scholarly journals Clinical manifestations, molecular characteristics, antimicrobial susceptibility patterns and contributions of target gene mutation to fluoroquinolone resistance in Elizabethkingia anophelis

2018 ◽  
Vol 73 (9) ◽  
pp. 2497-2502 ◽  
Author(s):  
Jiun-Nong Lin ◽  
Chung-Hsu Lai ◽  
Chih-Hui Yang ◽  
Yi-Han Huang ◽  
Hsi-Hsun Lin
2019 ◽  
Vol 63 (5) ◽  
Author(s):  
Jiun-Nong Lin ◽  
Chung-Hsu Lai ◽  
Chih-Hui Yang ◽  
Yi-Han Huang

ABSTRACTChryseobacteriuminfections are uncommon, and previous studies have revealed thatChryseobacterium gleumis frequently misidentified asChryseobacterium indologenes. We aimed to explore the differences in clinical manifestations and antimicrobial susceptibility patterns betweenC. gleumandC. indologenes. The database of a clinical microbiology laboratory was searched to identify patients withChryseobacteriuminfections between 2005 and 2017. Species were reidentified using 16S rRNA gene sequencing, and patients withC. gleumandC. indologenesinfections were included in the study. A total of 42C. gleumand 84C. indologenesisolates were collected from consecutive patients. A significant increase inC. indologenesincidence was observed.C. gleumwas significantly more associated with bacteremia thanC. indologenes. Patients withC. gleuminfections had more comorbidities of malignancy and liver cirrhosis than those withC. indologenesinfections. The overall case fatality rate was 19.8%. Independent risk factors for mortality were female sex andC. indologenesinfection. These isolates were most susceptible to minocycline (73%), followed by trimethoprim-sulfamethoxazole (47.6%), tigecycline (34.1%), and levofloxacin (32.5%).C. gleumexhibited a significantly higher rate of susceptibility thanC. indologenesto piperacillin, piperacillin-tazobactam, ceftazidime, tigecycline, and levofloxacin. Alterations in DNA gyrase subunit A were identified to be associated with fluoroquinolone resistance inC. indologenes. No nonsynonymous substitutions were observed in the quinolone resistance-determining regions (QRDRs) ofC. gleum. Differences in epidemiology, clinical manifestations, and antimicrobial susceptibility patterns exist betweenC. gleumandC. indologenes. Additional investigations are needed to explore the significance of these differences.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S229-S229
Author(s):  
Jae Hong Choi ◽  
Hyunju Lee ◽  
Eun Hwa Choi

Abstract Background Staphylococcal scalded skin syndrome (SSSS) is a blistering and desquamative skin disease caused by the exfoliative toxins of Staphylococcus aureus. SSSS mainly affects children younger than 5 years of age. Although many countries show a predominance of methicillin-susceptible S. aureus (MSSA), recently an increase in cases due to methicillin-resistant S. aureus (MRSA) has been reported. We investigated the molecular characteristics of S. aureus isolated from the children with SSSS in Korea. Methods From January 2010 to December 2017, children clinically diagnosed as SSSS under the age of 5 years were enrolled. Cases from 3 different university hospitals in Korea were included. S. aureus isolated from nasal, axillary, or inguinal area of the children were analyzed for multilocus sequence type and exfoliative toxins (eta, etb). Medical records were retrospectively reviewed for clinical characteristics and antimicrobial susceptibility patterns of S. aureus. Results A total of 26 cases were enrolled. The mean age was 2.3 years (range, 0–4.8 years). Twenty-two (84.6%) patients were hospitalized. Skin manifestations were classified as follows; generalized (n = 10, 38.5%), intermediate (n = 11, 42.3%), and abortive (n = 5, 19.2%). Twenty-five isolates (96.2%) were resistant to methicillin and macrolide-resistance was found in 92.3% (n = 24). ST89 (n = 21, 80.8%) was the most prevalent clone, with single clones of ST1, ST5, ST72, ST121, and ST1507. The eta gene was detected in 1 (3.8%) MSSA isolate. The etb gene was detected in 14 (53.8%) isolates all of which were ST89. All patients were treated with antibiotics, and the mean duration was 8.3 days regardless of the administration route. Nafcillin or first cephalosporin was most commonly prescribed (n = 20, 76.9%), clindamycin was administered in combination in 9 patients (34.6%) and vancomycin in 4 patients (15.4%). Among the 25 MRSA cases, only 6 (24.0%) were treated with susceptible antibiotics. However, there was no difference in treatment duration according to antimicrobial susceptibility (8.43:8.22 days, P > 0.05). Conclusion The molecular epidemiology of S. aureus isolated from the Korean children with SSSS demonstrated the high prevalence of methicillin-resistant ST89 clone that harbors the etb gene. Disclosures All authors: No reported disclosures.


2018 ◽  
Vol 7 (12) ◽  
pp. 538 ◽  
Author(s):  
Jiun-Nong Lin ◽  
Chung-Hsu Lai ◽  
Chih-Hui Yang ◽  
Yi-Han Huang

Elizabethkingia meningoseptica and Elizabethkingia anophelis are two major pathogens in the genus Elizabethkingia. Studies have revealed that Elizabethkingia anophelis is frequently misidentified as E. meningoseptica. Therefore, our aim was to explore the clinical and molecular differences between these two species. The database of a clinical microbiology laboratory in a university-affiliated hospital of Taiwan was searched to identify patients with Elizabethkingia infections between January 2005 and June 2018. Species were reidentified using 16S ribosomal RNA gene sequencing. Twenty E. meningoseptica and 72 E. anophelis samples were collected from consecutive patients. E. meningoseptica was significantly more frequently isolated from the cerebrospinal fluid than was E. anophelis. The most susceptible antibiotic for all Elizabethkingia isolates was minocycline (91.3%), followed by levofloxacin (52.2%), tigecycline (23.9%), and piperacillin tazobactam (23.9%). Compared with E. anophelis, E. meningoseptica was significantly less susceptible to piperacillin tazobactam, minocycline, and levofloxacin. Regarding nonsynonymous substitutions in the quinolone-resistance determining regions of DNA gyrase, six sites were recognized in E. meningoseptica and one site was recognized in E. anophelis. E. meningoseptica had a significantly higher rate of fluoroquinolone target gene mutations than did E. anophelis. Because of less susceptibility to multiple antibiotics than E. anophelis, empirical antimicrobial therapy of E. meningoseptica should be more rigorous.


Author(s):  
Gemedo Misha ◽  
Legese Chelkeba ◽  
Tsegaye Melaku

Abstract Background Globally, surgical site infections are the most reported healthcare-associated infection and common surgical complication. In developing countries such as Ethiopia, there is a paucity of published reports on the microbiologic profile and resistance patterns of an isolates. Objective This study aimed at assessing the bacterial profile and antimicrobial susceptibility patterns of isolates among patients diagnosed with surgical site infection at Jimma Medical Center in Ethiopia. Methods A prospective cohort study was employed among adult patients who underwent either elective or emergency surgical procedures. All the eligible patients were followed for 30 days for the occurrence of surgical site infection (SSI). From those who developed SSI, infected wound specimens were collected and studied bacteriologically. Results Of 251 study participants, 126 (50.2%) of them were females. The mean ± SD age of the patients was 38 ± 16.30 years. The overall postoperative surgical site infection rate was 21.1% and of these 71.7% (38/53) were culture positive. On gram stain analysis, 78% of them were Gram-negative, 11.5% were Gram-positive and 10.5% were a mixture of two microbial growths. Escherichia coli accounted for (21.43%), followed by Pseudomonas aeruginosa (19.05%), Proteus species (spp.) 14.29%), Staphylococcus aureus (11.90%), Klebsiella species (11.90%), Citrobacter spp. (9.5%), streptococcal spp. (7.14%), Coagulase-negative S. aureus (CoNS) (2.38%) Conclusion Gram-negative bacteria were the most dominant isolates from surgical sites in the study area. Among the Gram-negative bacilli, Escherichia coli were the most common bacteria causing surgical site infection. As there is high antibiotic resistance observed in the current study, it is necessary for routine microbial analysis of samples and their antibiogram.


2020 ◽  
Vol 33 (6) ◽  
pp. 793-802 ◽  
Author(s):  
Weijing Kong ◽  
Yan Meng ◽  
Liping Zou ◽  
Guang Yang ◽  
Jing Wang ◽  
...  

AbstractObjectivesSanfilippo syndrome (Mucopolysaccharidosis III, MPS III) is a rare autosomal recessive hereditary disease, which is caused by lysosomal enzyme deficiency. This study was operated to investigate clinical and molecular characteristics of patients with MPS III, which will improve the diagnosis and treatment of MPS III.MethodThirty four patients with MPS III were assessed using clinical evaluation, questionnaire, and scoring system.ResultsAmong the 34 patients, 14 had MPS IIIA, 19 had MPS III B, and one had MPS III C. Speech delay (100%) and intellectual disability (100%) were the most prevalent clinical manifestations in this cohort, followed by hyperactivity (94.12%), hirsutism (91.18%), enlarged head circumference (73.52%), repeated diarrhea (67.64%), sparse teeth (67.64%), and Mongolian spots (64.71%). There were two clinical manifestations that were significantly different between IIIA and IIIB: Hepatosplenomegaly and serrated teeth. The most common initial symptoms at diagnosis were speech delay (52.94%), hyperactivity (35.29%), and mental retardation (29.41%). Genetic analysis of 25 patients was conducted, which identified 12 novel mutations.ConclusionWhen language retardation, mental retardation, and rough facial features occurred, MPS III should be considered. At same time, more examination should be operated, such as examination of changes in cranial magnetic resonance imaging of cerebral cortex atrophy. Hepatosplenomegaly and serrated teeth could be used clinically to preliminarily distinguish IIIA from IIIB.


2017 ◽  
Vol 55 (4) ◽  
pp. 1025-1031 ◽  
Author(s):  
Kunatum Prasidthrathsint ◽  
Mark A. Fisher

ABSTRACTAntimicrobial susceptibility patterns from 599A. defectiva,G. adiacens, andG. elegansclinical isolates were determined by broth microdilution. We observed significant differences in susceptibility across species, particularly to penicillin and ceftriaxone, and across geographical regions.A. defectivawas the least susceptible species overall to penicillin. All isolates were susceptible to vancomycin and >90% were susceptible to levofloxacin.


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