Colonization of an amputation site by Flavobacterium odoratum after gentamicin therapy

Antibacterial and Antibiofilm Activities of Ceragenins Alone and in Combination with Levofloxacin Against Multidrug Resistant Myroides spp. Clinical Isolates from Patients with Urinary Tract Infections

Myroides spp. are rare opportunistic pathogens, but they can be life-threatening because of their multidrug-resistant drug properties and their potential to cause outbreaks, especially in immunosuppressed patients. In this study, 33 isolates isolated from intensive care patients with urinary tract infections were examined for drug susceptibility. All isolates except three proved to be resistant to the tested conventional antibiotics. The effects of ceragenins, a class of compounds developed to mimic endogenous antimicrobial peptides, were evaluated against these organisms. The MIC values of nine ceragenins were determined, and the most effective ceragenins were CSA-131 and CSA-138. Three isolates that were susceptible to levofloxacin and two isolates resistant to all antibiotics underwent 16 s rDNA analysis, and whereas resistant isolates were identified as M. odoratus, susceptible isolates were identified as M. odoratimimus. CSA-131 and CSA-138 showed rapid antimicrobial effects observed in time-kill analyses. Combinations of ceragenins and levofloxacin caused a significant increase in antimicrobial and antibiofilm activities against M. odoratimimus isolates. In this study, Myroides spp. were found to be multidrug-resistant and have biofilm forming capacity, and ceragenins CSA-131 and CSA-138 were found to be especially effective on both planktonic and biofilm forms of Myroides spp.

A case series and literature review of infections due to Myroides spp.: identification of contributing factors and emerging antibiotic susceptibility trends

Introduction

Infections forby Myroides spp. can lead to significant morbidity and mortality, particularly in immunocompromised patients with underlying co-morbidities. Recent reports have highlighted its intrinsic and acquired drug resistance, making it a particularly challenging infectious agent to combat.

Methods

Myroides spp. isolated and reported in clinically significant urine samples were considered for the study. Identification of the organism was done via the VITEK 2C system. Antibiotic susceptibility testing was done using both manual and automated methods following Clinical and Laboratory Standards Institute (CLSI) guidelines. Existing literature was searched on MEDLINE using PubMed.

Results

We present a series of five catheter-associated urinary tract infections due to Myroides odoratimimus , with sensitivity to only minocycline. This is the first case from Western India, and the third case in the existing literature that shows Myroides sensitivity only to minocycline. Our literature review is the first to systematically describe contributory factors to infection, allowing us to devise a clinically relevant tool that delineates contributory factors and efficacious drugs in Myroides spp. infection.

Conclusion

Myroides spp. infections, previously considered rare and opportunistic, need cognizance and diagnostic suspicion especially in particular associated conditions.

Myroides bacteremia: A case report and concise review

Myroides species are bacteria found commonly in environmental sources, such as water and soil. Despite this, they are historically uncommon pathogens, tending to affect primarily immunocompromised hosts. Based on a review of the current cases listed in the U.S. National Institutes of Health's National Library of Medicine (Table 1), there have been 48 reported cases of infection to date, one third of which have been reported in only the last seven years. This report outlines a case of bacteremia caused by Myroides species occurring in a diabetic male on chemotherapy for Merkel cell cancer. Myroides species can be difficult to treat, many strains are resistant to several antibacterial classes, this patient was treated successfully with meropenem.

MYROIDES INFECTION IN A BABOON AFTER PROLONGED PIG KIDNEY GRAFT SURVIVAL

BACKGROUND

Immunosuppressed patients and experimental nonhuman primates are at risk of opportunistic infection. We report a Myroides spp infection in an immunosuppressed baboon that had received a life-supporting kidney from a genetically-engineered pig.

CASE REPORT

The baboon received a costimulation blockade-based immunosuppressive regimen as well as two anti-inflammatory agents (tocilizumab and etanercept). Although the pig kidney functioned well, approximately four months after the transplant the baboon became less active and ate and drank poorly. On day 136, it collapsed and died despite inotropic and fluid support. A blood culture drawn before death grew Myroides spp.

DISCUSSION AND CONCLUSIONS

To our knowledge, Myroides spp has not been reported as a cause of opportunistic infection in either patients with organ allotransplants or experimental animals. We summarize what is known about this rare organism, and suggest it should be considered in any immunocompromised patient or animal. In the present case, we suggest the baboon died of circulatory shock following infection through an indwelling intravenous catheter.

Fatal case of necrotizing fasciitis due to Myroides odoratus

Myroides sp., previously known as Flavobacterium odoratum, is a relatively unknown organism with unclear human pathogenicity. While Myroides sp. has been implicated in human infections, many reports have described the organism as a relatively avirulent opportunistic pathogen. We present an unusual case of rapidly fatal necrotizing fasciitis and septic shock due to Myroides odoratus. Our case demonstrates the pathogenicity of Myroides, and highlights potential risk factors for infection including underlying liver disease and open wounds. The recognition of Myroides is of particular importance given its resistance to multiple antibiotics. We review the literature on Myroides sp. skin and soft tissue infections, including necrotizing forms, and discuss the clinical presentation and management of this potentially emerging pathogen.

Comparison of VITEK2, MALDI-TOF MS, and 16S rDNA sequencing for identification of Myroides odoratus and Myroides odoratimimus

The genus Myroides comprises the 2 medically relevant species Myroides odoratus and Myroides odoratimimus that are rare opportunistic pathogens and cause infections in immunocompromised patients. A fast identification of Myroides is of importance because these bacterial strains show multiple resistance against antibiotics and therefore limit treatment options. They are associated, for instance, with urinary tract infections, sepsis, meningitis, pneumonia, and infectious cellulitis. Since more and more Myroides spp. are being described, additional potentially pathogenic bacteria may be identified in the future demanding the need for fast and reliable identification methods at species level. However, to date, only molecular approaches meet these demands. In this study, we, therefore, attempt to define an appropriate method other than DNA fingerprinting that will permit a comparable efficacy and, possibly, a more economical strain identification. For this purpose, we compared 2 widely used automated diagnostic systems (VITEK 2 [bioMérieux, Nürtingen, Germany] and Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) [Bruker Daltonics, Bremen, Germany]) and correlated the results to 16S rDNA sequencing data. In total, we analyzed 22 strains collected in the course of routine diagnostics. In this study, we demonstrate that VITEK 2 reliably identifies the genus Myroides but cannot differentiate between M. odoratimimus and M. odoratus. In contrast to this, both MALDI-TOF MS and 16S rDNA sequencing efficiently distinguish between the 2 species.

Relationship between plasmid occurrence and antibiotic resistance in Myroides odoratimimus SKS05-GRD isolated from raw chicken meat

Fifteen flavobacterium strains were isolated from raw chicken meat, raw goat meat and poultry soil in Coimbatore, Tamil Nadu. Most of the isolates developed yellow pigmented colonies with mucoid-spreading edges on food flavobacterium medium. The flavobacteria were Gram-negative rods and failed to produce indole and were non-fermentative. Moreover, they produced a rich array of enzymes such as amylase, lipase, catalase, urease, gelatinase, DNase, and oxidase. Phylogenetic analyses of the strain SKS05-GRD based on 16S rRNA gene sequences revealed the bacterium as Myroides odoratimimus (nucleotide sequence accession number JQ178355). Antimicrobial susceptibility test for M. odoratimimus SKS05-GRD and other strains were assessed by disc diffusion method. M. odoratimimus SKS05-GRD showed wide resistance to the antibiotics such as amikacin, ampicillin, cefadroxil, cefoperazone, ceftazidine, ceftriaxone, netillin and gentamicin. M. odoratimimus was subjected to plasmid isolation and plasmid curing to seek the relationship between plasmid and antibiotic resistance. Plasmid curing was done by using ethidium bromide and was found to be effective at 300 and 500 μg/ml. Assessment of antibiotic sensitivity of M. odoratimimus SKS05-GRD showed sensitivity to amikacin, gentamicin and kanamycin confirming that resistance to these three antibiotics is plasmid mediated and other antibiotic resistance are chromosomal mediated.

Myroides phaeus sp. nov., isolated from human saliva, and emended descriptions of the genus Myroides and the species Myroides profundi Zhang et al. 2009 and Myroides marinus Cho et al. 2011

A novel bacterial strain, designated MY15T, was isolated from a saliva sample taken from a student during a teaching experiment in China. Phylogenetic analyses based on 16S rRNA gene sequences showed that the novel strain was most closely related to Myroides marinus JS-08T, Myroides odoratimimus LMG 4029T and Myroides profundi D25T with 96.5 %, 96.3 % and 96.1 % gene sequence similarities, respectively, demonstrating that the novel strain belonged to the genus Myroides. Strain MY15T formed pale yellow colonies that turned to brown on Luria-Bertani (LB) agar and that gave off a characteristic fruity odour. Cells were Gram-staining-negative, rod-shaped and non-motile. The new isolate contained menaquinone 6 (MK-6) as the major respiratory quinone and C15:0 iso (51.2 %), C17:0 iso 3-OH (12.9 %) and C13:0 iso (10.5 %) as the dominant fatty acids. The G+C content of the DNA was 34.3 mol%. On the basis of this study, based on a polyphasic taxonomic approach, strain MY15T (=DSM 23313T=LMG 25566T) represents a novel species of the genus Myroides, for which the name Myroides phaeus sp. nov. is proposed. Emended descriptions of the genus Myroides and of the species M. profundi and M. marinus are also given.

Septic shock, pneumonia, and soft tissue infection due to Myroides odoratimimus: report of a case and review of Myroides infections

The genus Myroides comprises aerobic, yellow-pigmented, non-motile, non-fermenting gram-negative rods formerly classified as Flavobacterium odoratum. Members of the genus are widely distributed in the environment, especially in water, and usually behave as low-grade opportunistic pathogens, having been found to cause urinary tract infection, endocarditis, ventriculitis, and cutaneous infections in severely immunocompromised patients. We report a case of soft tissue infection, septic shock, and pneumonia due to M. odoratimimus in an immunocompetent male. To our knowledge, this is the first description of life-threatening infection caused by this organism in an immunocompetent host. We have also reviewed the medical literature on the genus Myroides.

Chromosome-encoded beta-lactamases TUS-1 and MUS-1 from Myroides odoratus and Myroides odoratimimus (formerly Flavobacterium odoratum), new members of the lineage of molecular subclass B1 metalloenzymes

Myroides odoratus and Myroides odoratimimus (formerly designated in a single species as Flavobacterium odoratum) are gram-negative aerobes and sources of nosocomial infections in humans. They have variable susceptibility to beta-lactams and a decreased susceptibility to carbapenems. Using genomic DNAs of M. odoratus CIP 103105 and M. odoratimimus CIP 103073 reference strains, shotgun cloning of beta-lactamase genes was performed, followed by protein expression in Escherichia coli. The deduced amino acid sequences of these beta-lactamase genes revealed that TUS-1 and MUS-1 from M. odoratus CIP 103105 and M. odoratimimus CIP 103073, respectively, shared 73% amino acid identity. Mature proteins TUS-1 and MUS-1, with pI values of 7.8 and 5.2, respectively, had relative molecular masses of ca. 26 kDa. These beta-lactamases are members of the subclass B1 of metallo-beta-lactamases and are distantly related to other metalloenzymes, being most closely related to IND-1 from Chryseobacterium indologenes (42% amino acid identity). However, phylogenic analysis showed that TUS-1 and MUS-1 belong to the same phylogenic lineage of subclass B1 enzymes that groups the subclass B1 beta-lactamases of Flavobacterium species. Kinetic parameters of purified beta-lactamases TUS-1 and MUS-1 detailed their hydrolysis spectra, which encompass most beta-lactams except aztreonam. beta-Lactamases TUS-1 and MUS-1 were classified in functional subgroup 3a of metalloenzymes. This work further characterizes chromosome-encoded metalloenzymes from Flavobacteriaceae species that explain at least part of their intrinsic resistance to beta-lactams.