Pub Date : 2024-11-01DOI: 10.1016/j.ijmmb.2024.100744
Rosemol Varghese , V. Aravind , K. Kirubanandan , Purva Mathur , V. Balaji
Background
Streptococcus dysgalactiae subsp equisimilis (SDSE) is an emerging pathogen causing pharyngitis and post-streptococcal sequelae like S. pyogenes. SDSE was initially considered a commensal microorganism inhabiting the upper respiratory tract and skin. However, recently it has gained attention due to an increase in the invasive SDSE infections, which were reported in the early 20th century.
Objectives
The aim of this review is to bring awareness of SDSE in the medical microbiologists because often its ignorance leads to the under reporting or misdiagnosis of SDSE. This also highlights the clinical spectrum of infections and the molecular epidemiology of SDSE.
Content
Diagnosis of SDSE in clinical laboratories is challenging, because SDSE can be seen expressing either of the three Lancefield antigen Groups, Group A, C, and G. While MALDI-TOF (Matrix-Assisted Laser Desorption/Ionization Time-of-Flight) is a discriminatory method for identifying SDSE, its high cost can limit its use in many laboratories. Currently, there is limited data on SDSE, and further studies are required to associate the disease outcome and the emm type/ST of SDSE in India and other developing countries. This review highlights the importance of recognizing SDSE as an emerging pathogen, and to screen for SDSE in infections similar to S.pyogenes, especially in regions such as India with a high incidence of Streptococcal diseases.
{"title":"Exploring the necessity of molecular detection for Streptococcus dysgalactiae subsp equisimilis: Often misdiagnosed, and emerging pathogen","authors":"Rosemol Varghese , V. Aravind , K. Kirubanandan , Purva Mathur , V. Balaji","doi":"10.1016/j.ijmmb.2024.100744","DOIUrl":"10.1016/j.ijmmb.2024.100744","url":null,"abstract":"<div><h3>Background</h3><div><em>Streptococcus dysgalactiae</em> subsp <em>equisimilis</em> (SDSE) is an emerging pathogen causing pharyngitis and post-streptococcal sequelae like <em>S. pyogenes</em>. SDSE was initially considered a commensal microorganism inhabiting the upper respiratory tract and skin. However, recently it has gained attention due to an increase in the invasive SDSE infections, which were reported in the early 20th century.</div></div><div><h3>Objectives</h3><div>The aim of this review is to bring awareness of SDSE in the medical microbiologists because often its ignorance leads to the under reporting or misdiagnosis of SDSE. This also highlights the clinical spectrum of infections and the molecular epidemiology of SDSE.</div></div><div><h3>Content</h3><div>Diagnosis of SDSE in clinical laboratories is challenging, because SDSE can be seen expressing either of the three Lancefield antigen Groups, Group A, C, and G. While MALDI-TOF (Matrix-Assisted Laser Desorption/Ionization Time-of-Flight) is a discriminatory method for identifying SDSE, its high cost can limit its use in many laboratories. Currently, there is limited data on SDSE, and further studies are required to associate the disease outcome and the <em>emm</em> type/ST of SDSE in India and other developing countries. This review highlights the importance of recognizing SDSE as an emerging pathogen, and to screen for SDSE in infections similar to <em>S.pyogenes</em>, especially in regions such as India with a high incidence of Streptococcal diseases.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100744"},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.ijmmb.2024.100753
Diptanu Paul , Amit Satpathy , Pritinanda Mishra , Punyatoya Kar , Rumita Dey , Pritika Gahlot , Mukund Sable , Madhuchhanda Das , Vinaykumar Hallur
A 3-year-old boy being treated for disseminated tuberculosis with antitubercular drugs and steroids developed scalp swelling. Needle aspirate revealed yeasts inside macrophages, initially diagnosed as Histoplasmosis but later confirmed as Cryptococcosis. Treatment with liposomal amphotericin B and fluconazole resulted in lesion resolution.
Here we report a rare instance of disseminated cryptococcosis with skin involvement, possibly the first documented pediatric case of cryptococcosis from Odisha.
一名 3 岁男孩因患播散性结核病而接受抗结核药物和类固醇治疗,结果头皮肿胀。针吸结果显示巨噬细胞内有酵母菌,最初诊断为组织胞浆菌病,后来确诊为隐球菌病。经两性霉素 B 脂质体和氟康唑治疗后,病灶消退。在此,我们报告了一例罕见的皮肤受累的播散性隐球菌病,这可能是奥迪沙第一例记录在案的隐球菌病儿科病例。
{"title":"From Histoplasmosis to Cryptococcosis: A diagnostic journey of pediatric scalp abscess","authors":"Diptanu Paul , Amit Satpathy , Pritinanda Mishra , Punyatoya Kar , Rumita Dey , Pritika Gahlot , Mukund Sable , Madhuchhanda Das , Vinaykumar Hallur","doi":"10.1016/j.ijmmb.2024.100753","DOIUrl":"10.1016/j.ijmmb.2024.100753","url":null,"abstract":"<div><div>A 3-year-old boy being treated for disseminated tuberculosis with antitubercular drugs and steroids developed scalp swelling. Needle aspirate revealed yeasts inside macrophages, initially diagnosed as Histoplasmosis but later confirmed as Cryptococcosis. Treatment with liposomal amphotericin B and fluconazole resulted in lesion resolution.</div><div>Here we report a rare instance of disseminated cryptococcosis with skin involvement, possibly the first documented pediatric case of cryptococcosis from Odisha.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100753"},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Blood stream infection is a medical emergency associated with high morbidity and mortality. Prompt identification of bloodstream infection-causing microorganisms directly from positive blood culture will significantly enhance patient care by reducing the turnaround time of pathogen recognition.
Methods
A total of 256 freshly flagged positive blood culture bottles were subjected to Gram staining. Direct MALDI-TOF MS analysis was performed following sample preparation techniques such as lysis centrifugation, lysis filtration and VITEK® MS BC kit to directly identify microorganisms from positive blood cultures. Along with these short-term incubation methods of Choco spot and minute colony(8–10h) were also performed. All those positive bottles were identified by the routine (reference) laboratory method.
Results
177 isolates (69.14 %) were correctly identified by Lysis centrifugation, 163 isolates (63.67 %) were correctly identified by Lysis filtration, 206 isolates (80.47 %) were correctly identified by Choco spot,250 isolates (97.65 %) were correctly identified from minute colony (8–10h) of incubation. Of 162 isolates,115 isolates (70.99 %) were correctly identified by VITEK® MS Blood culture kit, (BioMérieux). VITEK® MS BC kit method revealed higher agreement with the kappa value of 0.697 than lysis centrifugation (0.672) followed by lysis filtration (0.611).
Conclusions
In house method of lysis centrifugation is found to be equivalent to VITEK® MS BC kit method and superior to lysis filtration method in correct direct identification of bacteria from positive blood cultures by MALDI-TOF MS analysis. As lysis centrifugation requires only 10 min of processing time as compared to overnight incubation, thus it offers a less expensive substitute for the VITEK® MS BC kit in the clinical laboratory. As a consequence of this study, we have implemented direct MALDI-TOF-based identification from positive BCs in our daily routine diagnostic management.
背景:血流感染是一种与高发病率和高死亡率相关的医疗急症。直接从阳性血培养物中迅速鉴定出导致血流感染的微生物,可缩短病原体识别的周转时间,从而大大加强对病人的护理:方法:对 256 个新鲜标记阳性血培养瓶进行革兰氏染色。方法:共对 256 个新鲜的标记阳性血培养瓶进行革兰氏染色,然后采用溶解离心、溶解过滤和 VITEK® MS BC 试剂盒等样品制备技术直接进行 MALDI-TOF MS 分析,以直接鉴定阳性血培养物中的微生物。此外,还采用了 Choco spot 和微小菌落(8-10 小时)的短期培养方法。所有阳性培养瓶均采用实验室常规(参考)方法进行鉴定:结果:177 个分离菌株(69.14%)通过裂解离心法得到了正确鉴定,163 个分离菌株(63.67%)通过裂解过滤法得到了正确鉴定,206 个分离菌株(80.47%)通过巧克力斑点法得到了正确鉴定,250 个分离菌株(97.65%)通过菌落微量培养法(8-10 小时)得到了正确鉴定。在 162 个分离物中,115 个分离物(70.99%)被 VITEK® MS 血液培养试剂盒(生物梅里埃)正确鉴定。VITEK® MS BC试剂盒方法的卡帕值为0.697,比裂解离心法(0.672)和裂解过滤法(0.611)的卡帕值高:在通过 MALDI-TOF MS 分析从阳性血液培养物中直接正确鉴定细菌方面,溶菌离心法与 VITEK® MS BC 试剂盒法相当,而溶菌过滤法优于 VITEK® MS BC 试剂盒法。与过夜培养法相比,裂解离心法只需 10 分钟的处理时间,因此在临床实验室中,它是 VITEK® MS BC 试剂盒的廉价替代品。通过这项研究,我们已将基于 MALDI-TOF 的阳性 BC 直接鉴定纳入了日常诊断管理中。
{"title":"Accuracy of various matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS)-based rapid identification methods—As a tool to augment diagnostic stewardship in blood culture laboratory, South India","authors":"Sonali Padhy , Ketan Priyadarshi , Sarumathi Dhandapani , Apurba Sankar Sastry","doi":"10.1016/j.ijmmb.2024.100747","DOIUrl":"10.1016/j.ijmmb.2024.100747","url":null,"abstract":"<div><h3>Background</h3><div>Blood stream infection is a medical emergency associated with high morbidity and mortality. Prompt identification of bloodstream infection-causing microorganisms directly from positive blood culture will significantly enhance patient care by reducing the turnaround time of pathogen recognition.</div></div><div><h3>Methods</h3><div>A total of 256 freshly flagged positive blood culture bottles were subjected to Gram staining. Direct MALDI-TOF MS analysis was performed following sample preparation techniques such as lysis centrifugation, lysis filtration and VITEK® MS BC kit to directly identify microorganisms from positive blood cultures. Along with these short-term incubation methods of Choco spot and minute colony(8–10h) were also performed. All those positive bottles were identified by the routine (reference) laboratory method.</div></div><div><h3>Results</h3><div>177 isolates (69.14 %) were correctly identified by Lysis centrifugation, 163 isolates (63.67 %) were correctly identified by Lysis filtration, 206 isolates (80.47 %) were correctly identified by Choco spot,250 isolates (97.65 %) were correctly identified from minute colony (8–10h) of incubation. Of 162 isolates,115 isolates (70.99 %) were correctly identified by VITEK® MS Blood culture kit, (BioMérieux). VITEK® MS BC kit method revealed higher agreement with the kappa value of 0.697 than lysis centrifugation (0.672) followed by lysis filtration (0.611).</div></div><div><h3>Conclusions</h3><div>In house method of lysis centrifugation is found to be equivalent to VITEK® MS BC kit method and superior to lysis filtration method in correct direct identification of bacteria from positive blood cultures by MALDI-TOF MS analysis. As lysis centrifugation requires only 10 min of processing time as compared to overnight incubation, thus it offers a less expensive substitute for the VITEK® MS BC kit in the clinical laboratory. As a consequence of this study, we have implemented direct MALDI-TOF-based identification from positive BCs in our daily routine diagnostic management.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100747"},"PeriodicalIF":1.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Papulaspora equi keratitis in an infant","authors":"Harsimran Kaur , Imola Jamir , Sonam Yangzes , Haseen Ahmad , Sourav Agnihotri , Sunita Gupta , Anup Ghosh , Shivaprakash M. Rudramurthy","doi":"10.1016/j.ijmmb.2024.100748","DOIUrl":"10.1016/j.ijmmb.2024.100748","url":null,"abstract":"","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100748"},"PeriodicalIF":1.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Melioidosis, caused by Burkholderia pseudomallei, is known for its diverse clinical presentations and high mortality rate. This brief communication reports the clinico-microbiological profile of twenty cases of melioidosis in a tertiary care hospital over three years. We have analyzed demographic data, clinical presentations, microbiological findings, and treatment outcomes to enhance the understanding and management of this under-recognized infection.
{"title":"Clinico-microbiological profile of Burkholderia pseudomallei infections in a tertiary care hospital in South India","authors":"Priya Ramachandran , K. Sandhya Bhat , Sheela Devi Chandrakesan , R.P. Swaminathan","doi":"10.1016/j.ijmmb.2024.100745","DOIUrl":"10.1016/j.ijmmb.2024.100745","url":null,"abstract":"<div><div>Melioidosis, caused by <em>Burkholderia pseudomallei</em>, is known for its diverse clinical presentations and high mortality rate. This brief communication reports the clinico-microbiological profile of twenty cases of melioidosis in a tertiary care hospital over three years. We have analyzed demographic data, clinical presentations, microbiological findings, and treatment outcomes to enhance the understanding and management of this under-recognized infection.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100745"},"PeriodicalIF":1.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Varicella zoster among sero-immune, vaccinated and unvaccinated health care workers in Mumbai","authors":"Sweta Shah, Tanu Singhal, Reshma Tejam, Priyanka Sakhare, Ganesh Madhu, Havovi Fouzdar","doi":"10.1016/j.ijmmb.2024.100743","DOIUrl":"10.1016/j.ijmmb.2024.100743","url":null,"abstract":"","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100743"},"PeriodicalIF":1.4,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-15DOI: 10.1016/j.ijmmb.2024.100735
Corinna Aimee Chavez-Manini, Sandra Alicia Reza-López, Carlos Arzate-Quintana, Celia María Quiñonez-Flores, María Alejandra Favila-Pérez, Javier Camarillo-Cisneros, Alva Rocío Castillo-González
Background
The bactericidal effect of electric current has been studied in various microorganisms such as Pseudomonas aeruginosa. The objective of this review is to identify the experimental parameters with the greatest antibacterial effect in the shortest time.
Methods
Literature search was conducted in the databases PubMed, Science Direct, and Google Scholar. Only original articles published between 2014 and 2023 were included, where the effect of electric current on viability, biofilm formation, and/or antibiotic resistance in P. aeruginosa was analyzed. Quality control criteria considered included specifying control and experimental groups, replicates performed, experimental parameters, and study limitations.
Results
Ten studies were included, which involved the strains Xen5, Xen41, PAO1 persistent cells, and PA14. An average reduction of 3.5 log in biofilm formation was observed in the included studies. The electric current parameters that achieved the greatest effect were 500 μA DC with platinum electrodes for 4 days [5.2–5.5 log], 200 μA intermittent with titanium electrodes for 4 days [4.99 log], and 150 ± 60 μA with silver electrodes for 24 h [4 log]. Complete eradication of PAO1 persistent cells was achieved in 1 h with a treatment of 70 μA/cm2 DC followed by 1.5 μg/mL tobramycin for 1 h each.
Conclusions
The bactericidal effect of electric current is proportional to the exposure time and current intensity. The electrode material influences the effectiveness of the treatment, possibly because of redox reactions, while differences are observed in the effect on the cell membrane and gene expression when using metallic or carbon electrodes, suggesting differences in the mechanism of action.
{"title":"Effect of electric current in viability, biofilm formation and antibiotic resistance of Pseudomonas aeruginosa: A systematic review","authors":"Corinna Aimee Chavez-Manini, Sandra Alicia Reza-López, Carlos Arzate-Quintana, Celia María Quiñonez-Flores, María Alejandra Favila-Pérez, Javier Camarillo-Cisneros, Alva Rocío Castillo-González","doi":"10.1016/j.ijmmb.2024.100735","DOIUrl":"10.1016/j.ijmmb.2024.100735","url":null,"abstract":"<div><h3>Background</h3><div>The bactericidal effect of electric current has been studied in various microorganisms such as <em>Pseudomonas aeruginosa</em>. The objective of this review is to identify the experimental parameters with the greatest antibacterial effect in the shortest time.</div></div><div><h3>Methods</h3><div>Literature search was conducted in the databases PubMed, Science Direct, and Google Scholar. Only original articles published between 2014 and 2023 were included, where the effect of electric current on viability, biofilm formation, and/or antibiotic resistance in <em>P. aeruginosa</em> was analyzed. Quality control criteria considered included specifying control and experimental groups, replicates performed, experimental parameters, and study limitations.</div></div><div><h3>Results</h3><div>Ten studies were included, which involved the strains Xen5, Xen41, PAO1 persistent cells, and PA14. An average reduction of 3.5 log in biofilm formation was observed in the included studies. The electric current parameters that achieved the greatest effect were 500 μA DC with platinum electrodes for 4 days [5.2–5.5 log], 200 μA intermittent with titanium electrodes for 4 days [4.99 log], and 150 ± 60 μA with silver electrodes for 24 h [4 log]. Complete eradication of PAO1 persistent cells was achieved in 1 h with a treatment of 70 μA/cm2 DC followed by 1.5 μg/mL tobramycin for 1 h each.</div></div><div><h3>Conclusions</h3><div>The bactericidal effect of electric current is proportional to the exposure time and current intensity. The electrode material influences the effectiveness of the treatment, possibly because of redox reactions, while differences are observed in the effect on the cell membrane and gene expression when using metallic or carbon electrodes, suggesting differences in the mechanism of action.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100735"},"PeriodicalIF":1.4,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-15DOI: 10.1016/j.ijmmb.2024.100741
Qiaozhi Guo , Xiaopeng Zhao , Jingxiang Ma , Yi Zhou , Fei Gao , Wei Huang , Li Sun , Sufei Zhu , Lijuan Li , Huimin Sun , Wei Jia , Huayan Zhang , Danyang Zhao
Purpose
This article describes the origin of a S. marcescens outbreak in a neonatal intensive care unit (NICU).
Materials and methods
A retrospective case-control study including 12 S. marcescens-positive and 22 S. marcescens-negative neonates in the NICU was performed to identify the source of the outbreak. S. marcescens isolates were collected during the outbreak and analyzed using whole-genome sequencing (WGS). IQ-Tree software, BEAST2 software package and SCOTTI software were used to construct a phylogenetic tree and a propagation path map.
Results
The index case occurred on February 21st and outbreak ended on March 9th, 2021, affecting a total of 12 neonates (2 with S. marcescens infection and 10 with S. marcescens colonization). Multivariate logistic regression identified that the distance of <0.8 m between the bed unit and the sink (odds ratio [OR], 20.50; 95 % confidence interval [CI], 1.09–384.86), a large number of rotating nurses within a week (OR 2.58, 95 % CI, 1.09–6.11) and use of humidification water in the incubator (OR 189.70, 95 % CI, 2.76–13027.31) were significant increased risk factors for S. marcescens infection or colonization in the outbreak. WGS sifted out a predominant clone between contaminated handwashing sinks and patients, suggesting that cross-transmission was involved in the dissemination of S. marcescens.
Conclusion
Contaminated handwashing sinks can be a communication intermediary of S. marcescens infection or colonization of neonates in the NICU. A distance of <0.8 m between the bed unit and the sink, and a large number of rotating nurses might play important roles in this outbreak. Attention should be paid to sinks contamination and contact transmission to prevent outbreaks.
{"title":"Serratia marcescens outbreak in a neonatal intensive care unit associated with contaminated handwashing sinks","authors":"Qiaozhi Guo , Xiaopeng Zhao , Jingxiang Ma , Yi Zhou , Fei Gao , Wei Huang , Li Sun , Sufei Zhu , Lijuan Li , Huimin Sun , Wei Jia , Huayan Zhang , Danyang Zhao","doi":"10.1016/j.ijmmb.2024.100741","DOIUrl":"10.1016/j.ijmmb.2024.100741","url":null,"abstract":"<div><h3>Purpose</h3><div>This article describes the origin of a <em>S. marcescens</em> outbreak in a neonatal intensive care unit (NICU).</div></div><div><h3>Materials and methods</h3><div>A retrospective case-control study including 12 <em>S. marcescens</em>-positive and 22 <em>S. marcescens</em>-negative neonates in the NICU was performed to identify the source of the outbreak. <em>S. marcescens</em> isolates were collected during the outbreak and analyzed using whole-genome sequencing (WGS). IQ-Tree software, BEAST2 software package and SCOTTI software were used to construct a phylogenetic tree and a propagation path map.</div></div><div><h3>Results</h3><div>The index case occurred on February 21st and outbreak ended on March 9th, 2021, affecting a total of 12 neonates (2 with <em>S. marcescens</em> infection and 10 with <em>S. marcescens</em> colonization). Multivariate logistic regression identified that the distance of <0.8 m between the bed unit and the sink (odds ratio [<em>OR</em>], 20.50; 95 % confidence interval [<em>CI</em>], 1.09–384.86), a large number of rotating nurses within a week (<em>OR</em> 2.58, 95 % <em>CI</em>, 1.09–6.11) and use of humidification water in the incubator (<em>OR</em> 189.70, 95 % <em>CI</em>, 2.76–13027.31) were significant increased risk factors for <em>S. marcescens infection or colonization</em> in the outbreak. WGS sifted out a predominant clone between contaminated handwashing sinks and patients, suggesting that cross-transmission was involved in the dissemination of <em>S. marcescens</em>.</div></div><div><h3>Conclusion</h3><div>Contaminated handwashing sinks can be a communication intermediary of <em>S. marcescens</em> infection or colonization of neonates in the NICU. A distance of <0.8 m between the bed unit and the sink, and a large number of rotating nurses might play important roles in this outbreak. Attention should be paid to sinks contamination and contact transmission to prevent outbreaks.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100741"},"PeriodicalIF":1.4,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-09DOI: 10.1016/j.ijmmb.2024.100742
Qin Wang , Yuxia Huang , Xiaoli Liu , Lin Deng , Jingruo Xia , Feng Wen , Chenggui Liu , Xuan Zhu , Jiajia Zhang
Objective
To investigate the clinical infection characteristics and antibiotic resistance of Group B Streptococcus (Streptococcus agalactiae, GBS) in Chengdu, China, from 2019 to 2021, as well as to provide data to support rational clinical drug use.
Methods
This was a retrospective study to collect 203 culture-positive GBS strains isolated from January 2019 to December 2021 in Chengdu, China, all of which were identified by the VITEK 2 Compact automated microbial Bacterial identification instrument. Data were derived using WHONET 5.6 software. The sample type and ward distribution were counted. Pregnant women and newborns were screened from the original data and their pregnancy outcomes were calculated respectively.
Results
GBS strains were mainly concentrated in obstetrics and neonatology departments, accounting for 40.9 % and 33.5 %. The types of specimens were mainly vaginal secretions, amniotic fluid and sputum, accounting for 25.6 %, 26.1 % and 18.7 %, respectively. Chorioamnionitis, premature rupture of membranes and preterm delivery occurred mainly in pregnant women after infection, accounting for 44.4 %, 31.5 % and 24.1 %. Neonates, on the other hand, were mainly diagnosed with neonatal pneumonia, neonatal sepsis, respiratory failure and septic meningitis, accounting for 91.8 %, 61.2 %, 44.9 % and 16.3 % of all positive neonates. 840 pregnant women were screened for GBS colonization from 2019 to 2021, and a total of 108 GBS positive pregnant women were identified, with a GBS colonization rate of 12.9 %. A total of 9 neonates from 108 GBS positive pregnant women developed early-onset disease. The morbidity in neonates was 8.3 %. No strains resistant to penicillin and ampicillin were found, while the resistance rates of tetracycline and clindamycin were higher than 50 %, respectively 60.1 % and 53.2 %.
Conclusion
GBS infection mainly affected pregnant women and newborns in Chengdu, China, which can lead to adverse maternal and infant outcomes. Attention should be paid to strengthening general screening of GBS in perinatal urogenital secretions and the prevention strategy of IAP (intrapartum antibiotic prophylaxis). Antimicrobial therapy should be administered with appropriate antibiotics. Penicillin was still the first line drug for the treatment of GBS. These initiatives were important to reduce mother-to-child transmission and neonatal infections.
{"title":"Characterization of clinical infection and drug resistance of group B streptococcus in Chengdu, China","authors":"Qin Wang , Yuxia Huang , Xiaoli Liu , Lin Deng , Jingruo Xia , Feng Wen , Chenggui Liu , Xuan Zhu , Jiajia Zhang","doi":"10.1016/j.ijmmb.2024.100742","DOIUrl":"10.1016/j.ijmmb.2024.100742","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the clinical infection characteristics and antibiotic resistance of Group B Streptococcus (<em>Streptococcus agalactiae</em>, GBS) in Chengdu, China, from 2019 to 2021, as well as to provide data to support rational clinical drug use.</div></div><div><h3>Methods</h3><div>This was a retrospective study to collect 203 culture-positive GBS strains isolated from January 2019 to December 2021 in Chengdu, China, all of which were identified by the VITEK 2 Compact automated microbial Bacterial identification instrument. Data were derived using WHONET 5.6 software. The sample type and ward distribution were counted. Pregnant women and newborns were screened from the original data and their pregnancy outcomes were calculated respectively.</div></div><div><h3>Results</h3><div>GBS strains were mainly concentrated in obstetrics and neonatology departments, accounting for 40.9 % and 33.5 %. The types of specimens were mainly vaginal secretions, amniotic fluid and sputum, accounting for 25.6 %, 26.1 % and 18.7 %, respectively. Chorioamnionitis, premature rupture of membranes and preterm delivery occurred mainly in pregnant women after infection, accounting for 44.4 %, 31.5 % and 24.1 %. Neonates, on the other hand, were mainly diagnosed with neonatal pneumonia, neonatal sepsis, respiratory failure and septic meningitis, accounting for 91.8 %, 61.2 %, 44.9 % and 16.3 % of all positive neonates. 840 pregnant women were screened for GBS colonization from 2019 to 2021, and a total of 108 GBS positive pregnant women were identified, with a GBS colonization rate of 12.9 %. A total of 9 neonates from 108 GBS positive pregnant women developed early-onset disease. The morbidity in neonates was 8.3 %. No strains resistant to penicillin and ampicillin were found, while the resistance rates of tetracycline and clindamycin were higher than 50 %, respectively 60.1 % and 53.2 %.</div></div><div><h3>Conclusion</h3><div>GBS infection mainly affected pregnant women and newborns in Chengdu, China, which can lead to adverse maternal and infant outcomes. Attention should be paid to strengthening general screening of GBS in perinatal urogenital secretions and the prevention strategy of IAP (intrapartum antibiotic prophylaxis). Antimicrobial therapy should be administered with appropriate antibiotics. Penicillin was still the first line drug for the treatment of GBS. These initiatives were important to reduce mother-to-child transmission and neonatal infections.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100742"},"PeriodicalIF":1.4,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carbapenem-colistin-resistant Klebsiella pneumoniae has emerged as a serious global problem. Klebsiella pneumoniae is a major culprit in healthcare settings and is responsible for septicemia, urinary tract infections, pneumonia, meningitis, burn wound and surgical site infections, and liver abscesses even in younger and healthier population worldwide. The formation of biofilm prevents antibiotics from reaching the bacteria and exerting their effector mechanism. The non-availability of therapeutic alternatives (antibiotic therapy) further complicates the scenario. However, in the era of antibiotic resistance, bacteriophage therapy emerges as a ray of hope against antibiotic-resistant bacteria.
Method
The present review focuses on the therapeutic potential of bacteriophages as an antimicrobial agent with special reference to safety, specificity, efficacy, dosage, and dosage frequency against Pan-Drug Resistant (PDR) K. pneumoniae, both in-vitro and in-vivo (animals and human) studies.
Result
This review highlights the perspectives therapeutic potential of bacteriophages, their impact on the host immune system, combination therapy, and bacteriophage-encoded gene product endolysin, artificial lysins (Artilysins), polysaccharide depolymerase, and peptidoglycan hydrolases.
Conclusion
This review briefly describes the application of bacteriophage and its encoded gene products in clinical trials.
{"title":"Klebsiella pneumoniae infections and phage therapy","authors":"Alakh Narayan Singh, Aprajita Singh, Sudhir Kumar Singh, Gopal Nath","doi":"10.1016/j.ijmmb.2024.100736","DOIUrl":"10.1016/j.ijmmb.2024.100736","url":null,"abstract":"<div><h3>Objective</h3><div>Carbapenem-colistin-resistant <em>Klebsiella pneumoniae</em> has emerged as a serious global problem. <em>Klebsiella pneumoniae</em> is a major culprit in healthcare settings and is responsible for septicemia, urinary tract infections, pneumonia, meningitis, burn wound and surgical site infections, and liver abscesses even in younger and healthier population worldwide. The formation of biofilm prevents antibiotics from reaching the bacteria and exerting their effector mechanism. The non-availability of therapeutic alternatives (antibiotic therapy) further complicates the scenario. However, in the era of antibiotic resistance, bacteriophage therapy emerges as a ray of hope against antibiotic-resistant bacteria.</div></div><div><h3>Method</h3><div>The present review focuses on the therapeutic potential of bacteriophages as an antimicrobial agent with special reference to safety, specificity, efficacy, dosage, and dosage frequency against Pan-Drug Resistant (PDR) <em>K. pneumoniae,</em> both <em>in-vitro</em> and <em>in-vivo</em> (animals and human) studies.</div></div><div><h3>Result</h3><div>This review highlights the perspectives therapeutic potential of bacteriophages, their impact on the host immune system, combination therapy, and bacteriophage-encoded gene product endolysin, artificial lysins (Artilysins), polysaccharide depolymerase, and peptidoglycan hydrolases.</div></div><div><h3>Conclusion</h3><div>This review briefly describes the application of bacteriophage and its encoded gene products in clinical trials.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"52 ","pages":"Article 100736"},"PeriodicalIF":1.4,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}