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FEMS Microbiology Reviews Jul 2013Among the Gram-positive anaerobic bacteria associated with clinical infections, the Gram-positive anaerobic cocci (GPAC) are the most prominent and account for... (Review)
Review
Among the Gram-positive anaerobic bacteria associated with clinical infections, the Gram-positive anaerobic cocci (GPAC) are the most prominent and account for approximately 25-30% of all isolated anaerobic bacteria from clinical specimens. Still, routine culture and identification of these slowly growing anaerobes to the species level has been limited in the diagnostic laboratory, mainly due to the requirement of prolonged incubation times and time-consuming phenotypic identification. In addition, GPAC are mostly isolated from polymicrobial infections with known pathogens and therefore their relevance has often been overlooked. However, through improvements in diagnostic and in particular molecular techniques, the isolation and identification of individual genera and species of GPAC associated with specific infections have been enhanced. Furthermore, the taxonomy of GPAC has undergone considerable changes over the years, mainly due to the development of molecular identification methods. Existing species have been renamed and novel species have been added, resulting in changes of the nomenclature. As the abundance and significance of GPAC in clinical infections grow, knowledge of virulence factors and antibiotic resistance patterns of different species becomes more important. The present review describes recent advances of GPAC and what is known of the biology and pathogenic effects of Anaerococcus, Finegoldia, Parvimonas, Peptoniphilus and Peptostreptococcus, the most important GPAC genera isolated from human infections.
Topics: Animals; Anti-Bacterial Agents; Bacteria, Anaerobic; Drug Resistance, Bacterial; Gram-Positive Bacterial Infections; Gram-Positive Cocci; Humans
PubMed: 23030831
DOI: 10.1111/1574-6976.12005 -
Zhong Nan Da Xue Xue Bao. Yi Xue Ban =... May 2023Gram-positive cocci is the main pathogen responsible for early infection after liver transplantation (LT), posing a huge threat to the prognosis of liver transplant...
OBJECTIVES
Gram-positive cocci is the main pathogen responsible for early infection after liver transplantation (LT), posing a huge threat to the prognosis of liver transplant recipients. This study aims to analyze the distribution and drug resistance of Gram-positive cocci, the risk factors for infections and efficacy of antibiotics within 2 months after LT, and to guide the prevention and treatment of these infections.
METHODS
In this study, data of pathogenic bacteria distribution, drug resistance and therapeutic efficacy were collected from 39 Gram-positive cocci infections among 256 patients who received liver transplantation from donation after citizens' death in the Third Xiangya Hospital of Central South University from January 2019 to July 2022, and risk factors for Gram-positive cocci infection were analyzed.
RESULTS
was the dominant pathogenic bacteria (33/51, 64.7%), followed by (11/51, 21.6%). The most common sites of infection were abdominal cavity/biliary tract (13/256, 5.1%) and urinary tract (10/256, 3.9%). Fifty (98%) of the 51 Gram-positive cocci infections occurred within 1 month after LT. The most sensitive drugs to Gram-positive cocci were teicoplanin, tigecycline, linezolid and vancomycin. Vancomycin was not used in all patients, considering its nephrotoxicity. Vancomycin was not administered to all patients in view of its nephrotoxicity.There was no significant difference between the efficacy of daptomycin and teicoplanin in the prevention of cocci infection (>0.05). Univariate analysis indicated that preoperative Model for End-Stage Liver Disease (MELD) score >25 (=0.005), intraoperative red blood cell infusion ≥12 U (=0.013) and exposure to more than 2 intravenous antibiotics post-LT (=0.003) were related to Gram-positive cocci infections. Multivariate logistic regression analysis revealed that preoperative MELD score >25 (=2.378, 95% 1.124 to 5.032, =0.024) and intraoperative red blood cell transfusion ≥ 12 U (=2.757, 95% 1.227 to 6.195, =0.014) were independent risk factors for Gram-positive cocci infections after LT. Postoperative Gram-positive cocci infections were reduced in LT recipients exposing to more than two intravenous antibiotics post-LT (=0.269, 95% 0.121 to 0.598, =0.001).
CONCLUSIONS
Gram-positive cocci infections occurring early after liver transplantation were dominated by infections at the abdominal/biliary tract and urinary tract. Teicoplanin, tigecycline and linezolid were anti-cocci sensitive drugs. Daptomycin and teicoplanin were equally effective in preventing cocci infections due to Gram-positive cocci. Patients with high preoperative MELD score and massive intraoperative red blood cell transfusion were more likely to suffer Gram-positive cocci infection after surgery. Postoperative Gram-positive cocci infections were reduced in recipients exposing to more than two intravenous antibiotics post-LT.
Topics: Humans; Daptomycin; Linezolid; Teicoplanin; Gram-Positive Cocci; Liver Transplantation; Tigecycline; End Stage Liver Disease; Gram-Positive Bacterial Infections; Severity of Illness Index; Anti-Bacterial Agents; Vancomycin; Microbial Sensitivity Tests
PubMed: 37539573
DOI: 10.11817/j.issn.1672-7347.2023.220631 -
Rhode Island Medical Journal (2013) Nov 2022Two cases of Brucellosis were identified at a hospital in Rhode Island. In both cases, the organisms were isolated from the blood cultures. The bacteria did not appear...
Two cases of Brucellosis were identified at a hospital in Rhode Island. In both cases, the organisms were isolated from the blood cultures. The bacteria did not appear as the classical textbook description of Brucella spp. as short, Gram-negative rods; instead, Gram-positive rods and Gram-positive cocci in chains were observed. Due to the atypical Gram stain morphology, Brucella spp. were not initially considered as a possible pathogen. Antimicrobial prophylaxes were offered to the technologists who were exposed to the organisms.
Topics: Humans; Gram-Positive Cocci; Brucella; Gram-Positive Rods; Bacteria; Staining and Labeling
PubMed: 36300962
DOI: No ID Found -
Anais Brasileiros de Dermatologia 2020The increasingly frequent use of dermoscopy makes us think about the possibility of transfer of microorganisms, through the dermatoscope, between doctor and patients.
BACKGROUND
The increasingly frequent use of dermoscopy makes us think about the possibility of transfer of microorganisms, through the dermatoscope, between doctor and patients.
OBJECTIVES
To identify the most frequent gram-positive cocci in dermatoscopes and smartphone adapters, as well as the resistance profile, and to evaluate the factors associated with a higher risk of bacterial contamination of the dermatoscopes.
METHODS
A cross-sectional study was carried out with 118 dermatologists from Porto Alegre/Brazil between September 2017 and July 2018. Gram-positive cocci were identified by MALDI-TOF MS and habits of use of the dermatoscope were evaluated through an anonymous questionnaire.
RESULTS
Of the dermatoscopes analysed, 46.6% had growth of gram-positive cocci on the lens and 37.3% on the on/off button. The microorganisms most frequently found were S. epidermidis, S. hominis and S. warneri. Attending a hospital, using the dermatoscope at the hospital, with inpatients and in the intensive care unit were significantly associated with colonisation by gram-positive cocci. The highest resistance rates were observed for penicillin, erythromycin and sulfamethoxazole-trimethoprim.
STUDY LIMITATIONS
The non-search of gram-negative bacilli, fungi and viruses. Moreover, the small number of adapters did not make it possible to better define if the frequency differences were statistically significant.
CONCLUSION
Coagulase-negative staphylococci were frequently identified. S. aureus was detected only on the lens.
Topics: Adult; Age Distribution; Anti-Bacterial Agents; Brazil; Cross-Sectional Studies; Dermatologists; Dermoscopy; Drug Resistance, Bacterial; Female; Gram-Positive Bacterial Infections; Gram-Positive Cocci; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Risk Factors; Sex Distribution; Smartphone; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Surveys and Questionnaires
PubMed: 32303433
DOI: 10.1016/j.abd.2019.11.004 -
Molecular Microbiology Apr 20205'-nucleotidases (5'-NTs) are enzymes that catalyze the hydrolysis of nucleoside monophosphates to produce nucleosides and phosphate. Since the identification of... (Review)
Review
5'-nucleotidases (5'-NTs) are enzymes that catalyze the hydrolysis of nucleoside monophosphates to produce nucleosides and phosphate. Since the identification of adenosine synthase A (AdsA) in Staphylococcus aureus in 2009, several other 5'-NTs have been discovered in Gram-positive cocci, mainly in streptococci. Despite some differences in substrate specificity, pH range and metal ion requirements, all characterized 5'-NTs use AMP and ADP, and in some cases ATP, to produce the immunosuppressive adenosine, which dampens pro-inflammatory immune responses. Several 5'-NTs are also able to use dAMP as substrate to generate deoxy-adenosine which is cytotoxic for macrophages. A synergy between 5'-NTs and exonucleases which are commonly expressed in Gram-positive cocci has been described, where the nucleases provide dAMP as a cleavage product from DNA. Some of these nucleases produce dAMP by degrading the DNA backbone of neutrophil extracellular traps (NETs) resulting in a "double hit" strategy of immune evasion. This Micro Review provides an overview of the biochemical properties of Gram-positive cell wall-anchored 5'-NTs and their role as virulence factors. A potential use of 5'-NTs for vaccine development is also briefly discussed.
Topics: 5'-Nucleotidase; Animals; Cell Wall; Gram-Positive Bacterial Infections; Gram-Positive Cocci; Humans; Immune Evasion; Kinetics; Substrate Specificity; Virulence Factors
PubMed: 31872460
DOI: 10.1111/mmi.14442 -
Polish Journal of Microbiology 2016Neutralization method evaluation is an important first step in a disinfectant validation study program. It is also crucial in assessment of the efficiency of microbial...
Neutralization method evaluation is an important first step in a disinfectant validation study program. It is also crucial in assessment of the efficiency of microbial recovery media in the presence of a residual biocidal agent. In the present study, four commercially available peroxygen/silver-based disinfectant formulae--intended to be used in a pharmaceutical facility sanitization program--were tested at two dilutions against three Gram-positive cocci and one yeast; Staphylococcus aureus (ATCC 6538), Kucoria rhizophila (ATCC 9341) and Candida albicans (ATCC 10231) and Staphylococcus capitis as an environmental monitoring (EM) isolate sample (identified by miniaturized biochemical identification system). Disinfectants preparation, dilutions and the test procedure were carried on in laboratory under conditions simulating the working environment of 20-25 degrees C and RH% 40-60. In-house made neutralizing broth was mixed with biocidal agents to make two dilutions of each disinfectant forming Peroxygen: neutralizing broth ratios of 1:10 and 1:100 (v/v). Three populations were established and two comparison ratio groups were examined, namely neutralizer efficacy and neutralizer toxicity. Two acceptance criteria were tested. One criterion showed higher rate of neutralization success than the other. S. aureus showed the highest rate of successful microbial recovery from neutralization process. The Disinfectant (Bixco) was exceptionally neutralized at all dilutions with all microorganisms. In conclusion, in-house made neutralizing broth effectively neutralized all disinfectants with all the tested microorganisms at 1:100 (v/v); thus, it can be used in sanitizer validation studies and EM media.
Topics: Candida albicans; Disinfectants; Gram-Positive Cocci; Microbial Sensitivity Tests; Peroxides; Silver Compounds
PubMed: 27281990
DOI: 10.5604/17331331.1197271 -
Clinical Microbiology Reviews Jan 1998Gram-positive anaerobic cocci (GPAC) are a heterogeneous group of organisms defined by their morphological appearance and their inability to grow in the presence of... (Review)
Review
Gram-positive anaerobic cocci (GPAC) are a heterogeneous group of organisms defined by their morphological appearance and their inability to grow in the presence of oxygen; most clinical isolates are identified to species in the genus Peptostreptococcus. GPAC are part of the normal flora of all mucocutaneous surfaces and are often isolated from infections such as deep organ abscesses, obstetric and gynecological sepsis, and intraoral infections. They have been little studied for several reasons, which include an inadequate classification, difficulties with laboratory identification, and the mixed nature of the infections from which they are usually isolated. Nucleic acid studies indicate that the classification is in need of radical revision at the genus level. Several species of Peptostreptococcus have recently been described, but others still await formal recognition. Identification has been based on carbohydrate fermentation tests, but most GPAC are asaccharolytic and use the products of protein degradation for their metabolism; the introduction of commercially available preformed enzyme kits affords a physiologically more appropriate method of identification, which is simple and relatively rapid and can be used in routine diagnostic laboratories. Recent reports have documented the isolation in pure culture of several species, notably Peptostreptococcus magnus, from serious infections. Studies of P. magnus have elucidated several virulence factors which correlate with the site of infection, and reveal some similarities to Staphylococcus aureus. P. micros is a strongly proteolytic species; it is increasingly recognized as an important pathogen in intraoral infections, particularly periodontitis, and mixed anaerobic deep-organ abscesses. Comparison of antibiotic susceptibility patterns reveals major differences between species. Penicillins are the antibiotics of choice, although some strains of P. anaerobius show broad-spectrum beta-lactam resistance.
Topics: Anti-Bacterial Agents; Bacteria, Anaerobic; Gram-Positive Bacterial Infections; Gram-Positive Cocci; Humans; Peptostreptococcus
PubMed: 9457430
DOI: 10.1128/CMR.11.1.81 -
Journal of Infection and Chemotherapy :... Mar 2022Complicated skin and soft tissue infections (cSSTIs) and bacteremia caused by Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA), are common causes...
INTRODUCTION
Complicated skin and soft tissue infections (cSSTIs) and bacteremia caused by Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA), are common causes of infection for children worldwide. Here, the safety and efficacy of daptomycin in Japanese pediatric participants are reported.
METHODS
This open-label, single-arm phase 2 study (NCT03643952) enrolled Japanese pediatric participants (age 1-17 years) with cSSTI or bacteremia caused by gram-positive cocci. Participants received age-adjusted doses of intravenous daptomycin for 5 to up to 14 days (cSSTI) or 5 to up to 42 days (bacteremia). The primary objective was safety and tolerability; efficacy among participants with infections caused by MRSA was a secondary objective.
RESULTS
A total of 18 participants (cSSTI, n = 14; bacteremia, n = 4) were enrolled across 12 study sites in Japan. The most common pathogen was S. aureus (15/18 [83.3%]), including methicillin-susceptible and -resistant isolates. Adverse events (AE) were reported in 42.9% (6/14) of participants with cSSTI and 100% (4/4) of participants with bacteremia. No deaths, serious AEs, discontinuations of study medication due to an AE, or events of clinical interest occurred in the study. In participants with infections caused by MRSA, 87.5% [7/8] achieved favorable clinical response at test of cure (TOC) visit (cSSTI, 85.7% [6/7]; bacteremia, 100% [1/1]). In this population, favorable microbiological response at TOC was achieved by 71.4% (5/7) of participants with cSSTI and 100% (1/1) of participants with bacteremia.
CONCLUSIONS
Daptomycin was well tolerated, exhibited a favorable safety profile, and was effective for the treatment of cSSTI or bacteremia in Japanese children.
Topics: Adolescent; Anti-Bacterial Agents; Bacteremia; Child; Child, Preschool; Daptomycin; Gram-Positive Cocci; Humans; Infant; Japan; Methicillin-Resistant Staphylococcus aureus; Soft Tissue Infections; Staphylococcal Infections; Staphylococcus aureus; Treatment Outcome
PubMed: 34920946
DOI: 10.1016/j.jiac.2021.11.019 -
Clinical Microbiology and Infection :... Jun 2019Gram-positive, anaerobic cocci (GPAC) can cause infections in humans. Only a few cases of bacteraemia with GPAC have been reported. We describe the clinical and...
OBJECTIVES
Gram-positive, anaerobic cocci (GPAC) can cause infections in humans. Only a few cases of bacteraemia with GPAC have been reported. We describe the clinical and microbiological characteristics of GPAC bacteraemia.
METHODS
A retrospective population-based study of GPAC bacteraemia 2012-2016 in southern Sweden was performed. GPAC were identified using matrix-associated laser desorption ionization time-of-flight mass spectrometry or 16S rRNA gene sequencing. Etests were used to determine antibiotic susceptibilities. Data on patient and infection characteristics, treatment, and outcome were collected from the medical records.
RESULTS
A total of 226 episodes of GPAC bacteraemia in adults were studied; this corresponds to an annual incidence of 3.4 cases per 100,000 persons per year. The bacteria identified were Anaerococcus spp. (n = 43), Atopobium spp. (n = 7), Blautia spp. (n = 1), Finegoldia spp. (n = 15), Parvimonas spp. (n = 100), Peptoniphilus spp. (n = 52), Peptostreptococcus spp. (n = 2), and Ruminococcus spp. (n = 9) of which 200 isolates were identified to the species level. Resistance to imipenem and piperacillin was not identified, whereas resistance among the 229 isolates to penicillin was detected in four, to metronidazole in six, and clindamycin in 16 isolates. The median age of patients was 73 years (55-83, IQR), 57% were male and comorbidities were common. Fifty-one per cent of infections were polymicrobial. In 60% of cases a focus of infection was identified. Forty per cent of patients had either organ dysfunction or shock. The 30-day mortality was 11%, and nosocomial infections were over-represented among the deceased.
CONCLUSIONS
GPAC bacteraemia is much more common than previously reported. GPAC-bacteraemia is a condition with significant mortality mainly affecting elderly persons with comorbidities.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacteremia; Bacteria, Anaerobic; Child; Cluster Analysis; DNA, Bacterial; DNA, Ribosomal; Disk Diffusion Antimicrobial Tests; Female; Gram-Positive Bacterial Infections; Gram-Positive Cocci; Humans; Incidence; Male; Middle Aged; Phylogeny; RNA, Ribosomal, 16S; Retrospective Studies; Sequence Analysis, DNA; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Sweden; Young Adult
PubMed: 30217761
DOI: 10.1016/j.cmi.2018.09.001 -
Journal of Microbiology, Immunology,... Aug 2021Ceftaroline, with a unique activity against methicillin-resistant Staphylococcus aureus (MRSA), was not launched in Taiwan before 2019. The in vitro susceptibility data...
In vitro susceptibility of ceftaroline against clinically important Gram-positive cocci, Haemophilus species and Klebsiella pneumoniae in Taiwan: Results from the Antimicrobial Testing Leadership and Surveillance (ATLAS) in 2012-2018.
BACKGROUND/PURPOSE
Ceftaroline, with a unique activity against methicillin-resistant Staphylococcus aureus (MRSA), was not launched in Taiwan before 2019. The in vitro susceptibility data of ceftaroline against important Taiwanese pathogens are lacking.
METHODS
The in vitro susceptibility of ceftaroline against important pathogens collected from 2012 through 2018 were extracted from the Antimicrobial Testing Leadership and Surveillance program. Broth microdilution method was used to determine the minimum inhibitory concentrations (MICs) to ceftaroline against all isolates.
RESULTS
During the study period, the in vitro data regarding isolates of S. aureus (n = 2049), Staphylococcus epidermidis (n = 185), Streptococcus pneumoniae (n = 334), Streptococcus pyogenes (n = 170), Haemophilus influenzae (n = 75), Haemophilus parainfluenzae (n = 10) and Klebsiella pneumoniae (n = 680) regardless of hospital sites of collection were analyzed. Among the S. aureus isolates studied, 19.4% showed MICs of 1 mg/L to ceftaroline, and 4.4% showed in vitro susceptible-dose dependent to ceftaroline (all MICs, 2 mg/L). Most of other Gram-positive cocci, all H. influenzae and H. parainfluenzae isolates were susceptible to ceftaroline. By contrast, about one-third (35.9%) of K. pneumoniae isolates, irrespective of infection sources, exhibited non-susceptibility to ceftaroline (MIC range, 0.015-256 mg/L; MIC and MIC values, 0.12 and 256 mg/L, respectively).
CONCLUSIONS
From the pharmacodynamic perspectives, the ceftaroline dosage of 600 mg as a 2-h intravenous infusion every 8 h is effective against all S. aureus and other Gram-positive isolates regardless of acquisition sites in Taiwan. Before ceftaroline is prescribed in treatment of the patient with Gram-negative infection, a cautious evaluation about patient's healthcare-associated factor is warranted.
Topics: Anti-Bacterial Agents; Cephalosporins; Gram-Positive Bacterial Infections; Gram-Positive Cocci; Haemophilus; Humans; Klebsiella pneumoniae; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Respiratory Tract Infections; Soft Tissue Infections; Staphylococcus aureus; Taiwan; Ceftaroline
PubMed: 32451293
DOI: 10.1016/j.jmii.2020.04.017