
- Réanimation Médicale Détresses Respiratoires - Infections Sévères, Hôpital Nord, Marseille, France
| | - Didier Raoult
- Aix-Marseille Université, Faculté de Médecine, Marseille, France
| | - Andreas Stein
- Centre de Référence des Infections Ostéo-Articulaires (CRIOAC) Interrégional Sud Méditerranée, Service des Maladies Infectieuses, Hôpital de la Conception, 147 boulevard Baille, 13005 Marseille, France; Aix-Marseille Université, Faculté de Médecine, Marseille, France
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Evaluation of the FilmArray Blood Culture Identification Panel: Results of a Multicenter Controlled Trial. J Clin Microbiol 2016; 54:687-98. [PMID: 26739158 PMCID: PMC4767991 DOI: 10.1128/jcm.01679-15] [Citation(s) in RCA: 160] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 12/28/2015] [Indexed: 12/16/2022] Open
Abstract
Sepsis is a major cause of morbidity, mortality, and increased medical expense. Rapid diagnosis improves outcomes and reduces costs. The FilmArray blood culture identification panel (BioFire Diagnostics LLC, Salt Lake City, UT), a highly multiplexed PCR assay, can identify 24 etiologic agents of sepsis (8 Gram-positive, 11 Gram-negative, and 5 yeast species) and three antimicrobial resistance genes (mecA, vanA/B, and blaKPC) from positive blood culture bottles. It provides results in about 1 h with 2 min for assay setup. We present the results of an eight-center trial comparing the sensitivity and specificity of the panel with those of the laboratories' standard phenotypic identification techniques, as well as with molecular methods used to distinguish Acinetobacter baumannii from other members of the A. calcoaceticus-A. baumannii complex and to detect antimicrobial resistance genes. Testing included 2,207 positive aerobic blood culture samples, 1,568 clinical and 639 seeded. Samples were tested fresh or were frozen for later testing within 8 h after the bottles were flagged as positive by an automated blood culture system. At least one organism was detected by the panel in 1,382 (88.1%) of the positive clinical specimens. The others contained primarily off-panel organisms. The panel reported multiple organisms in 81 (5.86%) positive clinical specimens. The unresolved blood culture identification sensitivity for all target detections exceeded 96%, except for Klebsiella oxytoca (92.2%), which achieved 98.3% sensitivity after resolution of an unavoidable phenotypic error. The sensitivity and specificity for vanA/B and blaKPC were 100%; those for mecA were 98.4 and 98.3%, respectively.
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Ponce-Alonso M, Rodríguez-Rojas L, Del Campo R, Cantón R, Morosini MI. Comparison of different methods for identification of species of the genus Raoultella: report of 11 cases of Raoultella causing bacteraemia and literature review. Clin Microbiol Infect 2015; 22:252-7. [PMID: 26577139 DOI: 10.1016/j.cmi.2015.10.035] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 10/15/2015] [Accepted: 10/29/2015] [Indexed: 11/27/2022]
Abstract
The genus Raoultella was excised from Klebsiella in 2001, but difficulties in its identification may have led to an underestimation of its incidence and uncertainty on its pathogenic role. Recently, clinical reports involving Raoultella have increased, probably through the introduction of mass-spectrometry in clinical microbiology laboratories and the development of accurate molecular techniques. We performed a retrospective analysis using our blood culture collection (2011-14) to identify Raoultella isolates that could have been erroneously reported as Klebsiella. PCR and gene sequencing of highly specific chromosomal class A β-lactamase genes was established as the reference method, and compared with 16S rRNA and rpoβ sequencing, as well as matrix-assisted laser desorption/ionization time-of-flight mass spectroscopy (MALDI-TOF MS), MicroScan Walkaway system and API20E biochemical identification. MALDI-TOF and rpoβ correctly identified all Raoultella isolates, whereas 16S rRNA provided inconclusive results, and MicroScan and API20E failed to detect this genus. The analysis of the clinical characteristics of all Raoultella bacteraemia cases reported in the literature supports the role of Raoultella as an opportunistic pathogen that causes biliary tract infections in elderly patients who suffer from some kind of malignancy or have undergone an invasive procedure. Two salient conclusions are that Raoultella shows tropism for the biliary tract and so its identification could help clinicians to suspect underlying biliary tract disease when bacteraemia occurs. Concomitantly, as most phenotypic identification systems are not optimized for the identification of Raoultella, the use of MALDI-TOF or additional phenotypic tests is recommended for the reliable identification of this genus.
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Affiliation(s)
- M Ponce-Alonso
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - L Rodríguez-Rojas
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - R Del Campo
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - R Cantón
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - M-I Morosini
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.
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30
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Srinivasan R, Karaoz U, Volegova M, MacKichan J, Kato-Maeda M, Miller S, Nadarajan R, Brodie EL, Lynch SV. Use of 16S rRNA gene for identification of a broad range of clinically relevant bacterial pathogens. PLoS One 2015; 10:e0117617. [PMID: 25658760 PMCID: PMC4319838 DOI: 10.1371/journal.pone.0117617] [Citation(s) in RCA: 211] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 12/29/2014] [Indexed: 01/06/2023] Open
Abstract
According to World Health Organization statistics of 2011, infectious diseases remain in the top five causes of mortality worldwide. However, despite sophisticated research tools for microbial detection, rapid and accurate molecular diagnostics for identification of infection in humans have not been extensively adopted. Time-consuming culture-based methods remain to the forefront of clinical microbial detection. The 16S rRNA gene, a molecular marker for identification of bacterial species, is ubiquitous to members of this domain and, thanks to ever-expanding databases of sequence information, a useful tool for bacterial identification. In this study, we assembled an extensive repository of clinical isolates (n = 617), representing 30 medically important pathogenic species and originally identified using traditional culture-based or non-16S molecular methods. This strain repository was used to systematically evaluate the ability of 16S rRNA for species level identification. To enable the most accurate species level classification based on the paucity of sequence data accumulated in public databases, we built a Naïve Bayes classifier representing a diverse set of high-quality sequences from medically important bacterial organisms. We show that for species identification, a model-based approach is superior to an alignment based method. Overall, between 16S gene based and clinical identities, our study shows a genus-level concordance rate of 96% and a species-level concordance rate of 87.5%. We point to multiple cases of probable clinical misidentification with traditional culture based identification across a wide range of gram-negative rods and gram-positive cocci as well as common gram-negative cocci.
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Affiliation(s)
- Ramya Srinivasan
- University of California San Francisco, Department of Medicine, Gastroenterology Division, 513 Parnassus Ave, San Francisco, CA 94143–0538, United States of America
| | - Ulas Karaoz
- Lawrence Berkeley National Laboratory, Earth Sciences Division, 1 Cyclotron Rd., MS70A-3317, Berkeley, CA 94720, United States of America
| | - Marina Volegova
- University of California, Berkeley, CA 94720, United States of America
| | - Joanna MacKichan
- School of Biological Sciences, Victoria University of Wellington, 34 Kenepuru Drive, Porirua, Wellington, New Zealand
| | - Midori Kato-Maeda
- San Francisco General Hospital, Department of Medicine, Bldg 100, San Francisco, CA 94110, United States of America
| | - Steve Miller
- University of California San Francisco, Clinical Microbiology Laboratory, 185 Berry Street, Suite 290, San Francisco, CA 94107, United States of America
| | - Rohan Nadarajan
- University of California San Francisco, Clinical Microbiology Laboratory, 185 Berry Street, Suite 290, San Francisco, CA 94107, United States of America
| | - Eoin L. Brodie
- Lawrence Berkeley National Laboratory, Earth Sciences Division, 1 Cyclotron Rd., MS70A-3317, Berkeley, CA 94720, United States of America
| | - Susan V. Lynch
- University of California San Francisco, Department of Medicine, Gastroenterology Division, 513 Parnassus Ave, San Francisco, CA 94143–0538, United States of America
- * E-mail:
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31
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Chun S, Yun JW, Huh HJ, Lee NY. Clinical characteristics of Raoultella ornithinolytica bacteremia. Infection 2014; 43:59-64. [PMID: 25367410 DOI: 10.1007/s15010-014-0696-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 10/20/2014] [Indexed: 01/04/2023]
Abstract
PURPOSE Raoultella ornithinolytica is not well known as a clinical pathogen. We performed a retrospective review of R. ornithinolytica bacteremia to investigate its clinical features, antimicrobial susceptibility, and overall patient outcomes. METHODS R. ornithinolytica bacteremia cases were collected from an electronic database of all cases of bacteremia over a 10-year period. Medical records were retrospectively reviewed. Demographic data, clinical information, the presence of underlying comorbidities, the results of antimicrobial susceptibility testing, and the antimicrobial regimen administered were investigated. RESULTS R. ornithinolytica was isolated from blood culture specimens in 16 cases. The majority of these patients had an underlying malignant condition of advanced stage (15 patients, 94 %). Seven of these patients had a solid tumor with lesions or metastases that extended to the bile duct or biliary tract. Neutropenic fever following hematologic stem cell transplantation was found in three cases. No resistance to piperacillin/tazobactam or imipenem was found. Four cases showed resistance to cefoxitin, while one of these cases showed resistance to multiple cephalosporins. In overall outcomes, seven patients (44 %) did not recover from the infection and subsequently expired. CONCLUSIONS R. ornithinolytica bacteremia occurs mainly in patients with underlying malignancies. The overall outcome was not favorable, despite favorable antimicrobial susceptibility test results. The findings of this study contradict those of other studies that demonstrated that infection from Raoultella species have good prognoses.
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Affiliation(s)
- S Chun
- Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Gu, Seoul, 135-710, Korea
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Haruki Y, Hagiya H, Sakuma A, Murase T, Sugiyama T, Kondo S. Clinical characteristics of Raoultella ornithinolytica bacteremia: a case series and literature review. J Infect Chemother 2014; 20:589-91. [PMID: 25012469 DOI: 10.1016/j.jiac.2014.05.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 05/19/2014] [Accepted: 05/26/2014] [Indexed: 10/25/2022]
Abstract
Raoultella ornithinolytica is a rare pathogen in human infection and bacteremic cases had been scarcely reported. For further comprehension of the rare infection, we summarized clinical characteristics of 6 cases that were detected at our medical facility and 5 cases from previous literature. The most common infectious focus was biliary infection and elderly patients with a history of any biliary intervention or malignancy were considered to be at a great risk for the infection. The prognosis of the patients was quite satisfactory. Bacterial identification in this report was performed on the basis of biochemical tests alone, and further investigations by molecular analysis are required to confirm our findings.
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Affiliation(s)
- Yuto Haruki
- Department of Pharmacy, Tsuyama Chuo Hospital, 1756, Kawasaki, Tsuyama, Okayama 708-0841, Japan.
| | - Hideharu Hagiya
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Akiko Sakuma
- Department of Pharmacy, Tsuyama Chuo Hospital, 1756, Kawasaki, Tsuyama, Okayama 708-0841, Japan
| | - Tomoko Murase
- Department of Clinical Laboratory, Microbiology Division, Tsuyama Chuo Hospital, Okayama, Japan
| | - Tetsuhiro Sugiyama
- Department of Pharmacy, Tsuyama Chuo Hospital, 1756, Kawasaki, Tsuyama, Okayama 708-0841, Japan
| | - Sachiyo Kondo
- Department of Pharmacy, Tsuyama Chuo Hospital, 1756, Kawasaki, Tsuyama, Okayama 708-0841, Japan
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Muñoz C, Hidalgo C, Zapata M, Jeison D, Riquelme C, Rivas M. Use of cellulolytic marine bacteria for enzymatic pretreatment in microalgal biogas production. Appl Environ Microbiol 2014; 80:4199-206. [PMID: 24795376 PMCID: PMC4068657 DOI: 10.1128/aem.00827-14] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 04/27/2014] [Indexed: 11/20/2022] Open
Abstract
In this study, we designed and evaluated a microalgal pretreatment method using cellulolytic bacteria that naturally degrades microalgae in their native habitat. Bacterial strains were isolated from each of two mollusk species in a medium containing 1% carboxymethyl cellulose agar. We selected nine bacterial strains that had endoglucanase activity: five strains from Mytilus chilensis, a Chilean mussel, and four strains from Mesodesma donacium, a clam found in the Southern Pacific. These strains were identified phylogenetically as belonging to the genera Aeromonas, Pseudomonas, Chryseobacterium, and Raoultella. The cellulase-producing capacities of these strains were characterized, and the degradation of cell walls in Botryococcus braunii and Nannochloropsis gaditana was tested with "whole-cell" cellulolytic experiments. Aeromonas bivalvium MA2, Raoultella ornithinolytica MA5, and Aeromonas salmonicida MC25 degraded B. braunii, and R. ornithinolytica MC3 and MA5 degraded N. gaditana. In addition, N. gaditana was pretreated with R. ornithinolytica strains MC3 and MA5 and was then subjected to an anaerobic digestion process, which increased the yield of methane by 140.32% and 158.68%, respectively, over that from nonpretreated microalgae. Therefore, a "whole-cell" cellulolytic pretreatment can increase the performance and efficiency of biogas production.
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Affiliation(s)
- Camilo Muñoz
- Laboratorio de Ecología Microbiana, Centro de Bioinnovación, Universidad de Antofagasta, Antofagasta, Chile
| | - Catalina Hidalgo
- Laboratorio de Ecología Microbiana, Centro de Bioinnovación, Universidad de Antofagasta, Antofagasta, Chile
| | - Manuel Zapata
- Centro de Investigación Científico Tecnológico para la Minería (CICITEM), Antofagasta, Chile Laboratorio de Ecología Microbiana, Centro de Bioinnovación, Universidad de Antofagasta, Antofagasta, Chile
| | - David Jeison
- Chemical Engineering Department and Scientific and Technological Bioresource Nucleus, University of La Frontera, Temuco, Chile
| | - Carlos Riquelme
- Laboratorio de Ecología Microbiana, Centro de Bioinnovación, Universidad de Antofagasta, Antofagasta, Chile
| | - Mariella Rivas
- Centro de Investigación Científico Tecnológico para la Minería (CICITEM), Antofagasta, Chile Laboratorio de Ecología Microbiana, Centro de Bioinnovación, Universidad de Antofagasta, Antofagasta, Chile
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Koukoulaki M, Bakalis A, Kalatzis V, Belesiotou E, Papastamopoulos V, Skoutelis A, Drakopoulos S. Acute prostatitis caused by Raoultella planticola in a renal transplant recipient: a novel case. Transpl Infect Dis 2014; 16:461-4. [PMID: 24750300 DOI: 10.1111/tid.12213] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 12/14/2013] [Indexed: 11/30/2022]
Abstract
We present a unique case of acute bacterial prostatitis caused by a very rare human pathogen, Raoultella planticola, in a renal allograft recipient 3.5 months post transplantation. Only a few cases of human infection by this pathogen have been reported worldwide. The present study reports the case of a 67-year-old man who was admitted to our transplant unit 3.5 months post transplantation with fever, dysuria, suprapubic pain, symptoms and signs of acute prostatitis, and elevated markers of inflammation and prostate-specific antigen. R. planticola was isolated in the urine culture. The patient was treated with ciprofloxacin (based on the antibiogram) and had a full recovery, with satisfactory renal function. To the best of our knowledge, this is not only the first reported case of R. planticola prostatitis, but also the first report of such an infection in a solid organ transplant recipient or in a patient on immunosuppressive medication.
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Affiliation(s)
- M Koukoulaki
- First Department of Surgery and Transplant Unit, Evangelismos General Hospital, Athens, Greece
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35
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de Jong E, Erkens-Hulshof S, van der Velden LBJ, Voss A, Bosboom R, Hodiamont CJ, Wever PC, Rentenaar RJ, Sturm PD. Predominant association of Raoultella bacteremia with diseases of the biliary tract. ACTA ACUST UNITED AC 2013; 46:141-3. [PMID: 24325334 DOI: 10.3109/00365548.2013.857044] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A case series of 14 patients with Raoultella bacteremia was compared with 28 Klebsiella oxytoca and 28 Klebsiella pneumoniae bacteremia cases. Forty-three percent of Raoultella bacteremia cases were associated with biliary tract disease, compared to 32% and 22% of patients with K. oxytoca and K. pneumoniae bacteremia, respectively.
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Affiliation(s)
- Eefje de Jong
- From the Department of Medical Microbiology, Radboud University Nijmegen Medical Center , Nijmegen
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García-Lozano T, Pascual Plá FJ, Aznar Oroval E. [Raoultella ornithinolytica in urinary tract infections. Clinical and microbiological study of a series of 4 oncologic patients]. Med Clin (Barc) 2013; 141:138-9. [PMID: 23332629 DOI: 10.1016/j.medcli.2012.11.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 10/30/2012] [Accepted: 11/08/2012] [Indexed: 10/27/2022]
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A novel case of Raoultella planticola urinary tract infection. Infection 2012; 41:259-61. [PMID: 22802099 DOI: 10.1007/s15010-012-0294-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 06/27/2012] [Indexed: 10/28/2022]
Abstract
Raoultella species are Gram-negative, non-motile bacilli primarily considered to be environmental bacteria (Bagley et al.; Curr Microbiol 6:105-109, 1981). R. planticola has rarely been documented as a cause of human infections and has never been reported to cause urinary tract infections. We report the first case of R. planticola cystitis.
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