Order Enterobacteriales Research Articles

Survey in ruminants from Rwanda revealed high diversity and prevalence of extended-spectrum cephalosporin-resistant Enterobacterales

BackgroundAntimicrobial resistance (AMR) in Enterobacterales constitutes a significant threat to the health of both humans and animals and a socioeconomic problem. Enterobacterales, mainly Escherichia coli, carrying β-lactamases has become one of the main indicators to estimate the burden of AMR in animals within “One Health” approach.ObjectivesTo assess the presence of extended-spectrum cephalosporin-resistant Enterobacterales associated with ruminants (cattle, sheep, goats) habituated in all five provinces of Rwanda and to perform in depth characterization of isolates.MethodsWe screened 454 rectal swabs from 203 cows, 170 goats, and 81 sheep and selective isolation of extended-spectrum cephalosporin-resistant Enterobacterales was conducted. Isolates were identified as a members of the order Enterobacterales by MALDI-TOF MS and further characterized by susceptibility testing and by whole-genome sequencing.ResultsOut of the 454 samples, 64 extended-spectrum cephalosporin-resistant Enterobacterales were isolated from 58 animals. Isolates belonged to seven bacterial species and were identified as Escherichia coli (n = 54), Enterobacter bugandensis (n = 4), Enterobacter mori (n = 2), Klebsiella pneumoniae (n = 2), Enterobacter dykesii (n = 1), and Citrobacter freundii (n = 1). All isolates displayed an Extended-spectrum β-lactamases (ESBL) phenotype, with exception of Citrobacter freundii isolate displayed both an ESBL and AmpC phenotype. In addition, all Enterobacter isolates were identified as stably de-repressed AmpC-producers. ESBLs genes, blaCTX−M−15 was predominant. Resistance to tetracycline and tet(A) was most frequently observed among non-β-lactam resistance. Forty-eight isolates displayed multidrug-resistance phenotypes. A shiga toxin-producing E. coli and an enterotoxigenic E. coli isolate were observed. Genome comparisons revealed thirty-five E. coli sequence types (ST) (ST10, ST307 being predominate).ConclusionsConsidering the high proximity between ruminants and humans in Rwanda, the dissemination of antimicrobial drug resistance highlights the public health threats and requires the joint and multisectoral action of human and veterinary medicine, at human-animal-environment interfaces. Therefore, it is important to establish national and global “One Health” surveillance programs of AMR to tackle the antibiotic-resistant crisis in human and veterinary medicine.

Community-acquired lower respiratory tract infection due to Serratia rubidaea: A rare and opportunistic pathogen

Abstract The genus Serratia belongs to the order enterobacterales consisting of Serratia marcescens as the most common species of clinical importance and non-S. marcescens species including Serratia fonticola, Serratia odorifera, Serratia plymuthica, Serratia liquefaciens, and Serratia rubidaea. Most of these non-S. marcescens species are usually considered as nonpathogenic and rarely reported to be associated with various clinical conditions in humans. S. rubidaea is rarely described as member of the genus Serratia which is naturally found in the environment including soil and water. S. rubidaea has been reported as human pathogen, and its isolation from clinical specimens is rare. S. rubidaea has been reported as an opportunistic pathogen affecting immunocompromised individuals. Only few case reports are available documenting clinical significance of S. rubidaea causing various invasive and life-threatening manifestations. We report four cases of community-acquired lower respiratory tract infection caused by S. rubidaea in immunocompromised patients from a tertiary care teaching institute from Uttar Pradesh, India.

Alterations in maternal–fetal gut and amniotic fluid microbiota associated with fetal growth restriction

BackgroundFetal growth restriction (FGR) is typically characterised as the fetus’ inability to reach its inherent growth potential. A growing body of evidence points to the important role of the maternal gut microbiota in FGR development. However, comprehensive research on changes in maternal–fetal gut and intrauterine microbiota related to FGR is lacking.MethodsIn this case–control study, we sequenced bacterial 16S rRNA from 35 maternal faecal, 35 meconium, and 31 amniotic fluid samples collected from 19 pregnant women diagnosed with FGR and 16 healthy controls. We identified putative bacterial taxonomic and functional characteristics associated with FGR by comparing these to control samples.ResultsWe identified 34 differential operational taxonomic units (OTUs) in amniotic fluid, seven differential OTUs in maternal faecal matter, and two differential OTUs in meconium. Compared to controls, FGR subjects exhibited enriched bacterial OTUs of the genus Bacteroides in the maternal gut. They also had depleted OTUs of the order Enterobacterales and genus Pseudomonas in the amniotic fluid and genus Stenotrophomonas in the fetal gut. These altered bacterial OTUs showed a significant correlation with neonatal weight and fetal ultrasonographic indexes. Additionally, we identified differential microbial functional pathways related to glycan and lipid metabolism in the maternal gut. We developed diagnostic biomarkers for FGR based on the maternal–fetal gut and amniotic fluid microbiota.ConclusionsThis study offers a comprehensive overview of the shifts in microbial composition and functional pathways in the maternal–fetal gut and amniotic fluid microbiota related to FGR, and present novel insights into the development and screening of FGR. However, the assessment of contamination’s impact on meconium and amniotic fluid remains inconclusive, necessitating further rigorous experimentation to address this scientific inquiry in future studies.

Urogenital colonization and pathogenicity of E. Coli in the vaginal microbiota during pregnancy

This study explores the role of the vaginal microbiota (VM) in the pathophysiology of asymptomatic bacteriuria (ASB) in a cohort of 1,553 pregnant women. Worldwide, E. coli remains the most common etiological agent of bacteriuria during pregnancy and also a major causative agent of newborn infections. A healthy VM is typically characterized by low diversity and is dominated by lactic acid-producing species, notably those from the Lactobacillus genus. Our results point to decreases in Lactobacillus spp associated with an increase of gut-microbiota-associated species from the Enterobacterales order. Escherichia coli exhibited the most pronounced increase in abundance within the VM during bacteriuria and was notably associated with ASB. Molecular typing and antimicrobial resistance characterization of 72 metagenome assembled E. coli genomes (MAGs) from these pregnant women revealed a genomic signature of extraintestinal pathogenic E. coli (“ExPEC”) strains, which are involved in various extraintestinal infections such as urinary tract infections, newborn infections and bacteremia. Microbial diversity within the vaginal samples from which an E. coli MAG was obtained showed a substantial variation, primarily marked by a decrease in abundance of Lactobacillus species. Overall, our study shows how disruption in key bacterial group within the VM can disrupt its stability, potentially leading to the colonization by opportunistic pathogens.

A rare case report of tissue infection caused by Pantoea piersonii (basionym Kalamiella piersonii).

In 2019, Pantoea piersonii was initially isolated from the interior surfaces of the International Space Station. This microorganism is a species within the genus Pantoea in the family Erwiniaceae, belonging to the order Enterobacterales. Recent literature has documented four cases of its isolation. Despite initial predictions suggesting the non-pathogenicity of P. piersonii strains, evidence from observed cases indicates potential pathogenicity. According to documented evidence in the literature, this microorganism is capable of causing severe and life-threatening conditions, including sepsis. Traditional tests, as well as automated systems, may fail to provide complete differentiation due to these similarities. While MALDI-TOF MS is a valuable tool for identification in clinical diagnostic microbiology, sequencing may be necessary for precise identification. To determine the antibiotic susceptibility profile, various methods can be utilized, including minimum inhibitory concentration determination, disk diffusion testing (Kirby-Bauer test), genotypic resistance assays (PCR and sequencing), and automated systems. The literature reports a limited number of cases associating P. piersonii with human infection. This study contributes to this body of knowledge by reporting a novel case in which P. piersonii was isolated from a tissue sample for the first time. In this case report, the patient achieved recovery following the administration of appropriate antibiotic treatment based on the diagnosis. It underscores the need for precise identification and understanding of its pathogenicity.

Gut microbiota and functional outcome after ischemic stroke: a Mendelian randomization study.

Previous studies have shown that gut microbiota dysbiosis could affect clinical prognosis through an unknown mechanism. However, the causal relationship between the gut microbiota and the functional outcome after ischemic stroke remains unclear. We aimed to investigate the causal association between the gut microbiota and the functional outcome after ischemic stroke using Mendelian randomization (MR). Genetic instrumental variables associated with 211 bacterial traits were obtained from the MiBioGen consortium (N = 18,340). Data from genome-wide association studies (GWAS) for functional outcome after ischemic stroke were obtained from two phenotypes (i.e., overall stroke outcome and motor recovery). The inverse variance weighted method was used to estimate the causal association. Enrichment analysis was conducted based on the results of the MR analyses. The genetically predicted family Peptostreptococcaceae (OR = 0.63, 95% CI = 0.41-0.98, p = 0.038) and the genera LachnospiraceaeNK4A136 group (OR = 0.65, 95% CI = 0.43-1.00, p = 0.048), LachnospiraceaeUCG004 (OR = 0.54, 95% CI = 0.33-0.90, p = 0.017), and Odoribacter (OR = 0.40, 95% CI = 0.21-0.77, p = 0.006) presented a suggestive association with favorable functional outcome, while the genera Eubacterium oxidoreducens group (OR = 1.77, 95% CI = 1.11-2.84, p = 0.018) and RuminococcaceaeUCG005 (OR = 1.85, 95% CI = 1.15-2.96, p = 0.010) were associated with unfavorable functional outcome. The genetically predicted family Oxalobacteraceae (OR = 2.12, 95% CI = 1.10-4.11, p = 0.025) and the genus RuminococcaceaeUCG014 (OR = 4.17, 95% CI = 1.29-13.52, p = 0.017) showed a suggestive association with motor recovery, while the order Enterobacteriales (OR = 0.14, 95% CI = 0.02-0.87, p = 0.035) and the family Enterobacteriaceae (OR = 0.14, 95% CI = 0.02-0.87, p = 0.035) were associated with motor weakness. Enrichment analysis revealed that regulation of the synapse structure or activity may be involved in the effect of the gut microbiota on the functional outcome after ischemic stroke. This study provides genetic support that the gut microbiota, especially those associated with short-chain fatty acids, could affect stroke prognosis by mediating synapse function. Our findings suggest that modifying the composition of the gut microbiota could improve the prognosis of ischemic stroke.

Fine mapping-based multi-omics analysis interprets the gut-lung axis function of SGLT2 inhibitors.

Currently, Sodium-glucose cotransporter 2 (SGLT2) inhibitors demonstrate additional effects beyond glucose control on the gut microbiota and circulating metabolites. The gut microbiota and metabolites have been found to be useful in elucidating potential biological mechanisms of pulmonary diseases. Therefore, our study aims to investigate the effects of gut microbiota and metabolites mediating SGLT2 inhibition in 10 pulmonary diseases through Mendelian randomization (MR) research. We conducted a two-sample, two-step MR study to assess the association between SGLT2 inhibition and 10 pulmonary diseases and to investigate the mediating effects of gut microbiota and metabolite. Gene-fine mapping and annotation of mediators by FUMA and Magma analyses were performed, and causal associations of mapped genes with diseases were assessed by muti-omics MR analyses. Possible side effects of SGLT2 inhibition were assessed by PheWAS analysis. SGLT2 inhibition was linked to a reduced risk of T2DM, Interstitial lung disease (ILD), Pneumoconiosis, Pulmonary tuberculosis, and Asthma(OR=0.457, 0.054, 0.002, 0.280, 0.706). The family Enterobacteriaceae and order Enterobacteriales were associated with SGLT2 inhibition and ILD(95% CI:0.079-0.138). The family Alcaligenaceae and X-12719 were linked to pneumoconiosis (95% CI: 0.042-0.120, 0.050-0.099). The genus Phascolarctobacterium was connected to pulmonary tuberculosis (95% CI: 0.236-0.703).The degree of unsaturation (Fatty Acids), ratio of docosahexaenoic acid to total fatty acids, and 4-androsten-3beta,17beta-diol disulfate 2, were associated with asthma(95% CI: 0.042-0.119, 0.039-0.101, 0.181-0.473). Furthermore, Fuma and Magma analyses identified target genes for the four diseases, and proteomic MR analysis revealed six overlapping target genes in asthma. PheWAS analysis also highlighted potential side effects of SGLT2 inhibition. This comprehensive study strongly supports a multi-omics association between SGLT2 inhibition and reduced risk of interstitial lung disease, tuberculosis, pneumoconiosis, and asthma. Four identified gut microbiota, four metabolites, sixteen metabolic pathways, and six target genes appear to play a potential role in this association. The results of the comprehensive phenome-wide association analysis also identified the full effect of SGLT2 inhibitors.

Evaluation of symbiotic relationships of oral microorganisms and their effect on the development of inflammatory changes of the oral mucosa in the complete absence of teeth

Introduction. By fixing on the exposed surfaces of complete removable dentures and oral soft tissues, bacteria form a biofilm, thereby increasing their overall virulence and resistance. The microorganisms that make up the biofilm are often in a symbiotic relationship, which allows them to increase their pathogenic potential and cause the development of denture stomatitis. Accordingly, when a particular strain is present in the oral cavity, the risks of symbiosis are significantly increased. The aim of the study was to evaluate the effect of symbiotic relationships of oral bacteria on the development of inflammatory changes in the oral cavity in the absence of teeth. Materials and methods. Two groups of patients belonging to the elderly age according to WHO systematization (60–74 years) with complete absence of teeth (K08.1) were formed, differing in the presence of clinical manifestations of inflammation (82 men and 49 women). Biological material sampled from the oral cavity of patients was studied using the culture method and RT-PCR. To quantify the interaction between members of the microbiocenosis, we used the Jaccard similarity coefficient. Results. Coagulase-negative and coagulase-positive staphylococci, Neisseria, Candida spp., Enterobacterales and F. nucleatum were more frequently found in patients with complete absence of teeth. Expressed symbiotic relations between microorganisms of the Enterobacterales order, Lactobacillus, Neisseria and Corynebacterium genera, as well as S. salivarius, C. albicans, F. nucleatum were established. The nature of these relations depended on the presence of inflammatory changes in the oral mucosa and, in turn, influenced the development of the latter. Thus, in the absence of inflammation, Corynebacterium, Lactobacillus and S. salivarius showed stable synergism. In case of inflammation, the association between these bacteria was accompanied by the introduction of F. nucleatum and displacement of S. salivarius. Conclusion. Thus, conditionally pathogenic microorganisms, forming microbial associations with multidirectional symbiotic relations increase their virulence, which allows them to occupy free niches in the oral cavity and subsequently trigger the development of pathological process of inflammatory character of prosthetic bed tissues.

Efficacy assessment of different cryoprotectants for preserving the viability of Enterobacterales strains at − 20 °C

The preservation of microorganisms is pivotal in microbiological practice. Currently, cryopreservation is assumed to be an effective and inexpensive approach for the storage of microorganisms, including bacteria. The key point of cryopreservation is optimal cryoprotectant selection. In the present study, different cryoprotectant compositions were tested for long-term storage of 15 Enterobacterales bacterial strains at − 20 °C. The survival rates of the bacterial strains were evaluated in four different cryoprotectant solutions containing 70% glycerin only (cryoprotectants 1 and 4), 10% dimethyl sulfoxide (DMSO) with 70% glycerin (cryoprotectant 2), and 10% DMSO (cryoprotectant 3). In addition, cryoprotectants 1 and 2 contained peptone and yeast extract as nutritional supplements. The general survival rates of the bacterial strains were evaluated after 12 months of storage. After 12 months, the survival rates of the different cryoprotectants were as follows: cryoprotectant 1—88.87%; cryoprotectant 2—84.85%; cryoprotectant 3—83.50%; and cryoprotectant 4—44.81%. Thus, the composition of cryoprotectant 1 (70% glycerin with nutrient supplements) was optimal for preserving 15 tested strains of the order Enterobacterales. Despite these findings, the biochemical properties of the tested strains changed after cryopreservation for 12 months in the presence of 1 or 3 cryoprotectants. Alterations in the biochemical profile could be related to changes in environmental conditions and cold adaptation. We assume that the composition of cryoprotectant 1 can be optimal for storing the order Enterobacterales at − 20 °C. However, further investigations are needed to elucidate the problem of cryopreservation and to support our assumption.

First report of bacteria associated with soft rot in yellow pitahaya (Selenicereus megalanthus haw.) in Colombia crops

Colombia is the ninth largest producer of dragon fruit in the world and the department of Boyacá is the largest with 440 hectares planted. Bacterial phytopathogens can cause pitahaya fruit losses and low yields by producing stem soft rot. This research aimed to study and identified possible agents of bacterial diseases of pitahaya in Boyacá, Colombia. Thirteen farms in the region were selected to take 20 samples by means of a targeted and random sampling of stem and fruit tissues with soft rot symptoms in the early stages of the disease. A process of microbiological isolation, biochemical and molecular taxonomic identification of the isolated bacteria. The 16s rRNA gene sequences of the V2-V5 region were edited by removing the primers, assembling and obtaining the consensus sequence of the primers 1100R-337F and 800R -518F. The phylogenetic analysis was performed by BLAST at NCBI, using the “Classifier” and “SeqMatch” tools from the RDP website, and phylogenetic trees were created by multiple alignment using the MUSCLE algorithm and the Tamura Nei distance method was performed. Signs like blisters and mucilaginous fluids, symptoms like yellow and brown chlorotic spots, soft rot, and liquefaction were identified, and possible vectors like flies and ants were report. Twenty-five bacterial morphotypes were identified classifieds in 4 phyla, 9 families and 13 genera. The analysis of the 16S rRNA gene sequences of the bacterial strains showed a 98 to 100% identity with Enterobacter cloacae, Pectobacterium carotovora and Paenibacillus glucanolyticus, reported in other studies as causing the soft rot of the pitahaya stem and fruit. New species were reported as possible pathogenic bacteria of pitahaya: Pantoea cypripedii, Kluyvera intermedia and Klebsiella oxytoca. Infectivity assays did not have positive results. The microbiota identified in the stages of the necrotrophic phase or final stage of soft rot of the stem belong to the genera Achromobacter, Sphingobacterium, Pseudomonas, Klebsiella, Paenibacillus, Bacillus, Stenotrophomonas and Microbacterium. In the fly Leptoglossus zonatus associated with the crop were identified Pseudomonas fulva and Lysinibacillus fusiformis were identified. This is also the first official report of a complex of possible phytopathogen bacteria of the order Enterobacterales (Enterobacteriacea, Erwiniaceae and Pectobacteriaceae family) in symptoms by bacterial disease on pitahaya Colombian crops. Identification of the bacteria in a pathogenic system can guide chemical and biological control practices in order to increase the productive and export potential of exotic and orphan crops from small local farmings.

Fitness factor genes conserved within the multi-species core genome of Gram-negative Enterobacterales species contribute to bacteremia pathogenesis.

There is a critical gap in knowledge about how Gram-negative bacterial pathogens, using survival strategies developed for other niches, cause lethal bacteremia. Facultative anaerobic species of the Enterobacterales order are the most common cause of Gram-negative bacteremia, including Escherichia coli, Klebsiella pneumoniae, Serratia marcescens, Citrobacter freundii, and Enterobacter hormaechei. Bacteremia often leads to sepsis, a life-threatening organ dysfunction resulting from unregulated immune responses to infection. Despite a lack of specialization for this host environment, Gram-negative pathogens cause nearly half of bacteremia cases annually. Based on our existing Tn-Seq fitness factor data from a murine model of bacteremia combined with comparative genomics of the five Enterobacterales species above, we prioritized 18 conserved fitness genes or operons for further characterization. Mutants were constructed for all genes in all five species. Each mutant was used to cochallenge C57BL/6 mice via tail vein injection along with each respective wild-type strain to determine competitive indices for each fitness gene. Five fitness factor genes, when mutated, attenuated mutants in four or five species in the spleen and liver (tatC, ruvA, gmhB, wzxE, arcA). Five additional fitness factor genes or operons were validated as outcompeted by wild-type in three, four, or five bacterial species in the spleen (xerC, prc, apaGH, atpG, aroC). Overall, 17 of 18 fitness factor mutants were attenuated in at least one species in the spleen or liver. Together, these findings allow for the development of a model of bacteremia pathogenesis that may include future targets of therapy against bloodstream infections.

Antimicrobial susceptibility in bacterial isolates from water and agricultural products of the Chanchán river, Chimborazo Province, Ecuador

Introduction: river contamination with pathogenic and multidrug-resistant microorganisms is a public health issue due to its impact on health and its potential to transmit infectious diseases. Objective: To determine the presence of multidrug-resistant bacteria in irrigation water samples and agricultural products from the Chachán River. Method: a descriptive, non-experimental study with a quantitative and cross-sectional approach was conducted. Water samples were collected from six different points, and pH and temperature were measured. Additionally, 13 agricultural product samples from the same points were analyzed. The identification and antimicrobial susceptibility testing of bacteria were performed using the VITEK2 system and amplification and sequencing of the 16S rRNA gene. Results: a total of 17 bacterial strains were isolated from the water samples, 16 of which (94 %) belonged to the order Enterobacterales, including Proteus mirabilis, Proteus vulgaris, Morganella morganii, and Citrobacter diversus. From the agricultural products, 24 bacteria were isolated, including species of Klebsiella, Stenotrophomonas maltophilia, and Enterococcus faecalis. Antimicrobial resistance was observed in various strains, notably P. mirabilis, C. diversus, and P. vulgaris with multiple resistances. Resistance was also identified in pathogenic strains such as Yersinia enterocolitica, Plesiomonas shigelloides, and Aeromonas hydrophila. Conclusions: the Chachan River and the agricultural products irrigated with its waters contain multidrug-resistant bacteria, posing a significant risk to public health. It is crucial to implement control and monitoring measures to reduce the spread of these pathogens and ensure food safety

Characterisation of glucose-induced protein fragments among the order Enterobacterales using matrix-assisted laser desorption ionization-time of flight mass spectrometry

To characterise the glucose-induced protein fragments by MALDI-TOF MS analysis, we compared data for samples from Escherichia coli cultured in media with or without glucose. Characteristic peaks were observed in the presence of glucose, and MS/MS revealed Asr-specific fragments. The amino acid sequences of the fragments suggested sequence-specific proteolysis. Blast-analysis revealed that numerous Enterobacterales harbored genes encoding Asr as well as E. coli. Here, we analysed 32 strains from 20 genera and 25 species of seven Enterobacterales families. We did not detect changes in the mass spectra of four strains of Morganellaceae lacking asr, whereas peaks of Asr-specific fragments were detected in the other 28 strains. We therefore concluded that the induction of Asr production in the presence of glucose is common among the Enterobacterales, except for certain Morganellaceae species. In members of family Budviciaceae, unfragmented Asr was detected. Molecular genetic information suggested that the amino acid sequences of Asr homologs are diverse, with fragments varying in number and size, indicating that Asr may serve as a discriminative biomarker for identifying Enterobacterales species.

Characterization of pectolytic bacteria causing soft rot on sugar beet in the west of Iran

AbstractBacterial soft rots are amongst the most economically important diseases that cause significant yield losses in various crops. A clear identification of the causal agents is required to develop management strategies. In 2022 and 2023, after the widespread occurrence of soft rot disease in sugar beet fields in the Firuzan region, Hamedan Province, Iran, the current study was conducted to identify and characterize the causal agents. A total of 38 bacterial isolates were obtained from sugar beet plants with soft rot symptoms and subjected to biochemical and phenotypical characterization and pathogenicity tests on healthy slices from potato tubers and sugar beet taproots. Twelve isolates from this study along with the type strain Pectobacterium carotovorum ICMP 5702 were selected for subsequent screening by BOX‐PCR. Six isolates were chosen for sequencing the 16SrRNA gene and phylogenetic analysis. In BLAST analyses, the pathogenic isolates S2, S9, S22, S11, S23 and 111 showed the highest similarity values (≥99%) with the reference sequences of Raoultella terrigena, Klebsiella michiganensis, Erwinia (Winslowiella) iniecta, Pantoea agglomerans and P. carotovorum, respectively. These isolates induced soft rot and maceration on plant materials from five species (bell pepper fruits, garlic cloves and slices from sugar beet taproot, potato tubers and carrot roots) 72 h after inoculation. In the greenhouse experiment, they caused soft rot symptoms in the taproots of 2‐month‐old sugar beet plants 3 weeks after inoculation. These soft rot agents had Gram‐negative, catalase‐positive and oxidase‐negative reactions, grew under both aerobic and anaerobic conditions, tolerated and grew at 37°C and 5% NaCl. In general, the results of this research showed that in addition to Pectobacterium, four other genera from the order Enterobacterales including Erwinia, Pantoea, Klebsiella and Raoultella, are amongst the causes of soft rot in sugar beet in Firuzan region of Hamedan.

Yokenella regensburgei-Past, Present and Future.

Yokenella regensburgei is a Gram-negative rod part of the Enterobacteriaceae family (order Enterobacterales) and a rare cause of human infections. Although improved diagnostic methods have led to an increase in reports of this elusive pathogen, information remains limited. In order to provide a better understanding of this bacterium, we developed the first comprehensive review of its biology, biochemical profile, antimicrobial resistance pattern, virulence factors, natural reservoir and involvement in various veterinary and human infections. Human infections with this bacterium are scarcely reported, most probably due to constraints regarding its identification and biochemical similarities to Hafnia alvei. Multiple systematic searches revealed 23 cases of human infection, with a seemingly worldwide distribution, mostly in middle-aged or elderly male patients, often associated with immunosuppression. To date, Y. regensburgei has been reported in skin and soft tissue infections, bacteremia and sepsis, osteoarticular infections and in others such as urinary tract and digestive infections. The unique ability of Y. regensburgei to degrade polystyrene presents a novel and promising avenue for addressing plastic pollution in the near future. However, large-scale applications of this bacterium will undoubtedly increase human exposure, highlighting the necessity for comprehensive research into its role in human and veterinary infections, pathogenicity and antibiotic resistance.

Ewingella americana Infections in Humans-A Narrative Review.

Ewingella americana is a Gram-negative rod that belongs to the order Enterobacterales and the family Yersiniaceae and was first identified in 1983 from 10 clinical strains in the United States of America. The present study aimed to identify all the published cases of E. americana in the literature, describe the epidemiological, clinical, and microbiological characteristics, and provide data regarding its antimicrobial resistance, treatment, and outcomes. A narrative review was performed based on a PubMed and Scopus databases search. In total, 16 studies provided data on 19 patients with infections by E. americana. The median age of the patients was 55 years, and 47.4% were male. The most common infections were those of the bloodstream, the respiratory tract, and the peritoneal cavity. Antimicrobial resistance to cephalosporins, aminoglycosides, and the combination of trimethoprim with sulfamethoxazole was minimal, and these were the most commonly used antimicrobials for treating these infections. No included study provided information on the genetic or molecular mechanism of this pathogen's antimicrobial resistance. The overall mortality was minimal, with only one patient with bacteremia succumbing to the infection. Further studies are needed to better understand this microorganism, its pathogenic potential in humans, and the genetic and molecular mechanisms underlying its antimicrobial resistance, for which very little evidence exists to date.

Phytobacter spp: the emergence of a new genus of healthcare-associated Enterobacterales encoding carbapenemases in Argentina: a case series

Members of the genus Phytobacter (order Enterobacterales) are isolated from the natural environment and clinical settings. Identification of Phytobacter strains based on biochemical characteristics is complicated due to taxonomic confusion, and they are often misidentified by automated identification systems in laboratories. In this study we describe the first three clinical cases associated with Phytobacter spp. reported in Argentina. We describe the identification, the molecular analysis using whole genome sequencing and the potential clinical relevance.

Pathogenic diversification of the gut commensal Providencia alcalifaciens via acquisition of a second type III secretion system.

Providencia alcalifaciens is a Gram-negative bacterium found in a wide variety of water and land environments and organisms. It has been isolated as part of the gut microbiome of animals and insects, as well as from stool samples of patients with diarrhea. Specific P. alcalifaciens strains encode gene homologs of virulence factors found in other pathogenic members of the same Enterobacterales order, such as Salmonella enterica serovar Typhimurium and Shigella flexneri. Whether these genes are also pathogenic determinants in P. alcalifaciens is not known. Here we have used P. alcalifaciens 205/92, a clinical isolate, with in vitro and in vivo infection models to investigate P. alcalifaciens -host interactions at the cellular level. Our particular focus was the role of two type III secretion systems (T3SS) belonging to the Inv-Mxi/Spa family. T3SS 1b is widespread in Providencia spp. and encoded on the chromosome. T3SS 1a is encoded on a large plasmid that is present in a subset of P. alcalifaciens strains, which are primarily isolates from diarrheal patients. Using a combination of electron and fluorescence microscopy and gentamicin protection assays we show that P. alcalifaciens 205/92 is internalized into eukaryotic cells, rapidly lyses its internalization vacuole and proliferates in the cytosol. This triggers caspase-4 dependent inflammasome responses in gut epithelial cells. The requirement for the T3SS 1a in entry, vacuole lysis and cytosolic proliferation is host-cell type specific, playing a more prominent role in human intestinal epithelial cells as compared to macrophages. In a bovine ligated intestinal loop model, P. alcalifaciens colonizes the intestinal mucosa, inducing mild epithelial damage with negligible fluid accumulation. No overt role for T3SS 1a or T3SS 1b was seen in the calf infection model. However, T3SS 1b was required for the rapid killing of Drosophila melanogaster . We propose that the acquisition of two T3SS by horizontal gene transfer has allowed P. alcalifaciens to diversify its host range, from a highly virulent pathogen of insects to an opportunistic gastrointestinal pathogen of animals.

Possible impact of revisions in disc diffusion breakpoints for aminoglycosides and piperacillin/tazobactam in the 33rd edition of CLSI M100 document on clinical reporting and use in Indian settings with low susceptibility

PurposeThe study explores the impact of significant interpretative breakpoint changes for aminoglycosides and piperacillin-tazobactam in Enterobacterales and Pseudomonas aeruginosa, considering PK/PD, clinical data, and susceptibility on clinical reporting and use. ProcedureBetween January 2021 and June 2023, a total of 189,583 samples were processed for bacterial pathogens and antimicrobial susceptibility testing was performed using disc diffusion method/VITEK® 2 Compact system/broth microdilution. WHONET software was utilised to capture and analyse the changes in the interpretation of disc diffusion method, following updates to CLSI M100 documents in comparison to previous editions. Antimicrobial consumption data was collected and interpreted as DDD/100 bed days using AMC tool software. Here, we present data for 13,615 members of Order Enterobacterales and 1793 Pseudomonas aeruginosa isolates. FindingEnterobacterales exhibited a significant susceptibility drop of 14.7% for gentamicin and 21.7% for amikacin. Pseudomonas aeruginosa showed an increase in isolates with intermediate tobramycin susceptibility, from 0.6% to 29.7%, with relatively minor changes in piperacillin-tazobactam interpretation. ConclusionThe changes indicate a shift toward increased 'resistance' and 'intermediate susceptibility' for these antibiotics, emphasizing the need for cautious use and leveraging PK/PD knowledge for improved antibiotic utilization, patient outcomes, and antimicrobial stewardship.

Causal roles of gut microbiota in cholangiocarcinoma etiology suggested by genetic study.

Cholangiocarcinoma (CCA) is a highly malignant biliary tract cancer with poor prognosis. Previous studies have implicated the gut microbiota in CCA, but evidence for causal mechanisms is lacking. To investigate the causal relationship between gut microbiota and CCA risk. We performed a two-sample mendelian randomization study to evaluate potential causal associations between gut microbiota and CCA risk using genome-wide association study summary statistics for 196 gut microbial taxa and CCA. Genetic variants were used as instrumental variables. Multiple sensitivity analyses assessed result robustness. Fifteen gut microbial taxa showed significant causal associations with CCA risk. Higher genetically predicted abundance of genus Eubacteriumnodatum group, genus Ruminococcustorques group, genus Coprococcus, genus Dorea, and phylum Actinobacteria were associated with reduced risk of gallbladder cancer and extrahepatic CCA. Increased intrahepatic CCA risk was associated with higher abundance of family Veillonellaceae, genus Alistipes, order Enterobacteriales, and phylum Firmicutes. Protective effects against CCA were suggested for genus Collinsella, genus Eisenbergiella, genus Anaerostipes, genus Paraprevotella, genus Parasutterella, and phylum Verrucomicrobia. Sensitivity analyses indicated these findings were reliable without pleiotropy. This pioneering study provides novel evidence that specific gut microbiota may play causal roles in CCA risk. Further experimental validation of these candidate microbes is warranted to consolidate causality and mechanisms.