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Zhang W, Ma C, Hu L, Wang L, Xu F. Late-onset sepsis in newborns caused by Bacillus Cereus: a case report and literature review. Ann Clin Microbiol Antimicrob 2024; 23:66. [PMID: 39061043 PMCID: PMC11282708 DOI: 10.1186/s12941-024-00712-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 06/02/2024] [Indexed: 07/28/2024] Open
Abstract
Bacillus cereus is a bacterium capable of causing late-onset neonatal sepsis. By analyzing 11 cases, this study investigates the diagnosis, treatment, and prognosis of Bacillus cereus infections, aiming to provide insights into clinical diagnosis and therapy. The study scrutinized 11 instances of late-onset neonatal sepsis, including two fatalities attributable to Bacillus cereus, one accompanied by cerebral hemorrhage. An examination and analysis of these cases' symptoms, signs, laboratory tests, and treatment processes, along with a review of related literature from 2010 to 2020, revealed a high mortality rate of 41.38% in non-gastrointestinal infections caused by Bacillus cereus. Our findings underscore the critical importance of rapid diagnosis and effective antimicrobial therapy in reducing mortality rates. Once the source of infection is identified, implementing effective infection control measures is essential.
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Affiliation(s)
- Wang Zhang
- The Third Affiliated Hospital of Zhengzhou University, No. 7, Kangfuqian Street, Erqi District, Zhengzhou, Henan, 450052, China
| | - Caihua Ma
- The Third Affiliated Hospital of Zhengzhou University, No. 7, Kangfuqian Street, Erqi District, Zhengzhou, Henan, 450052, China
| | - Linghui Hu
- The Third Affiliated Hospital of Zhengzhou University, No. 7, Kangfuqian Street, Erqi District, Zhengzhou, Henan, 450052, China
| | - Ling Wang
- The Third Affiliated Hospital of Zhengzhou University, No. 7, Kangfuqian Street, Erqi District, Zhengzhou, Henan, 450052, China
| | - Falin Xu
- The Third Affiliated Hospital of Zhengzhou University, No. 7, Kangfuqian Street, Erqi District, Zhengzhou, Henan, 450052, China.
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2
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Bacillus cereus Invasive Infections in Preterm Neonates: an Up-to-Date Review of the Literature. Clin Microbiol Rev 2022; 35:e0008821. [PMID: 35138121 PMCID: PMC8826972 DOI: 10.1128/cmr.00088-21] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Bacillus cereus group species are widespread, Gram-positive, spore-forming environmental bacteria. B. cereus sensu stricto is one of the major causes of food poisoning worldwide. In high-risk individuals, such as preterm neonates, B. cereus infections can cause fatal infections. It is important to note that the phenotypic identification methods commonly used in clinical microbiology laboratories make no distinction between B. cereus sensu stricto and the other members of the group (Bacillus anthracis excluded). As a result, all the invasive infections attributed to B. cereus are not necessarily due to B. cereus sensu stricto but likely to other closely related species of the B. cereus group. Next-generation sequencing (NGS) should be used to characterize the whole genome of the strains belonging to the B. cereus group. This could confirm whether the strains involved in previously reported B. cereus invasive infections preferentially belong to formerly known or emerging individual species. Moreover, infections related to B. cereus group species have probably been overlooked, since their isolation in human bacteriological samples has for a long time been regarded as an environmental contaminant of the cultures. Recent studies have questioned the emergence or reemergence of B. cereus invasive infections in preterm infants. This review reports our current understanding of B. cereus infections in neonates, including taxonomical updates, microbiological characteristics, bacterial identification, clinical features, host-pathogen interactions, environmental sources of contamination, and antimicrobial resistance.
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Lampropoulos PK, Gkentzi D, Tzifas S, Dimitriou G. Neonatal Sepsis Due to Bacillus subtilis. Cureus 2021; 13:e17692. [PMID: 34650866 PMCID: PMC8487653 DOI: 10.7759/cureus.17692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2021] [Indexed: 11/05/2022] Open
Abstract
Bacillus subtilis is a gram-positive bacillus, commonly found in the environment (also as an endospore) and in the human gut (in a carrier-state), being considered as a bacterium of minimal virulence. We present a rare case of late-onset neonatal sepsis with multiple positive blood cultures and isolation of B. subtilis as the causative pathogen.
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Affiliation(s)
| | - Despoina Gkentzi
- Pediatrics/Infectious Diseases, University Hospital Patras, Patras, GRC
| | | | - Gabriel Dimitriou
- Pediatrics and Neonatology, University Hospital Patras, Patras Medical School, Patras, GRC
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4
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Butcher M, Puiu D, Romagnoli M, Carroll KC, Salzberg SL, Nauen DW. Rapidly fatal infection with Bacillus cereus/thuringiensis: genome assembly of the responsible pathogen and consideration of possibly contributing toxins. Diagn Microbiol Infect Dis 2021; 101:115534. [PMID: 34601446 PMCID: PMC9716716 DOI: 10.1016/j.diagmicrobio.2021.115534] [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: 05/06/2021] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 10/20/2022]
Abstract
Bloodstream infection with Bacillus cereus/thuringiensis can be life threatening, particularly in patients who are severely immunocompromised. In this report we describe a case that progressed from asymptomatic to fatal over approximately 5 hours despite extensive resuscitation efforts. We identify the pathogen and assemble its genome, in which we find genes for toxins that may have contributed to the precipitous demise. In the context of this and other cases we discuss the possible indication for rapid appropriate antibiotic administration and potentially antitoxin treatment or toxin removal in fulminant illness in immunocompromised patients.
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Affiliation(s)
- Monica Butcher
- Department of Pathology and Center for Computational Biology, Johns Hopkins University, Baltimore, MD, USA
| | - Daniela Puiu
- Department of Pathology and Center for Computational Biology, Johns Hopkins University, Baltimore, MD, USA
| | - Mark Romagnoli
- Department of Pathology and Center for Computational Biology, Johns Hopkins University, Baltimore, MD, USA
| | - Karen C Carroll
- Department of Pathology and Center for Computational Biology, Johns Hopkins University, Baltimore, MD, USA
| | - Steven L Salzberg
- Department of Pathology and Center for Computational Biology, Johns Hopkins University, Baltimore, MD, USA
| | - David W Nauen
- Department of Pathology and Center for Computational Biology, Johns Hopkins University, Baltimore, MD, USA.
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Shea S, Paniz-Mondolfi A, Sordillo E, Nowak M, Dekio F. Florid Bacillus cereus Infection of the Placenta Associated With Intrauterine Fetal Demise. Pediatr Dev Pathol 2021; 24:361-365. [PMID: 33729850 DOI: 10.1177/1093526621999026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Bacillus cereus is a gram-positive, rod-shaped bacterium that is commonly implicated in foodborne illness but has also become increasingly recognized as a source of serious non-gastrointestinal infections, including sepsis, meningitis, and pneumonia. Non-gastrointestinal B. cereus infections have been identified in children, especially in neonates; however, there are no previously described cases of fetal demise associated with B. cereus placental infection. We present a case of acute chorioamnionitis-related intrauterine fetal demise of twin A at 17 weeks gestation, noted two days after selective termination of twin B. Histological examination revealed numerous gram-positive bacilli in placental tissue, as well as fetal vasculature, in the setting of severe acute necrotizing chorioamnionitis and subchorionitis, intervillous abscesses, acute villitis, and peripheral acute funisitis. Cultures of maternal blood and placental tissue both yielded growth of B. cereus. This case underscores the importance of B. cereus as a human pathogen, and specifically demonstrates its potential as an agent of severe intraamniotic and placental infection with poor outcomes for the fetus.
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Affiliation(s)
- Stephanie Shea
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Emilia Sordillo
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Michael Nowak
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Fumiko Dekio
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York
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Fulminant Necrotizing Soft-tissue Infection in an Extremely Low Gestational Age Infant. Pediatr Infect Dis J 2021; 40:e189-e190. [PMID: 33480664 DOI: 10.1097/inf.0000000000003064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We report a case of rapidly progressive necrotizing skin and soft-tissue infection caused by Bacillus cereus in an extremely low for gestational age infant. This case reminds clinicians to consider this opportunistic pathogen as the etiologic agent in fulminant necrotizing infections in vulnerable hosts, and to institute appropriate therapy in a timely fashion.
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Cormontagne D, Rigourd V, Vidic J, Rizzotto F, Bille E, Ramarao N. Bacillus cereus Induces Severe Infections in Preterm Neonates: Implication at the Hospital and Human Milk Bank Level. Toxins (Basel) 2021; 13:123. [PMID: 33562185 PMCID: PMC7915446 DOI: 10.3390/toxins13020123] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/18/2021] [Accepted: 02/02/2021] [Indexed: 12/15/2022] Open
Abstract
Human breast milk (HBM) is a source of essential nutrients for infants and is particularly recommended for preterm neonates when their own mother's milk is not available. It provides protection against infections and decreases necrotizing enterocolitis and cardiovascular diseases. Nevertheless, HBM spoilage can occur due to contamination by pathogens, and the risk of a shortage of HBM is very often present. B. cereus is the most frequent ubiquitous bacteria responsible for HBM being discarded. It can contaminate HBM at all stages, from its collect point to the storage and delivery. B. cereus can induce severe infection in newborns with very low birth weight, with sometimes fatal outcomes. Although the source of contamination is rarely identified, in some cases, HBM was suspected as a potential source. Even if the risk is low, as infection due to B. cereus in preterm infants should not be overlooked, human milk banks follow strict procedures to avoid contamination, to accurately identify remaining bacteria following pasteurization and to discard non-compliant milk samples. In this review, we present a literature overview of B. cereus infections reported in neonates and the suspected sources of contamination. We highlight the procedures followed by the human milk banks from the collection of the milk to its microbiological characterization in Europe. We also present improved detection and decontamination methods that might help to decrease the risk and to preserve the public's confidence in this vital biological product for infants whose mothers cannot breastfeed.
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Affiliation(s)
- Delphine Cormontagne
- Micalis Institute, INRAE, AgroParisTech, Université Paris-Saclay, 78350 Jouy-en-Josas, France; (D.C.); (J.V.); (F.R.)
| | - Virginie Rigourd
- Région Île-de-France Human Milk Bank, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France;
| | - Jasmina Vidic
- Micalis Institute, INRAE, AgroParisTech, Université Paris-Saclay, 78350 Jouy-en-Josas, France; (D.C.); (J.V.); (F.R.)
| | - Francesco Rizzotto
- Micalis Institute, INRAE, AgroParisTech, Université Paris-Saclay, 78350 Jouy-en-Josas, France; (D.C.); (J.V.); (F.R.)
| | - Emmanuelle Bille
- Department of Clinical Microbiology, Necker Enfants-Malades Hospital, AP-HP, 75015 Paris, France;
- INSERM U1151-CNRS UMR 8253, Institut Necker-Enfants Malades, Université de Paris, 75015 Paris, France
| | - Nalini Ramarao
- Micalis Institute, INRAE, AgroParisTech, Université Paris-Saclay, 78350 Jouy-en-Josas, France; (D.C.); (J.V.); (F.R.)
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Bacillus cereus infection in neonates and the absence of evidence for the role of banked human milk: Case reports and literature review. Infect Control Hosp Epidemiol 2020; 40:787-793. [PMID: 31172903 DOI: 10.1017/ice.2019.110] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Banked human milk (BHM) has inherent infectious risks, even when pasteurized. Because of the ubiquity of Bacillus cereus in the environment and its ability to resist the Holder pasteurization process, there is a concern that BHM might lead to severe B. cereus infections. OBJECTIVE We reviewed observed and published cases to determine the potential causal role of BHM as the source of these infections. METHODS Two infants in the province of Québec (Canada) developed a B. cereus neonatal infection, and both had received BHM. We conducted bacteriological studies to compare clinical isolates and those found in these cases. RESULTS After extended culture of BHM retention lots, B. cereus was found to have been involved in batches related to the first case. However, molecular typing showed that the strain was different from the clinical isolate, therefore excluding BHM as the source of contamination. In the second case, a Brevibacillus spp was isolated, a species distinct from the clinical isolate. CONCLUSION Based on these cases and others reported in the literature, a causal link between B. cereus contaminated BHM and preterm neonatal infection has never been documented. Therefore, the risk that BHM can cause this infection remains theoretical. Given the widespread presence of B. cereus in the hospital environment and its capacity to resist standard cleaning procedures, it seems likely that airborne or direct or indirect contact are the main sources of most, if not all, cases of severe B. cereus neonatal infections, even in babies exposed to BHM.
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Butin M, Dumont Y, Monteix A, Raphard A, Roques C, Martins Simoes P, Picaud JC, Laurent F. Sources and reservoirs of Staphylococcus capitis NRCS-A inside a NICU. Antimicrob Resist Infect Control 2019; 8:157. [PMID: 31636900 PMCID: PMC6798403 DOI: 10.1186/s13756-019-0616-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 10/01/2019] [Indexed: 12/23/2022] Open
Abstract
Background The methicillin-resistant clone Staphylococcus capitis NRCS-A, involved in sepsis in neonatal intensive care units (NICUs) worldwide, is able to persist and spread in NICUs, suggesting the presence of reservoirs inside each setting. The purpose of the present study was to identify these reservoirs and to investigate the cycle of transmission of NRCS-A in one NICU. Methods In a single institution study, NRCS-A was sought in 106 consecutive vaginal samples of pregnant women to identify a potential source of NRCS-A importation into the NICU. Additionally NICU caregivers and environmental including incubators were tested to identify putative secondary reservoirs. Finally, the efficacy of disinfection procedure in the elimination of NRCS-A from incubators was evaluated. Results No S. capitis was isolated from vaginal samples of pregnant women. Three of the 21 tested caregivers (14%) carried S. capitis on their hands, but none remain positive after a five-day wash-out period outside NICU. Moreover, the clone NRCS-A persisted during six consecutive weeks in the NICU environment, but none of the sampled sites was constantly contaminated. Finally in our before/after disinfection study, all of 16 incubators were colonized before disinfection and 10 (62%) incubators remained colonized with NRCS-A after the disinfection procedure. Conclusions The partial ineffectiveness of incubators’ disinfection procedures is responsible for persistence of NRCS-A inside a NICU, and the passive hand contamination of caregivers could be involved in the inter-patient transmission of S. capitis.
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Affiliation(s)
- Marine Butin
- 1Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS UMR5308, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon 1, 46 Allée d'Italie, 69364 Lyon Cedex 07, France.,2Réanimation Néonatale, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 59 boulevard Pinel, 69500 Bron, France
| | - Yann Dumont
- 3Institut des Agents Infectieux, Centre National de Référence des Staphylocoques, Hôpital de la Croix Rousse, Hospices Civils de Lyon, 104 grande rue de la Croix Rousse, 69004 Lyon, France
| | - Alice Monteix
- 3Institut des Agents Infectieux, Centre National de Référence des Staphylocoques, Hôpital de la Croix Rousse, Hospices Civils de Lyon, 104 grande rue de la Croix Rousse, 69004 Lyon, France
| | - Aurane Raphard
- 3Institut des Agents Infectieux, Centre National de Référence des Staphylocoques, Hôpital de la Croix Rousse, Hospices Civils de Lyon, 104 grande rue de la Croix Rousse, 69004 Lyon, France
| | - Christine Roques
- Laboratoire de Génie Chimique UMR 5503, Université de Toulouse, CNRS, INPT, UPS, Faculté des Sciences Pharmaceutiques, 35 chemin des maraîchers, 31062 Toulouse cedex 4, France
| | - Patricia Martins Simoes
- 1Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS UMR5308, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon 1, 46 Allée d'Italie, 69364 Lyon Cedex 07, France.,3Institut des Agents Infectieux, Centre National de Référence des Staphylocoques, Hôpital de la Croix Rousse, Hospices Civils de Lyon, 104 grande rue de la Croix Rousse, 69004 Lyon, France
| | - Jean-Charles Picaud
- 5Réanimation Néonatale, Hôpital de la Croix Rousse, Hospices Civils de Lyon, 104 grande rue de la Croix Rousse, 69004 Lyon, France.,6CarMeN, INSERM U1060, INRA U1397, Université de Lyon, 165 Chemin du Grand Revoyet, 69310 Pierre Bénite, France
| | - Frédéric Laurent
- 1Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS UMR5308, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon 1, 46 Allée d'Italie, 69364 Lyon Cedex 07, France.,3Institut des Agents Infectieux, Centre National de Référence des Staphylocoques, Hôpital de la Croix Rousse, Hospices Civils de Lyon, 104 grande rue de la Croix Rousse, 69004 Lyon, France.,7Département de Microbiologie et Mycologie, Institut des Sciences Pharmaceutiques et Biologiques de Lyon, Université de Lyon, 6 Avenue Rockefeller, 69008 Lyon, France
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Viel-Thériault I, Saban J, Lewis A, Bariciak E, Grynspan D. A Case of Fulminant Bacillus cereus Lung Necrosis in a Preterm Neonate. Pediatr Dev Pathol 2019; 22:461-464. [PMID: 30760116 DOI: 10.1177/1093526619825895] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Bacillus cereus is a ubiquitous Gram-positive rod seldom considered pathogenic in clinical isolates. However, it possesses multiple virulence factors explaining why it has been linked to fulminant and pyogenic infections in vulnerable hosts. Its recovery from sterile samples in immunocompromised patients cannot be disregarded. Premature infants would fall into this category. We describe the case of a neonate born at 26 weeks of gestational age, who died of a rapidly progressive B. cereus necrotizing pneumonia following suspected nosocomial acquisition. The rapidity of his course and the autopsy findings of necrosis with minimal inflammation suggest a toxin-mediated process. Pathologists should be aware of this pathogen and obtain proper microbiological samples in the presence of such autopsy findings, as the diagnosis may have infection-prevention implications in health-care settings.
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Affiliation(s)
- Isabelle Viel-Thériault
- Division of Infectious Diseases, Department of Pediatrics, The Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Jeremy Saban
- Department of Pediatrics, The Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Alana Lewis
- Department of Pediatrics, Northern Ontario School of Medicine, Sudbury, Ontario, Canada
| | - Erika Bariciak
- Division of Neonatology, Department of Pediatrics, The Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - David Grynspan
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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Banked Human Milk and Quantitative Risk Assessment of Bacillus cereus Infection in Premature Infants: A Simulation Study. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2019; 2019:6348281. [PMID: 30863469 PMCID: PMC6378033 DOI: 10.1155/2019/6348281] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 12/31/2018] [Indexed: 11/17/2022]
Abstract
Background Banked human milk (BHM) offers potential health benefits to premature babies. BHM is pasteurized to mitigate infectious risks, but pasteurization is ineffective against sporulating bacteria such as Bacillus cereus. Sepsis related to Bacillus cereus in premature infants is severe and can often be fatal. Even if a causal link has never been established, BHM has been suggested as a potential source of infection in premature infants. Objective Our aim was to estimate the potential risk of Bacillus cereus infection in preterm infants caused by the ingestion of contaminated pasteurized BHM using different post-pasteurization release criteria (i.e., 9 sampling of 100 microliters versus the HMBANA guideline of 1 sampling of 100 microliters per pool). Methods In the absence of scientific evidence regarding the risk of Bacillus cereus infection by the ingestion of BHM in premature infants, risk assessment using Monte Carlo simulation with the exponential dose-response model was performed. Three scenarios of infectious risk (annual incidence rate of 0.01%, 0.13%, and 0.2%) with 18 variations of the B. cereus virulent dose (from 0.5 CFU/ml to 200 CFU/ml) were simulated. Results The mean risk differential between the two methods of post-pasteurization bacteriological control for realistic infectious doses of 30 to 200 CFU/ml ranges from 0.036 to 0.0054, 0.47 to 0.070, and 0.72 to 0.11 per million servings, for each of the three scenarios. Conclusion Simulation highlights the very small risk of Bacillus cereus infection following the ingestion of pasteurized BHM, even in the worst case scenarios, and suggests that a 100-microliter sample for post-pasteurization culture is sufficient.
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12
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Recent actuality about Bacillus cereus and human milk bank: a new sensitive method for microbiological analysis of pasteurized milk. Eur J Clin Microbiol Infect Dis 2018; 37:1297-1303. [PMID: 29725957 DOI: 10.1007/s10096-018-3249-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 03/28/2018] [Indexed: 10/17/2022]
Abstract
Three cases of Bacillus cereus infection or colonization occurred in the same region in France, and milk from the milk bank was suspected as a possible common source of contamination. All Batches delivered to the three cases complied with the requirements of the bacteriological reference method recommended by good practices guidelines. Still, a retrospective analysis with a more sensitive method showed one batch to contain B. cereus, however straincomparison revealed no epidemiological link betweenisolates from patients and those from the milk. Consequently, in accordance with the precautionary principle, we developed a new sensitive method for the screening of pasteurized milk for pathogenic bacteria. From January 1 to August 31, 2017, 2526 samples of pasteurized milk were prospectively included in the study. We showed that a 20 mL sample of pasteurized milk incubated for 18 h at 37 °C under aerobic conditions was favoring the detection of B. Cereus. The nonconformity rate was 6.3% for the reference method and 12.6% for the improved method (p < 0.0001). Nonconformity was due to the presence of B. cereus in 88.5% of cases for the improved method and 53% of cases for the reference method (p < 0.0001). Thus our new method is improves the microbiological safety of the product distributed and only moderately increases the rate of bacteriological nonconformity .
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13
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Sasahara T, Ae R, Watanabe M, Kimura Y, Yonekawa C, Hayashi S, Morisawa Y. Contamination of healthcare workers' hands with bacterial spores. J Infect Chemother 2016; 22:521-5. [PMID: 27236515 DOI: 10.1016/j.jiac.2016.04.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 04/21/2016] [Accepted: 04/25/2016] [Indexed: 01/05/2023]
Abstract
Clostridium species and Bacillus spp. are spore-forming bacteria that cause hospital infections. The spores from these bacteria are transmitted from patient to patient via healthcare workers' hands. Although alcohol-based hand rubbing is an important hand hygiene practice, it is ineffective against bacterial spores. Therefore, healthcare workers should wash their hands with soap when they are contaminated with spores. However, the extent of health care worker hand contamination remains unclear. The aim of this study is to determine the level of bacterial spore contamination on healthcare workers' hands. The hands of 71 healthcare workers were evaluated for bacterial spore contamination. Spores attached to subject's hands were quantitatively examined after 9 working hours. The relationship between bacterial spore contamination and hand hygiene behaviors was also analyzed. Bacterial spores were detected on the hands of 54 subjects (76.1%). The mean number of spores detected was 468.3 CFU/hand (maximum: 3300 CFU/hand). Thirty-seven (52.1%) and 36 (50.7%) subjects were contaminated with Bacillus subtilis and Bacillus cereus, respectively. Nineteen subjects (26.8%) were contaminated with both Bacillus species. Clostridium difficile was detected on only one subject's hands. There was a significant negative correlation between the hand contamination level and the frequency of handwashing (r = -0.44, P < 0.01) and a significant positive correlation between the hand contamination level and the elapsed time since last handwashing (r = 0.34, P < 0.01). Healthcare workers' hands may be frequently contaminated with bacterial spores due to insufficient handwashing during daily patient care.
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Affiliation(s)
- Teppei Sasahara
- Department of Infection and Immunity, School of Medicine, Jichi Medical University, Tochigi, Japan; Center for Infectious Diseases, Jichi Medical University Hospital, Tochigi, Japan.
| | - Ryusuke Ae
- Division of Public Health, School of Medicine, Jichi Medical University, Tochigi, Japan
| | - Michiyo Watanabe
- Center for Infectious Diseases, Jichi Medical University Hospital, Tochigi, Japan
| | - Yumiko Kimura
- Division of Microbiology Laboratory, Jichi Medical University Hospital, Tochigi, Japan
| | - Chikara Yonekawa
- Department of Emergency Medicine, School of Medicine, Jichi Medical University, Tochigi, Japan
| | - Shunji Hayashi
- Division of Microbiology, School of Medicine, Kitasato University, Kanagawa, Japan
| | - Yuji Morisawa
- Center for Infectious Diseases, Jichi Medical University Hospital, Tochigi, Japan
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Sakihama T, Tokuda Y. Use of Peripheral Parenteral Nutrition Solutions as a Risk Factor for Bacillus cereus Peripheral Venous Catheter-Associated Bloodstream Infection at a Japanese Tertiary Care Hospital: a Case-Control Study. Jpn J Infect Dis 2016; 69:531-533. [PMID: 26902219 DOI: 10.7883/yoken.jjid.2015.489] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The risk factors are unclear for peripheral venous catheter-associated bloodstream infections (PVCBSIs) caused by Bacillus cereus. We aimed to examine for these risk factors in patients with B. cereus PVCBSI by conducting a 2-year case-control study in a large teaching hospital. We analyzed all adult cases of B. cereus PVCBSI (37 patients) and 180 controls who were randomly selected from among patients who had a PVC in place for at least 2 days. Multivariate analysis using a conditional logistic regression model indicated that independent risk factors were use of a peripheral parenteral nutrition (PPN) solution with an adjusted odds ratio (OR) of 88.7 (95% confidence interval [CI], 17.4-451.9), and steroid therapy (adjusted OR, 5.7 [95% CI, 1.3-24.4]). In conclusion, use of PPN solutions or steroids was an independent risk factor for B. cereus PVCBSI. Appropriate use of PPN solutions may help prevent B. cereus PVCBSI. Prospective studies are needed to confirm these results.
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Affiliation(s)
- Tomoko Sakihama
- Department of Nursing, International University of Health and Welfare Graduate School
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15
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Saito N, Kondo J, Haruki S, Itoga M, Yamamoto A, Kimura M, Inoue F, Kobayashi M, Tsutaya S, Kojima K, Ueki S, Hirokawa M, Kayaba H. Possible involvement of reusable towels in the high rate of Bacillus species-positive blood cultures in Japanese hospitals. J Infect Chemother 2016; 22:96-101. [DOI: 10.1016/j.jiac.2015.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 10/15/2015] [Accepted: 11/02/2015] [Indexed: 12/30/2022]
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16
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The Endospore-Forming Pathogen Bacillus cereus Exploits a Small Colony Variant-Based Diversification Strategy in Response to Aminoglycoside Exposure. mBio 2015; 6:e01172-15. [PMID: 26646008 PMCID: PMC4676280 DOI: 10.1128/mbio.01172-15] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Bacillus cereus is among the microorganisms most often isolated from cases of food spoilage and causes gastrointestinal diseases as well as nongastrointestinal infections elicited by the emetic toxin cereulide, enterotoxins, and a panel of tissue-destructive virulence factors. This opportunistic pathogen is increasingly associated with rapidly fatal clinical infections especially linked to neonates and immunocompromised individuals. Fatality results from either the misdiagnosis of B. cereus as a contaminant of the clinical specimen or from failure of antibiotic therapy. Here we report for the first time that exposure to aminoglycoside antibiotics induces a phenotype switching of emetic B. cereus subpopulations to a slow-growing small colony variant (SCV) state. Along with altered antibiotic resistance, SCVs showed distinct phenotypic and metabolic properties, bearing the risk of antibiotic treatment failure and of clinical misdiagnosis by standard identification tests used in routine diagnostic. The SCV subpopulation is characterized by enhanced production of the toxin cereulide, but it does not secrete tissue-destructive and immune system-affecting enzymes such as sphingomyelinase and phospholipase. SCVs showed significantly prolonged persistence and decreased virulence in the Galleria mellonella model for bacterial infections, indicating diversification concerning their ecological lifestyle. Importantly, diversification into coexisting wild-type and SCV subpopulations also emerged during amikacin pressure during in vivo infection experiments. This study shows for the first time that pathogenic spore-forming B. cereus strains are able to switch to a so far unreported slow-growing lifestyle, which differs substantially in terms of developmental, phenotypic, metabolic, and virulence traits from the wild-type populations. This underpins the necessity of molecular-based differential diagnostics and a well-chosen therapeutic treatment strategy in clinical environments to combat B. cereus in a tailored manner. The reported induction of SCV in an endospore-forming human pathogen requires further research to broaden our understanding of a yet unexplored antibiotic resistance mechanism in sporulating bacteria. Our work also raises a general question about the ecological meaning of SCV subpopulation emergence and importance of SCV in sporeformer populations as an alternative route, next to sporulation, to cope with stresses encountered in natural niches, such as soil or host interfaces.
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Pai S, Enoch DA, Aliyu SH. Bacteremia in children: epidemiology, clinical diagnosis and antibiotic treatment. Expert Rev Anti Infect Ther 2015; 13:1073-88. [PMID: 26143645 DOI: 10.1586/14787210.2015.1063418] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The diagnosis of bacteremia in children is important and it can be clinically challenging to recognize the signs and symptoms. The reported rates of bacteremia are higher in young children but with the increasing vaccine coverage, there has been a decrease in bacteremia due to the three vaccine preventable bacteria (Streptococcus pneumoniae, Haemophilus influenzae group b and Neisseria meningitidis). Notably, there have been increases in healthcare-associated bacteremias with a rise in Staphylococcus aureus and Gram negative bacteremias. This review provides a brief overview of the clinical diagnosis of bacteremia in children, focusing on the epidemiology, clinical characteristics, risk factors, antibiotic treatment, outcomes and preventative measures to reduce the incidence of bacteremia and improve morbidity and mortality.
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Affiliation(s)
- Sumita Pai
- Public Health England, Clinical Microbiology and Public Health Laboratory, Cambridge, UK
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18
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Meites E, Taur Y, Marino L, Schaefer M, Eagan J, Jensen B, Williams M, Kamboj M, Srinivasan A. Investigation of Increased Rates of Isolation ofBacillusSpecies. Infect Control Hosp Epidemiol 2015; 31:1257-63. [DOI: 10.1086/657584] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background.In 2007–2008, several US hospitals reported summertime increases in the number of clinical blood cultures positive forBacillusspecies, which are common environmental bacteria.Objective.To investigate increased rates of isolation ofBacillusspecies from blood cultures, identify risk factors, and recommend control strategies.Design.Survey and case-control study.Setting.Multiple hospitals, including a cancer center.Methods.We surveyed 24 facilities that reported increases. We also conducted a field investigation at a hospital with a high rate, reviewing charts, collecting clinical and environmental isolates, and observing infection control procedures. A case-control study compared inpatient case patients who had any blood culture positive forBacilluswith unmatched control patients who had a blood culture with no growth during June-August 2008.Results.Among surveyed facilities, mean monthly rates rose from 25 to a peak of 75Bacillus-positive blood cultures per 10,000 blood cultures performed during the period June-August. At the hospital where the case-control investigation was conducted, for most case patients (75%), theBacillus-positive blood cultures represented contamination or device colonization rather than infection. We enrolled 48 case patients and 48 control patients; in multivariate analysis, only central venous access device use was significantly associated with case status (odds ratio, 14.0;P< .01). Laboratory testing identified at least 12 differentBacillusspecies (non-anthracis) among the isolates. Observation of infection control procedures revealed variability in central line care and blood sample collection techniques.Conclusions.Periodic increases in the environmental load ofBacillusspecies may occur in hospitals. Our investigation indicated that at one facility, these increases likely represented a pseudo-outbreak ofBacillusspecies colonizing central venous lines or their accessories, such as needleless connector devices. Vigilant attention should be paid to infection control practices when collecting blood samples for culture, to minimize the risk of contamination by environmental microorganisms.
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Dolan SA, Littlehorn C, Glodé MP, Dowell E, Xavier K, Nyquist AC, Todd JK. Association ofBacillus cereusInfection with Contaminated Alcohol Prep Pads. Infect Control Hosp Epidemiol 2015; 33:666-71. [DOI: 10.1086/666334] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background.Bacillusspecies have caused healthcare-associated outbreaks of invasive disease as well as pseudo-outbreaks. We report an outbreak investigation of blood cultures positive forBacillus cereusassociated with alcohol prep pads (APPs) contaminated withB. cereusandBacillusspecies resulting in a rapid internal product recall and subsequent international product recall.Design.Epidemiologic and microbiologic outbreak investigation.Setting.A 300-bed tertiary care children's hospital in Aurora, Colorado.Patients.Patients with blood or cerebrospinal fluid cultures positive forB. cereus.Methods.Three patients with blood cultures positive forB. cereuswere identified in late 2010. Breaches in procedural and surgical techniques, common interventions, and products were explored. The following 3 common products were cultured: sterile saline syringes, chlorhexidine/alcohol skin preparation solution, and APPs. Repetitive sequence-based polymerase chain reaction (Rep-PCR) was used to compare isolates obtained from patients and from APPs and was confirmed by independent pulsed-field gel electrophoresis.Results.There appeared to be a significant increase in blood cultures positive forB. cereusduring 2009-2010.B. cereusand otherBacillusspecies were cultured from the internal contents of 63.3% of APPs not labeled as sterile, and 8 of the 10 positive lots were manufactured after 2007. None of the isolates obtained from the patients matched strains isolated from the APPs. However, some lots of APPs had strains that were indistinguishable from one another.Conclusions.APPs that were not labeled as sterile were contaminated withBacillusspecies. The product was immediately recalled internally and replaced with APPs from another manufacturer that were labeled as sterile. On January 3, 2011, the manufacturer voluntarily recalled its APPs. Healthcare facilities, healthcare providers, and users of APPs should avoid the use of APPs not specifically labeled as sterile.
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Campbell JR, Hulten K, Baker CJ. Cluster ofBacillusSpecies Bacteremia Cases in Neonates during a Hospital Construction Project. Infect Control Hosp Epidemiol 2015; 32:1035-8. [DOI: 10.1086/661910] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We report an outbreak ofBacillusbacteremia among premature infants during a construction project. Our investigation revealed potential environmental sources. After replacement of air filters, cleaning of the unit, emphasis on hand hygiene, and relocation of the loading dock for linen and supply delivery, no further cases were detected.
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Ali MMM, Aburowes AH, Albakush AM, Rzeg MM, Alrtail A, Ghenghesh KS. Identification of multidrug-resistant bacteria and Bacillus cereus from healthcare workers and environmental surfaces in a hospital. Libyan J Med 2014; 9:25794. [PMID: 25280977 PMCID: PMC4185342 DOI: 10.3402/ljm.v9.25794] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
| | | | | | - Moftah Mohamed Rzeg
- Department of Laboratories, Microbiology Unit Central Hospital, Zliten, Libya
| | - Amna Alrtail
- Department of Laboratories, Microbiology Unit Central Hospital, Zliten, Libya
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22
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Machado C, Silva A, Magalhães MJ, Sá C, Abreu E, Matos AM, Pereira A. Severe Bacillus cereus infection in a neonatal intensive care unit. CASE REPORTS IN PERINATAL MEDICINE 2014. [DOI: 10.1515/crpm-2013-0073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Infections of the central nervous system (CNS) in neonates with very low birth weight (VLBW) may have major clinical consequences due to their immunocompromised status. Bacillus cereus is a rare pathogen that can cause serious infection in these patients and is associated with a high mortality rate. We report the case of an extremely preterm neonate who developed severe infection of the CNS caused by B. cereus with progressive neurological deterioration despite broad spectrum antibiotic treatment. She died at the age of 16 months. In conclusion, we wish to increase the awareness among health care practitioner about the possibility of infection due to B. cereus in sick neonates and its devastating course in this population.
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Affiliation(s)
- Clara Machado
- Neonatal Intensive Care Unit, Hospital de Braga, Braga, Portugal
| | - Albina Silva
- Neonatal Intensive Care Unit, Hospital de Braga, Braga, Portugal
| | | | - Carla Sá
- Neonatal Intensive Care Unit, Hospital de Braga, Braga, Portugal
| | - Eduarda Abreu
- Neonatal Intensive Care Unit, Hospital de Braga, Braga, Portugal
| | - António M. Matos
- Neonatal Intensive Care Unit, Hospital de Braga, Braga, Portugal
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SASAHARA TEPPEI, HAYASHI SHUNJI, HOSODA KOUICHI, MORISAWA YUJI, HIRAI YOSHIKAZU. Comparison of Hand Hygiene Procedures for Removing Bacillus cereus Spores. Biocontrol Sci 2014; 19:129-34. [DOI: 10.4265/bio.19.129] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Cho HJ, Bae MH, Lee BS, Kim KS, Kim MN, Kim EAR. Detrimental Neurological Outcome caused by Bacillus cereusMeningoencephalitis in an Extremely Low Birth Weight Infant. NEONATAL MEDICINE 2014. [DOI: 10.5385/nm.2014.21.3.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Hyun-Ju Cho
- Division of Neonatology, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Mi Hyun Bae
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Byong Sop Lee
- Division of Neonatology, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Ki-Soo Kim
- Division of Neonatology, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Mi-Na Kim
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ellen Ai-Rhan Kim
- Division of Neonatology, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
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25
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Summertime Bacillus cereus colonization of hospital newborns traced to contaminated, laundered linen. J Hosp Infect 2013; 85:149-54. [DOI: 10.1016/j.jhin.2013.06.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 06/08/2013] [Indexed: 11/20/2022]
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26
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Decousser JW, Ramarao N, Duport C, Dorval M, Bourgeois-Nicolaos N, Guinebretière MH, Razafimahefa H, Doucet-Populaire F. Bacillus cereus and severe intestinal infections in preterm neonates: Putative role of pooled breast milk. Am J Infect Control 2013; 41:918-21. [PMID: 23769834 DOI: 10.1016/j.ajic.2013.01.043] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 01/31/2013] [Accepted: 01/31/2013] [Indexed: 01/24/2023]
Abstract
BACKGROUND Bacillus cereus is an environmental pathogen whose spores resist the usual cleaning procedure applied by the food industry and hospitals. We reported a cluster of severe intestinal infections due to B cereus in 2 very low birth weight neonates from a neonatal intensive care unit. METHODS Environmental sampling and bacteriological analysis of pooled breast milk (PBM) were performed. Practices for preparation and administration of milk were observed and additional laboratory experiments performed. Strains were typed using M13-polymerase chain reaction and their virulence tested using cellular and insect models. RESULTS B cereus strains were exclusively isolated from intestinal tracts and PBM. No environmental culture yielded any viable B cereus. Although genotypically diverse, both clinical and food strains exhibited high virulence potency. These findings pointed out the pathogenic potency of B cereus in neonates; the putative role of PBM as a reservoir for pathogenic B cereus and the triggered effect of a defective care procedure, which allowed the growth of bacteria in pasteurized PBM. Well described from dried formula, the presence of pathogenic B cereus strains in PBM was not previously reported. CONCLUSIONS Careful monitoring of conditions during collection, conservation, and administration of PBM should be implemented in high-risk populations such as premature neonates.
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Affiliation(s)
- Jean-Winoc Decousser
- Department of Virology, Bacteriology-Infection Control, Parasitology-Mycology, Assistance Publique-Hôpitaux de Paris, University Hospital Henri Mondor, Créteil, France.
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27
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Turabelidze G, Gee JE, Hoffmaster AR, Manian F, Butler C, Byrd D, Schildknecht S, Hauser LC, Duncan M, Ferrett R, Evans D, Talley C. Contaminated ventilator air flow sensor linked to Bacillus cereus colonization of newborns. Emerg Infect Dis 2013; 19:781-3. [PMID: 23647973 PMCID: PMC3647488 DOI: 10.3201/eid1905.12039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We investigated Bacillus cereus–positive tracheal aspirates from infants on ventilators in a neonatal intensive care unit. Multilocus sequence typing determined a genetic match between strains isolated from samples from a case-patient and from the air flow sensor in the ventilator. Changing the sterilization method for sensors to steam autoclaving stopped transmission.
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Affiliation(s)
- George Turabelidze
- Missouri Department of Health and Senior Services, Jefferson City, Missouri 63103, USA.
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28
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Turabelidze G, Gee JE, Hoffmaster AR, Manian F, Butler C, Byrd D, Schildknecht S, Hauser LC, Duncan M, Ferrett R, Evans D, Talley C. Contaminated Ventilator Air Flow Sensor Linked toBacillus cereusColonization of Newborns. Emerg Infect Dis 2013. [DOI: 10.3201/eid1905.120239] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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29
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Meningitis due to Bacillus cereus: A case report and review of the literature. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2013; 23:e16-9. [PMID: 23449377 DOI: 10.1155/2012/609305] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Bacillus cereus is infrequently associated with invasive central nervous system (CNS) disease. Infection is associated with conditions that lead to reduced host immunity and provide direct access to the CNS, such as spinal anesthesia and ventricular tubes and shunts. A case of ventriculitis secondary to B cereus in a patient receiving intrathecal chemotherapy is reported, along with a review of the current literature. B cereus can colonize medical devices, thus posing a risk for invasive disease. Despite aggressive treatment with broad-spectrum anti-infectives, the mortality of CNS invasive B cereus is high. Clinicians should not dismiss Gram-positive rods resembling Bacillus species from normally sterile sites as contaminants in critically ill patients. Appropriate antibiotic therapy should be promptly initiated to limit morbidity and mortality. Bacillus cereus is infrequently associated with invasive central nervous system (CNS) disease. Infection is associated with conditions that lead to reduced host immunity and provide direct access to the CNS, such as spinal anesthesia and ventricular tubes and shunts. A case of ventriculitis secondary to B cereus in a patient receiving intrathecal chemotherapy is reported, along with a review of the current literature. B cereus can colonize medical devices, thus posing a risk for invasive disease. Despite aggressive treatment with broad-spectrum anti-infectives, the mortality of CNS invasive B cereus is high. Clinicians should not dismiss Gram-positive rods resembling Bacillus species from normally sterile sites as contaminants in critically ill patients. Appropriate antibiotic therapy should be promptly initiated to limit morbidity and mortality.
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Bacillus cereus Bloodstream Infection in a Preterm Neonate Complicated by Late Meningitis. Case Rep Infect Dis 2012; 2012:358789. [PMID: 22924139 PMCID: PMC3424644 DOI: 10.1155/2012/358789] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 07/02/2012] [Indexed: 11/25/2022] Open
Abstract
Central nervous system infections caused by Bacillus cereus have rarely been reported in infants. In this paper, the case of a 2-month-old low-birth-weight female who developed meningitis 45 days after resolution of a bloodstream infection (BSI) is described. The pulsed-field gel electrophoresis results revealed that the patterns of both B. cereus isolates responsible for the acute meningitis and for the prior bacteraemic episode were closely related. Although the source of the infection from within the patient was not clear, it is suggested that the B. cereus BSI developed in the neonate was complicated by acute meningitis.
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31
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Hot and steamy: outbreak of Bacillus cereus in Singapore associated with construction work and laundry practices. J Hosp Infect 2012; 81:224-30. [DOI: 10.1016/j.jhin.2012.04.022] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 04/24/2012] [Indexed: 11/21/2022]
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32
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Oda M, Hashimoto M, Takahashi M, Ohmae Y, Seike S, Kato R, Fujita A, Tsuge H, Nagahama M, Ochi S, Sasahara T, Hayashi S, Hirai Y, Sakurai J. Role of sphingomyelinase in infectious diseases caused by Bacillus cereus. PLoS One 2012; 7:e38054. [PMID: 22701599 PMCID: PMC3368938 DOI: 10.1371/journal.pone.0038054] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2012] [Accepted: 05/02/2012] [Indexed: 12/01/2022] Open
Abstract
Bacillus cereus (B. cereus) is a pathogen in opportunistic infections. Here we show that Bacillus cereus sphingomyelinase (Bc-SMase) is a virulence factor for septicemia. Clinical isolates produced large amounts of Bc-SMase, grew in vivo, and caused death among mice, but ATCC strains isolated from soil did not. A transformant of the ATCC strain carrying a recombinant plasmid containing the Bc-SMase gene grew in vivo, but that with the gene for E53A, which has little enzymatic activity, did not. Administration of an anti-Bc-SMase antibody and immunization against Bc-SMase prevented death caused by the clinical isolates, showing that Bc-SMase plays an important role in the diseases caused by B. cereus. Treatment of mouse macrophages with Bc-SMase resulted in a reduction in the generation of H2O2 and phagocytosis of macrophages induced by peptidoglycan (PGN), but no effect on the release of TNF-α and little release of LDH under our experimental conditions. Confocal laser microscopy showed that the treatment of mouse macrophages with Bc-SMase resulted in the formation of ceramide-rich domains. A photobleaching analysis suggested that the cells treated with Bc-SMase exhibited a reduction in membrane fluidity. The results suggest that Bc-SMase is essential for the hydrolysis of SM in membranes, leading to a reduction in phagocytosis.
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Affiliation(s)
- Masataka Oda
- Department of Microbiology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Yamashiro-cho, Tokushima, Japan
| | - Manabu Hashimoto
- Department of Microbiology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Yamashiro-cho, Tokushima, Japan
| | - Masaya Takahashi
- Department of Microbiology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Yamashiro-cho, Tokushima, Japan
| | - Yuka Ohmae
- Department of Microbiology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Yamashiro-cho, Tokushima, Japan
| | - Soshi Seike
- Department of Microbiology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Yamashiro-cho, Tokushima, Japan
| | - Ryoko Kato
- Department of Microbiology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Yamashiro-cho, Tokushima, Japan
| | - Aoi Fujita
- Department of Microbiology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Yamashiro-cho, Tokushima, Japan
| | - Hideaki Tsuge
- Institute for Health Sciences, Tokushima Bunri University, Yamashiro-cho, Tokushima, Japan
- Faculty of Life Sciences, Kyoto Sangyo University, Kamigamo Motoyama Kita-ku, Kyoto, Japan
| | - Masahiro Nagahama
- Department of Microbiology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Yamashiro-cho, Tokushima, Japan
| | - Sadayuki Ochi
- School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Teppei Sasahara
- School of Medicine, Jichi Medical University, Shimono-city, Tochigi, Japan
| | - Shunji Hayashi
- School of Medicine, Jichi Medical University, Shimono-city, Tochigi, Japan
| | - Yoshikazu Hirai
- School of Medicine, Jichi Medical University, Shimono-city, Tochigi, Japan
| | - Jun Sakurai
- Department of Microbiology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Yamashiro-cho, Tokushima, Japan
- * E-mail:
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Horii T, Notake S, Tamai K, Yanagisawa H. Bacillus cereus from blood cultures: virulence genes, antimicrobial susceptibility and risk factors for blood stream infection. ACTA ACUST UNITED AC 2011; 63:202-9. [DOI: 10.1111/j.1574-695x.2011.00842.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Kiyoko Tamai
- Miroku Medical Laboratory Inc.; Saku; Nagano; Japan
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Wiedermann CJ, Stockner I, Plattner B. Bacillus species infective arthritis after knee arthroscopy. Surg Infect (Larchmt) 2011; 11:555-8. [PMID: 20969473 DOI: 10.1089/sur.2009.080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Bacillus species infection of the joints is a very rare occurrence, with sporadic reports in the medical literature. CASE REPORT A 67-year-old woman with osteoarthritis developed infection in the knee joint after arthroscopy. Percutaneous needle aspiration of articular fluid performed post-operatively showed a positive culture for Bacillus species. The diagnosis of septic arthritis was, however, not confirmed as the results were considered contamination. Failure of treatment with beta-lactam antibiotics on two occasions and successful cure of infective arthritis by long-term administration of a fluoroquinolone confirmed iatrogenic clinical joint infection with Bacillus species. CONCLUSION Any clinically suspected joint infection must be treated as septic arthritis until proved otherwise.
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Yoh M, Matsuyama J, Shime A, Okayama K, Sakamoto R, Honda T. [Can industrial laundry remove Bacillus cereus from hospital linen?]. ACTA ACUST UNITED AC 2010; 84:583-7. [PMID: 20960937 DOI: 10.11150/kansenshogakuzasshi.84.583] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Contaminated hospital linen has caused some cases of Bacillus cereus bacteremia in Japan. We analyzed the disinfection efficacy of industrial washing of hospital towels and sheets by counting the number of B. cereus on linen before and after washing. That before washing averaged 7.6 cells/cm2 on unwashed sheets, decreasing to 1.2 cells/cm2 after washing. That on unwashed towels, however, averaged 10(6) cells/cm2 before washing and 1096 cells/cm2 after washing, which was very high and suggested the possibility of causing nosocomial infection.
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Affiliation(s)
- Myonsun Yoh
- Pathogenic Microbes Repository Unit, International Research Center for Infectious Diseases
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Sasahara T, Hayashi S, Morisawa Y, Sakihama T, Yoshimura A, Hirai Y. Bacillus cereus bacteremia outbreak due to contaminated hospital linens. Eur J Clin Microbiol Infect Dis 2010; 30:219-26. [DOI: 10.1007/s10096-010-1072-2] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Accepted: 09/21/2010] [Indexed: 10/19/2022]
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Abstract
Bacillus cereus is a Gram-positive aerobic or facultatively anaerobic, motile, spore-forming, rod-shaped bacterium that is widely distributed environmentally. While B. cereus is associated mainly with food poisoning, it is being increasingly reported to be a cause of serious and potentially fatal non-gastrointestinal-tract infections. The pathogenicity of B. cereus, whether intestinal or nonintestinal, is intimately associated with the production of tissue-destructive exoenzymes. Among these secreted toxins are four hemolysins, three distinct phospholipases, an emesis-inducing toxin, and proteases. The major hurdle in evaluating B. cereus when isolated from a clinical specimen is overcoming its stigma as an insignificant contaminant. Outside its notoriety in association with food poisoning and severe eye infections, this bacterium has been incriminated in a multitude of other clinical conditions such as anthrax-like progressive pneumonia, fulminant sepsis, and devastating central nervous system infections, particularly in immunosuppressed individuals, intravenous drug abusers, and neonates. Its role in nosocomial acquired bacteremia and wound infections in postsurgical patients has also been well defined, especially when intravascular devices such as catheters are inserted. Primary cutaneous infections mimicking clostridial gas gangrene induced subsequent to trauma have also been well documented. B. cereus produces a potent beta-lactamase conferring marked resistance to beta-lactam antibiotics. Antimicrobials noted to be effective in the empirical management of a B. cereus infection while awaiting antimicrobial susceptibility results for the isolate include ciprofloxacin and vancomycin.
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Affiliation(s)
- Edward J Bottone
- Division of Infectious Diseases, Box 1090, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA.
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Drazin D, Lehman D, Danielpour M. Successful surgical drainage and aggressive medical therapy in a preterm neonate with Bacillus cereus meningitis. Pediatr Neurosurg 2010; 46:466-71. [PMID: 21577046 DOI: 10.1159/000325073] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Accepted: 02/02/2011] [Indexed: 11/19/2022]
Abstract
Bacillus cereus meningitis is a rare disease with a very high mortality rate in neonates. The authors present the rare case of a premature infant with B. cereus bacteremia and subsequent intracranial abscesses. In addition to aggressive medical therapy, surgical drainage was performed via a left frontal mini-craniotomy. At 15 months of age, the patient had mild developmental delay, cortical blindness, and sensorineural hearing loss. The clinical case is described and difficulties in the management of B. cereus meningoencephalitis in infants are discussed.
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Affiliation(s)
- Doniel Drazin
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
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Lebessi E, Dellagrammaticas HD, Antonaki G, Foustoukou M, Iacovidou N. Bacillus cereus meningitis in a term neonate. J Matern Fetal Neonatal Med 2009; 22:458-61. [PMID: 19530006 DOI: 10.1080/14767050802610336] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A case of Bacillus cereus meningitis in a term neonate without identifiable risk factors or source of the organism is presented. Prompt identification of the organism and treatment resulted in a favourable outcome.
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Affiliation(s)
- Evangelia Lebessi
- Department of Microbiology, NICU Aglaia Kyriakou Children's Hospital, University of Athens, Athens, Greece
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40
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Kuroki R, Kawakami K, Qin L, Kaji C, Watanabe K, Kimura Y, Ishiguro C, Tanimura S, Tsuchiya Y, Hamaguchi I, Sakakura M, Sakabe S, Tsuji K, Inoue M, Watanabe H. Nosocomial bacteremia caused by biofilm-forming Bacillus cereus and Bacillus thuringiensis. Intern Med 2009; 48:791-6. [PMID: 19443973 DOI: 10.2169/internalmedicine.48.1885] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Bacterial biofilms cause serious problems, such as antibiotic resistance and medical device-related infections. Recent reports indicate that Bacillus species potentially form biofilms and cause nosocomial bacteremia via catheter infection. Our objective was to investigate the relationship between nosocomial bacteremia caused by Bacillus species and biofilm formations. METHODS Between 2001 and 2006, Bacillus cereus and Bacillus thuringiensis were isolated from blood samples of 21 patients with nosocomial bacteremia in two hospitals. The patients had underlying diseases such as cerebrovascular damage, malignant disease, or chronic obstructive lung disease and had high fever at the onset of bacteremia. After investigation, B. cereus and B. thuringiensis were isolated from patient's catheter tip, gauze, and hospital environment. Pulsed-field gel electrophoresis (PFGE) on 32 B. cereus and 7 B. thuringiensis isolates, microtiter biofilm assay and scanning electron microscopy (SEM) on 22 B. cereus isolates from patient's blood were performed. RESULTS Molecular analysis by PFGE showed that 32 B. cereus strains had 21 patterns and 7 B. thuringiensis strains had 3 patterns. The PFGE patterns of B. thuringiensis and B. cereus in blood samples from 2 patients blood were similar to those from the same patient's catheter tip. The PFGE pattern of B. cereus from a hospital environment was similar to that from 2 patients' blood samples, and the PFGE pattern of B. thuringiensis from 2 hospital environments was similar to that from 2 patients' blood. The biofilm formations by 22 B. cereus isolates from patients' blood were confirmed by microtiter biofilm assay and SEM even at 24 hours. CONCLUSION Our data indicate that various types of Bacillus species exist in hospital environments and the biofilm-forming strains potentially cause nosocomial bacteremia by catheter infection.
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Affiliation(s)
- Reiki Kuroki
- Department of Internal Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki
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Tilquin M, Paris M, Reynaud S, Despres L, Ravanel P, Geremia RA, Gury J. Long lasting persistence of Bacillus thuringiensis Subsp. israelensis (Bti) in mosquito natural habitats. PLoS One 2008; 3:e3432. [PMID: 18941501 PMCID: PMC2563433 DOI: 10.1371/journal.pone.0003432] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2008] [Accepted: 09/12/2008] [Indexed: 11/19/2022] Open
Abstract
Background The detrimental effects of chemical insecticides on the environment and human health have lead to the call for biological alternatives. Today, one of the most promising solutions is the use of spray formulations based on Bacillus thuringiensis subsp. israelensis (Bti) in insect control programs. As a result, the amounts of Bti spread in the environment are expected to increase worldwide, whilst the common belief that commercial Bti is easily cleared from the ecosystem has not yet been clearly established. Methodology/Main Findings In this study, we aimed to determine the nature and origin of the high toxicity toward mosquito larvae found in decaying leaf litter collected in several natural mosquito breeding sites in the Rhône-Alpes region. From the toxic fraction of the leaf litter, we isolated B. cereus-like bacteria that were further characterized as B. thuringiensis subsp. israelensis using PCR amplification of specific toxin genes. Immunological analysis of these Bti strains showed that they belong to the H14 group. We finally used amplified length polymorphism (AFLP) markers to show that the strains isolated from the leaf litter were closely related to those present in the commercial insecticide used for field application, and differed from natural worldwide genotypes. Conclusions/Significance Our results raise the issue of the persistence, potential proliferation and environmental accumulation of human-spread Bti in natural mosquito habitats. Such Bti environmental persistence may lengthen the exposure time of insects to this bio-insecticide, thereby increasing the risk of resistance acquisition in target insects, and of a negative impact on non-target insects.
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Affiliation(s)
- Mathieu Tilquin
- Floralis-UJF Filiale, Gières, France
- Laboratoire d'Ecologie Alpine (LECA), CNRS UMR 5553, Universite' Joseph Fourier, Grenoble, France
| | - Margot Paris
- Laboratoire d'Ecologie Alpine (LECA), CNRS UMR 5553, Universite' Joseph Fourier, Grenoble, France
| | - Stéphane Reynaud
- Laboratoire d'Ecologie Alpine (LECA), CNRS UMR 5553, Universite' Joseph Fourier, Grenoble, France
| | - Laurence Despres
- Laboratoire d'Ecologie Alpine (LECA), CNRS UMR 5553, Universite' Joseph Fourier, Grenoble, France
| | - Patrick Ravanel
- Laboratoire d'Ecologie Alpine (LECA), CNRS UMR 5553, Universite' Joseph Fourier, Grenoble, France
| | - Roberto A. Geremia
- Laboratoire d'Ecologie Alpine (LECA), CNRS UMR 5553, Universite' Joseph Fourier, Grenoble, France
- * E-mail:
| | - Jérôme Gury
- Laboratoire d'Ecologie Alpine (LECA), CNRS UMR 5553, Universite' Joseph Fourier, Grenoble, France
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Abstract
The classic organisms associated with central nervous system infection in the neonate are herpes simplex, Listeria monocytogenes, Escherichia coli, and Streptococcus agalactiae; we describe an unusual case of neonatal meningoencephalitis caused by Bacillus cereus.
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Kalpoe J, Hogenbirk K, van Maarseveen N, Gesink-Van der Veer B, Kraakman M, Maarleveld J, van der Reyden T, Dijkshoorn L, Bernards A. Dissemination of Bacillus cereus in a paediatric intensive care unit traced to insufficient disinfection of reusable ventilator air-flow sensors. J Hosp Infect 2008; 68:341-7. [DOI: 10.1016/j.jhin.2008.01.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2007] [Accepted: 01/16/2008] [Indexed: 10/22/2022]
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Genetic diversity of Actinobacillus pleuropneumoniae assessed by amplified fragment length polymorphism analysis. J Clin Microbiol 2007; 45:3921-9. [PMID: 17959758 DOI: 10.1128/jcm.00906-07] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Amplified fragment length polymorphism (AFLP) was evaluated as a method for genotypic characterization and subtyping within the bacterial species Actinobacillus pleuropneumoniae. A total of 155 isolates of A. pleuropneumoniae, representing the serotypic variation described to occur within this species, were analyzed. In order to elucidate the species boundaries, six strains of the phylogenetically closely related species Actinobacillus lignieresii were also included. Furthermore, the ability of AFLP to subtype was studied using 42 isolates of serovar 2 and the performance compared to that obtained by pulsed-field gel electrophoresis (PFGE). AFLP analysis provided a clear separation of A. lignieresii and A. pleuropneumoniae and divided the isolates of A. pleuropneumoniae into 20 clusters. Most of the serovars of A. pleuropneumoniae were represented by single and quite homogeneous clusters. The exceptions were serovars 10, K2:O7, and K1:O7, which were represented by two clusters each. In the cases where the serovars were represented by more than one cluster, the existence of these clusters was supported by additional phenotypic or genotypic properties. Furthermore, AFLP typing was able to allocate serologically nontypeable isolates to appropriate genetic groups within the species. Further investigations are needed to determine whether some of the clusters revealed through AFLP analysis represent additional serovars. When evaluated as a method for subtyping within serovar 2 of A. pleuropneumoniae, AFLP was found to achieve a degree of separation among isolates superior to that obtained by PFGE. However, a higher degree of separation between serovar 2 isolates was obtained by a combination of the two methods.
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López AC, Alippi AM. Phenotypic and genotypic diversity of Bacillus cereus isolates recovered from honey. Int J Food Microbiol 2007; 117:175-84. [PMID: 17466403 DOI: 10.1016/j.ijfoodmicro.2007.03.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2006] [Revised: 03/19/2007] [Accepted: 03/19/2007] [Indexed: 10/23/2022]
Abstract
Of 433 honey samples collected in Argentina, 114 (27%) yielded Bacillus cereus isolates (27%) and 60 (14%) yielded other species of Bacillus. The Argentinian B. cereus isolates were compared with isolates recovered from honey from other countries (n=16) and with strain ATCC 11718. The 133 B. cereus isolates and the ATCC strain were characterized using rep-PCR fingerprinting with primers BOX, REP and ERIC, restriction fragment length polymorphism analysis of a 16S rRNA gene fragment (16S rRNA PCR/RFLP), and morphological and biochemical tests. There was a high degree of diversity, both phenotypic and genotypic among the isolates of B. cereus. Our results demonstrate the usefulness of rep-PCR genomic fingerprinting for characterizing populations of B. cereus. According to our knowledge, this is the first report of phenotypic and genotypic characterization of B. cereus isolates from honey.
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Affiliation(s)
- Ana C López
- Centro de Investigaciones de Fitopatología, Facultad de Ciencias Agrarias y Forestales, Universidad Nacional de La Plata, calle 60 y 118 s/n, 1900 La Plata, Argentina
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Ohsaki Y, Koyano S, Tachibana M, Shibukawa K, Kuroki M, Yoshida I, Ito Y. Undetected Bacillus pseudo-outbreak after renovation work in a teaching hospital. J Infect 2007; 54:617-22. [DOI: 10.1016/j.jinf.2006.10.049] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2006] [Revised: 10/22/2006] [Accepted: 10/24/2006] [Indexed: 10/23/2022]
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48
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Evreux F, Delaporte B, Leret N, Buffet-Janvresse C, Morel A. Méningite néonatale à Bacillus cereus, à propos d'un cas. Arch Pediatr 2007; 14:365-8. [PMID: 17337168 DOI: 10.1016/j.arcped.2007.01.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2006] [Accepted: 01/22/2007] [Indexed: 11/15/2022]
Abstract
A fatal case of meningoencephalitis caused by Bacillus cereus, an uncommon but potential pathogen, resistant to most beta-lactam antibiotics, is described in a 28-day old premature neonate. Difficulties for clinical diagnosis and treatment are discussed. A review of the literature (26 published cases) is given. Early diagnosis of neonatal B. cereus infection is crucial as it leads to a standard treatment including vancomycin.
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MESH Headings
- Anti-Bacterial Agents/therapeutic use
- Bacillaceae Infections/drug therapy
- Bacillaceae Infections/pathology
- Bacillus cereus/drug effects
- Bacteriological Techniques
- Diagnosis, Differential
- Drug Resistance, Multiple
- Drug Therapy, Combination
- Fatal Outcome
- Female
- Humans
- Infant, Newborn
- Infant, Premature, Diseases/diagnosis
- Infant, Premature, Diseases/drug therapy
- Infant, Premature, Diseases/pathology
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Affiliation(s)
- F Evreux
- Département de microbiologie, groupe hospitalier du Havre, hôpital Jacques-Monod, 76083 Le Havre cedex, France.
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Lequin MH, Vermeulen JR, van Elburg RM, Barkhof F, Kornelisse RF, Swarte R, Govaert PP. Bacillus cereus meningoencephalitis in preterm infants: neuroimaging characteristics. AJNR Am J Neuroradiol 2005; 26:2137-43. [PMID: 16155172 PMCID: PMC8148855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND AND PURPOSE Meningoencephalitis can severely damage the developing brain. Preterms are more prone for nosocomial infections with pathogens other than Group B streptococci and Escherichia coli. In this report we focus on the deleterious clinical course and imaging characteristics of proven Bacillus cereus meningoencephalitis. METHODS We collected 3 cases of proven Bacillus cereus meningoencephalitis. In the medical records we focused on prenatal, perinatal, and postnatal risk factors. Imaging data of several brain ultrasounds, MR images, and diffusion-weighted images were reevaluated. RESULTS The ultrasound and MR images show a typical pattern of mainly hemorrhagic and early cavitating, selective white matter destruction. CONCLUSION Knowledge of this paradigm of acquired brain injury may help to better understand the natural course of these severe neonatal infections.
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Affiliation(s)
- Maarten H Lequin
- Department of Radiology, Sophia Children's Hospital, Erasmus MC--University Medical Center, Rotterdam, the Netherlands
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Kim K, Seo J, Wheeler K, Park C, Kim D, Park S, Kim W, Chung SI, Leighton T. Rapid genotypic detection of Bacillus anthracis and the Bacillus cereus group by multiplex real-time PCR melting curve analysis. ACTA ACUST UNITED AC 2005; 43:301-10. [PMID: 15681162 DOI: 10.1016/j.femsim.2004.10.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2004] [Revised: 10/10/2004] [Accepted: 10/18/2004] [Indexed: 11/27/2022]
Abstract
Bacillus anthracis has four plasmid possible virulence genotypes: pXO1+/pXO2+, pXO1+/pXO2-, pXO1-/pXO2+ or pXO1-/pXO2-. Due to the lack of a specific chromosomal marker for B. anthracis, differentiation of the pXO1-/pXO2- form of B. anthracis from closely related Bacillus cereus group species is difficult. In this study, we evaluate the ability of sspE, pXO1 and pXO2 primers to discriminate individual B. anthracis and the B. cereus group genotypes using multiplex real-time PCR and melting curve analysis. Optimal conditions for successful multiplex assays have been established. Purified DNAs from 38 bacterial strains including 11 strains of B. anthracis and 18 B. cereus group strains were analyzed. Nine of the B. cereus group near-neighbor strains were shown by multilocus sequence typing to be phylogenetically proximate to the B. anthracis clade. We have demonstrated that the four plasmid genotypes of B. anthracis and B. cereus group near-neighbors were differentially and simultaneously discriminated by this assay.
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Affiliation(s)
- Kijeong Kim
- Department of Microbiology, College of Medicine, Chung-Ang Univerisity, 221, Heuksuk-dong, Dongjak-gu, Seoul 156-756, South Korea.
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