Antibiotic Profiles and Draft Genome Sequences of Kerstersia gyiorum, Providencia stuartii, Providencia vermicola, and Alcaligenes faecalis Strains Recovered from Soft Tissue Biopsy Samples in Ghana

Whole-genome sequence data for clinically relevant Gram-negative bacteria from the African continent are scarce. In this report, we present the draft genome sequence data and antibiograms of four species, namely, Kerstersia gyiorum, Providencia vermicola, Providencia stuartii, and Alcaligenes faecalis, that were recovered from human soft tissue biopsy samples.

Right Lower Extremity Osteomyelitis With Alcaligenes faecalis in a Patient With Poorly Controlled Type 2 Diabetes Mellitus

Alcaligenes faecalis (A. faecalis) is a Gram-negative, rod-shaped, oxidase(+) and catalase(+), obligate aerobe commonly found in soil or water. It has also been found in human intestinal microbiota and more rarely in hospital settings and is typically associated with opportunistic infections. Although it has intrinsic resistance to many commonly used antibiotics, it is increasingly found to have developed antibiotic resistance. We present a rare case of A. faecalis osteomyelitis in a patient with a chronic diabetic foot ulcer.

Whole Proteome-Based Therapeutic Targets Annotation and Designing of Multi-Epitope-Based Vaccines against the Gram-Negative XDR-Alcaligenes faecalis Bacterium

This study involved therapeutic targets mining for the extremely drug-resistant bacterial species called Alcaligenes faecalis, which is known to infect humans. The infections caused by this species in different parts of the human body have been linked with a higher degree of resistance to several classes of antibiotics. Meanwhile, alternate therapeutic options are needed to treat these bacterial infections in clinical settings. In the current study, a subtractive proteomics approach was adapted to annotate the whole proteome of Alcaligenes faecalis and prioritize target proteins for vaccine-related therapeutics design. This was followed by targeted protein-specific immune epitope prediction and prioritization. The shortlisted epitopes were further subjected to structural design and in silico validation of putative vaccines against Alcaligenes faecalis. The final vaccine designs were also evaluated for potential interaction analysis with human TLR-2 through molecular docking. Finally, the putative vaccines were subjected to in silico cloning and immune simulation approaches to ensure the feasibility of the target-specific vaccine constructs in further experimental designs.

Extensively drug-resistant Alcaligenes faecalis infection

Background

Alcaligenes faecalis is usually causes opportunistic infections in humans. Alcaligenes faecalis infection is often difficult to treat due to its increased resistance to several antibiotics. The results from a clinical study of patients with Alcaligenes faecalis infection may help improve patients’ clinical care.

Methods

We conducted a retrospective analysis of all patients presenting with Alcaligenes faecalis infection from January 2014 to December 2019. The medical records of all patients were reviewed for demographic information, clinical symptoms and signs, comorbidities, use of intravenous antibiotics within the past three months, bacterial culture, antibiotics sensitivity test, and clinical outcomes.

Results

Sixty-one cases of Alcaligenes faecalis infection were seen during the study period, including 25 cases of cystitis, nine cases of diabetic foot infection, eight cases of pneumonia, seven cases of acute pyelonephritis, three cases of bacteremia, and nine cases of infection at specific sites. Thirty-seven patients (60.7%) had a history of receiving intravenous antibiotics within three months of the diagnosis. Fifty-one (83.6%) cases were mixed with other bacterial infections. Extensively drug-resistant infections have been reported since 2018. The best sensitivity rate to Alcaligenes faecalis was 66.7% for three antibiotics (imipenem, meropenem, and ceftazidime) in 2019. Two antibiotics (ciprofloxacin and piperacillin/tazobactam) sensitivity rates to A. faecalis were less than 50%.

Conclusions

The most frequent Alcaligenes faecalis infection sites, in order, are the bloodstream, urinary tract, skin and soft tissue, and middle ear. The susceptibility rate of Alcaligenes faecalis to commonly used antibiotics is decreasing. Extensively drug-resistant Alcaligenes faecalis infections have emerged.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12879-020-05557-8.