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Cureus May 2022is an aerobic, Gram-negative bacterium that is found widely in the environment and on hospital equipment. Although this organism usually causes infection in...
is an aerobic, Gram-negative bacterium that is found widely in the environment and on hospital equipment. Although this organism usually causes infection in immunocompromised patients, it may cause pulmonary disease in immunocompetent patients, in rare cases. We report a case of pneumonia complicated by empyema in an immunocompetent patient. We present a case of a 59-year-old female who was admitted for a congestive heart failure exacerbation and pneumonia. After imaging confirmed pneumonia and pleural effusion, monotherapy with levofloxacin was started. Thoracentesis revealed empyema caused by . Despite chest tube placement, thoracoscopy with decortication was required due to continued clinical deterioration. After surgical intervention and an adjusted antibiotic regimen of cefepime, the patient clinically improved and was discharged. Upon follow-up, she had recovered completely with no residual disease. Alongside a concise review of the literature, our study highlights the importance of this infection in immunocompetent patients and advises providers to identify causes of aspiration when empyema is diagnosed.
PubMed: 35693369
DOI: 10.7759/cureus.24820 -
Evidence-based Complementary and... 2022Mobile phones have become an indispensable part of human lives for communication, education, and entertainment activities. This study aims to evaluate the diversity...
Mobile phones have become an indispensable part of human lives for communication, education, and entertainment activities. This study aims to evaluate the diversity pattern of bacterial contaminants on mobiles and to check antibiotic resistance profiles in 105 samples. The study revealed a contamination of 51% in men and 49% in women, the highest in the 21- to 30-year age group, evidencing the extreme use of mobiles by teenagers. The study observed Gram-negative bacteria (63%) versus Gram-positive bacteria (37%). Overall, Gram-negative bacterial isolates showed the highest sensitivity to antibiotic nitrofurantoin (90%) and the lowest in ampicillin (35%). Gram positive has highest incidence of sensitivity towards tigecycline (100%) and lowest in cefoxitin (20%). ESL producers were found to be 21.0% and highest being in (35%) followed by (31%). have been identified on the mobile phones for the very first time. Interestingly, some soil microbes were also isolated and unfortunately found to have some antibiotic resistance like and . The results revealed that mobiles were contaminated with multidrug-resistant (MDR) pathogens, and this study also showed that few of the saprophytic soil strains have antibiotic resistance, which can be an alarming situation that needs to be addressed.
PubMed: 35668788
DOI: 10.1155/2022/1527488 -
Microbiology Spectrum Jun 2022The indiscriminate use and overuse of various antibiotics have caused the rapid emergence of antibiotic-resistant bacteria (ARB) in poultry products and the surrounding...
The indiscriminate use and overuse of various antibiotics have caused the rapid emergence of antibiotic-resistant bacteria (ARB) in poultry products and the surrounding environment, giving rise to global public health issues. This study aimed to determine the prevalence of multidrug-resistant (MDR) Gram-negative bacteria (GNB) found in the environment of poultry farms and to evaluate the risk of contamination in these farms based on multiple antibiotic resistance (MAR) index values. Soil and effluent samples were collected from 13 poultry farms. The VITEK 2 system was used for bacterial identification and susceptibility testing of the isolates. The identified Gram-negative isolates were Acinetobacter spp., spp., Enterobacter spp., Klebsiella pneumoniae, Proteus spp., spp., Pseudomonas spp., and Sphingomonas paucimobilis. The results showed that Enterobacter spp. spp., and spp. exhibited the highest MDR rates and MAR indices; 14% of K. pneumoniae isolates (3/21 isolates) were resistant to 13 antibiotics and found to be extended-spectrum β-lactamase (ESBL)-producing bacteria. As for the tested antibiotics, 96.6% of the isolates (28/29 isolates) demonstrated resistance to ampicillin, followed by ampicillin-sulbactam (55.9% [33/59 isolates]) and cefazolin (54.8% [57/104 isolates]). The high percentage of MDR bacteria and the presence of ESBL-producing K. pneumoniae strains suggested the presence of MDR genes from the poultry farm environment, which poses an alarming threat to the effectiveness of the available antibiotic medicines to treat infectious diseases. Therefore, the use of antibiotics should be regulated and controlled, while studies addressing One Health issues are vital for combating and preventing the development and spread of ARB. The occurrence and spread of ARB due to high demand in poultry industries are of great public health concern. The widespread emergence of antibiotic resistance, particularly MDR among bacterial pathogens, poses challenges in clinical treatment. Some pathogens are now virtually untreatable with current antibiotics. However, those pathogens were rarely explored in the environment. In alignment with the concept of One Health, it is imperative to study the rate of resistance in the environment, because this domain plays an important role in the dissemination of bacteria to humans, animals, and other environmental areas. Reliable data on the prevalence of MDR bacteria are crucial to curb the spread of bacterial pathogens that can cause antimicrobial-resistant infections.
Topics: Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Animals; Anti-Bacterial Agents; Bacteria; Drug Resistance, Multiple, Bacterial; Farms; Gram-Negative Bacteria; Klebsiella pneumoniae; Microbial Sensitivity Tests; Poultry; beta-Lactamases
PubMed: 35467407
DOI: 10.1128/spectrum.02694-21 -
International Journal of Infectious... Jun 2022Small case series and reports suggest that Sphingomonas paucimobilis is predominantly a cause of nosocomial bloodstream infections (BSI) with very low associated...
BACKGROUND
Small case series and reports suggest that Sphingomonas paucimobilis is predominantly a cause of nosocomial bloodstream infections (BSI) with very low associated mortality. Our objective was to describe the epidemiology and outcome of Sphingomonas species BSI in a large Australian population.
METHODS
We included all residents of Queensland, Australia, with BSI because of Sphingomonas species identified within the publicly funded system from 2000 to 2019.
RESULTS
A total of 282 incident episodes of Sphingomonas species BSI were identified for an age- and sex-adjusted incidence of 3.2 per million population annually. Incidence rates were highest in the tropical regions of the state. Most (94%) of the isolates were confirmed as Sphingomonas paucimobilis. In addition, 77% of the infections were community-onset, of which 48% were community-associated, and 30% were healthcare-associated. The very young, the old, and male patients were at the highest risk. Patients with community-associated disease were, on average, younger, had fewer co-morbidities, and were less likely to have polymicrobial infections. At least 1 co-morbidity was identified in 62% of patients, with malignancy, diabetes, and lung disease most prevalent. The overall all-cause 30-day case-fatality rate was 6%.
CONCLUSION
Sphingomonas paucimobilis BSI is a predominantly community-onset disease associated with a significant risk of death.
Topics: Australia; Bacteremia; Cross Infection; Humans; Male; Sepsis; Sphingomonas
PubMed: 35398302
DOI: 10.1016/j.ijid.2022.03.060 -
Cureus Feb 2022Septic arthritis, also known as infectious arthritis, is inflammation of the joints due to a wide range of pathogens, such as bacterial, fungal, mycobacterial, viral,...
Septic arthritis, also known as infectious arthritis, is inflammation of the joints due to a wide range of pathogens, such as bacterial, fungal, mycobacterial, viral, or/and other pathogens; however, some opportunistic pathogens tend to affect immunocompromised patients and rarely infect immunocompetent patients. For example, is an opportunistic pathogen with a particular tropism toward bones and soft tissues that rarely causes infections in immunocompetent humans. We present a case of causing septic arthritis in a 34-year-old man who is medically free and with no history of previous surgeries or any other comorbidities. He was treated successfully by both pharmacological treatment and surgical intervention. To our knowledge, there are only four cases published in the literature involving as a causative organism of septic arthritis affecting immunocompetent patients.
PubMed: 35308729
DOI: 10.7759/cureus.22167 -
Journal of Infection in Developing... Feb 2022Sphingomonas paucimobilis, previously known as Pseudomonas paucimobilis, is a Gram-negative rod. It is emerging as an opportunistic pathogen that can infect individuals...
INTRODUCTION
Sphingomonas paucimobilis, previously known as Pseudomonas paucimobilis, is a Gram-negative rod. It is emerging as an opportunistic pathogen that can infect individuals in community or hospital settings. It is believed that the natural habitat of this organism is soil and water, including water sources in the hospital environment.
CASE REPORT
We describe the case of a 46-year-old patient in whom S. paucimobilis was identified in the implanted bone flap after craniotomy. The postoperative bone flap was implanted in the right hypochondria and replaced after 8 weeks. There was a hypochondriac abscess in the area under the bone. Specimens from the thickened fascia and bone flap were cultured. The Gram stain showed Gram-negative rods and these rods were identified as S. paucimobilis. The patient was treated with a combination of Gentamicin 240 mg and Levofloxacin 750 mg once daily because the bacteria were resistant to carbapenem, trimethoprim-sulfamethoxazole, and anti-pseudomonal penicillin.
CONCLUSIONS
Although S. paucimobilis characteristically presents low virulence, for better patient management and outcome, the diagnosis should be immediately followed by appropriate antibiotic therapy guided by susceptibility test results of each case.
Topics: Anti-Bacterial Agents; Craniotomy; Gram-Negative Bacterial Infections; Humans; Middle Aged; Sphingomonas
PubMed: 35298437
DOI: 10.3855/jidc.15369 -
International Journal of Environmental... Feb 2022The opportunistic infections with Gram-negative bacilli are frequently reported. The clinical studies are focused on the course of human infectious and very often the... (Review)
Review
The opportunistic infections with Gram-negative bacilli are frequently reported. The clinical studies are focused on the course of human infectious and very often the source of infection remain unclear. We aim to see if the Gram-negative bacilli isolated from a non-contaminated environment-the caves-are reported in human infections. Eleven samples were collected from six Romanian caves. We used the standard procedure used in our clinical laboratory for bacterial identification and for antibiotic susceptibility testing of the cave isolates. Out of the 14 bacterial strains, three isolates are Gram-negative bacilli-one isolate belong to and two strains belong to . We screened for the published studies-full-text original articles or review articles-that reported human infections with and Data sources-PubMed and Cochrane library. We retrieved 447 cases from 49 references-262 cases (58.61%) are infections and 185 cases (41.39%) are infections. The types of infections are diverse but there are some infections more frequent; there are 116 cases (44.27%) and many infections of the bloodstream with (116 cases) and 121 cases (65.41%) are urinary tract infections with . The acquired source of the bloodstream infections is reported for 93 of bloodstream infections-50 cases (43%) are hospital-acquired, and 40 cases (37%) are community-acquired. Most of the infections are reported in patients with different underlying conditions. There are 80 cases (17.9%) are reported of previously healthy persons. Out of the 72 cases of pediatric infections, 62 cases (86.11%) are caused by . There are ten death casualties-three are infections, and seven are infections.
Topics: Caves; Child; Gram-Negative Bacterial Infections; Hafnia alvei; Humans; Sphingomonas
PubMed: 35206510
DOI: 10.3390/ijerph19042324 -
Journal of Global Antimicrobial... Jun 2022Gram-negative bacilli (GNB) are currently the predominant bacterial pathogens in patients with cancer. Many GNB have become problematic due to the widespread emergence...
OBJECTIVES
Gram-negative bacilli (GNB) are currently the predominant bacterial pathogens in patients with cancer. Many GNB have become problematic due to the widespread emergence of resistance. Imipenem/relebactam (IMI/REL) is a combination of the carbapenem imipenem with relebactam, a non-β-lactam β-lactamase inhibitor. It is active against most pathogenic GNB including many that are resistant to other agents. We compared its in vitro activity to six other agents against 490 GNB recovered exclusively from patients with cancer because such data are scarce.
METHODS
Clinical and Laboratory Standards Institute (CLSI) microbroth dilution methods were used for susceptibility testing. Whole genome sequencing (Illumina MiSeq) was performed on 30 selected isolates.
RESULTS
IMI/REL was active against 98% of Enterobacterales and 87% of non-Enterobacterales isolates (excluding Stenotrophomonas maltophilia). It had potent activity against extended spectrum β-lactamase-producing Escherichia coli, Klebsiella pneumoniae, and other Enterobacterales (Enterobacter cloacae, Citrobacter Spp., and Serratia Spp.) and moderate activity against carbapenem-resistant Enterobacterales. IMI/REL had potent activity against Achromobacter Spp., non-multidrug resistant Pseudomonas aeruginosa, and Sphingomonas paucimobilis and moderate activity against multidrug resistant P. aeruginosa. Overall, IMI/REL was associated with the lowest number of nonsusceptible isolates compared with six other agents (imipenem, meropenem, cefepime, piperacillin/tazobactam, amikacin, and tigecycline) commonly used in patients with cancer. Whole genome sequencing performed on 30 resistant isolates (10 each of E. coli, K. pneumonia, and P. aeruginosa) did not reveal any predominant mechanism of resistance to IMI/REL.
CONCLUSION
Its in vitro activity indicates that IMI/REL might have a role to play in the treatment of Gram-negative infections in patients with cancer.
Topics: Anti-Bacterial Agents; Carbapenems; Escherichia coli; Gram-Negative Bacteria; Humans; Imipenem; Microbial Sensitivity Tests; Neoplasms; Pseudomonas aeruginosa
PubMed: 35121163
DOI: 10.1016/j.jgar.2022.01.020 -
Japanese Journal of Infectious Diseases Jul 2022Sphingomonas paucimobilis is an aerobic, non-fermentative, opportunistic Gram-negative bacillus found in water systems. This study was conducted to analyze concurrent S.... (Review)
Review
Sphingomonas paucimobilis Outbreak a Pediatric Hematology-Oncology Hospital: Epidemiological Investigation and Literature Review of an Emerging Healthcare-Associated Infection.
Sphingomonas paucimobilis is an aerobic, non-fermentative, opportunistic Gram-negative bacillus found in water systems. This study was conducted to analyze concurrent S. paucimobilis bacteremia cases and treatment outcomes, potential outbreak sources, and antimicrobial resistance profiles. This ambidirectional cohort study was conducted in a 30-bed pediatric hematology-oncology hospital. The patients' ages ranged from 1 to 17 years, with a median age of 5 years. Environmental sampling was applied to investigate the outbreak source. Bacterial identification and antimicrobial susceptibility tests of the isolated bacteria were performed using the disk diffusion method and Vitek®2 automated system. S. paucimobilis was detected in 181 blood culture samples from 51 patients over 2 years and was isolated from hot tap water. Acute lymphoblastic leukemia (ALL) was diagnosed for 66% of patients, and two of our patients with ALL died due to S. paucimobilis sepsis. S. paucimobilis isolates are susceptible to carbapenems and quinolones. Surveillance and epidemic control should be performed for hospital-acquired infectious agents such as S. paucimobilis. In additon, water distribution systems should be checked for colonizing agents at regular intervals.
Topics: Adolescent; Anti-Bacterial Agents; Anti-Infective Agents; Child; Child, Preschool; Cohort Studies; Cross Infection; Delivery of Health Care; Disease Outbreaks; Gram-Negative Bacterial Infections; Hematology; Hospitals; Humans; Infant; Sphingomonas; Water
PubMed: 35095025
DOI: 10.7883/yoken.JJID.2021.661 -
IDCases 2022is an aerobic, yellow-pigmented, glucose non-fermenting, gram negative bacillus that is a rare cause of human infection found mostly in the immunocompromised and also...
is an aerobic, yellow-pigmented, glucose non-fermenting, gram negative bacillus that is a rare cause of human infection found mostly in the immunocompromised and also in intravenous (IV) drug users. We report a case of a 31-year-old female with current IV drug use, who presented with chest pain and was diagnosed with tricuspid valve endocarditis with bacteremia and pulmonary infarction of the right middle lobe. The patient initially presented with sharp right sided chest pain. She was treated with meropenem and levofloxacin based on the susceptibility profile. Our purpose is to highlight the treatment options and raise awareness of this uncommon organism. Even though Sphingomonas is considered to be of low-pathogenicity, it can be fatal if not treated properly and not diagnosed early.
PubMed: 35070718
DOI: 10.1016/j.idcr.2022.e01399