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Infection and Immunity Jun 2020The regulation and timely expression of bacterial genes during infection is critical for a pathogen to cause an infection. Bacteria have multiple mechanisms to regulate... (Review)
Review
The regulation and timely expression of bacterial genes during infection is critical for a pathogen to cause an infection. Bacteria have multiple mechanisms to regulate gene expression in response to their environment, one of which is two-component systems (TCS). TCS have two components. One component is a sensory histidine kinase (HK) that autophosphorylates when activated by a signal. The activated sensory histidine kinase then transfers the phosphoryl group to the second component, the response regulator, which activates transcription of target genes. The genus contains members that cause human disease and are often extensively resistant to many antibiotics. The complex (BCC) can cause severe lung infections in patients with cystic fibrosis (CF) or chronic granulomatous disease (CGD). BCC members have also recently been associated with several outbreaks of bacteremia from contaminated pharmaceutical products. Separate from the BCC is , which is the causative agent of melioidosis, a serious disease that occurs in the tropics, and a potential bioterrorism weapon. Bioinformatic analysis of sequenced isolates predicts that most strains have at least 40 TCS. The vast majority of these TCS are uncharacterized both in terms of the signals that activate them and the genes that are regulated by them. This review will highlight TCS that have been described to play a role in virulence in either the BCC or Since many of these TCS are involved in virulence, TCS are potential novel therapeutic targets, and elucidating their function is critical for understanding pathogenesis.
Topics: Bacterial Physiological Phenomena; Burkholderia; Burkholderia Infections; Burkholderia cepacia complex; Gene Expression Regulation, Bacterial; Host-Pathogen Interactions; Humans; Signal Transduction; Virulence; Virulence Factors
PubMed: 32284365
DOI: 10.1128/IAI.00927-19 -
Le Infezioni in Medicina Dec 2018Burkholderia cepacia complex (Bcc) is a Gram-negative bacterium commonly found in moist environments and soil. Bcc species are associated with many outbreaks in... (Review)
Review
Burkholderia cepacia complex (Bcc) is a Gram-negative bacterium commonly found in moist environments and soil. Bcc species are associated with many outbreaks in intensive care units (ICUs). In this review, we describe the sources of Bcc outbreaks among non-cystic fibrosis (CF) patients in various ICUs that include neonatal intensive care units, pediatric intensive care units and adult ICUs. Also we summarize the risk factors and outcome predictors of Bcc infection or colonization in non-CF critically ill patients. Finally, we describe the infection control measures that are used to manage and prevent the spread of Bcc outbreaks. PubMed was searched from 1 January 1994 and 31 December 2017. We found 30 outbreaks of Bcc among non-cystic fibrosis patients in ICUs; 17 outbreaks occurred in adult ICUs. The source was identified in 22 outbreaks. B. cepacia was the most common Bcc species causing outbreaks in ICUs; it was detected in 21 outbreaks. Indwelling central lines, presence of renal failure on hemodialysis, multiple bronchoscopic procedures, and recent abdominal surgery are independently associated with the development of B. cepacia bacteremia, while prolonged duration on a mechanical ventilator, a large number of nebulized albuterol therapies delivered, and prescription of beta-lactam, aztreonam, or macrolide-vancomycin antibiotics are risk factors for respiratory tract acquisition of B. cepacia. Disease severity and age were the main significant independent predictors of 14-day mortality in adult ventilated non-CF patients with Bcc acquisition. Bcc species have been linked to many outbreaks in non-CF patients in ICUs. Strict application of infection control standards is critical to limit the emergence and spread of Bcc in ICU settings.
Topics: Adult; Burkholderia Infections; Burkholderia cepacia complex; Child; Cystic Fibrosis; Disease Outbreaks; Humans; Intensive Care Units
PubMed: 30555132
DOI: No ID Found -
Microorganisms Jun 2022complex (BCC) contamination has resulted in recalls of non-sterile pharmaceutical products. The fast, sensitive, and specific detection of BCC is critical for ensuring...
complex (BCC) contamination has resulted in recalls of non-sterile pharmaceutical products. The fast, sensitive, and specific detection of BCC is critical for ensuring the quality and safety of pharmaceutical products. In this study, a rapid flow cytometry-based detection method was developed using a fluorescence-labeled oligonucleotide probe that specifically binds a KefB/KefC membrane protein sequence within BCC. Optimal conditions of a 1 nM probe concentration at a 60 °C hybridization temperature for 30 min were determined and applied for the flow cytometry assay. The true-positive rate (sensitivity) and true-negative rate (specificity) of the probe assay were 90% (18 positive out of 20 BCC species) and 88.9% (16 negative out of 18 non-BCC), respectively. The detection limit for AU1054 with the probe flow cytometry assay in nuclease-free water was 1 CFU/mL. The average cell counts using the probe assay from a concentration of 10 μg/mL chlorhexidine gluconate and 50 μg/mL benzalkonium chloride were similar to those of the RAPID-B total plate count (TPC). We demonstrate the potential of probe flow cytometry as a more sensitive alternative to culture-based methods for detecting BCC in non-sterilized pharmaceutical raw materials and products with regards to water-based environments.
PubMed: 35744688
DOI: 10.3390/microorganisms10061170 -
Indian Journal of Critical Care... Sep 2019is metabolically versatile organism which is not only resistant to many antibiotics but also disinfectants. This makes their survival easy even in restricted areas like...
BACKGROUND
is metabolically versatile organism which is not only resistant to many antibiotics but also disinfectants. This makes their survival easy even in restricted areas like intensive care unit (ICU) and management difficult.
AIMS AND OBJECTIVES
To describe sudden emergence of at a tertiary care centre ICU setting in milieu of colistin usage.
MATERIALS AND METHODS
Cases were patients with culture proven They were picked up as non-lactose fermenting, oxidase positive, motile, gram-negative bacilli which was resistant to colistin and aminoglycosides and sensitive to cotrimoxazole. These isolates were further confirmed by both VITEK-2 compact system (Biomerieux, France) and standard bacterial techniques.Colistin consumption data were retrospectively collected from medical store records of hospitals and individual ICU pharmacy records from January 2016 to June 2016, and were expressed as total dialy doses in a month per 1000 patient days (DDD/1000PD).
RESULTS
An increase was observed in infection linked to increased consumption of colistin in ICU.
CONCLUSION
Based on these results an increase was observed in infection which correlated with increased consumption of colistin in ICU. We speculate that extensive use of colistin may lead to selection of intrinsically resistant and may facilitate their spread as nosocomial pathogens.
HOW TO CITE THIS ARTICLE
Meena S, Bir R, Sood S, Das BK, Kapil A. Emergence of in ICU Setting. Indian J Crit Care Med 2019;23(9):423-426.
PubMed: 31645828
DOI: 10.5005/jp-journals-10071-23237 -
Peritoneal Dialysis International :... 2016♦
UNLABELLED
♦
BACKGROUND
Burkholderia cepacia is a hardy bacterium with intrinsic resistance to multiple antibiotics and high transmissibility. Opportunistic healthcare-associated B. cepacia infections among immunocompromised or critically ill patients have been reported, but there is limited data on the clinical characteristics and treatment outcomes of exit-site infection (ESI) in peritoneal dialysis (PD) patients. ♦
PATIENTS AND METHODS
Patients who suffered from B. cepacia ESI from 1 January 2004 to 31 December 2014 were reviewed. The clinical characteristics and treatment outcomes of the patients and the antibiotic susceptibility patterns of the bacterial isolates were analyzed. ♦
RESULTS
Twenty-two patients were included for analysis. Eight patients (36.4%) had medical conditions which impaired host immunity, while 7 (31.8%) had pre-existing skin abnormalities. Three patients (13.6%) progressed to tunnel-tract infection and another 3 patients (13.6%) developed associated peritonitis. Fifteen patients (68.2%) responded to medical treatment while 7 (31.8%) required catheter removal. Eleven patients (50.0%) had recurrent B. cepacia ESI, which occurred at 7.8 months (95% confidence interval [CI] 0.1 - 19.4 months) after the first episode. Most B. cepacia strains were susceptible to ceftazidime (95.5%), piperacillin/tazobactam (95.5%), and piperacillin (90.9%). Besides aminoglycosides (80 - 100%), high rates of resistance were also observed for ticarcillin/clavulanate (90.9%). ♦
CONCLUSION
Burkholderia cepacia ESI is associated with low rates of tunnel-tract infection or peritonitis, but the risk of recurrence is high. Most cases can be managed with medical treatment alone, although one third of patients might require catheter removal.
Topics: Aged; Anti-Bacterial Agents; Burkholderia Infections; Burkholderia cepacia; Catheter-Related Infections; Catheters, Indwelling; Device Removal; Drug Resistance, Bacterial; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Peritoneal Dialysis; Peritonitis; Retrospective Studies; Treatment Outcome
PubMed: 26493755
DOI: 10.3747/pdi.2015.00122 -
The American Journal of Tropical... Dec 2020Patients undergoing hemodialysis are at an increased risk for bloodstream infections (BSIs). Infection usually occurs because of contamination of water supply, water...
Patients undergoing hemodialysis are at an increased risk for bloodstream infections (BSIs). Infection usually occurs because of contamination of water supply, water treatment, distribution systems, or reprocessing dialyzers. Here, we report an outbreak of BSIs caused by Stenotrophomonas maltophilia (n = 21) and Burkholderia cepacia (n = 22) among dialyzed patients at a large hemodialysis center in Brazil. Overall, three patients died (7%), two of which had bacteremia caused by S. maltophilia and the other had a B. cepacia infection. We collected water samples from different points of the hemodialysis system for culture and typing. Genetic patterns were identified through polymerase chain reaction-random amplified polymorphic DNA (PCR-RAPD) and pulsed-field gel electrophoresis. The same genotypes of S. maltophilia and B. cepacia recovered from blood cultures were found in dialysis water. Also, multiple genetic profiles were identified among water isolates, suggesting heavy contamination. Bacteremia cases persisted even after implementing standard control measures, which led us to believe that the piping system was contaminated with microbial biofilms. Soon after we changed the entire plumbing system, reported cases dropped back to the number typically expected, and the outbreak came to an end.
Topics: Adult; Aged; Aged, 80 and over; Brazil; Burkholderia Infections; Burkholderia cepacia; Disease Outbreaks; Disinfection; Female; Gram-Negative Bacterial Infections; Humans; Male; Middle Aged; Renal Dialysis; Sepsis; Stenotrophomonas maltophilia
PubMed: 33319730
DOI: 10.4269/ajtmh.20-1035 -
Epidemiology and Infection Aug 2022In March 2018, the US Food and Drug Administration (FDA), US Centers for Disease Control and Prevention, California Department of Public Health, Los Angeles County...
In March 2018, the US Food and Drug Administration (FDA), US Centers for Disease Control and Prevention, California Department of Public Health, Los Angeles County Department of Public Health and Pennsylvania Department of Health initiated an investigation of an outbreak of complex () infections. Sixty infections were identified in California, New Jersey, Pennsylvania, Maine, Nevada and Ohio. The infections were linked to a no-rinse cleansing foam product (NRCFP), produced by Manufacturer A, used for skin care of patients in healthcare settings. FDA inspected Manufacturer A's production facility (manufacturing site of over-the-counter drugs and cosmetics), reviewed production records and collected product and environmental samples for analysis. FDA's inspection found poor manufacturing practices. Analysis by pulsed-field gel electrophoresis confirmed a match between NRCFP samples and clinical isolates. Manufacturer A conducted extensive recalls, FDA issued a warning letter citing the manufacturer's inadequate manufacturing practices, and federal, state and local partners issued public communications to advise patients, pharmacies, other healthcare providers and healthcare facilities to stop using the recalled NRCFP. This investigation highlighted the importance of following appropriate manufacturing practices to minimize microbial contamination of cosmetic products, especially if intended for use in healthcare settings.
Topics: Aerosols; Burkholderia Infections; Burkholderia cepacia complex; Cross Infection; Disease Outbreaks; Electrophoresis, Gel, Pulsed-Field; Humans; United States
PubMed: 35923078
DOI: 10.1017/S0950268822000668 -
Infection and Drug Resistance 2023is an aerobic opportunistic Gram-negative pathogen that mainly infects immunodeficiency patients. However, soft tissue infections with fractures due to are rare with...
is an aerobic opportunistic Gram-negative pathogen that mainly infects immunodeficiency patients. However, soft tissue infections with fractures due to are rare with no cases reported. Here, we report a rare case of 3 years of brain death in a 43-year-old woman with resulting in an occipital subcutaneous abscess and fracture. Through the second-generation sequencing of the whole genome of this strain, it was found that there were no high virulence genes and virulence factors. The patient received targeted antibiotic therapy and showed improvement in clinical symptoms and radiological signs. Bone destruction because of is easily overlooked due to the lack of characteristic symptoms and limited clinical examination. This case reminds us that without major virulence factors could damage the bone in immune-compromised patients.
PubMed: 37457794
DOI: 10.2147/IDR.S418967 -
Antibiotics (Basel, Switzerland) Nov 2021Bacteria of the genus include pathogenic , and the complex (Bcc). These Gram-negative pathogens have intrinsic drug resistance, which makes treatment of infections...
Bacteria of the genus include pathogenic , and the complex (Bcc). These Gram-negative pathogens have intrinsic drug resistance, which makes treatment of infections difficult. Bcc affects individuals with cystic fibrosis (CF) and the species is associated with one of the worst clinical outcomes. Following the repurposing of auranofin as an antibacterial against Gram-positive bacteria, we previously synthetized auranofin analogs with activity against Gram-negatives. In this work, we show that two auranofin analogs, MS-40S and MS-40, have antibiotic activity against clinical isolates. The compounds are bactericidal against and kill stationary-phase cells and persisters without selecting for multistep resistance. and tolerated high concentrations of MS-40S and MS-40, demonstrating that these compounds have low toxicity in these model organisms. In summary, we show that MS-40 and MS-40S have antimicrobial properties that warrant further investigations to determine their therapeutic potential against infections.
PubMed: 34943654
DOI: 10.3390/antibiotics10121443 -
Frontiers in Cellular and Infection... 2017Cystic fibrosis (CF) is an autosomal recessive disorder caused by mutations in the gene that codes for the CF trans-membrane conductance regulator. These mutations... (Review)
Review
Cystic fibrosis (CF) is an autosomal recessive disorder caused by mutations in the gene that codes for the CF trans-membrane conductance regulator. These mutations result in abnormal secretions viscous airways of the lungs, favoring pulmonary infection and inflammation in the middle of neutrophil recruitment. Recently it was described that neutrophils can contribute with disease pathology by extruding large amounts of nuclear material through a mechanism of cell death known as Neutrophil Extracellular Traps (NETs) into the airways of patients with CF. Additionally, NETs production can contribute to airway colonization with bacteria, since they are the microorganisms most frequently found in these patients. In this review, we will discuss the implication of individual or mixed bacterial infections that most often colonize the lung of patients with CF, and the NETs role on the disease.
Topics: Bacteria; Bacterial Infections; Coinfection; Cystic Fibrosis; Extracellular Traps; Humans; Neutrophil Infiltration
PubMed: 28428948
DOI: 10.3389/fcimb.2017.00104