Gram-negative Rod Bacterium Research Articles

Pantoea peritonitis in peritoneal dialysis: a report of two cases and literature review

BackgroundPantoea spp., a non-encapsulated, non-spore-forming Gram-negative rod bacterium that belongs to the Erwiniaceae family, can be found as a colonizer in humans, plants, and the environment, such as water and soil. Although it has the pathogenic potential to cause disease in humans, patients infected with this pathogen generally experience favorable outcomes. In this article, we present two cases of peritoneal dialysis (PD)-associated peritonitis caused by Pantoea spp. along with literature review.Case presentationThe first case is a 66-year-old male patient with end-stage kidney disease (ESKD) on PD, admitted for P. dispersa peritonitis. He presented with abdominal pain and cloudy dialysis effluent, responding well to intraperitoneal vancomycin and cefepime. Antibiotics were deescalated to ceftazidime monotherapy on the basis of antibiotic susceptibility testing. Despite initial recovery with a 3-week course of antibiotics, he developed recurrent peritonitis with P. dispersa, necessitating PD catheter removal and transition to hemodialysis. The second case is a 42-year-old male patient with ESKD on PD who was admitted after 6 days of bloody PD fluid without trauma or associated symptoms. With elevated PD fluid cell counts and positive PD fluid culture showing Streptococcus mitis and P. agglomerans, he was empirically treated for PD-associated peritonitis with intraperitoneal vancomycin and cefepime. Due to a suboptimal response in repeat PD fluid cell counts at day 5, the PD catheter was removed, and he was switched to hemodialysis, followed by a 3-week course of intravenous ceftriaxone.ConclusionsWe described two unique cases of Pantoea peritonitis in PD, recurrent P. dispersa peritonitis and refractory P. agglomerans peritonitis, both of which resulted in PD catheter removal. Our cases indicate the formation of bacterial biofilm as a potential reason for recurrence of infection and underscores the importance of vigilant monitoring and need for PD catheter removal in Pantoea peritonitis.

Sphingobium sp. V4, a bacterium degrading multiple allelochemical phenolic acids

BackgroundContinuous cropping challenges constrain the development of agriculture. Three main obstacles limit continuous cropping: autotoxicity of plant allelochemicals, deterioration of physicochemical characteristics of soil, and microflora imbalance. Plant-derived phenolic acids can cause autotoxicity, which is considered the main factor mediating continuous cropping obstacles. Reducing the phenolic acids in continuous cropping soils can decrease the autotoxicity of phenolic acids and ameliorate continuous cropping obstacles. Therefore, it is important to study the microbial resources that degrade allelochemical phenolic acids. Thus, the bacterial strain V4 that can degrade phenolic acids was isolated, identified, and genomically analyzed.ResultsStrain V4 isolated from strawberry soil using vanillic acid-mineral agar was identified as a Gram-negative short rod bacterium. Subsequent 16S rRNA phylogenetic analysis revealed that V4 clustered with members of the genus Sphingobium. The most closely related species were Sphingobium lactosutens DS20T (99% similarity) and Sphingobium abikonense NBRC 16140T (97.5% similarity). V4 also shared > 95% sequence similarity with other members of Sphingobium, so Sphingobium sp. V4 was named accordingly. Biochemical tests revealed that the biochemical characteristics of Sphingobium sp. V4 were similar to its most similar strains except for some properties. Sphingobium sp. V4 effectively degraded vanillic acid, ferulic acid, p-coumaric acid, p-hydroxybenzoic acid, and syringic acid. V4 grew best at the conditions of 30 °C, pH 6.0–7.0, and 0–0.05% NaCl. 500 mg/L vanillic acid was completely degraded by V4 within 24 h under the optimal conditions. Whole genome analysis showed that Sphingobium sp. V4 contained one chromosome and three plasmids. Two genes involved in vanillic acid degradation were found in the V4 genome: the gene encoding vanillate O-demethylase oxidoreductase VanB on the chromosome and the gene encoding vanillate monooxygenase on a large plasmid. The organization of vanillate catabolic genes differed from the adjacent organization of the genes, encoding vanillate o-demethylase VanA and VanB subunits, in Pseudomonas and Acinetobacter.ConclusionsThe isolated bacterium Sphingobium sp. V4 degraded multiple phenolic acids. Its properties and genome were further analyzed. The study provides support for further investigation and application of this phenolic acid-degrading microorganism to alleviate continuous cropping obstacles in agriculture.

Clinical Characteristics, Treatment, and Outcomes of Veterans with Cerebrospinal Fluid Culture Positive for Gram-Negative Rod Bacteria: A Retrospective Analysis over 18 Years in 125 Veterans Health Administration Hospitals.

Optimal management for patients with bacterial ventriculitis/meningitis due to Gram-negative rods (GNRs) has yet to be well investigated. We assessed the clinical characteristics, treatment, and outcomes of patients with a positive cerebrospinal fluid (CSF) culture for GNRs. We conducted a retrospective cohort study of all patients with a positive CSF culture within the Veterans Health Administration (VHA) system during 2003-2020. Clinical and microbiological characteristics between the true meningitis and contamination groups were compared. Of the 5919 patients with positive CSF cultures among 125 nationwide VHA acute-care hospitals, 297 (5.0%) were positive for GNRs. Among 262 patients analyzed, 156 (59.5%) were assessed as patients with true meningitis, and 106 (40.5%) were assessed as patients with contaminated CSF cultures. Patients with true meningitis had a significantly higher CSF protein (median 168 vs 57mg/dL, p < 0.001), CSF white blood cell count (median 525 vs 3/µL, p = 0.008) and percentage of neutrophils in CSF (median 88 vs 4%, p < 0.001). Enterobacterales were more common in the true meningitis group, while unidentified GNR or polymicrobial CSF cultures were more common in the contamination group. The all-cause 90-day mortality was 25.0% (39/156) in patients with true meningitis and 10.4% (11/106) in those with contaminated CSF cultures. None of the 11 patients with contaminated CSF cultures who died were considered due to missed meningitis. More than 40% of patients with a positive CSF culture with GNR did not receive treatment without negative consequences. Careful clinical judgment is required to decide whether to treat such patients.

Thyroid abscess associated with thyrotoxicosis caused by Yersinia enterocolitica subsp. palearctica in a patient with follicular adenoma of the thyroid gland

BackgroundYersinia enterocolitica is a gram-negative zoonotic bacterial pathogen that is typically transmitted via the fecal-oral route. The most common clinical manifestation of a Y. enterocolitica infection is self-limited gastroenteritis. Although various extraintestinal manifestations of Y. enterocolitica infection have been reported, there are no reports of thyroid abscesses.Case presentationAn 89-year-old Japanese man with follicular adenoma of the left thyroid gland was admitted to our hospital with a 2-day history of fever and left neck pain. Laboratory tests revealed low levels of thyroid stimulating hormone and elevated levels of free thyroxine 4. Contrast-enhanced computed tomography showed low-attenuation areas with peripheral enhancement in the left thyroid gland. He was diagnosed with thyroid abscess and thyrotoxicosis, and treatment with intravenous piperacillin-tazobactam was initiated after collecting blood, drainage fluid, and stool samples. The isolated Gram-negative rod bacteria from blood and drainage fluid cultures was confirmed to be Y. enterocolitica. He was diagnosed with thyroid abscess and thyrotoxicosis due to be Y. enterocolitica subsp. palearctica. The piperacillin-tazobactam was replaced with levofloxacin.ConclusionWe report a novel case of a thyroid abscess associated with thyrotoxicosis caused by Y. enterocolitica subsp. palearctica in a patient with a follicular thyroid adenoma.

Cellulitis caused by Roseomonas mucosa in a child: a case report

BackgroundRoseomonas mucosa (R. mucosa) is a pink-pigmented, Gram-negative short rod bacterium. It is isolated from moist environments and skin, resistant to multiple drugs, including broad-spectrum cephalosporins, and a rare cause of infection with limited reports. R. mucosa mostly causes catheter-related bloodstream infections, with even fewer reports of skin and soft tissue infections.Case presentationA 10-year-old boy received topical steroid treatment for sebum-deficient eczema. A few days before the visit, he was bitten by an insect on the front of his right lower leg and scratched it due to itching. The day before the visit, redness, swelling, and mild pain in the same area were observed. Based on his symptoms, he was diagnosed with cellulitis. He was treated with sulfamethoxazole/trimethoprim, and his symptoms improved. Pus culture revealed R. mucosa.ConclusionsWe report a rare case of cellulitis caused by R. mucosa. Infections caused by rare organisms that cause opportunistic infections, such as R. mucosa, should be considered in patients with compromised skin barrier function and regular topical steroid use. Gram stain detection of organisms other than Gram-positive cocci should be considered.

Hoeflea algicola sp. nov. and Hoeflea ulvae sp. nov., isolated from phycosphere of marine algae.

Two Gram-negative, moderately halophilic, and motile rod bacteria, strains G2-23T and J2-29T, showing catalase- and oxidase-positive activities were isolated from species of the marine algae Chondrus and Ulva, respectively. Both strains optimally grew at 30 °C, pH 7.0 and 2% (w/v) NaCl. Both strains contained ubiquinone-10 as the sole isoprenoid quinone. Strain G2-23T contained summed feature 8 (C18 : 1 ω7c and/or C18 : 1 ω6c), C16 : 0 and summed feature 3 (iso-C15 : 0 2-OH and/or C16 : 1 ω7c/ω6c) as major cellular fatty acids, and phosphatidylethanolamine (PE), phosphatidyl-N-monomethylethanolamine (PME), phosphatidylglycerol (PG), diphosphatidylglycerol and an unidentified phospholipid (PL) as major polar lipids. Strain J2-29T contained summed feature 8, C18 : 1 ω7c 11-methyl and C16 : 0 as major cellular fatty acids and PE, PME, PG and PL as major polar lipids. The genomic DNA G+C contents of strains G2-23T and J2-29T were 59.5 and 62.2 mol%, respectively. Both strains shared 97.9 % 16S rRNA gene sequence similarity, 79.8 % average nucleotide identity (ANI) and 22.8 % digital DNA-DNA hybridization (dDDH) values, indicating that they represent different species. Phylogenetic and phylogenomic analyses by 16S rRNA gene and genome sequences, respectively, revealed that strains G2-23T and J2-29T formed different phylogenic lineages within the genus Hoeflea. ANI and dDDH values between strains G2-23T and J2-29T and other Hoeflea type strains were less than 79.0 and 22.1% and 80.5 and 23.3 %, respectively, suggesting that they represent novel species of the genus Hoeflea. In summary, based on their phenotypic, chemotaxonomic and molecular properties, strains G2-23T and J2-29T represent two different novel species of the genus Hoeflea, for which the names Hoeflea algicola sp. nov. (G2-23T=KACC 22714T=JCM 35548T) and Hoeflea ulvae sp. nov. (J2-29T=KACC 22715T=JCM 35549T), respectively, are proposed.

Comparison of Cefazolin and Ceftriaxone as Antimicrobial Prophylaxis in Pancreatoduodenectomy with Preoperative Drainage: Incidence of Surgical Site Infection and Susceptibility of Bacteria in Bile.

The optimal perioperative antimicrobial agent for preventing surgical site infection (SSI) in pancreatoduodenectomy (PD) with preoperative biliary drainage (PBD) remains unclear. We retrospectively reviewed 288 patients who underwent PD after PBD between 2010 and 2020 at our institution. Patients were classified into two groups according to the perioperative antimicrobial agent used (cefazoline [CEZ] group [n = 108] and ceftriaxone [CTRX] group [n = 180]). The incidence of SSI, type of bacteria in intraoperative bile culture (IBC), and antimicrobial susceptibility to prophylactic antimicrobial agents were analyzed. The incidence of incisional SSI was significantly lower in the CTRX group than in the CEZ group (18% vs. 31%, P = 0.021), whereas the incidence of organ/space SSI in the two groups did not differ to a statistically significant extent (35% vs. 44%, P = 0.133). Gram-negative rod (GNR) bacteria in the IBC showed better antimicrobial susceptibility in the CTRX group than in the CEZ group. In multivariate analysis, antimicrobial resistance due to GNR was a significant risk factor for incisional SSI (odds ratio, 3.50; P < 0.001). CTRX had better antimicrobial coverage than CEZ for GNR cultured from intraoperative bile samples. In addition, CTRX provides better antimicrobial prophylaxis than CEZ against superficial SSI in patients with PD after PBD. This study was not a clinical trial and had no registration numbers.

Quality changes, potential spoilage organisms, and shelf-life prediction of brackish river prawn (Macrobrachium macrobrachion) at different storage temperatures

The brackish river prawn (Macrobrachium macrobrachion) is a species of commercial importance in West Africa. However, like other fishery products, it is prone to deterioration due mainly to microbial activities. The present study aimed at evaluating the spoilage characteristics of M. macrobrachion and predicting the growth of the main spoilage bacteria as well as the shelf-life of the product as a function of storage temperature. Freshly caught brackish river prawn samples from Lake Aheme were aerobically stored at 0, 7, 15, and 28 °C and, at pre-determined times during storage, they were taken for microbiological, chemical, and sensory analysis. At sensory rejection times, the spoilage potential of 185 isolates from specific groups of organisms enumerated was assessed in prawn of which the endogenous microbiota was heat inactivated. Isolates capable of producing strong off-odor were identified using 16S rRNA sequencing. Models predicting the maximum growth rate of Pseudomonas spp. and H2S-producing bacteria in the brackish river prawn as well as the shelf-life of the product were developed. These models were validated using an independent experiment during which prawn was stored at 0, 4, 10, and 25 °C. Results showed that Pseudomonas spp. at 0 °C, Pseudomonas spp. and H2S-producing bacteria at 7 °C, and H2S-producing bacteria at 15 °C and 28 °C were the dominant groups of microorganisms during storage. As expected, total volatile basic nitrogen, trimethylamine, and pH with initial values of 21.2 ± 3.0 mg-N/100 g, 4.1 ± 0.8 mg-N/100 g, and 7.46 ± 0.15 increased during storage reaching approximately 35 mg-N/100 g, 10 mg/ 100 g and 8, respectively at sensory rejection times which were 7 h at 28 °C, 1.2 d at 15 °C, 4.6 d at 7 °C, and 11.7 d at 0 °C. The main spoilage organisms were Citrobacter braakii at 28 °C, Citrobacter braakii, Pseudomonas kurunegalensis, and Shewanella bicestrii at 15 °C, Shewanella putrefaciens, Shewanella baltica, and Pseudomonas bubulae at 7 °C, and Pseudomonas versuta at 0 °C. The validation of the developed models showed an adequate agreement between the predicted and observed values. This study highlights the specific spoilage characteristics of the brackish river prawn and reveals that Gram-negative rod bacteria are the main spoilage organisms even at high storage temperatures, contrary to many earlier reports on the spoilage of tropical fishery products.

Life-Threatening Capnocytophaga canimorsus Sepsis Associated With Ustekinumab Use for Psoriatic Arthritis

Abstract Capnocytophage canimorsus is a gram-negative rod bacterium that composes the microbial biome in the oral cavity of some canines and felines. It is mostly seen in patients with underlying disorder such as asplenia, general alcohol abuse, and cirrhosis. It can lead to multiple complications for patients that include meningitis, endocarditis, and sepsis. The history and the broad differential are important details for clinicians because of its slow-growing nature during blood culturing. Broad-spectrum antibiotics and life support are considered the mainstays of treatment for a patient presenting with unknown sepsis that may be caused by C. canimorsus. The authors present the risk factors, clinical picture, and treatment for the encounter of a patient with sepsis secondary to C. canimorsus.

Characteristic and Otopathogenic Analysis of a Vibrio alginolyticus Strain Responsible for Chronic Otitis Externa in China.

Vibrio alginolyticus, a Gram-negative rod bacterium found in marine environments, is known to cause opportunistic infections in humans, including ear infections, which can be difficult to diagnose. We investigated the microbiological and otopathogenic characteristics of a V. alginolyticus strain isolated from an ear exudate specimen obtained from a patient with chronic otitis externa to provide a basis for the future diagnosis of V. alginolyticus-associated infections. The identification of V. alginolyticus was accomplished using a combination of matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS), classical biochemical identification methods, and the use of Vibrio-selective media and advanced molecular identification methodologies. Antimicrobial susceptibility testing revealed that the strain was resistant to ampicillin and sensitive to β-lactam, aminoglycosides, fluoroquinolones, and sulfonamide antibiotics. The potential otopathogenic effects of V. alginolyticus were determined through the performance of cell viability, cell apoptosis, and cell death assays in tympanic membrane (TM) keratinocytes and HEI-OC1 cells treated with V. alginolyticus-conditioned medium using cell-counting kit (CCK)-8 assay, a wound-healing migration assay, Annexin V/propidium iodide (PI) flow cytometric analysis, and terminal deoxynucleotidyl transferase deoxyuridine triphosphate (dUTP) nick-end labeling (TUNEL staining). The results indicated that the identified V. alginolyticus strain exerts cytotoxic effects on keratinocytes and HEI-OC1 cells by inhibiting cell proliferation and migration and inducing apoptosis and cell death. To evaluate the ototoxicity of V. alginolyticus, the cell density and morphological integrity of hair cells (HCs) and spiral ganglion neurons (SGNs) were analyzed after exposing cochlear organotypic explants to the bacterial supernatant, which revealed the pre-dominant susceptibility and vulnerability of HCs and SGNs in the basal cochlear region to the ototoxic insults exerted by V. alginolyticus. Our investigation highlights the challenges associated with the identification and characteristic analysis of the Vibrio strain isolated in this case and ultimately aims to increase the understanding and awareness of clinicians and microbiologists for the improved diagnosis of V. alginolyticus-associated ear infections and the recognition of its potential otopathogenic and ototoxic effects.

Elizabethkingia meningoseptica –An emerging infection: A case report

Elizabethkingia meningoseptica are Gram-negative rod bacteria that are commonly found in the environment. The bacteria have also been associated with nosocomial infections, having been isolated on contaminated medical equipment, especially in neonatal wards. Rapid diagnosis and early institution of appropriate therapy for prolonged period are essential for the management of such infections. Here, we report a case of bacteremia due to E. meningoseptica in a neonate who was presented with respiratory distress and seizure episodes. A diagnosis of bacterial meningitis was made based on clinical findings and examination of cerebrospinal fluid. The baby was treated with antibiotics and other supportive measures, that helped to improve the condition. During follow-up, the baby showed developmental delay with hydrocephalus. E. meningoseptica can cause severe infection, with high risk of mortality and neurological sequelae in neonates. Intensive care and multidisciplinary interventions are crucial for the case management. Awareness among clinicians along with correct diagnosis in microbiology laboratory is required to minimize the fatal outcome associated with this infection.

Bacteremic cholangitis due to Raoultella planticola complicating intrahepatic bile duct stricture 5 years post-laparoscopic cholecystectomy: a case report

BackgroundRaoultella Planticola is a facultative anaerobic, gram-negative, water- and soil-dwelling rod bacterium rarely reported as a cause of human disease. However, the number of reported R. planticola infections is growing, without a concomitant increase in research on the microbe or its pathogenesis. Previous genomic studies demonstrating genetic similarities between R. planticola and Klebsiella pneumoniae suggest that capsule biosynthesis, mucoid phenotype, biofilm production, and lipopolysaccharide (endotoxin) synthesis may all be potential virulence factors of R. planticola. We present a unique case of R. planticola infection of the biliary tract 5 years after biliary surgery in a patient with no previously documented risk factors. We also use in silico techniques to predict virulence factors of R. planticola.Case presentationThis case report is the first to discuss a R. planticola infection in the biliary tract of late onset post-surgery (5 years) in a Caucasian patient with no previously documented risk factors.ConclusionsAn in-depth search of the current literature did not yield other similar cases of R. planticola infections. Moreover, to the best of our knowledge, our case is the first case of R. planticola isolated from post-endoscopic retrograde cholangiopancreatography (ERCP) as part of biliary sepsis not associated with gastroenteritis. The late onset of the infection in our patient and the results of the in silico analysis suggest that R. planticola may have survived exposure to the host immune system through the creation of an intracellular biofilm or in a non-culturable but viable state (NCBV) for the 5-year period. The in silico analysis also suggests that biofilms, enterobactin, and mucoid phenotype may play a role in the pathogenesis of R. planticola. However, further research is needed to illuminate the significance of pili, capsule biosynthesis, and lipopolysaccharide (LPS) in the virulence of R. planticola. Lastly, as our patient did not have any risk factors previously associated with R. planticola, we suggest that biliary tract stricture, cholecystitis, and prior surgery may be possible novel risk factors.

Detection ofblaKPCandblaNDMGenes from Gram-Negative Rod Bacteria Isolated from a General Hospital in Gyeongnam

본 연구는 국내에서 가장 빈번히 검출되는 CPE의 유전자형 중 blaKPC 및 blaNDM 유전자의 진단으로 기존의 표현형 검사 및 일반 PCR 검사보다 시간 단축 및 사후 분석의 단점이 보완된 real-time PCR의 융해 곡선을 이용한 분석법에 대해 알아보았다. 표현형적 검사결과 MHT는 35균주 중 25균주에서 양성을 확인하고, CIT는 meropenem+PBA 및 meropenem+EDTA에서 각각 14균주의 양성을 확인하였다. PCR 검사결과 KPC 25균주에서 증폭 산물을 확인하였고, K. pneumoniae 10균주, E. coli 5균주, A. baumannii 5균주, P. aeruginosa 4균주, P. putida 1균주로 나타났다. NDM은 8균주에서 증폭 산물을 확인하였고, K. pneumoniae 2균주, E. coli 3균주, P. aeruginosa 1균주, E. cloacae 1균주, P. rettgeri 1균주로 나타났다. 실시간 중합효소연쇄반응(Real-time PCR)을 이용한 융해 곡선 분석결과 KPC 25균주, NDM은 8균주에서 증폭을 확인하였고, PCR 결과와 100% 일치함을 확인하였다. 결론적으로 real-time PCR을 이용한 신속하고 특이성이 높은 CRE의 조기진단은 공중보건 및 감염 중에 항균 관리접근법을 통한 병원내 감염확산 방지 및 통제가 가능할 것으로 사료된다.

Septic shock due to Yersinia pseudotuberculosis infection in an adult immunocompetent patient: a case report and literature review

BackgroundYersinia pseudotuberculosis infection can occur in an immunocompromised host. Although rare, bacteremia due to Y. pseudotuberculosis may also occur in immunocompetent hosts. The prognosis and therapeutic strategy, especially for immunocompetent patients with Y. pseudotuberculosis bacteremia, however, remains unknown.Case presentationA 38-year-old Japanese man with a mood disorder presented to our hospital with fever and diarrhea. Chest computed tomography revealed consolidation in the right upper lobe with air bronchograms. He was diagnosed with pneumonia, and treatment with intravenous ceftriaxone and azithromycin was initiated. The ceftriaxone was replaced with doripenem and the azithromycin was discontinued following the detection of Gram-negative rod bacteria in 2 sets of blood culture tests. The isolated Gram-negative rod bacteria were confirmed to be Y. pseudotuberculosis. Thereafter, he developed septic shock. Doripenem was switched to cefmetazole, which was continued for 14 days. He recovered without relapse.ConclusionsWe herein report a case of septic shock due to Y. pseudotuberculosis infection in an adult immunocompetent patient. The appropriate microorganism tests and antibiotic therapy are necessary to treat patients with Y. pseudotuberculosis bacteremia.

Acute fibrinous pleuropneumonia and septicaemia caused by Bibersteinia trehalosi in neonatal calves in New Zealand

ABSTRACT Case history: In July and August 2019, 15/40, ≤48-hour-old calves became acutely ill. The calves were all born on-farm, transferred to pens soon after birth, and fed with “gold” colostrum. The hygiene, biosecurity and ventilation in the pens were poor. Of the 15 calves, 11 died or were euthanised and four calves, ≤48-hour-old, that became acutely ill later in the outbreak were treated with cefquinome, a fourth-generation cephalosporin, and recovered. Clinical findings: The affected calves presented with acute recumbency, lethargy, tachypnoea, tachycardia, increased lung sounds, inability to stand or feed, and dehydration without pyrexia. Pathological findings: Gross findings in a calf that died naturally included fibrinous pleuropneumonia, marked oedematous expansion of the interlobular septa, especially in the ventral lung lobes, fibrinous polyserositis and fibrinous polyarthritis. A second calf that was euthanised had strikingly similar lung lesions. Histologically, the pulmonary interlobular septa of both calves were prominently expanded by oedema, dilated lymphatics and the infiltration of numerous neutrophils and macrophages interspersed with small Gram-negative rod bacteria. Likewise, the visceral pleura showed fibrinopurulent inflammation with numerous small Gram-negative rods. Microbiological findings: Microbial culture and matrix-assisted laser desorption ionisation time-of-flight (MALDI-TOF) mass spectrometry identified Bibersteinia trehalosi in the lung, stifle joint and peritoneal cavity of the first calf and lung of the second. Diagnosis: B. trehalosi acute fibrinous pleuropneumonia and septicaemia. Clinical relevance: This is the first report of the clinical findings and histological lesions of B. trehalosi pleuropneumonia and septicaemia in calves in New Zealand. The pathogen is isolated with increasing frequency from cases of bovine respiratory disease in dairy cows, feedlot cattle and calves in the United Kingdom and North America. The importance of microbial culture in cases such as this with unusual lung lesions in calves <48 hours of age, cannot be over emphasised. Cefquinome was administered to all remaining heifer calves and four calves that became ill later in the outbreak recovered after cefquinome treatment.

ANALISIS MIKROBIOLOGI Escherichia coli JAJANAN MINUMAN DI SEKITAR JALAN KAPTEN MUSLIM KOTA MEDAN

Escherichia coli is a gram-negative rod bacteria, not encapsulated and is a normal flora in the digestive tract of animals and humans that easily pollutes water. Escherichia coli can turn into an opportunist pathogen if it lives outside the intestine, for example in urinary tract infections, wound infections and mastitis. Drinks contaminated with microorganisms can cause health problems in the form of disturbances in the digestive tract with symptoms of nausea, heartburn, vomiting and diarrhea. The purpose of this study was to determine the presence of Escherichia coli bacterial contamination in snacks sold around the Kapten Muslimstreet. This descriptive study used 4 samples of iced drinks, namely young coconut ice, sugar cane ice, mixed ice and dawet ice. The sample testing technique uses the Most Probable Number (MPN) method. The media used in this study were lactose Broth, Brilliant Green Lactose Bile Broth, Eosin Methylene Blue Agar. This research was conducted at the Pharmacy Microbiology Laboratory, Sari Mutiara University, Indonesia. After the research, the results showed that 1 of 4 samples of snacks found on Jalan Captain Muslim was detected with Escherichia coli bacteria ranging from 2,800 cells/100 ml so that it was included in the poor criteria, in the category These snacks are not suitable for consumption and do not meet the criteria set out in the Indonesian Ministry of Health No.492/Menkes/Per/IV/2010 (Colifrom and Escherichia coli 0/100 ml).

Sepsis Due to Ignatzschineria ureiclastica Caused by Maggot-Infested Wounds in a Homeless Man in Germany: a Case Report

The gram-negative rod bacteria Ignatzschineria inhabits the digestive tract of larvae and adult forms of flesh flies and mostly causes bloodstream infections in animals, but rarely in humans with chronic wounds. This is the second case report of sepsis due to Ignatzschineria ureiclastica worldwide and the first reported case of Ignatzschineria species in Germany. We present a case report of 57-year-old homeless male with chronic leg and foot ulcers with maggot infestation. Blood cultures revealed gram-negative rod bacteria, which later could be identified by 16S rRNA sequence analysis as Ignatzschineria ureiclastica. Intravenous antibiotic treatment with ampicillin/sulbactam and later oral ciprofloxacin as well as local wound management lead to complete wound healing. Blood cultures of patients with chronic wounds and maggot infestation should be analyzed with 16S rRNA sequence analysis when commercial-automated devices lead to indecisive results. Live and preserved samples of insect infestation should be acquired for further entomological characterization. Susceptibility testing of rare pathogens should be performed and published. Antibiotic treatment of bloodstream infections due to Ignatzschineria species with ampicillin/sulbactam showed good clinical outcome.

Rheinheimera pleomorphica sp. nov., a Novel Alkali-Tolerant Bacteria Isolated from Chilika Lake, India.

A novel Gram-negative gamma-proteobacterium, non-sporulating motile, rod or coccus-shaped bacterium designated as strain PKS7T was isolated from a sediment sample collected from Chilika Lake, Odisha, India and characterized taxonomically using a polyphasic approach. The major quinone was Q8 and major cellular fatty acids were C16:0, C17:0, C15:1w8c, C17:1w8c, C12:03-OH. The chemotaxonomic features confirmed the isolate to be a member of genus Rheinheimera. 16SrRNA gene sequence of strain PKS7T was closest in similarity to R. aquimaris SW-353T (99.36% identity), R. muenzenbergensis E49T (98.63%), R. nanhaiensis E407-8T (98.35%), R. japonica KMM 9513T (98.35%) and R. baltica DSM-14885T (98.08%). The 16S rRNA gene sequence-based phylogenetic analysis and sequence similarity between the isolated strain and type strains also revealed its affiliation to genus Rheinheimera. DNA-DNA relatedness with closest type strain R. aquimaris SW-353T was 25.0% (±3.40) and in silico DDH showed values in the range of 17.7-37.1% with the type strains of the genus Rheinheimera for which whole genome sequence are available. Strain PKS7T was also distinguished by a multi-locus sequence analysis (MLST) by alingning gyrB gene sequences of the closest type strains of Rheinheimera. The draft genome of strain PKS7T contained 32 contigs of total size 3,963,569bp comprising of 3763 predicted coding sequences with a G + C content of 50.7mol%. Comparision of phenotypic and genotypic data with its closest neighbours and closely related species confirm the strain PKS7T to be recognised as a novel species within the genus Rheinheimera, for which the name Rheinheimera pleomorphica sp. nov. is proposed. The type strain is PKS7T (= KCTC 42365 = JCM 30460).

PULMONARY CAVITARY LESION WITH RARE PSEUDOMONAS STUTZERI

SESSION TITLE: Monday Medical Student/Resident Case Report Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: 10/21/2019 02:30 PM - 03:15 PM INTRODUCTION: Pseudomonas stutzeri is a gram-negative rod bacterium infrequently associated with clinical infection. We present a case of pulmonary cavitary lesions caused by P.stutzeri. CASE PRESENTATION: A 59-year-old male with history significant for intravenous (IV) heroin abuse (last use 1 week prior), splenectomy and culture negative endocarditis (10 months prior) presented to the hospital with 1 week of chest pain, dyspnea and subjective fevers. Within a few hours of admission, a rapid response was called for altered mental status, chest pain and tachypnea. Computed tomography of the chest revealed a 12cm cavitary left lower lung lesion. He was placed on tuberculosis precautions and subsequently transferred to the Intensive Care Unit (ICU) for further management. Blood cultures were obtained prior to empiric vancomycin plus piperacillin/tazobactam. He required intubation for impending respiratory failure. Bronchoscopy with bronchoalveolar lavage (BAL) was performed demonstrating copious mucus and purulent secretions bilaterally. Approximately 36 hours into his admission, he suffered a PEA (pulseless electrical activity) arrest. Return of spontaneous circulation (ROSC) was achieved after 15 minutes of cardiopulmonary resuscitation (CPR). Physical exam revealed diffuse crepitus, subcutaneous emphysema tracking along posterior thorax extending into left lateral thigh and profound scrotal swelling. Arterial blood gas demonstrated acidemia with hypercarbia. Within less than an hour, he suffered a second PEA arrest. There was concern for ruptured pleural cavitary lesion leading to a tension pneumothorax. Needle decompression performed bilaterally was unsuccessful; surgery at bedside placed left hemithorax chest tube. Again, achieved ROSC after 18 minutes of CPR. Unfortunately, within a few minutes he decompensated into ventricular fibrillation. Further resuscitation efforts a third time were unsuccessful. Post-mortem blood cultures were negative but his BAL cultures were positive for pan-sensitive Pseudomonas stutzeri. All acid-fast bacilli smears and cultures were negative. DISCUSSION: Pseudomonas stutzeri has rarely been reported as a cause of necrotizing pneumonia (1) and may represent only 1% of all clinical Pseudomonas isolates (2). In our patient, the timeline of events, whether the cavitary lesion ruptured from the positive pressure of mechanical ventilation or as a consequence of CPR remains a mystery. CONCLUSIONS: There is debate in the literature regarding the pathogenicity of this organism which is frequently deemed to be colonization rather than pathogenic. However, in the case of this patient, all other infectious work up was negative and no alternative pathogen could be linked to the development of the cavitary lesions. This case emphasizes the necessity of diagnostic testing to identify uncommon pathogens. Reference #1: Lin KH et al, Pseudomonas stutzeri necrotizing pneumonia in pre-existing pulmonary tuberculosis. Intern Med. 2014;53(21):2543-6. 2014 Nov 1. Reference #2: Bisharat, N et al, 10-Years Hospital Experience in Pseudomonas stutzeri and Literature Review. The Open Infectious Diseases Journal, 2012, 6, 21-24. DOI: 10.2174/1874279301206010021 DISCLOSURES: No relevant relationships by Zachary Bugos, source=Web Response No relevant relationships by Brandon Smith, source=Web Response

Acute Bacterial Parotitis in Adult Hematologic Malignancy

Abstract Acute bacterial parotitis (ABP) is an uncommon condition in immunosuppressed adult cancer patients. Here, we report 2 cases of parotitis in immunocompromised patients; one with a diagnosis of extranodal marginal zone B-cell lymphoma and the other with acute myeloid lymphoma. Both patients were treated with antibiotics and local management with resolution of their parotitis. Per review of literature, this is the first article describing ABP in patients with bone marrow transplantation and hematologic malignancies. Moreover, this is also the first article reporting ABP due to Stenotrophomonas maltophilia, an opportunistic gram-negative rod bacterium.