Citrobacter Koseri Research Articles

LONEPINELLA SP. ISOLATED FROM WOUND INFECTIONS OF KOALAS.

We describe two cases of wound infections of koalas (Phascolarctos cinereus), one wild and one captive, in which Lonepinella-like organisms were involved. The wild adult koala was captured with bite wound injuries, as part of a koala population management program in Queensland, Australia. In both cases, there was evidence of physical trauma causing the initial wound. The captive koala suffered injury from the cage wire, and the wild koala had injuries suggestive of intermale fighting. Gram-negative bacteria isolated from both cases proved to be challenging to identify using routine diagnostic tests. The wound in the captive koala yielded a pure culture of an organism shown by whole genome sequence (WGS) analysis to be a member of the genus Lonepinella, but not a member of the only formally described species, L. koalarum. The wound of the wild koala yielded a mixed culture of Citrobacter koseri, Enterobacter cloacae and an organism shown by WGS analysis to be Lonepinella, but again not Lonepinella koalarum. Both cases were difficult to treat; the captive koala eventually had to have the phalanges amputated, and the wild koala required removal of the affected claw. The two Lonepinella isolates from these cases have a close relationship to an isolate from a human wound caused by a koala bite and may represent a novel species within the genus Lonepinella. Wound infections in koalas linked to Lonepinella have not been reported previously. Wildlife veterinarians need to be aware of the potential presence of Lonepinella-like organisms when dealing with wound infections in koalas, and the inability of commercial kits and systems to correctly identify the isolates.

Neonatal necrotizing fasciitis with gas gangrene due to peripherally inserted central catheter-related infection

BackgroundNecrotizing fasciitis in neonates is a rare and life-threatening infection involving necrosis of the skin, subcutaneous tissues, deep fascia, and sometimes underlying muscles, with a fulminant course and high mortality rate. Necrotizing fasciitis with gas gangrene related to infection of a peripherally inserted central catheter is very rare.Case presentationThe patient was a full-term female neonate born by vaginal delivery. Following diagnosis of patent ductus arteriosus, indomethacin was administered from a peripherally inserted central catheter for 3 days. Four days after the termination of medical treatment for the patent ductus arteriosus, the patient developed fever and a severely elevated inflammatory response was identified from blood testing. Around the right anterior chest wall, corresponding to the site of the catheter tip, redness was increased and gas crepitus was felt under the skin. Computed tomography revealed emphysema in the anterior chest, in subcutaneous areas and between muscles. Emergency surgical debridement was performed under a diagnosis of necrotizing fasciitis with gas gangrene. With antibiotic treatment, we started to fill the wound with a dialkyl carbamoyl chloride-coated dressing and povidone-iodine sugar ointment after washing with saline once a day. The patient survived and after 3 weeks of treatment with the dressing, the wound had successfully resolved without motor impairments.ConclusionsIn addition to medical treatment and prompt surgical debridement, we used dialkyl carbamoyl chloride-coated dressing and povidone-iodine sugar ointment for antiseptic dressings and successfully treated neonatal necrotizing fasciitis with gas gangrene caused by peripherally inserted central catheter infection with Citrobacter koseri.

The Epidemiology and Incidence of Bloodstream Infections (BSIs) in Under-Five Children in a Tertiary Care Hospital of Northern India – IGMC Shimla

Background: Clinical and diagnostic challenges are due to the result of a variable presentation of neonatal sepsis and bloodstream infections (BSIs) and uncertain disease epidemiology in children below five years of age. Although the criteria for achieving an adequate blood culture specimen in adults have been well described, there is much more equivocation in the pediatric population, especially for the under-five-year age group. Therefore, the present study is designed to evaluate the etiological profile of BSI among under-five children by the automated BACTEC systems. Materials and Methods: All blood culture samples received in the Department of Microbiology for culture falling in the age group were included in the study for a period of one year from 01 July 2015 to 30 June 2016 using the BD BACTEC FX except in the exclusion criteria. The blood culture was observed in the BD BACTEC FX system for at least five days before being reported as sterile. Results: A total of 1533 samples in the age group of < 5 years and suspected of BSIs were received in the Department of Microbiology, Indira Gandhi Medical College (IGMC), Shimla. Among them, 963 (62.8%) were males, while 570 (37.2%) were females. Among the total of 1533 samples, 604 (39.40%) were found positive in culture, 898 (58.57%) were negative, and 31 (2.02%) were contaminants. Among the 604 positive cases, 390 (64.6%) were men, while 214 (35.4%) were women. S. aureus was the highest among the gram-positive isolates 98 (16.22%), followed by coagulase-negative Staphylococcus, group B Streptococcus, and S. pneumoniae. Among the gram-negative organisms, E. coli 80 (13.24%) was isolated mostly followed by K. pneumoniae 70 (11.58%), P. aeruginosa 68 (11.25%), Salmonella typhi 50 (8.27%), Citrobacter koseri 18 (2.98%), Acinetobacter baumannii 12 (1.98%) and a group of organisms without fermentation 86 (14.23%). Conclusion: There was quite high positivity in culture in the preschool group. Positivity was significantly high in males as compared to females. It is essential to administer appropriate and synergistic antimicrobial agents empirically early and appropriately for treating children under five-year age with BSI.

Resistance patterns of bacterial pathogens causing lower respiratory tract infections: Aleppo-Syria.

This study aimed to scan the bacterial spectrum causing LRTIs, their susceptibility profile and patient related risk factors. Two hundred sixty-eight specimens from LRTIs suspected patients attending University Hospital were collected. Specimens included bronchial washings, transtracheal aspiration samples and sputum. After appropriate culture and identification tests, susceptibility test was done using minimum inhibitory concentration method. Data were collected from patients for further analysis. of total specimens, 150 showed positive culture results (Acinetobacter baumannii, Pseudomonas aeruginosa, Citrobacter koseri, Escherichia coli, Klebsiella pneumonia, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Streptococcus pneumonia and Candida spp.). The antibiogram showed high resistance among all bacterial isolates against most antibiotics. Good susceptibility rates were shown to colistin in Gram-negative group and piperacillin\tazobactam in Gram-positive group. Trimethoprim\sulfamethoxazole showed good susceptibility results in both groups. Many factors showed correlation with LRTIs such as age (P=0.004), smoking (P=0.049), residency (P=0.043), hypertension (P=0.012), lung chronic disease (P=0.007) and cancer (P=0.048). The leading cause of LRTIs in our study were A. baumannii and P. aeruginosa which both are very troublesome pathogens and multidrug resistant frequency was alarming. Random empirical antibiotic using can highly lead to increased resistance. Further care must be taken after patients with risk factors, and adjustments should be done to those modifiable factors.

Long-term Follow-up Results of Primary Canaliculitis Patients.

To evaluate the demographic characteristics, clinical presentation, microbiologic profile, and treatment results of patients with primary canaliculitis. Patients diagnosed and treated for primary canaliculitis between May 2014 and May 2021 were analyzed retrospectively. There were 26 patients with primary canaliculitis, including 17 females (65.4%) and 9 males (34.6%) with a mean age of 50.6±16.4 years (range: 9-80 years). Canaliculitis affected the right eye in 11 patients, the left eye in 13 patients, and bilateral involvement was seen in 2 patients. Inferior canaliculus involvement was more frequent (73%). The most common complaint was epiphora (46.1%). Five patients (19.2%) were wrongly diagnosed as chronic conjunctivitis. The time interval between the beginning of symptoms and canaliculitis diagnosis was 18.2±14.3 months (range: 1-60 months). Canaliculotomy and curettage of canalicular content with dacryolith removal were performed in 23 patients. After surgery, antibiotic irrigation of the canaliculus was added to the treatment regimen in 12 of these 23 patients. Intracanalicular antibiotic therapy was administered to the remaining 3 patients. The most cultured organism was Actinomyces (6 patients). Gemella (1 patient), Porphyromonas (1 patient), Candida parapsilosis (1 patient), Citrobacter koseri (1 patient) were also grown in culture. The follow-up time of patients was 26.2±23.7 months (range: 6-83 months). All symptoms and findings resolved in all patients in one month. In two patients, recurrence occurred at 4 and 16 months after surgical treatment. With appropriate treatment, no further recurrence was seen in either patient over 24-month follow-up. One patient presented with iatrogenic canaliculus blockage during follow-up. Primary canaliculitis is often overlooked and can be misdiagnosed. The most common symptom was epiphora. All patients with epiphora and chronic conjunctivitis should be examined carefully for canaliculitis.

(443) A Randomized Prospective Evaluation of Next-generation Sequencing Versus Traditional Cultures for Clinically Infected Penile Prostheses: Impact of Microbial Identification on Outcomes

Abstract Introduction Traditional culture is the current standard-of-care to determine therapeutic antibiotics for patients suffering from penile prostheses (PP) infections. However, approximately 50% of PPs removed for infection are culture negative. Next-generation sequencing (NGS) of DNA has proven to be beneficial in its thorough analysis of biofilm composition and determination of the relative abundance of specific microbes. In this prospective, multicenter, single-blinded, randomized controlled trial, we hypothesize that the use of NGS will lead to better therapeutic strategies that will result in improved patient outcomes by determining the microbial composition of infected PP. Objective We present our early results from our prospective study that compares outcomes of microbial identification between NGS versus culture for clinically infected PP. Methods Upon institutional review board approval, adult men undergoing treatment for mild to moderate PP infection are enrolled after providing informed consent. Enrollees are randomized to one of two analytic arms – traditional culture or NGS, using Captivate by ClinCapture. Patients with severe infection requiring urgent explantation are excluded. Traditional culture and NGS samples are collected upon clinical presentation prior to initiation of antibiotics. Specimens of infected fluid were collected, stored in sterile packaging, and transported for both traditional culture at the institutional laboratory and NGS testing (MicroGenDX, Lubbock, TX). Patients are started on set empiric antibiotics and randomized to traditional culture or NGS. Patients with a positive culture or NGS result will receive treatment-specific antibiotics, while patients with negative results continue empiric antibiotics for two weeks. For patients randomized to the NGS arm, positive results will undergo central infectious disease (ID) review, and antibiotics initiated based on their recommendations. Patients will follow up within ten days of antibiotic initiation and at six months to complete a safety and compliance questionnaire which assesses symptoms, device function, and patient satisfaction. Results To date, two patients have been enrolled. The first patient was randomized to the culture arm and presented with mild tenderness and drainage around the scrotal pump area for five days but remained afebrile. His culture resulted as Citrobacter koseri. He started empiric treatment with amoxicillin-clavulanate which was changed to ciprofloxacin based on culture results. The second patient was randomized to the NGS arm and presented with four days of bloody and purulent drainage from the scrotal pump area. Although he was afebrile, he had moderate tenderness, swelling, and erythema in his scrotum. NGS identified multiple organisms (data remains blinded). He was started on empiric trimethoprim-sulfamethoxazole but was treated successfully with a course of cefdinir and doxycycline per ID. Both patients had primary implants and did not require device removal. On the post-treatment questionnaire, both patients reported that their devices were working and endorsed high satisfaction rates. Conclusions This is the first prospective, randomized controlled trial comparing the utility and outcomes of NGS and culture for the identification of microbes in clinically infected PP. Currently, recruitment is ongoing. We hope that this trial will demonstrate a clinical benefit of NGS in characterizing distinct microbiomes of infected PP to tailor antimicrobial therapy. Disclosure Yes, this is sponsored by industry/sponsor: MicroGenDX Clarification Industry funding only - investigator initiated and executed study Any of the authors act as a consultant, employee or shareholder of an industry for: MicroGenDX

Biodegradation of polyvinyl chloride by Citrobacter koseri isolated from superworms (Zophobas atratus larvae).

Polyvinyl chloride (PVC) is one of the widely used plastic products worldwide, and its accumulation in the natural environment has become a major global issue with regard to the environment and biotic health. There is accordingly strong demand for the development of solutions and methods for environmental remediation. Degrading plastic waste using microorganisms is an effective and eco-friendly method. However, evidence of bacteria that afford efficient biodegradation of unplasticized, pure PVC film has yet to be reported. Therefore, the biodegradation of PVC becomes very important. Here, we present results on the physicochemical and structural studies of PVC by Citrobacter koseri (C. koseri) isolated from the gut of the superworm, Zophobas atratus (Z. atratus) larvae. We also studied the biodegradability of PVC by the gut microbiota compared with C. koseri. We analyzed the microbial degradation of the PVC surface using field emission scanning electron microscopy (FE-SEM) and energy-dispersive X-ray spectroscopy (EDS) and confirmed that the physical and chemical changes were caused by C. koseri and the gut microbiota. The chemical structural changes were further investigated using X-ray photoelectron spectroscopy (XPS) and Fourier-transform-infrared (FTIR) spectroscopy, and it was confirmed that the oxidation of the PVC surface proceeded with the formation of carbonyl groups (C = O), and hydroxyl groups (-OH) by C. koseri. Additionally, the gut microbiota composed of diverse microbial species showed equal oxidation of PVC compared to C. koseri. Further, we evaluated the capabilities of single bacterial isolate and gut microbiota for pure PVC film biodegradation. Our results verified that C. koseri and the culturable microbiota from the gut of superworms present similar potential to utilize pure PVC film as a carbon source. These findings provide a potential solution for the biodegradation of unplasticized PVC.

A CASE REPORT OF CITROBACTER KOSERI ENDOCARDITIS

The present case report describes the clinical course of a patient ,who presented with citrobacter koseri endocarditis (subacute)with background chronic rheumatic heart disease. Which was initially treated medically , followed by elective double valve replacement. Perioperatively he developed complete heart block which was managed by permanent pacemaker implantation successfully.

CkP1 bacteriophage, a S16-like myovirus that recognizes Citrobacter koseri lipopolysaccharide through its long tail fibers

Citrobacter koseri is an emerging Gram-negative bacterial pathogen, which causes urinary tract infections. We isolated and characterized a novel S16-like myovirus CKP1 (vB_CkoM_CkP1), infecting C. koseri. CkP1 has a host range covering the whole C. koseri species, i.e., all strains that were tested, but does not infect other species. Its linear 168,463-bp genome contains 291 coding sequences, sharing sequence similarity with the Salmonella phage S16. Based on surface plasmon resonance and recombinant green florescence protein fusions, the tail fiber (gp267) was shown to decorate C. koseri cells, binding with a nanomolar affinity, without the need of accessory proteins. Both phage and the tail fiber specifically bind to bacterial cells by the lipopolysaccharide polymer. We further demonstrate that CkP1 is highly stable towards different environmental conditions of pH and temperatures and is able to control C. koseri cells in urine samples. Altogether, CkP1 features optimal in vitro characteristics to be used both as a control and detection agent towards drug-resistant C. koseri infections.Key points• CkP1 infects all C. koseri strains tested• CkP1 recognizes C. koseri lipopolysaccharide through its long tail fiber• Both phage CkP1 and its tail fiber can be used to treat or detect C. koseri pathogens

Microbial Colonization of Capsular Traction Sutures in Hip Arthroscopic Surgery.

A common practice in hip arthroscopic surgery is the utilization of capsular traction sutures that can be incorporated into the capsular repair site at the end of the procedure, potentially seeding the hip joint with colonized suture material. To investigate the rate of the microbial colonization of capsular traction sutures used during hip arthroscopic surgery and to identify patient-associated risk factors for this microbial colonization. Cross-sectional study; Level of evidence, 3. A total of 50 consecutive patients who underwent hip arthroscopic surgery with a single surgeon were enrolled. There were 4 braided nonabsorbable sutures utilized for capsular traction during each hip arthroscopic procedure. These 4 traction sutures and 1 control suture were submitted for aerobic and nonaerobic cultures. Cultures were held for 21 days. Demographic information was collected, such as age, sex, and body mass index. All variables underwent bivariate analysis, and variables with a P value <.1 underwent further analysis in a multivariate logistic regression model. One of 200 experimental traction sutures and 1 of 50 control sutures had a positive culture. Proteus mirabilis and Citrobacter koseri were isolated in both these positive experimental and control cultures from the same patient. Age and traction time were not significantly associated with positive cultures. The rate of microbial colonization was 0.5%. The rate of the microbial colonization of capsular traction sutures used in hip arthroscopic surgery was low, and no patient-associated risk factors were identified for microbial colonization. Capsular traction sutures used in hip arthroscopic surgery were not a significant potential source of microbial contamination. Based on these results, capsular traction sutures can be incorporated in capsular closure with a low risk of seeding the hip joint with microbial contaminants.

Molecular Characterization of Microbial Quality of Ready-to-eat Salads using Multi-locus Sequence Typing

Uncertainty persists concerning the role of ready-to-eat (RTE) salad as a bacterial reservoir. The attention paid to food safety by international agencies and international regulations has not improved food safety despite technological advancements, RTE salad’s microbiological quality and safety still seems challenging. The present study’s objective was to detect any microorganism in the RTE salads sold in supermarkets of Riyadh, Saudi Arabia, and to interpret the susceptibility pattern of isolated bacteria to a set of antimicrobials. Phenotypic methods and biochemical analysis were used to identify the isolated bacterium from each salad sample. Antibiograms of the isolated bacteria was determined by VITEK system 2. Multi-locus sequence typing (MLST) was performed for 15 Escherichia coli isolates for investigating evolutionary relationship and genetic analysis. The culture-based technique showed that the major species identified in samples were Aeromonas spp., Acinetobacter spp., E. coli, Roultella ornithinolytica, Citrobacter koseri, Luciferciaadec arboxylata, Klebsiella oxytoca, and Aerococcus viridians. Remarkably, Acinetobacter spp. showed the highest antibiotic resistance to erythromycin, nitrofurantoin and co-trimoxazole. ST 1887 was the most common one traced in 3 E. coli isolates, when total of 12 STs (sequence types) were specified to 15 isolates. A total of three clonal complexes (CC); CC-12, CC-14 &amp; CC-23 were reported in this study. Implementing an accurate, rapid, and easy microbiological analysis method could be valuable for providing higher quality products. Based on the obtained results, dedicated regular RTE salad quality monitoring is recommended, and hand hygiene should be maintained while handling and packaging of RTE.

Molecular analysis of clinical Citrobacter spp. isolates: Acquisition of the Yersinia high-pathogenicity island mediated by ICEkp in C. freundii.

Studies on Citrobacter spp. are limited, hindering our understanding of its species evolution and medical relevance. A total of 164 clinical Citrobacter spp. isolates were collected from 2017 to 2020 and identified by VITEK MALDI-TOF MS or VITEK-2 Gram-Negative Identification Card. All isolates were further analyzed by whole-genome sequencing using a HiSeq sequencer. All sequences were processed using different modules of the PGCGAP integrated package: Prokka and fastANI were used for annotation and average nucleotide identification (ANI), respectively. Antibiotic resistance and virulence genes were identified by searching CARD, ResFinder, and VFDB databases, respectively. Strains were identified using Ribosomal Multi-locus Sequence Typing (rMLST) classification based on 53 ribosome protein subunits (rps). The evolutionary relationship was analyzed using kSNP3 and visualized by iTOL editor v1_1. Genetic environments were compared by BLAST and visualized by Easyfig 2.2.5. The pathogenicity of some Citrobacter freundii isolates was confirmed by Galleria mellonella larvae infection test. A total of 14 species of Citrobacter spp. were identified from 164 isolates. However, 27 and 11 isolates were incorrectly identified as C. freundii and Citrobacter braakii by MALDI-TOF MS, respectively. In addition, MS also failed to identify Citrobacter portucalensis. The virulence genes mainly encoded proteins related to flagella and iron uptake systems. Citrobacter koseri isolates (n = 28) contained two iron uptake systems, coding yersiniabactin and aerobactin, respectively. C. braakii isolates (n = 32), like Salmonella, carried Vi capsule polysaccharide synthesis genes. The yersiniabactin gene clusters identified in five C. freundii isolates are located on various ICEkp elements and have not been reported previously. Moreover, ICEkp-carrying C. freundii showed diverse pathogenic features. Conventional methods have significant defects in identifying Citrobacter spp. ICEkp-like elements-mediated acquirement of the Yersinia high-pathogenicity island was identified for the first time in C. freundii.

Qualitative Risk Assessment of Microbial Indicators in the Lower Reaches of Meenachil River, Kerala, India

Pristine natural freshwater resources being severely contaminated by microbiological pollutants is still a big issue in many parts of the world. In the present study, water samples taken from the upstream, midstream, and downstream reaches of the Meenachil River were analysed for the presence of microbial pollution indicators such as faecal coliforms (FC), faecal streptococci (FS), and Eschericia coli. The E. coli isolates were subjected to antimicrobial susceptibility tests and the multiple antibiotic resistance (MAR) indexes were calculated so as to delineate the potential risk posed by infections to humans and animals using the river for routine potable and recreational purposes. E. coli was consistently isolated from all the samples collected from the different zones of the river. Other faecal coliforms such as Klebsiella oxytoca, Citrobacter koseri, Enterobacter, Proteus vulgaricus, and Shigella boydii were also identified. Higher FC/FS ratios were noticed for the midstream and the downstream sites indicating the contamination from high-risk sources such as human and anthropogenic domestic wastes. The MAR index values of E. coli isolates ranged from 0.33 upstream, 0.416 for midstream and 0.583 for the downstream reaches. Given that E. coli is an ideal indicator of faecal pollution, their existence and extended survival of multiple antibiotic resistance natural freshwater pose a potential risk for the consumers. Rapid urbanization and resultant waste drainage in the downstream stretches of the river might have accelerated the deterioration of the water quality up to a certain extent. Furthermore, the riverine system as it flows downstream loses its self-purification capacity due to the loss of natural water drifts. This may be attributed to the periodic shutdown of the salinity barrier, Thanneermukkam Bund in the confluence zone of the river which results in a temporary stagnation of the running waters in the lower stretches.

Co-existence of Extended Spectrum β-Lactamase and carbapenemase-producing genes from Diarrheagenic Enteric pathogens isolated in a tertiary care hospital.

Multiple drug resistance (MDR) among bacterial pathogens is a growing concern that clinicians are facing worldwide. Diarrhea among infants is frequent and is caused by various bacterial and viral infectious agents. Two hundred and twelve stool specimens were collected from pediatric patients from a rural quaternary hospital in Barshi, Sholapur, India, between March and December 2017. Total 180 specimens were positive for various bacterial pathogens, while the remaining 32 diarrhea cases may have been caused by a viral or uncultured bacterial pathogen. Identification of the bacterium and its antibiotic susceptibility were primarily carried out with VITEK-2. Distribution of diarrhea-causing bacteria among the 180 samples was as follows: 61.11% (110) Escherichia coli, 30.55% (55) Klebsiella pneumoniae, 4.44% (8) Proteus mirabilis, 2.22% (4) Shigella spp. 1.11% (2) Morganella morganii and 0.55% (1) each for Enterobacter cloacae and Citrobacter koseri. There was a co-existence of multiple genetic traits conferring extreme drug resistance (XDR) status to 19 isolates, 17 of which were determined to be E. coli and one each of E. cloacae and C. koseri. Antibiotype determination using VITEK-2 and polymerase chain reaction (PCR) amplification of the genetic traits indicated the co-existence of blaTEM and blaCTX-M15 isolates in all 19 isolates, with the exception of E. cloacae. Results showed that 10 out of 19 strains expressed the AmpC cephalosporinase blaCMY-2 gene, whereas metallo-carbapenemase was expressed in four isolates. Distribution of blaNDM-11 and acquired penicillinase blaSHV-1 resistance among 180 clinical isolates is discussed in the light of ESBL traits. This is the first report from the rural part of Maharashtra India showing that as many as 10.55% of the pathogenic strains were XDR, a step ahead of MDR.

A pyocele of the frontal sinus as a complication of chronic sinusitis – a case report

Introduction: Pyocele is a rare complication of sinusitis that is usually associated with stenosis of the ostium of the sinus caused by inflammation, trauma. Case report: A 68-year-old woman was admitted to the Otolaryngology Clinical Department of the University Hospital in Krakow, Poland because of a tumor of the right frontal bone which was painful during palpation. In anamnesis the patient reported previous laryngological surgeries associated with the treatment of chronic sinusitis. The conducted medical imaging presented the destruction of the walls of both the right and left frontal sinuses caused by pathological changes penetrating to the orbit and adhering to the dura mater. The clinical and radiological picture suggested the diagnosis of empyema of the paranasal sinus (pyocele). The patient was scheduled for bilateral endoscopic frontoethmoidectomy and the surgery ended without complications. Nowadays, the patient remains under follow-up in the outpatient otolaryngology clinic. Discussion: The main disease entity, which should be included in the differential diagnosis of pyocele is the retention cyst of the sinus. The vast majority of pyocele cases are caused by superinfection of a mucocele by bacteria (in the described case the bacterial culture of the lesion content revealed the presence of Citrobacter koseri). An efficient and sufficient method of treatment of pyocele of paranasal sinuses is their endoscopic drainage. Conclusion: In the diagnosis of pyocele, the most important are data from anamnesis, physical examination and results from computed tomography and magnetic resonance imaging. Treatment is mainly based on properly performed surgery, pharmacotherapy and consecutive rehabilitation. Endoscopic surgery is an effective procedure and its early use often prevents serious complications resulting from the expansion of the lesion.

In vitro resistance pattern of Citrobacter infections: A retrospective study

Background: Citrobacter infections are associated with a high mortality rate of about 33-48% if infected patients develop bacteremia. This is partly due to high prevalence of intrinsic resistance, extended spectrum beta lactamases and inducible chromosomal Amp C beta lactamases in Citrobacter spp. thus limiting the therapeutic options. We undertook this study to throw light on the current scenario of infection with this organism. Materials and methods: This retrospective study was conducted over a period of 1 year in Microbiology laboratory of a tertiary care teaching hospital in Eastern part of India. From various samples, 146 clinically significant Citrobacter spp. identified by standard biochemical tests and susceptibility testing performed by Kirby Bauer’s disc diffusion method were included in this study. Results: Majority of patients age ranged of 41-50 year. The highest number (70/146, 47.9%) of Citrobacter spp. was isolated from pus and wound swabs followed by urine (46/146, 31.5%) and out of these, 51.4% strains were of Citrobacter koseri whereas 48.6% were of Citrobacter fruendii. Of Citrobacter isolates 36.6% were ESBL producers. They showed 54.1%, 37.9%, 47.1%, 39.8% and 58.5% resistance to imipenem, netilmycin, piperacillin tazobactam, minocycline and levofloxacin respectively. We also found 9.6% and 28.4% strains of Citrobacter spp. being resistant to colistin and tigecycline respectively. Conclusion: Citrobacter spp. showed high degree of resistance to carbapenem and there were colistin resistance strains as well. This study reiterates the emerging resistance in these supposedly low virulence microbes which may pose future challenge in infection control activities.

Citrobacter koseri related abortion and fetal septicemia in cattle.

A 31-month-old Holstein dairy cow aborted at 224 days of gestation with ejection of cheese-like lochia. Citrobacter koseri, which commonly exists in the normal flora of human and animal digestive tracts, was isolated from aborted fetal tissues (liver, spleen, kidney, heart, lung, cerebrum, and skeletal muscle) and fetal membranes. Histopathological examination revealed suppurative fibrinous meningoencephalitis of the cerebrum, cerebellum, and brainstem; suppurative bronchopneumonia; suppurative chorioamnionitis; and fibrous splenic serositis. Numerous gram-negative bacilli were detected in the cytoplasm of macrophages and/or neutrophils in these lesions. Bacteriological investigation and immunohistochemical staining identified the bacilli as C. koseri. This is the first report of cattle abortion caused by C. koseri infection in dairy cattle.

Skin Beautification with an ImmunatuRNA® Complex: A Natural Complex Based on Yeast RNA and Marine Derivatives on the Human Skin Immunity and Microbiome Composition

The skin is the largest organ of human body implicated in vital physiological and immunological processes, including protection against injury, infections, and environmental exposures. Nevertheless, a number of negative external and internal factors, including increased pollution along with modern lifestyle can significantly influence on the skin immunity, promote aging and reduce regenerative capabilities. Cosmetic formulations based on natural ingredients, including plant and marine/algae extracts, and microbial-derived bio-actives may help to maintain healthy skin condition and protect its beautiful appearance. The ImmunatuRNA®* (*The trademark ImmunatuRNA® is a registered trademark in the European Union EUTM 018365297 and Great Britain UK00003630172. Any reference to the registration of the ImmunatuRNA® trademark applies to the designated territories), a signature complex (VRFD SA/VERDILAB Switzerland) based on the Natural RNA molecules obtained from yeasts, with added marine exopolysaccharides and natural hyaluronic acid with potential benefits for antibacterial and antiradical defense and maintaining skin detox homeostasis. Therefore, the main aim of this study is to experimentally assess the ImmunatuRNA® complex capabilities to enhance natural skin antioxidant defenses and protection against oxidative stress, by using human fibroblast cell culture. Additionally, this study will investigate the effects of the skincare products with added ImmunatuRNA® complex on the skin microbiome composition in the group of healthy adults with various skin types. The results obtained from the in vitro studies consistently demonstrated that treatment with an ImmunatuRNA® complex protects human fibroblasts against exposure to pro-oxidants, while at the same time enhances anti-oxidative defenses of these cells, demonstrated as reduced formation of free radicals and upregulation of SIRT-1 protein. Furthermore, the cosmetic intervention carried on the group of 10 healthy human volunteers with different skin types (oily, dry, combined, normal) aged between 23 and 65 years old demonstrated that using interchangeably of two cosmetic products-a Natural Moisturizer Probiotic Cream and Natural Detox Replenishing Face Mask containing the ImmunatuRNA® complex, for 4-weeks led to favorable changes in the composition of skin microbiome observed as a reduction of relative abundance of adverse microorganisms, previously linked to the skin inflammation and infections, such as Citrobacter koseri, Bacillus spp., Enterococcus spp., Alcaligenes spp., Pantoea spp. and Staphylococcus aureus. Based on following results, the use of skincare products containing the ImmunatuRNA® complex can help maintain a healthy skin microbiome while possibly preventing against infections and negative environmental exposures, in particularly against oxidative stress in healthy adults with all types of skin with age range 23-65 years old.

Citrobacter koseri Meningitis in an Adult Patient: A Case Report and Literature Review

Citrobacter koseri Meningitis in an Adult Patient: A Case Report and Literature Review

Isolation and identification of major bacteria from three Ethiopian rift valley lakes live and processed fish, and water samples: implications in sanitary system of fish products

Bacterial pathogens are a great threat to fish production. Gram-negative bacteria are among the major bacterial fish pathogens and are zoonotic with the potential to infect humans. This cross-sectional study was conducted to isolate and identify major gram-negative bacteria from live and processed fish, and water samples from Lakes Hawassa, Langanoo and Ziway. A total of 674 different types of samples: 630 tissue samples (210 samples for each intestine, Kkidney and liver collected from 210 live fish (Oreochromis niloticus, Cyprinus carpio and Clarias gariepinus), 20 processed fish samples from lake Ziway fish processing center and 24 lake water samples were included in the study from each lake. The mean values of pH, temperature, dissolved oxygen and nitrate in all water samples were within the normal range at which most freshwater fish species become non-stressed. Of a total of 674 samples included in the study, bacteria were isolated from 154(22.8%) samples with significant difference (P < 0.05) observed in some isolates with respect to sample origin. Of these 154 isolates, 103(66.8%) isolates were gram-negative bacteria consisting of 15 species based on morphology and a range of biochemical tests. From live fish samples, Escherichia coli was the dominant species with 15 isolates followed by Edwardsiella tarda (12), Salmonella Paratyphi (10), Salmonella Typhi (9), Shigella dysenteriae (7), Shigella flexneri (7), Klebsiella pneumonia (7), Enterobacter aerogenes (6), Enterobacter cloacae (5), Pseudomonas aeruginosa (5), Vibrio parahemolyticus (5), Aeromonas sobria (4), Citrobacter freundii (4), Citrobacter koseri (4) and Plesiomonas shigelloides (3). The detection of the common fecal coliforms (E. coli, K. pneumoniae and E. aerogenes) and Salmonella spp. in processed fish indicates the potential danger of passage of pathogenic bacteria and/or their poisons to humans via infected and/or contaminated fish products. Human infection by pathogenic fish bacteria and food poisoning is possible through contamination of fish product in fish production chain due to inadequate handling, poor hygiene and contact with contaminated water. Therefore, producers, consumers and all other stakeholders need to be cautious during handling, processing and consumption of fish harvested from the study lakes.