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International Microbiology : the... Apr 2024Morganella morganii is a bacterium belonging to the normal intestinal microbiota and the environment; however, in immunocompromised individuals, this bacterium can...
Clonal relationship, virulence genes, and antimicrobial resistance of Morganella morganii isolated from community-acquired infections and hospitalized patients: a neglected opportunistic pathogen.
Morganella morganii is a bacterium belonging to the normal intestinal microbiota and the environment; however, in immunocompromised individuals, this bacterium can become an opportunistic pathogen, causing a series of diseases, both in hospitals and in the community, being urinary tract infections more prevalent. Therefore, the objective of this study was to evaluate the prevalence, virulence profile, and resistance to antimicrobials and the clonal relationship of isolates of urinary tract infections (UTI) caused by M. morganii, both in the hospital environment and in the community of the municipality of Londrina-PR, in southern Brazil, in order to better understand the mechanisms for the establishment of the disease caused by this bacterium. Our study showed that M. morganii presents a variety of virulence factors in the studied isolates. Hospital strains showed a higher prevalence for the virulence genes zapA, iutA, and fimH, while community strains showed a higher prevalence for the ireA and iutA genes. Hospital isolates showed greater resistance compared to community isolates, as well as a higher prevalence of multidrug-resistant (MDR) and extended-spectrum beta lactamase (ESBL)-producing isolates. Several M. morganii isolates from both sources showed high genetic similarity. The most prevalent plasmid incompatibility groups detected were FIB and I1, regardless of the isolation source. Thus, M. morganii isolates can accumulate virulence factors and antimicrobial resistance, making them a neglected opportunistic pathogen.
Topics: Humans; Anti-Bacterial Agents; Morganella morganii; Virulence; Community-Acquired Infections; Drug Resistance, Bacterial; Urinary Tract Infections; Virulence Factors; beta-Lactamases; Microbial Sensitivity Tests
PubMed: 37479959
DOI: 10.1007/s10123-023-00400-x -
3 Biotech May 2023a non-negligent opportunistic pathogen of the family enlisted recently in the global priority pathogens by WHO for its swift propensity to acquire drug-resistant...
UNLABELLED
a non-negligent opportunistic pathogen of the family enlisted recently in the global priority pathogens by WHO for its swift propensity to acquire drug-resistant genes, engendering enhanced death rates. A combination of diverse antimicrobials could be recycled to overcome the ongoing acquisition of resistance mechanisms by . Herein, we investigated the in vitro synergistic effect of colistin with meropenem, rifampicin, minocycline and linezolid against three intrinsic colistin-resistant strains collected from critical departments of tertiary care hospitals. The strains were identified and tested for antimicrobial susceptibility by VITEK 2 automated system. The 16S rRNA sequencing was used to reconfirm the species identification. Minimum inhibitory concentrations (MICs) of colistin, meropenem, rifampicin, minocycline and linezolid were determined by the broth microdilution method. Synergistic interactions were studied by checkerboard and time-kill assay. The VITEK 2 identification and 16S rRNA sequencing confirmed that the strains were . The automated antimicrobial susceptibility test revealed that all three isolates were multi-drug resistant. The checkerboard analysis demonstrated the synergy of all four combinations with FICI values ranging from 0.06 to 0.31 in all three isolates. These results suggest a potential role of meropenem as an adjuvant for treating infections. The current work presented the first evidence of synergy between colistin and other antibiotics against infection, which needs validation through in vitro and in vivo studies using a larger number of isolates.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s13205-023-03551-w.
PubMed: 37064006
DOI: 10.1007/s13205-023-03551-w -
PLoS Neglected Tropical Diseases Mar 2023Snakebites represent a significant health problem in tropical countries, with an annual incidence of 2.7 million cases worldwide. The incidence of secondary infections...
BACKGROUND
Snakebites represent a significant health problem in tropical countries, with an annual incidence of 2.7 million cases worldwide. The incidence of secondary infections after snake bites is also high and is usually caused by bacteria from the oral cavity of snakes. Morganella morganii has been identified as an important cause of infections and has been guiding antibiotic therapy in several regions of Brazil and the world.
METHODOLOGY/PRINCIPAL FINDINGS
We performed a retrospective cross-sectional evaluation of snakebites in hospitalized patients between January 2018 and November 2019 and selected those with secondary infection in their medical records. During the period, 326 cases of snakebites were treated, and 155 (47.5%) of them eventually had secondary infections. However, only seven patients underwent culture of soft tissue fragments, in which three cases were negative culture results, while Aeromonas hydrophila was identified in four cases. Of these, 75% were resistant to ampicillin/sulbactam, 50% had intermediate sensitivity to imipenem, and 25% had intermediate sensitivity to piperacillin/tazobactam. Trimethoprim/sulfamethoxazole (TMP-SMX) was not tested on any strain. Of the 155 cases that progressed to secondary infections, 48.4% (75) were empirically treated with amoxicillin/clavulanate, 41.9% (65) with TMP-SMX, and 32 (22%) of these 144 cases required a change to a second regimen, and 10 of these 32 patients required a third therapeutic regimen.
CONCLUSION
Wild animals act as reservoirs of resistant bacteria because their oral cavity favors biofilm formation, which explains the finding of A. hydrophila with a reduced sensitivity profile in this study. This fact is essential for the appropriate choice of empirical antibiotic therapy.
Topics: Animals; Snake Bites; Trimethoprim, Sulfamethoxazole Drug Combination; Coinfection; Brazil; Retrospective Studies; Cross-Sectional Studies; Anti-Bacterial Agents
PubMed: 36877732
DOI: 10.1371/journal.pntd.0011167 -
Caspian Journal of Internal Medicine Mar 2021Peritoneal infection following pleural empyema is not a common occurrence. Concomitant pleural empyema and peritonitis have been described in the literature mostly in...
BACKGROUND
Peritoneal infection following pleural empyema is not a common occurrence. Concomitant pleural empyema and peritonitis have been described in the literature mostly in immunocompromised patients with different pathogenic mechanisms and a wide array of microorganisms. Here we report a case of concomitant pleural empyema and peritonitis with an unusual microorganism in an immunocompetent host.
CASE PRESENTATION
The patient is a 42-year-old man with a history of 2 weeks epigastric pain who had been referred for surgical consult after failure of outpatient medical therapy. Physical examination at emergency ward revealed generalized abdominal guarding, tenderness and rebound tenderness. On emergent laparotomy, the peritoneal cavity was full of malodor pus. All abdominal viscera were intact but there was a 2x2 centimeter defect in the top of left hemi-diaphragm. Pus originated from the left thoracic cavity and then drained to the peritoneal cavity. grew in the culture of aspirated pleural fluid. After abdominal lavage and chest tube drainage and receiving 14 days course of parenteral antibiotics, the patient experienced marked clinical improvement. Punctual history taking revealed a history of pneumonia before the beginning of abdominal symptoms.
CONCLUSION
In concomitant empyema and peritonitis in an immunocompetent patient, one should keep in mind the possibility of diaphragmatic defect and infection by unusual organisms like
PubMed: 34012544
DOI: 10.22088/cjim.12.2.232 -
FEMS Microbiology Letters Mar 2020Morganella morganii, a gram negative, facultative anaerobic bacterium belonging to the Proteeae tribe of the Morganellaceae family, is an unusual opportunistic pathogen...
Morganella morganii, a gram negative, facultative anaerobic bacterium belonging to the Proteeae tribe of the Morganellaceae family, is an unusual opportunistic pathogen mainly responsible for nosocomial and urinary tract infections. While cattle have long been established as a source of a few zoonotic pathogens, no such data has been recorded for M. morganii despite its ubiquitous presence in nature and a number of animal hosts. In this study, draft genomes were produced of three M. morganii isolates from Bangladeshi cattle. The three isolates, named B2, B3 and B5, possessed an average genome size of 3.9 Mp, a GC% of ∼51% and pan and core genomes of 4637 and 3812 genes, respectively. All strains were bearers of the qnrD1 carrying plasmid Col3M and possessed roughly similar virulence profiles and prophage regions. The strains also carried genes that were unique when compared with other publicly available M. morganii genomes. Many of these genes belonged to metabolic pathways associated with adaptation to environmental stresses and were predicted in silico to be borne in genomic islands. The findings of this study expand on the current understanding of M. morganii''s genomic nature and its adaptation in cattle.
Topics: Animals; Bangladesh; Cattle; Genome, Bacterial; Genomic Islands; Morganella morganii; Prophages; Rectum; Virulence Factors; Whole Genome Sequencing
PubMed: 32129839
DOI: 10.1093/femsle/fnaa043 -
Cureus Mar 2020Morganella morganii is a rare opportunistic pathogen that is known to cause urinary tract and intra-abdominal infections. Per our literature review, there are few case...
Morganella morganii is a rare opportunistic pathogen that is known to cause urinary tract and intra-abdominal infections. Per our literature review, there are few case reports of neonatal sepsis associated with this organism but to our knowledge, there are no case reports of Morganella morganii causing fetal demise in published literature in the Englishlanguage. In this case report, we present a case of a 34-year-old pregnant woman who had a hospital course complicated by Morganella morganii, which eventually led to stillbirth.
PubMed: 32257711
DOI: 10.7759/cureus.7169 -
BMC Infectious Diseases Nov 2019Patients with multiple myeloma (MM) are known to be immune incompetent and experience higher incidences of infectious diseases. However, infective endocarditis (IE) is...
BACKGROUND
Patients with multiple myeloma (MM) are known to be immune incompetent and experience higher incidences of infectious diseases. However, infective endocarditis (IE) is rarely observed in patients with MM and Morganella morganii (M. morganii) has rarely been associated with IE.
CASE PRESENTATION
A 72-year-old female receiving 4th line treatment for MM presented with fever and concomitant confusion. Urinary culture revealed growth of Escherichia coli, wherefore broadspectrum penicillin and high-dose corticosteroids were initiated. However, blood cultures showed growth of M. morganii. Fluoroquinolone was added due to penicillin-resistance of the Morganella species. Two days after admission, the patient acutely deteriorated with hemodynamic instability. Gentamicin and high dose corticosteroids were added. Echocardiography showed marked aortic valve vegetation with severe aortic valve regurgitation, leading to the diagnosis of bacterial endocarditis of the native aortic valve. Shortly after diagnosis, the patient died. At autopsy, vegetation with gram-negative rods in the native aortic valve was observed, confirming the diagnosis of M. morganii-endocarditis. Additional staining for amyloid confirmed advanced light-chain (AL) amyloidosis with extensive amyloid depositions of the aortic valve and valvular damage as complications of her MM.
CONCLUSIONS
Our case suggests that IE with M. morganii was facilitated by the combination of the cardiac amyloidosis with valvular impairment and the profound immune deficiency caused by the several chemo-immunomodulatory treatment lines and the MM itself. This case further illustrates that awareness for rare opportunistic infections in an era with growing potential of combined chemoimmunotherapy is warranted.
Topics: Aged; Aortic Valve; Echocardiography; Endocarditis, Bacterial; Female; Humans; Morganella morganii; Multiple Myeloma
PubMed: 31707976
DOI: 10.1186/s12879-019-4511-4 -
Acta Neuropsychiatrica Dec 2019To examine associations between IgA responses to Gram-negative gut commensal bacteria and peri-menstrual symptoms and sex hormone levels during the menstrual cycle in...
OBJECTIVE
To examine associations between IgA responses to Gram-negative gut commensal bacteria and peri-menstrual symptoms and sex hormone levels during the menstrual cycle in women with and without premenstrual symptoms.
METHODS
Forty women aged 18-45 years completed the Daily Record of Severity of Problems (DRSP) during all 28 consecutive days of the menstrual cycle. We assayed, in plasma, IgA responses to six Gram-negative bacteria, that is, Hafnei alvei, Pseudomonas aeruginosa, Morganella morganii, Klebsiella pneumoniae, Pseudomonas putida and Citobacter koseri, progesterone and oestradiol at days 7, 14, 21 and 28 of the menstrual cycle.
RESULTS
Significant changes in Δ (actual - 1 week earlier) IgA to lipopolysaccharides (LPS) of the six Gram-negative bacteria during the menstrual cycle were observed with peak IgA levels at T4 (day 28) and lows at T1 or T2 (day 7 or 14). The ΔIgA changes in H. alvei, M. Morganii, P. putida during the menstrual cycle were significantly and positively associated with changes in the total DRSP score, and severity of physio-somatic, anxiety and breast-craving, but not depressive, symptoms. The changes in IgA responses to LPS were largely predicted by changes in progesterone and steady-state levels of progesterone averaged over the luteal phase.
DISCUSSION
Menstrual cycle-associated changes in IgA directed against LPS and by inference bacterial translocation may be driven by the effects of progesterone on transcellular, paracellular and vascular pathways (leaky gut) thereby contributing to the severity of physio-somatic and anxiety symptoms as well as fatigue, breast swelling and food cravings.
Topics: Adolescent; Adult; Anxiety; Bacterial Translocation; Depression; Endometrium; Estradiol; Female; Gram-Negative Bacteria; Humans; Immunoglobulin A; Menstrual Cycle; Middle Aged; Permeability; Progesterone; Young Adult
PubMed: 31364524
DOI: 10.1017/neu.2019.30 -
Journal of Global Antimicrobial... Sep 2020The increasing trend of β-lactam resistance among Enterobacteriaceae is a worldwide problem. This study investigated isolates of the tribe Proteeae (Proteus,...
Antimicrobial susceptibility and distribution of extended-spectrum β-lactamases, AmpC β-lactamases and carbapenemases among Proteus, Providencia and Morganella isolated from global hospitalised patients with intra-abdominal and urinary tract infections: Results of the Study for Monitoring...
OBJECTIVES
The increasing trend of β-lactam resistance among Enterobacteriaceae is a worldwide problem. This study investigated isolates of the tribe Proteeae (Proteus, Providencia and Morganella) causing intra-abdominal and urinary tract infections from the worldwide Study for Monitoring Antimicrobial Resistance Trends (SMART) collected from 2008-2011.
METHODS
Antimicrobial susceptibility testing was performed on isolates with an ertapenem minimum inhibitory concentration >0.5mg/L or those phenotypically producing extended-spectrum β-lactamases (ESBLs). ESBLs, AmpC β-lactamases and carbapenemases were detected by multiplex PCR.
RESULTS
A total of 142 isolates, including Proteus mirabilis (n=121), Proteus vulgaris (n=3), Providencia stuartii (n=5), Providencia rettgeri (n=6) and Morganella morganii (n=7), were analysed. Proteus mirabilis was generally susceptible to ertapenem (∼90%) compared with imipenem (≤25%). The most common ESBLs were CTX-M types (n=64), followed by TEM (n=27) and SHV (n=7). CTX-M-1, CTX-M-2 and CTX-M-15 were the dominant CTX-M-type ESBLs in P. mirabilis isolates. CMY (n=14), which included CMY-2 (n=6), was the most common AmpC β-lactamase, followed by DHA (n=6) and FOX (n=4). NDM (n=7), which included NDM-1 (n=4), was the most common carbapenemase, followed by KPC (n=2). Isolates from hospital-associated infections had more complicated β-lactamase combinations than isolates from community-acquired infections.
CONCLUSION
The global emergence and spread of β-lactamase-producing Proteeae isolates are major issues in tackling antimicrobial resistance. Continuous monitoring of antimicrobial resistance trends and developing further resistance surveillance are necessary.
Topics: Anti-Bacterial Agents; Bacterial Proteins; Drug Resistance, Bacterial; Humans; Morganella; Proteus mirabilis; Providencia; Urinary Tract Infections; beta-Lactamases
PubMed: 32311502
DOI: 10.1016/j.jgar.2020.04.011 -
Wilderness & Environmental Medicine Jun 2020Clinical and bacteriological features of cobra (Naja) bites are still relatively unknown in Vietnam. This study aimed to characterize the clinical and bacteriological...
INTRODUCTION
Clinical and bacteriological features of cobra (Naja) bites are still relatively unknown in Vietnam. This study aimed to characterize the clinical and bacteriological characteristics of local wounds in patients with presumed Naja spp bite, as well as their antibiotic treatment.
METHODS
A cross-sectional study was performed on presumed Naja bite patients who were admitted to Bach Mai Hospital in Hanoi, Vietnam. In vitro bacterial isolation, blood tests, and lesion measure were conducted, and antibiotic susceptibilities of localized bite wounds were assessed. The Mann-Whitney test was used to examine the difference in clinical characteristics between patients experiencing presumed Naja atra bites and Naja kaouthia bites. Data are presented as percentages or median with interquartile range, as appropriate. Statistical significance was accepted at P<0.05.
RESULTS
Among 46 patients, all had typical clinical features of Naja bite. The median bite-to-hospital time was 6 h (interquartile range 4.0-11.3). The dominant organisms isolated from local wounds were Morganella morganii (11/36) and Enterococcus faecalis (25/36). All cultures were susceptible to ciprofloxacin. No difference was found with regard to pain, swelling circumference, swelling spread, or necrotic area between patients bitten by presumed Naja atra and Naja kaouthia (P>0.05).
CONCLUSIONS
Wound necrosis and infection were important clinical issues in presumed Naja spp snake bites. Morganella morganii and Enterococcus faecalis were dominant in local wound swabs of such cases. Ciprofloxacin should be an effective first-line antibiotic for patients with presumed Naja bite.
Topics: Animals; Anti-Bacterial Agents; Cross-Sectional Studies; Humans; Naja; Snake Bites; Species Specificity; Vietnam
PubMed: 32335010
DOI: 10.1016/j.wem.2020.01.002