-
Frontiers in Microbiology 2022serovar Gallinarum (. Gallinarum) is a host-specific pathogen causing fowl typhoid, a severe systemic infection in poultry, which leads to substantial economic losses...
serovar Gallinarum (. Gallinarum) is a host-specific pathogen causing fowl typhoid, a severe systemic infection in poultry, which leads to substantial economic losses due to high morbidity and mortality in many developing countries. However, less is known about the pathogenic characteristics and mechanism of . Gallinarum-induced systemic infection in chickens. In this study, we deleted the . Gallinarum UDP--acetylglucosamine-1-phosphate transferase gene, which contributes to the biosynthesis of enterobacterial common antigen (ECA), and studied the pathogenicity of this ::Cm strain in a chicken model of systemic infection. The ::Cm mutant strain showed comparable growth but lower resistance to bile acid and nalidixic acid than the wild-type strain . In the oral infection model of chickens, the virulence of the ::Cm strain was significantly attenuated . Chickens infected with wild-type strain showed typical clinical signs and pathological changes of fowl typhoid and died between 6 and 9 days post-infection, and the bacteria rapidly disseminated to systemic organs and increased in the livers and spleens. In contrast, the ::Cm mutant strain did not cause chicken death, there were no significant clinical changes, and the bacterial numbers in the liver and spleen of the chickens were significantly lower than those of the chickens infected with the wild-type strain. In addition, the expression of interleukin (IL)-1β, tumor necrosis factor (TNF)-α, and CXCLi1 in the livers of ::Cm-infected chickens was significantly lower than that of the chickens infected with the wild-type strain. Furthermore, the attenuated ::Cm strain could persistently colonize the liver and spleen at low levels for up to 25 days post-infection and could induce a protective immune response in the chickens. These results indicate that the gene is an important virulence factor of . Gallinarum in the chicken model of systemic infection, and the avirulent ::Cm mutant could possibly be used as a live-attenuated vaccine strain for controlling fowl typhoid.
PubMed: 35694286
DOI: 10.3389/fmicb.2022.880932 -
Antibiotics (Basel, Switzerland) Apr 2022The objective of this study was to determine the presence and persistence of antimicrobial-resistant enterobacteria and their clonal distribution in hospital wastewater....
The objective of this study was to determine the presence and persistence of antimicrobial-resistant enterobacteria and their clonal distribution in hospital wastewater. A descriptive cross-sectional study was carried out in wastewater from two Mexico City tertiary level hospitals. In February and March of 2020, eight wastewater samples were collected and 26 isolates of enterobacteria were recovered, 19 (73.1%) isolates were identified as , 5 (19.2%) as spp. and 2 (7.7%) as spp. Antimicrobial susceptibility profiles were performed using the VITEK 2 automated system and bacterial identification was performed by the Matrix-Assisted Laser Desorption/Ionization-Time of Flight mass spectrometry (MALDI-TOF MS). ESBL genes were detected by polymerase chain reaction (PCR) and clonal distributions of isolates were determined by pulsed-field gel electrophoresis (PFGE). susceptibility to different classes of antimicrobials was analyzed and resistance was mainly detected as ESBLs and fluoroquinolones. One strain was resistant to doripenem, ertapenem, imipenem and meropenem. The analysis by PCR showed the presence of specific β-lactamases resistance genes (, ). The PFGE separated the isolates into 19 different patterns (A-R). PFGE results of spp. showed the presence of a majority clone A. Surveillance of antimicrobial resistance through hospital wastewater is an important tool for early detection of clonal clusters of clinically important bacteria with potential for dissemination.
PubMed: 35625245
DOI: 10.3390/antibiotics11050601 -
Military Medicine May 2022During the wars in Iraq and Afghanistan, increased incidence of multidrug-resistant (MDR) organisms, as well as polymicrobial wounds and infections, complicated the... (Review)
Review
INTRODUCTION
During the wars in Iraq and Afghanistan, increased incidence of multidrug-resistant (MDR) organisms, as well as polymicrobial wounds and infections, complicated the management of combat trauma-related infections. Multidrug resistance and wound microbiology are a research focus of the Trauma Infectious Disease Outcomes Study (TIDOS), an Infectious Disease Clinical Research Program, Uniformed Services University, research protocol. To conduct comprehensive microbiological research with the goal of improving the understanding of the complicated etiology of wound infections, the TIDOS MDR and Virulent Organisms Trauma Infections Initiative (MDR/VO Initiative) was established as a collaborative effort with the Brooke Army Medical Center, Naval Medical Research Center, U.S. Army Institute of Surgical Research, and Walter Reed Army Institute of Research. We provide a review of the TIDOS MDR/VO Initiative and summarize published findings.
METHODS
Antagonism and biofilm formation of commonly isolated wound bacteria (e.g., ESKAPE pathogens-Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.), antimicrobial susceptibility patterns, and clinical outcomes are being examined. Isolates collected from admission surveillance swabs, as part of infection control policy, and clinical infection workups were retained in the TIDOS Microbiological Repository and associated clinical data in the TIDOS database.
RESULTS
Over the TIDOS study period (June 2009 to December 2014), more than 8,300 colonizing and infecting isolates were collected from military personnel injured with nearly one-third of isolates classified as MDR. At admission to participating U.S. military hospitals, 12% of wounded warriors were colonized with MDR Gram-negative bacilli. Furthermore, 27% of 913 combat casualties with ≥1 infection during their trauma hospitalization had MDR Gram-negative bacterial infections. Among 335 confirmed combat-related extremity wound infections (2009-2012), 61% were polymicrobial and comprised various combinations of Gram-negative and Gram-positive bacteria, yeast, fungi, and anaerobes. Escherichia coli was the most common Gram-negative bacilli isolated from clinical workups, as well as the most common colonizing MDR secondary to extended-spectrum β-lactamase resistance. Assessment of 479 E. coli isolates collected from wounded warriors found 188 pulsed-field types (PFTs) from colonizing isolates and 54 PFTs from infecting isolates without significant overlap across combat theaters, military hospitals, and study years. A minority of patients with colonizing E. coli isolates developed subsequent infections with the same E. coli strain. Enterococcus spp. were most commonly isolated from polymicrobial wound infections (53% of 204 polymicrobial cultures). Patients with Enterococcus infections were severely injured with a high proportion of lower extremity amputations and genitourinary injuries. Approximately 65% of polymicrobial Enterococcus infections had other ESKAPE organisms isolated. As biofilms have been suggested as a cause of delayed wound healing, wound infections with persistent recovery of bacteria (isolates of same organism collected ≥14 days apart) and nonrecurrent bacterial isolates were assessed. Biofilm production was significantly associated with recurrent bacteria isolation (97% vs. 59% with nonrecurrent isolates; P < 0.001); however, further analysis is needed to confirm biofilm formation as a predictor of persistent wound infections.
CONCLUSIONS
The TIDOS MDR/VO Initiative provides comprehensive and detailed data of major microbial threats associated with combat-related wound infections to further the understanding of wound etiology and potentially identify infectious disease countermeasures, which may lead to improvements in combat casualty care.
Topics: Anti-Bacterial Agents; Bacteria; Bacterial Infections; Communicable Diseases; Drug Resistance, Multiple, Bacterial; Enterococcus; Escherichia coli; Gram-Negative Bacteria; Hospitals, Military; Humans; Microbial Sensitivity Tests; United States; Wound Infection
PubMed: 35512375
DOI: 10.1093/milmed/usab131 -
Cureus Apr 2022Cloacal malformation (CM) is a severe, complex, and extremely rare category of anorectal and urogenital tract malformations. Prenatal diagnosis is illusory and vague;...
Cloacal malformation (CM) is a severe, complex, and extremely rare category of anorectal and urogenital tract malformations. Prenatal diagnosis is illusory and vague; therefore, magnetic resonance imaging (MRI) is the most effective test point toward an accurate diagnosis. Thus, careful investigation and evaluation are mandatory since they could be associated with syndromes and other anomalies, including urogenital tract, vertebral, and cord abnormalities. Despite the severity and complexity of the deformity, CM cases are curable, not desperate, and can have an excellent prognosis with great surgical correction. However, managing persistent cloaca necessitates a careful assessment because corrective surgeries require inclusive surgical planning, multidisciplinary, expert, and highly specialized medical center. In surgically repaired malformations, fecal and urinary incontinence has been a major issue, which was resolved when Dr. Pena Alberto suggested safer dissection and less harmful techniques for neurovascular structures and great functional corrected anomaly to ensure fertility and less incontinence. For improved results and prognosis on quality of life, patients should be scheduled for extended bowel training along with the clinical evaluation follow-up. In this article, we present a case successfully treated with the posterior sagittal approach, Pena operation, and anorecto-vagino-urethroplasty with feminizing clitoroplasty and highlight the value and impact of prenatal evaluation, diagnosis, and management. The rarity of the case and excellent results, including fair to normal bowel and urinary control, prompted us to report it and assert the significance of assessment, surgical management and technique, challenges, postoperative bowel training, and clinical investigation and examination.
PubMed: 35509764
DOI: 10.7759/cureus.23737 -
Journal of Surgical Case Reports Apr 2022The duplication of the cecum and appendix is a rare congenital anomaly found incidentally on exploration for another indication. We present here a case of a female child...
The duplication of the cecum and appendix is a rare congenital anomaly found incidentally on exploration for another indication. We present here a case of a female child at 18 months of life, who was a diagnosed case of anorectal malformation with a persistent cloaca and at the time of the surgery, duplication of the appendix and cecum was found. Both the appendices were attached to the cecum with a separate base. Thus, appendectomies and a sigmoid divided colostomy were performed.
PubMed: 35495084
DOI: 10.1093/jscr/rjac125 -
BMJ Case Reports Mar 2022A man in his 70s with a complex medical history, including cadaveric renal transplant, presented with recurrent urinary tract infections. Investigation revealed...
A man in his 70s with a complex medical history, including cadaveric renal transplant, presented with recurrent urinary tract infections. Investigation revealed recurrent urinary pathogens, including and persistent BK viruria. Cystoscopy revealed a pedunculated mass in the right posterior-lateral wall, inferior to the transplant urethral orifice, and biopsy of this mass showed invasive small cell carcinoma with a prominent adenocarcinoma component. The tumour was treated with complete transurethral resection followed by carboplatin, etoposide and radiation. Laboratory analysis of biopsied samples showed immunostaining and molecular evidence of BK virus DNA in the cancer cells. Follow-up cystoscopies have shown no recurrence of the cancer.
Topics: BK Virus; Carcinoma, Small Cell; Humans; Kidney Transplantation; Lung Neoplasms; Male; Polyomavirus Infections; Urinary Bladder
PubMed: 35351771
DOI: 10.1136/bcr-2021-244740 -
Environmental Science and Pollution... Jun 2022The major reason behind the spread of antibiotic resistance genes (ARGs) is persistent selective pressure in the environment encountered by bacteria. Genome plasticity... (Review)
Review
The major reason behind the spread of antibiotic resistance genes (ARGs) is persistent selective pressure in the environment encountered by bacteria. Genome plasticity plays a crucial role in dissemination of antibiotic resistance among bacterial pathogens. Mobile genetic elements harboring ARGs are reported to dodge bacterial immune system and mediate horizontal gene transfer (HGT) under selective pressure. Residual antibiotic pollutants develop selective pressures that force the bacteria to lose their defense mechanisms (CRISPR-cas) and acquire resistance. The present study targets the ESKAPE organisms (namely, Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp.) causing various nosocomial infections and emerging multidrug-resistant species. The role of CRISPR-cas systems in inhibition of HGT in prokaryotes and its loss due to presence of various stressors in the environment is also focused in the study. IncF and IncH plasmids were identified in all strains of E. faecalis and K. pneumoniae, carrying Beta-lactam and fluoroquinolone resistance genes, whereas sal3, phiCTX, and SEN34 prophages harbored aminoglycoside resistance genes (aadA, aac). Various MGEs present in selected environmental niches that aid the bacterial genome plasticity and transfer of ARGs contributing to its spread are also identified.
Topics: Acinetobacter baumannii; Anti-Bacterial Agents; Drug Resistance, Microbial; Enterococcus faecium; Gene Transfer, Horizontal; Klebsiella pneumoniae
PubMed: 35349073
DOI: 10.1007/s11356-022-19840-5 -
Journal of Pediatric Urology Apr 2022Urological problems are a recognised feature of anorectal malformation (ARM). Previous assumptions of favourable long-term urinary outcomes are being challenged.
INTRODUCTION
Urological problems are a recognised feature of anorectal malformation (ARM). Previous assumptions of favourable long-term urinary outcomes are being challenged.
OBJECTIVE
We hypothesised that urinary tract problems are common in ARM and frequently persist into adulthood. We retrospectively reviewed long-term renal and bladder outcomes in ARM patients.
STUDY DESIGN
Patients with ARM born between 1984-2005 were identified from electronic hospital databases. Their case notes were reviewed. Renal outcomes included serum creatinine and the need for renal replacement therapy. Bladder outcomes included symptom review, bladder medication, need for intermittent catheterisation, videourodynamics and whether the patient had undergone augmentation cystoplasty. RESULT (TABLE 1): The case notes of 50 patients were reviewed. The median age at last follow up was 18 years (range 12-34 years). The level of fistula was noted to be high in 17 patients, intermediate in eight, and low in 10. Four had cloaca. Congenital urological abnormalities were present in 25 (50%). An abnormal spinal cord was present in 22 (44%) patients. VACTERL association occurred in 27 (54%). Chronic kidney disease stage II or above was found in 14 (28%) patients, of whom four required a renal transplant. Abnormal bladder outcomes were found in 39 (78%) patients. Augmentation cystoplasty with Mitrofanoff had been performed in 12. Of those who had not undergone cystoplasty, 17 had urinary symptoms, including urinary incontinence in 12. Of the 39 patients with abnormal bladder outcome, 19 (49%) did not have a spinal cord abnormality. There was no significant statistical association between level of ARM and abnormal renal outcome or presence of bladder abnormality.
DISCUSSION
Adverse renal and bladder outcomes are common in our cohort of young people with ARM with a significantly higher incidence compared with current literature. We did not demonstrate an association between level of ARM or presence of spinal cord anomaly with persistent bladder problems. Congenital urological anomalies are more common in those who later have an abnormal renal outcome. Although this difference is statistically significant, one fifth of patients born with anatomically normal upper tracts develop reduced renal function, implying an important acquired component.
CONCLUSION
Bladder problems and reduced renal function affect a significant proportion of young adults with ARM. Neither adverse outcome is reliably predicted from ARM level, congenital urological anomaly or spinal cord anomaly. We advise continued long-term bladder and kidney follow-up for all patients with ARM.
Topics: Adolescent; Adult; Animals; Anorectal Malformations; Child; Cloaca; Humans; Retrospective Studies; Urinary Incontinence; Urology; Young Adult
PubMed: 35283020
DOI: 10.1016/j.jpurol.2022.01.019 -
Chemosphere May 2022Due to the presence of various organic contaminants, improper disposal of pulp-paper wastewater poses harm to the environment and human health. In this work, pulp-paper...
Due to the presence of various organic contaminants, improper disposal of pulp-paper wastewater poses harm to the environment and human health. In this work, pulp-paper sludge (PPS) after secondary treatment were collected from M/s Century Pulp-paper Mills in India, the chemical nature of the organic pollutants was determined after solvent extraction. All the isolates were able to produce lipase (6.34-3.93 U ml) which could account for the different fatty acids detected in the PPS. The dominant strains were in the classes of α and γ Proteobacteria followed by Firmicutes. The Shannon-Weiner diversity indexes for phylotype richness for the culturable and non-culturable bacterial community were 2.01 and 3.01, respectively, indicating the non-culturable bacterial strains has higher species richness and diversity compared to the culturable bacterial strains. However, the culturable strains had higher species evenness (0.94 vs 0.90). Results suggested only a few isolated strains were resistant to the POPs in the PPS, where as non-cultural bacteria survived by entering viable but non-cultural state. The isolated strains (Brevundimonas diminuta, Aeromonas punctata, Enterobacter hormaechei, Citrobacter braakii, Bacillus pumilus and Brevundimonas terrae) are known for their multidrug resistance but their tolerance to POPs have not previously been reported and deserved further investigation. The findings of this research established the presence of POPs which influence the microbial population. Tertiary treatment is recommended prior to the safe disposal of pulp paper mill waste into the environment.
Topics: Bacteria; Humans; Industrial Waste; Paper; Persistent Organic Pollutants; Sewage; Waste Disposal, Fluid
PubMed: 35134397
DOI: 10.1016/j.chemosphere.2022.133892 -
Journal of Research in Medical Sciences... 2021Nosocomial surfaces are potential pathogen reservoirs. Our aim was to describe the microbial diversity and analyze microbial patterns of healthcare-associated pathogens...
Nosocomial surfaces are potential pathogen reservoirs. Our aim was to describe the microbial diversity and analyze microbial patterns of healthcare-associated pathogens in two step-down-care-units at a tertiary care hospital. We monitored infected patients over 45 days to describe microbial diversity and colonization patterns. A total of 2762 isolates were recovered from the sampled sites, coagulase-negative staphylococci represented 44.64% (1233/2762) of the isolates. The most frequently recovered ESKAPE species (, , , , , and ) were (7.53%; 208/2762 isolates) and / (5.18%; 143/2762). We recovered a high diversity of species, including potential pathogens. was detected more frequently on diverse surfaces and persisted in patients' nostrils during the hospital stay.
PubMed: 35126589
DOI: 10.4103/jrms.JRMS_1074_20