-
International Journal of Infectious... Sep 2016Morganella morganii belongs to the tribe Proteeae of the Enterobacteriaceae family. This species is considered as an unusual opportunistic pathogen that mainly causes... (Review)
Review
Morganella morganii belongs to the tribe Proteeae of the Enterobacteriaceae family. This species is considered as an unusual opportunistic pathogen that mainly causes post-operative wound and urinary tract infections. However, certain clinical M. morganii isolates present resistance to multiple antibiotics by carrying various resistant genes (such as blaNDM-1, and qnrD1), thereby posing a serious challenge for clinical infection control. Moreover, virulence evolution makes M. morganii an important pathogen. Accumulated data have demonstrated that M. morganii can cause various infections, such as sepsis, abscess, purple urine bag syndrome, chorioamnionitis, and cellulitis. This bacterium often results in a high mortality rate in patients with some infections. M. morganii is considered as a non-negligent opportunistic pathogen because of the increased levels of resistance and virulence. In this review, we summarized the epidemiology of M. morganii, particularly on its resistance profile and resistant genes, as well as the disease spectrum and risk factors for its infection.
Topics: Anti-Bacterial Agents; Drug Resistance, Bacterial; Enterobacteriaceae Infections; Humans; Morganella morganii; Urinary Tract Infections
PubMed: 27421818
DOI: 10.1016/j.ijid.2016.07.006 -
Science (New York, N.Y.) Oct 2022Microbiota-derived metabolites that elicit DNA damage can contribute to colorectal cancer (CRC). However, the full spectrum of genotoxic chemicals produced by indigenous...
Microbiota-derived metabolites that elicit DNA damage can contribute to colorectal cancer (CRC). However, the full spectrum of genotoxic chemicals produced by indigenous gut microbes remains to be defined. We established a pipeline to systematically evaluate the genotoxicity of an extensive collection of gut commensals from inflammatory bowel disease patients. We identified isolates from divergent phylogenies whose metabolites caused DNA damage and discovered a distinctive family of genotoxins-termed the indolimines-produced by the CRC-associated species A non-indolimine-producing mutant lacked genotoxicity and failed to exacerbate colon tumorigenesis in mice. These studies reveal the existence of a previously unexplored universe of genotoxic small molecules from the microbiome that may affect host biology in homeostasis and disease.
Topics: Animals; Mice; Colorectal Neoplasms; DNA Damage; Gastrointestinal Microbiome; Inflammatory Bowel Diseases; Morganella morganii; Indoles; Carcinogenesis; Humans; Mutagens; HeLa Cells
PubMed: 36302024
DOI: 10.1126/science.abm3233 -
Open Forum Infectious Diseases Aug 2021Carbapenems are recommended treatment for serious infections caused by AmpC-producing gram-negative bacteria but can select for carbapenem resistance....
Meropenem Versus Piperacillin-Tazobactam for Definitive Treatment of Bloodstream Infections Caused by AmpC β-Lactamase-Producing spp, , , spp, or : A Pilot Multicenter Randomized Controlled Trial (MERINO-2).
BACKGROUND
Carbapenems are recommended treatment for serious infections caused by AmpC-producing gram-negative bacteria but can select for carbapenem resistance. Piperacillin-tazobactam may be a suitable alternative.
METHODS
We enrolled adult patients with bloodstream infection due to chromosomal AmpC producers in a multicenter randomized controlled trial. Patients were assigned 1:1 to receive piperacillin-tazobactam 4.5 g every 6 hours or meropenem 1 g every 8 hours. The primary efficacy outcome was a composite of death, clinical failure, microbiological failure, and microbiological relapse at 30 days.
RESULTS
Seventy-two patients underwent randomization and were included in the primary analysis population. Eleven of 38 patients (29%) randomized to piperacillin-tazobactam met the primary outcome compared with 7 of 34 patients (21%) in the meropenem group (risk difference, 8% [95% confidence interval {CI}, -12% to 28%]). Effects were consistent in an analysis of the per-protocol population. Within the subcomponents of the primary outcome, 5 of 38 (13%) experienced microbiological failure in the piperacillin-tazobactam group compared to 0 of 34 patients (0%) in the meropenem group (risk difference, 13% [95% CI, 2% to 24%]). In contrast, 0% vs 9% of microbiological relapses were seen in the piperacillin-tazobactam and meropenem arms, respectively. Susceptibility to piperacillin-tazobactam and meropenem using broth microdilution was found in 96.5% and 100% of isolates, respectively. The most common AmpC β-lactamase genes identified were , , , and . No ESBL, OXA, or other carbapenemase genes were identified.
CONCLUSIONS
Among patients with bloodstream infection due to AmpC producers, piperacillin-tazobactam may lead to more microbiological failures, although fewer microbiological relapses were seen.
CLINICAL TRIALS REGISTRATION
NCT02437045.
PubMed: 34395716
DOI: 10.1093/ofid/ofab387 -
Frontiers in Microbiology 2021Ongoing acquisition of antimicrobial resistance genes has made a new clinical treatment challenge. Understanding the molecular epidemiology of will contribute to...
Ongoing acquisition of antimicrobial resistance genes has made a new clinical treatment challenge. Understanding the molecular epidemiology of will contribute to clinical treatment and prevention. We undertook a 6-year clinical molecular epidemiological investigation of from three tertiary hospitals in China since 2014. Antimicrobial susceptibility testing was performed using a VITEK-2 system. All isolates were screened for β-lactam and plasmid-mediated quinolone resistance genes by PCR. Isolates carrying carbapenem-resistant genes were subjected to whole-genome sequencing (WGS). The variation and evolution of these mobile genetic elements (MGEs) were then systematically analyzed. Among all isolates ( = 335), forty (11.9%) were recognized as multidrug resistant strains. , , , and were the top four most prevalent resistance genes. Notably, phylogenomic and population structure analysis suggested clade 1 (rhierBAPS SC3 and SC5) associated with multiple resistance genes seemed to be widely spread. WGS showed a -carrying IncX3 plasmid and a genomic island 2 variant carrying , coexisted in the same multidrug resistant strain zy_m28. Additionally, a -carrying IncP-1β type plasmid was found in the strain nx_m63. This study indicates a clade of is prone to acquire resistance genes, and multidrug resistant are increasing by harboring a variety of MGEs including two newly discovered ones in the species. We should be vigilant that may bring more extensive and challenging antimicrobial resistance issue.
PubMed: 34650543
DOI: 10.3389/fmicb.2021.744291 -
Frontiers in Microbiology 2021The bacterium can produce the biogenic amines (BA) cadaverine, putrescine, and histamine and is responsible for high histamine concentrations in fish products. These...
The bacterium can produce the biogenic amines (BA) cadaverine, putrescine, and histamine and is responsible for high histamine concentrations in fish products. These BA can have toxic effects upon ingestion and are undesired in food. The purpose of this study was to characterize the phenotype and genotype of 11 isolated from cheese in regard to the BA formation. In addition, we investigated the phylogeny, trehalose fermentation ability, and antibiotic resistance of the cheese isolates. To do so, we sequenced their genomes using both long and short read technologies. Due to the presence of the trehalose operon and the ability to ferment trehalose, the cheese isolates can be assigned to the subsp. . Comparative genomics with public available genomes shows that the genomes of the cheese isolates cluster together with other subsp. genomes. All genomes between subsp. and subsp. are separated by an average nucleotide identity (ANI) of less than 95.0%. Therefore, the subspecies could represent two distinct species. Nine of the strains decarboxylated lysine yielding cadaverine . This metabolic activity is linked to a previously unknown gene cluster comprising genes encoding a lysine-tRNA ligase (), an HTH-transcriptional regulator (), a cadaverine-lysine antiporter (), and a lysine decarboxylase (. The formation of putrescine is linked to the gene encoding an ornithine decarboxylase. The gene is disrupted in five strains by an insertion sequence, and these strains only exhibit a weak putrescine production. Antimicrobial susceptibility profiling revealed that all cheese strains are resistant to tetracycline, chloramphenicol, tigecycline, colistin, and ampicillin. These phenotypes, except for colistin which is intrinsic, could be linked to antimicrobial resistance genes located on the chromosome.
PubMed: 34867855
DOI: 10.3389/fmicb.2021.738492 -
European Journal of Case Reports in... 2022Purpura fulminans (PF) is a dermatological manifestation of a life-threatening condition characterized by disseminated intravascular coagulation and endovascular...
UNLABELLED
Purpura fulminans (PF) is a dermatological manifestation of a life-threatening condition characterized by disseminated intravascular coagulation and endovascular thrombosis. The idiopathic/infectious form is the most common and usually associated with infection by or . We describe a case of -induced bacteriaemia complicated with PF in an individual who had undergone a recent urinary tract infection intervention. The patient presented with purpuric skin lesions, fever and hypotension but had no alterations in coagulation parameters or disseminated intravascular coagulation. Aggressive early resuscitation, intravenous antibiotics and wound care were essential to a favourable response.
LEARNING POINTS
Purpura fulminans is a dermatological manifestation of an underlying life-threatening condition, and is characterized by disseminated intravascular coagulation and skin necrosis.It is a morbid and potentially fatal condition that can be a cutaneous manifestation of bacteraemia.Early identification and accurate diagnosis of the underlying cause can help minimize morbidity and mortality; management should be tailored to the individual, with the use of intravenous antibiotics, necrotic skin excision and aggressive early resuscitation.
PubMed: 36506741
DOI: 10.12890/2022_003670 -
Life (Basel, Switzerland) Apr 2021bites cause severe soft tissue injury and are prone to wound infections. The pathogens of bite-wound infections are highly variable in different geographical regions....
bites cause severe soft tissue injury and are prone to wound infections. The pathogens of bite-wound infections are highly variable in different geographical regions. Here, we report the first coinfection with and from a bite wound with resistome analysis using whole genome sequencing.
PubMed: 33920102
DOI: 10.3390/life11040329 -
BMC Infectious Diseases Mar 2022Postvitrectomy endophthalmitis is a rare and serious complication following vitreoretinal surgeries. Morganella morganii, an emerging gram-negative, facultative... (Review)
Review
BACKGROUND
Postvitrectomy endophthalmitis is a rare and serious complication following vitreoretinal surgeries. Morganella morganii, an emerging gram-negative, facultative anaerobic rod, is related to severe nosocomial infections in various organs and thus has gained importance in recent decades. Morganella morganii infection following intraocular surgery is rarely reported.
CASE PRESENTATION
We report an immunocompetent patient with Morganella morganii-related endophthalmitis after vitrectomy for retinal detachment who presented with hand motion visual acuity, hypopyon and a unique retrolental exudative membrane. Initially, the patient was unresponsive to empirical intravitreal ceftazidime and vancomycin but recovered with vision preservation (20/63) after surgical removal of the membrane and silicone oil tamponade.
CONCLUSIONS
Morganella morganii intraocular infection is often devastating, likely due to its high multidrug-resistance rate via intrinsic ß-lactamase production, multiple acquired traits related to additional genetic mechanisms, and fimbrial adhesion, urease production, and type III secretion system-associated biofilm formation. The above characteristics of M. morganii may lead to an inadequate response to empirical intravitreal antibiotics, and early surgical intervention should be considered.
Topics: Anti-Bacterial Agents; Endophthalmitis; Humans; Morganella morganii; Retinal Detachment; Vitrectomy
PubMed: 35303817
DOI: 10.1186/s12879-022-07248-y -
Frontiers in Microbiology 2019The increasing prevalence and transmission of the carbapenem resistance gene has led to a severe threat to public health. So far, has been widely detected in various...
The increasing prevalence and transmission of the carbapenem resistance gene has led to a severe threat to public health. So far, has been widely detected in various species of and different hosts across various cities. However, there is no report on the harboring In January 2016, the first NDM-5-producing L241 was found in a stool sample of a patient diagnosed as recurrence of liver cancer in China. Identification of the species was performed using 16S rRNA gene sequencing. Carbapenemase genes were identified through both PCR and sequencing. To investigate the characteristics and complete genome sequence of the -harboring clinical isolate, antimicrobial susceptibility testing, S1 nuclease pulsed field gel electrophoresis, Southern blotting, transconjugation experiment, complete genome sequencing, and comparative genomic analysis were performed. L241 was found to be resistant to broad-spectrum cephalosporins and carbapenems. The complete genome of L241 is made up from both a 3,850,444 bp circular chromosome and a 46,161 bp self-transmissible IncX3 plasmid encoding , which shared a conserved genetic context of (ΔIS-ΔIS-IS- ----IS). BLASTn analysis showed that IncX3 plasmids harboring genes have been found in 15 species among from 13 different countries around the world thus far. In addition, comparative genomic analysis showed that L241 exhibits a close relationship to KT with 107 SNPs. Our research demonstrated that IncX3 is a key element in the worldwide dissemination of - among various species. Further research will be necessary to control and prevent the spread of such plasmids.
PubMed: 31191484
DOI: 10.3389/fmicb.2019.01156 -
BMC Ophthalmology Nov 2023Endophthalmitis following intravitreal injection is a potentially devastating complication of anti-VEGF injections. Post-injection endophthalmitis due to Enterococcus...
BACKGROUND
Endophthalmitis following intravitreal injection is a potentially devastating complication of anti-VEGF injections. Post-injection endophthalmitis due to Enterococcus faecalis is rare, and no previous case of Morganella morganii endophthalmitis after intravitreal injection has been reported.
CASE PRESENTATION
We present the first reported case of Morganella morganii and Enterococcus faecalis endophthalmitis after intravitreal injection in an immunocompetent patient in the absence of recent ocular surgery. Our patient presented with hand movement visual acuity one day after anti-VEGF injection and demonstrated no clinical improvement despite repeated intravitreal ceftazidime and vancomycin injections. A decision was made to proceed with early vitrectomy given failure of intravitreal antibiotics. Visual acuity improved to 6/90 at 12 weeks after vitrectomy without any evidence of disease recurrence.
CONCLUSIONS
Post-injection endophthalmitis due to concurrent Morganella morganii and Enterococcus faecalis infections can have visually devastating consequences despite repeated empirical and targeted intravitreal antibiotics. Lack of clinical improvement following intravitreal antibiotics should warrant consideration of early vitrectomy. Our experience is a pertinent reminder of the ever-growing threat of uncommon and multi-resistant bacteria that must be considered when treating infections such as post-injection endophthalmitis.
Topics: Humans; Morganella morganii; Enterococcus faecalis; Intravitreal Injections; Eye Infections, Bacterial; Endophthalmitis; Anti-Bacterial Agents; Vitrectomy; Bacteria; Retrospective Studies
PubMed: 37950172
DOI: 10.1186/s12886-023-03198-4