Normal Human Intestinal Flora Research Articles

Study on Biofilm Formation Among Enterococcus Isolates and Association With Their Antibiotic Resistance Patterns.

Background Enterococci are a part of the normal intestinal flora of humans. They have emerged as one of the leading causes of nosocomial infection. The evolved antibiotic resistance mechanisms coupled with the virulence properties of enterococci have made it a successful pathogen. Aim This study aimed to determine the ability of biofilm formation among the clinical enterococci isolates and the antimicrobial resistance pattern of the strains. Materials and methods Clinical samples of patients who attended Saveetha Medical College and Hospital, Chennai, India, over six months. Identification and characterization of Enterococcus species were done using various biochemical tests. Antibiotic susceptibility patterns for each isolate were performed using the Kirby- Bauer disc diffusion method. Results The formation of biofilm formation was detected using the microtiter plate method. In total, 90 Enterococcus species were isolated; Enterococcus faecalis were 63 (70%), Enterococcus faecium were 25 (28%) and Enterococcus gallinarum were 2 (2%)independently. E. faecalis displayed advanced resistance rates compared to other Enterococcus species. Resistance against penicillin was found in 42 strains (47%) and resistance to ampicillin was observed in 39 strains (43%). This was followed by resistance to high-level gentamicin in 35 strains (39%) and resistance to ciprofloxacin in 32 strains (36%). Resistance to vancomycin and linezolid also were noted in some strains. Conclusion Our results indicate that E. faecalis exhibits an increasing rate of antimicrobial resistance but lower biofilm conformation. The unique traits of E. faecalis raise concerns for the associated infections, especially hospital-acquired infections.

ISOLATION OF ENTEROCOCCUS SPP. IN VARIOUS CLINICAL SAMPLE AND THEIR ANTIMICROBIAL RESISTANT PATTERN WITH MIC OF VANCOMYCIN IN PATIENT ATTENDING TERTIARY CARE CENTRE, RIMS, RANCHI, JHARKHAND

Introduction- Enterococci are part of normal intestinal flora of humans and animals but have also emerged as important pathogens responsible for serious infections in hospital and community acquired infections.it is second most common cause of nosocomial infections in gastrointestinal tract, wound and genitourinary tract. To process all the clinicalAim- samples from various department in our hospital, for isolation of Enterococci spp. To speciate the isolates & to have resistance pattern of the isolates of vancomycin total 926 sample were collected from both outMaterial & Methods- patients and in patient in all clinical departments and transported to microbiology laboratory. specimens were processed by inoculating on to blood agar, MacConkey Agar, nutrient agar, potassium tellurite agar and incubated at 37°C for24-48 hr. Enterococci were identified by their typical arrangement in and salt tolerance test Gram stain, bile esculin test and biochemical tests. Antimicrobial susceptibility patterns were determined by performing Kirby-Bauer disc diffusion method and Minimum inhibitory concentration (MIC) values were identified by tube dilution methods. Result- a total of 926 sample, 645 (69.72%) were culture positive and 281 (30.28%) were culture negative. Among 645 culture positive cases, 81(12.55%) were Enterococcus faecalis. Antimicrobial susceptibility & MIC done as per standard protocols. The E. Faecalis showed 99% sensitive to Vancomycin. the resistance to vancomycin was 1% & further confirmed by MIC via tube dilution methods. In which MIC was ≥32 μg/ml in one isolate. About 8 of Enterococcal strains showed MIC of 0.0125μg/ml. species level identification of Enterococcus is important forConclusions- epidemiological study and also for analysis of drug resistant pattern. Effective detection of vancomycin resistance helps in reducing the morbidity and mortality of VRE in hospitalized patients.

Characterization of a Multidrug-ResistantCitrobacter pasteurii isolate carrying blaKPC-2 from municipal wastewater

A carbapenem-resistant strain, UL-CPE-01, was isolated from a domestic wastewater treatment plant and subjected to antibiotic susceptibility testing showing resistance to a wide range of antibiotics. Complete genome and bioinformatic analysis of UL-CPE-01 was performed to investigate the nature of its resistance determinants and the strain identified as Citrobacter pasteuriibased onANI score. Citrobacter spp. are part of the normal human and animal intestinal flora and the UL-CPE-01 Citrobacter pasteuriistrain detected here is closely related to Citrobacter freundii, which is an emerging opportunistic nosocomial pathogen. UL-CPE-01 showed both phenotypic and genotypic multiple resistance to aminoglycoside, β-lactams, sulfonamides, fluoroquinolone, rifampicin, phenicol and macrolide antibiotics. The UL-CPE-01 genome revealed 16 acquired antimicrobial resistance gene (ARGs) conferring resistance to eight different antibiotic groups: dfrA12 (trimethoprim); sul1 (sulfonamide); mph(A), mph(E) and msr(E) (macrolide); qnrB4 and aac(6′)-Ib-cr (fluoroquinolone); blaDHA-1, blaOXA-1, blaCMY-77,blaOXA-10, blaTEM-1B, blaKPC-2(β-lactams); arr-3 (rifampicin); catB3 and catA1 (chloramphenicol) and aac(6′)-Ib-cr, aadA2 and ant(2″)-Ia (aminoglycoside). The novel blaKPC-2 determinant was found to be associated with in a Tn4401-like element.

Detection and Antibiogram Profile of Enterococcus Species from Local Cheese Sample within Ikare and Akungba Akoko, Ondo State Nigeria

Enterococci are part of the normal intestinal flora of humans and animals and are increasingly recognized as significant human pathogens and capable of causing major therapeutic challenges. The aim of this study was to isolate, identify and determine the antimicrobial susceptibility pattern of Enterococcus species in two local cheese sample collected from Akungba and Ikare. The isolation of Enterococcus was carried out using standard culture-based techniques. Antimicrobial susceptibility profile of the Enterococcus species was determined using disk diffusion method. A total number of 93 presumptive Enterococcus species were recovered from forty two different samples over a period of three months. The bacterial count observed on the Bile Aesculin agar ranged from 1.5x104 cfu/ml to 4.6x104 cfu/ml with Akungba sample having the highest bacterial load of 4.6x104 cfu/ml. The Morphology and biochemical characteristics of suspected Enterococcus spp. isolated from the cheese sample revealed Enterococci feacalis as the isolated bacteria. The isolated Enterococcus species were tested against a panel of six antibiotics which include Penicillin G, Vancomycin, Tetracycline, Nitrofurantoin, Ciprofloxacin and Imipenem. It was observed that the isolates were susceptible to tetracycline, imipinem and ciprofloxacin while they are resistant to ciprofloxacin and vancomycin. The prevalence of Enterococci was confirmed with Enterococcus feacium and Enterococcus faecalis as the predominant species isolated in both cheese sample. The ability of Enterococcus species to survive a range of adverse environments allows multiple routes of cross-contamination of Enterococci in causing human disease, including those from food. Overall, greater understanding of the ability of Enterococcus species to survive stresses, of virulence traits and especially of increasing antibiotic resistance, is needed in order to fully appreciate the complexity of Enterococcus species in causing disease.

Detection of β-Lactamase–Producing Proteus mirabilis Strains of Animal Origin in Andhra Pradesh, India and Their Genetic Diversity

Proteus mirabilis is abundant in soil and water. Although this bacterium is part of the normal human intestinal flora, it can cause serious infections in humans, including complicated urinary tract infections. This pathogen is also commonly associated with multidrug resistance. In the present study, analysis of 1,093 samples from foods of animal origin and animal intestinal samples recovered 232 P. mirabilis isolates identified by PCR assay. Of these 232 isolates, 72 produced β-lactamase (determined by both phenotypic and genotypic methods), with the highest prevalence in poultry cloacal swabs (11.82%) followed by mutton (9.18%), khoa (6.32%), pork (5.63%), pig rectal swabs (5.52%), beef (5.45%), and chicken (5.13%) but none from sheep rectal swabs and bovine rectal swabs. Among β-lactamase genes, blaTEM was the predominant gene detected (59 isolates) followed by blaOXA (11 isolates), blaSHV (5 isolates), blaFOX (5 isolates), blaCIT (4 isolates), blaCTX-M1 and blaCTX-M9 (2 isolates each) and blaCTX-M2, blaDHA, and blaEBC (1 isolate each). None of the isolates carried blaACC, blaMOX, or carbapenemase genes (blaVIM, blaIMP, blaKPC, and blaNDM-1). Dendrogram analysis of enterobacterial repetitive intergenic consensus sequences and repetitive extragenic palindromic sequences obtained with PCR analysis of β-lactamase-producing isolates revealed 63 isolates, but 9 isolates did not yield bands. The analysis revealed that 6.58% of the samples had β-lactamase-producing P. mirabilis isolates that may affect food safety and contaminate the environment. Further genotyping revealed the genetic relationships between isolates of different origin. These findings emphasize the need for careful use of antibiotics to control the spread of β-lactamase-producing bacteria.

Molecular studies on some factors of E. coli isolated from avian products and infants with diarrhea

Extraintestinal pathogenic E. coli (ExPEC) are facultative pathogens that are part of the normal human intestinal flora which classified into several types, uropathogenic E. coli (UPEC), neonatal meningitis E. coli (NMEC), sepsis-associated E. coli (SEPEC), and avian pathogenic E. coli (APEC) (Jolanta et al.,2019). The present study was performed on a total number of 150 samples from which 100 samples were collected from poultry products (Gizzard, Liver, Banih, and Nuggets) also 50 samples from infants stool at Gharbia Governorate for isolation of E.coli and detection of some virulence genes. The results revealed that 26 samples were positive for Escherichia coli, 11 from infants stool, 7 from poultry liver samples, 5 poultry gizzard , 2 Banih and 1 from Nuggets samples. Amikacin 30 and ciprofluxacin 5 (oxoid) were the highest efficiency antimicrobial agents used in vitro. Six E.coli isolates were serotyped and identified as O157, O128, O125 and O86a. PCR results showed that TraT and pic pathotypic genes ( at 307 bp and 572 bp) were detected in all, but only O157 and O125 have stx2 gene ( at 779 bp). All that indicate that E.coli strains isolated were extra-intestinal pathogenic strains.

Association of bacteria in pancreatic fistula fluid with complications after pancreatic surgery.

BackgroundPancreatic fistula (PF) is a common complication after pancreatic surgery. It is unclear how microbes in PF fluid affect outcomes and which microbes are present after pancreatoduodenectomy (PD) and distal pancreatectomy (DP). The aim of this study was to compare the microbiological spectrum of PF fluid after PD versus DP, and its association with postoperative complications.MethodsBacterial strains and antibiotic resistance rates of bacterial swabs obtained from the PF fluid of patients who underwent DP or PD were analysed. Cultured bacteria were classified as Enterobacterales and as ‘other intestinal and non‐intestinal microorganisms’ based on whether they are typically part of the normal human intestinal flora.ResultsA total of 847 patients had a pancreatic resection (PD 600; DP 247) between July 2007 and December 2016. Clinically relevant PF was detected in 131 patients (15·5 per cent). Bacterial swabs were obtained from 108 patients (DP 47; PD 61), of which 19 (17·6 per cent) were sterile. Enterobacterales were detected in 74 per cent of PF fluid swabs after PD, and in 34 per cent after DP. Infected, polymicrobial or multidrug‐resistant PF fluid was more common after PD (rates of 95, 50 and 48 per cent respectively) than after DP (66, 26 and 6 per cent respectively). Patients with higher grade complications (Clavien–Dindo grade IV–V) or grade C PF had more Enterobacterales and multidrug‐resistant Enterobacterales in the PF fluid after DP.ConclusionEnterobacterales and multidrug‐resistant bacteria are detected frequently after PD and DP, and are associated with more severe complications and PF in patients undergoing DP.

Complete genome arrangement revealed the emergence of a poultry origin superbug Citrobacter portucalensis strain NR-12.

Citrobacter spp. are part of normal human and animal intestinal flora. Citrobacter portucalensis (C. portucalensis) is closely related to Citrobacter freundii, which is an emerging opportunistic nosocomial pathogen. The aim of this study was to retrieve colistin-resistant Citrobacter spp. from poultry in Bangladesh. The C. portucalensis strain NR-12 was isolated from poultry droppings and subjected to antibiotic susceptibility testing. Complete genome analysis of NR-12 was performed followed by bioinformatics. It is believed that this is one of first reports of its kind of complete genome sequence of multidrug-resistant (MDR) C. portucalensis isolated from veterinary samples. The C. portucalensis strain NR-12 showed resistance to polymyxin, sulfonamide, tetracycline, fluoroquinolone, and macrolide. Its complete genome revealed 13 acquired antimicrobial resistance gene markers (AMRs) conferring resistance to eight different antibiotic groups: dfrA12 (trimethoprim); sul1 and sul2 (sulfonamide); mph (A) (macrolide); tet (A) (tetracycline); qnrS1 and qnrB13 (fluoroquinolone); blaCMY-39 (extended-spectrum β-lactamase (ESBL)), blaTEM-176 (non-ESBL) and aadA2, aph (3')-Ia, aph (3″)-Ib, aph (3')-Ic, aph (3')-Id, strA, strB) (aminoglycoside). The genome possessed a class 1 integron (IntI1) gene cassette harbouring four different antibiotic resistance genes (dfrA12, aadA2, sul1, mph (A)). The organisation of class 1 integron (IntI1) carrying MDR determinants in C. portucalensis strain NR-12 was also first reported here. Colistin-resistant genes such as mgrB, phoP, phoQ, pmrA, pmrB, eptB and arnB were also present within NR-12. C. portucalensis NR-12 was resistant to eight different antibiotics from six antimicrobial groups. To formulate a control strategy, it is important to understand this resistant mechanism.

Shiga toxin-producing Escherichia coli (STEC) food-borne outbreaks

Escherichia coli (E. coli) are Gram negativo, non-sporulating bacteria, which belong to the normal intestinal flora of humans and animals. Shiga toxin-producing E. coli (STFC) arc a group of if. coli that is defined by the capacity to produce toxins called Shiga toxins (Stx). hollowing ingestion of STEC, the significant risk of two serious and potentially life-threatening complications of infection, hemorrhagic colitis and hemolytic uremic syndrome (HUS), makes STHC food poisoning a serious public health problem. Besides Stx, human pathogenic STFC harbor additional virulence factors that are important for their pathogenicity. Although human infection may also be acquired by direct transmission from person to person or by direct contact of humans with animal carriers, the majority of STFC infections are food-borne in origin.The gastrointestinal tract of healthy ruminants seems to be the foremost important reservoir for STFC and ingestion of undercooked beef one of the most likely routes of transmission to humans, Other important food sources include faecally contaminated vegetables and drinking water, The serogroup classification of STHC is based on the somatic (O) and flagellar (H) antigens, and, to date, more than 200 STFC serogroups have been identified, Human STFC infections are, however, associated with a minor subset of 0;H serotypes. Of these, the 0157:H7 or the 0157 :H- serogroups (STFC 0157) are the ones most frequently reported to be associated with food-borne outbreaks. However other non-0157 STFC serogroups such as E. coli 026, 0103, O l l i , 012I, 045 and 0145 have caused several outbreaks in recent years.Two outbreaks of gastroenteritis caused by E. coli 0157:117 were first reported in the US, following the consumption of undercooked hamburgers, in 1982. Since then several outbreaks were reported worldwide. A major E. coli 0157:117 outbreak occurred in Japan and contaminated radish sprouts was identified as the vehicle of infection. More than 6,000 school children were affected, 101 people were hospitalized with lILS and 12 deaths were recorded. The recent outbreak of STFC 0104:114 infection and HUS reported in Germany in the spring of 2011 was one of the largest outbreaks worldwide. As of 27 July, 3 126 cases of STFC infections, 773 cases of HUS including 46 deaths linked to the outbreak in Germany and occurring in the Furopean Union (FU) (including Norway), Outside the FU 8 cases of STFC and 5 cases of HUS, including 1 death have been reported in the USA, Canada and Switzerland, all with recent travel history to Germany.The present review on major STliC food-borne outbreaks recorded worldwide highlights the need for eontrol measures in order to prevent or at least minimize the occurrence of similar events in the future.

Abstract 4564: Synergistic anti-tumor efficacy of combination therapy with APS001F, a cytosine deaminase (CD) expressing Bifidobacterium, 5-fluorocytosine (5-FC) and anti-mPD-1 antibody in syngeneic mice model

Abstract Immune checkpoint blockers like anti-PD-1 antibody are leading the new generation in anti-cancer drug development. A lot of scientific evidences have demonstrated that immune checkpoint antibodies have promising clinical response in patients with multiple cancer types. Nevertheless, limited fraction of patients responds to the antibody immunotherapy, and moreover, immune related serious adverse events caused by nonspecific reaction with immune checkpoint blockers result in treatment discontinuation. Many approaches have been attempted to improve therapeutic outcomes of antibody immunotherapy, particularly a combination of antibody treatment and other therapies is one of worth-trying ideas. APS001F is a live recombinant Bifidobacterium longum expressing cytosine deaminase (CD), which is an enzyme to catalyze the hydrolytic deamination of cytosine to uracil. Bifidobacterium is a non-pathogenic anaerobic bacterium derived from normal human intestinal flora. It can only survive and grow at low oxygen environment such as solid tumor. Intravenous administration of APS001F to patients leads to colonization of the B.longum and production of CD enzyme only inside the solid tumor. Locally expressed CD enzyme converts orally taken prodrug, 5-FC, into anti-tumor drug 5-FU, which increases 5-FU concentration specifically inside tumor and results in alleviation of side effects caused by attacking normal organs. The phase 1 clinical trial for APS001F is conducted in the US sponsored by us. 5-FU has been shown to alleviate Myeloid Derived Suppressor Cells (MDSC) in the tumor site and release immune suppression in tumor [1]. Furthermore, Van Der Kraak et. al. have reported that 5-FU upregulated PD-L1 expression on the surface of tumor cells [2]. These findings drove us to combine anti-PD-1 antibody with the APS001F therapy. At this present study, systemic administration of APS001F and 5-FC significantly suppressed tumor growth in CT26 bearing syngeneic mice model, which is consistent with our previous finding. Additionally, anti-murine PD-1 antibody combined with APS001F and 5-FC further suppressed tumor progression and some of individual samples achieved complete regression of CT26 tumors. The combination treatment effect of anti-murine PD-1 antibody and APS001F with 5-FC showed statistical significance in comparison with either treatment group, which encourages us to expect much effective results and less side effects in clinic. Reference: 1. Vincent J. et. al., Cancer Res. 2010 Apr 15;70(8):3052-61, 5-Fluorouracil selectively kills tumor-associated myeloid-derived suppressor cells resulting in enhanced T cell-dependent antitumor immunity. 2. Van Der Kraak et. al., J Immunother Cancer., 2016 Oct 18;4:65. 5-Fluorouracil upregulates cell surface B7-H1 (PD-L1) expression in gastrointestinal cancers. Citation Format: Koichiro Shioya, Yuji Seki, Tomio Matsumura, Yuko Shimatani, Shun'ichiro Taniguchi, Minoru Fujimori. Synergistic anti-tumor efficacy of combination therapy with APS001F, a cytosine deaminase (CD) expressing Bifidobacterium, 5-fluorocytosine (5-FC) and anti-mPD-1 antibody in syngeneic mice model [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4564. doi:10.1158/1538-7445.AM2017-4564

Antimicrobial Susceptibility Pattern of Enterococci Isolated from Clinical Specimens at Mymensingh Medical College Hospital, Mymensingh, Bangladesh

Enterococci are part of the normal intestinal flora of humans and animals but have also emerged as important pathogens responsible for serious infections in hospital and community acquired infections. The aim of this study was to investigate the prevalence of Enterococcus with their antimicrobialsusceptibility pattern from patients ofMymensingh Medical College Hospital, Bangladesh during the period from July 2015 to June 2016.Samples were collected and identification of enterococcus was done by standard microbiological procedure and biochemical tests.Multiplex PCR was performed by using species specific primers for Enterococcus faecalis (E. faecalis) and Enterococcus faecium (E. faecium),vanA, vanB, vanC1, vanC2/C3 genes for vancomycin resistance.A total of 105 enterococci were isolated from 1201 different clinical specimens (from urine (931), pus (175) and wound swab (95) respectively) from July, 2015 to June, 2016.The prevalence of enterococci was 12.34% in urine, 17.17% in pus and 1.58% in wound samples. Out of 105 enterococci,80 (77.14%) were Enterococcus faecalis,1 (0.95%) was E. gallinaramand 24 (22.86%) were other species. All the species were highly resistant to aminoglycosides (Gentamicin) (75.24%) and ciprofloxacin (73.33%). Regarding antibiotic sensitivity, all the enterococci were (100%) sensitive to linezolidand vancomycin followed by nitrofurantoin 93 (88.57%) and imipenem 89 (84.76%). No vancomycin resistant enterococci were identified by disk-diffusion method. But by PCR, vanB was found in 1/80 (1.25%) of the E. faecalis isolates and 01 (100%) of the E. gallinarum.vanC1 was detected in 1 (100%) ofE. gallinarum isolates. The vanA and vanC2/C3 gene was not found in any isolates. For the first time, one isolate of E. gallinarum has been found harboringthe vanB gene in our hospital.The presence of multidrug resistant enterococci should be considered as danger alarm for serious enterococcal infections and further study in large scale is needed.

Characterization of Enterococcus species in a tertiary care hospital

Background & objectives: Enterococci are a part of normal intestinal flora of humans and animals but are increasingly being recognized as important human pathogens. Although they cause only a few clinical infections in human beings since the beginning of antibiotic era, they have posed major therapeutic challenges to humans. Material & methods: Various samples coming to Microbiology division of central laboratory such as blood, pus, urine etc. were included in the study. All the essential biochemical reactions needed to establish the identity of Enterococci spp. were put followed by antibiotic sensitivity testing by Kirby Bauer disc diffusion technique. Results: In our study we found the predominance of Enterococcus faecalis followed by E. faecium and E.columbae.44.4 % isolates were recovered from surgery ward predominantly from urine samples. Discussion: The present study was undertaken for phenotypic characterization of Enterococcus spp. Majority of cases belonged to surgery probably due to catheterization, surgical procedures and prolonged hospitalization.

Bacteremia Due to Clostridium cadaveris

Abstract Clostridium cadaveris is ubiquitously found in the environment and part of the normal intestinal flora of humans. Although it is generally considered non-toxigenic to humans, it has been reported to cause a wide array of infectious etiologies, including bacteremia. Heightened awareness of C. cadaveris is warranted for clinicians because immunocompromised individuals are particularly at risk for developing significant complications due to Clostridium infections.

Identification of Salmonella sp. in Curraleiro Pé-Duro cattle raw milk

The microbiological quality of raw milk can be directly affected by animal health, hygiene procedures performed during milking and product storage condition. Faced with the need to characterize the microbiological aspects due to the milk production of cattle herd of CurraleiroPe-Duro breed, there were evaluated 226 samples of raw milk collected in the period of january 2013 to january 2014, for research of Salmonella sp.. The analytical tests were performed in Multi-User Laboratory of Microbiology Food Research Center at Veterinary Medicine School of the Federal University of Goias. According to the results in this study it was identified the presence of Salmonella sp., serovar Heidelberg and Schwarzengrund. Although this microorganism comprise the normal intestinal flora of humans and warm-blooded animals, be eliminated in feces and consequently promote environmental contamination and other animals, the identification of Salmonella in raw milk results the need for control in obtaining the milk process, storage and processing procedures of dairy products to ensure safety to consumers.

Specific features of the enteric microbiota composition in patients with alcoholic liver cirrhosis

To establish the specific features of the taxonomic and functional composition of the enteric microbiota in patients with alcoholic liver cirrhosis (LC). Metagenomic analysis was used to study the taxonomic composition and functional potential of the enteric microbiota in 20 patients with alcoholic LC. Total DNA was isolated from the patients' fecal samples; thereafter full genome sequencing was carried out. The metagenomic analysis yielded the results of the relative taxonomic and functional abundance of microbial species in the test samples. These were comparatively analyzed with the previously published metagenomic datasets of healthy population cohorts in the Russian Federation, as well as in Denmark, China, and the USA. In the majority of patients, the dominant part of the intestinal community represented bacterial species constituting the normal human intestinal flora. At the same time, abnormal gut microbiota composition, which was suggestive of marked dysbacteriosis, was identified in a number of patients. In addition, pooled analysis of the data could identify a number of species with a statistically significantly increase and decrease in the relative abundance as compared to the control groups. Thus, the enteric microbiota of the patients with alcoholic LC showed a high proportion of bacteria characteristic of the oral cavity. Analysis of the pooled metabolic potential of the microbiota in these patients demonstrated the higher abundance of enzyme genes involved in alcohol metabolism. In the patients with alcoholic LC, the microbiota composition changes identified in individual bacterial species may be associated with gastrointestinal comorbidities, such as chronic erosive gastritis, chronic pancreatitis, and gastric ulcer. The alterations occurring in alcoholic cirrhosis promote the penetration and generation of oral cavity-specific microorganisms in the human intestine. This may a potential biomarker for the diagnosis of liver diseases. The bacterial enzyme genes involved in alcohol metabolism have an increased abundance in patients with alcoholic LC and healthy volunteers from the Russian Federation.

English

INTRODUCTION: Diarrhoea is defined as passage of loose, liquid or watery stools. In the developing countries, diarrhoea remains a wet season disease with bacteria playing a greater role. The agents responsible for infantile diarrhoea may be bacteria, viruses, parasites, malnutrition and drugs. Infectious agents that cause diarrhoeal disease are usually spread by the fecal-oral route. Escherichia coli (E. coli) is a gram-negative bacillus that may be found in the normal intestinal flora of humans and animals, but can also be an important cause of enteric illness. Our present study is an attempt to fulfil this vacuum and investigate the most common pathogens causing these diseases amongst patients in and around a tertiary care hospital of eastern Bihar, with special reference to the serotypes of Escherichia coli. MATERIAL AND METHODS: Samples were collected from both male and female patients below five years of age, admitted to the Pediatrics Department, with complains of diarrhoea and gastroenteritis. Samples were processed, identified and antibiotic sensitivity was done as per standard protocol. Serotyping of E. coli isolates was carried out using antisera as per manufacturer's instructions. RESULTS: Different diarrhoeagenic strains of E. coli showed that the maximum numbers of strains were EPEC, followed by DAEC. EAEC and ETEC accounted for only a small percentage of strains. Upon Serotyping the different E. coli isolates from patients with diarrhoea, the results showed that the Serotype O26, O111 and O55 were the predominant serotypes of EPEC. Among the ETEC strains only 2 serotypes were seen viz. O6 and O15. Serotype O44 and O125 were the only two serotypes of EAEC seen. Among the DAEC, the only serotype was O1. The antibiotic susceptibility pattern of various isolates shows maximum resistance against ampicillin followed by cefixime. Strains were significantly sensitive to amikacin, gentamicin and ofloxacin. CONCLUSION: Our result shows high rate of diarrhoeagenic E. coli among Indian children presenting with diarrhoea particularly in Katihar / Kosi region of Bihar. The finding of diverse E. coli subtypes even amongst the small number of E. coli isolates highlights the importance of pathogenic E. coli in cases of diarrhoea and gastroenteritis and stresses upon the need for enhanced surveillance of children with diarrhoea in these parts of the globe.

Escherichia coli Capsular Polysaccharide Synthesis, Antibiotic Susceptibility, and Red Blood Cell Agglutination

Background Escherichia coli is a normal component of the human intestinal flora, but it is also a pathogen particularly in women with urinary tract infections, cystitis, and kidney diseases. A new capsular polysaccharide (CPS)-synthesizing variant strain of E. coli was isolated from a culturing bacterial medium containing proteose peptone No. 3 glycerin salt in our previous study. In this study, we further isolated a new E. coli variant, which produces capsular polysaccharides (CEF-CPS), using cefazolin (CEF) and examined the pathogenic characteristics of this CEF-CPS strain. Methods Polysaccharides produced by CEF-treated E. coli were separated and purified using anion exchange resin and gel filtration column chromatographic methods. The red blood cell (RBC) agglutination assay and antibiotic susceptibility test were conducted, and serum bactericidal activity, antibiotic tolerance, and antibiotic uptake were also examined. Results (1) Variant strains had greater RBC hemagglutination ability than parental strains. (2) The CEF-CPS variant strain showed a two-fold increase compared to the parental strain. (3) Antibiotic resistance to CEF, ampicillin, and polymyxin B was increased four-fold in the CEF-CPS variant strain. (4) Bacterial cell counts in the parental strain incubated in a medium containing gentamicin were reduced significantly, near to the undetectable level, within 4 hours. By contrast, bacterial counts of the CEF-CPS strain displayed only 50% reduction compared to the original bacterial counts under the same culture environment. Conclusion E. coli derived from normal human intestinal flora generated a new variant strain along with the production of newly synthesized additional polysaccharides on the cell wall in the presence of CEF. Their productions can contribute to enhancing multiple-drug resistance and pathogenicity.

A Case of Morganella morganii Meningoencephatitis

Morganella morganii (M. morganii) is a Gram-negative bacillus found in the environment and among normal human intestinal flora. It is a well known cause of urinary tract infections, wound infections, sepsis and other extra-intestinal infections. It also is considered to be an opportunistic pathogen and has been known to occur both in community and nosocomial infections. Most reported cases of severe infections with M. morganii were in patients with some immunological defects. In this paper, we present a rare case in a child who had a residual cavernous hemangioma in the right frontal lobe and suffered from M. morganii meningoencephalitis.

English

IntroductionEnterococci are part of the normal intestinal flora of humans and animals but have also emerged as important pathogens responsible for serious infections in hospital and community acquired infections. According to recent surveys, Enterococci remain in the top 3 most common pathogens that cause nosocomial infections. AimTo process all the clinical samples from various departments in our hospital, for the isolation of Enterococci sp. To speciate the isolates & to have the resistance pattern of the isolates to Vancomycin Methods and MaterialA total of 928 samples were collected from both out patients and in patients in all clinical departments and transported to microbiology laboratory. Specimens were processed by inoculating on to Mac Conkeys agar, blood agar, nutrient agar and Pfizer selective media and incubated at 370C for 24 48 hours. Enterococci were identified by their typical arrangement in Gram stain, Bile esculin test and salt tolerance test. Speciation was done by subjecting the isolates to a battery of biochemical tests. Antimicrobial susceptibility patterns were determined by performing Kirby-Bauer disc diffusion method and Minimum Inhibitory Concentration (MIC) values were identified by Tube & Agar dilution method. ResultsA total of 928 samples. Among these, 647 (69.72%) were culture positive with different isolates and 281 (30.28%) were culture negative. Among 647 culture positive cases, 100 (15.46%) were Enterococcus faecalis. Antimicrobial susceptibility & MIC done as per standard protocols. The E. Faecalis showed 99% sensitive to Vancomycin. The resistance to Vancomycin was further confirmed by MIC both Agar &Tube dilution methods, in which the MIC was: 32μg/ml in one isolate. ConclusionsSpecies level identification of Enterococcus is not only important for epidemiological study, but also for analysing the drug resistant pattern. Effective detection of Vancomycin resistance in laboratory helps in reducing the morbidity and mortality due to VRE in hospitalized patients. Key wordsBlood agar, Mac Conkeys agar, Bile esculin, Vancomycin resistant Enterococci, Minimum inhibitory concentration. International Journal of Medical and Clinical Research ISSN:0976-5530 & E-ISSN:0976-5549, Volume 3, Issue 4, 2012 Citation: Sunilkumar Jada and Karthika Jayakumar (2012) Prevalence of Enterococcus species from various clinical specimens in Shri Sathya Sai Medical College & Research Institute with special reference to speciation and their resistance to Vancomycin. International Journal of Medical and Clinical Research, ISSN:0976-5530 & E-ISSN:0976-5549, Volume 3, Issue 4, pp.-154-160. Copyright: Copyright©2012 Sunilkumar Jada and Karthika Jayakumar. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited. Introduction Enterococci are part of the normal intestinal flora of humans and animals but have also emerged as important pathogens responsible for serious infections in hospital and community acquired infections. The genus Enterococcus includes more than 17 species, but only a few cause clinical infections in humans [1]. Enterococci were originally classified as enteric gram-positive cocci and later included in the genus Streptococcus. In the 1930s, with the establishment of the Lancefield serological typing system, Enterococci were classified as group D streptococci and were differentiated from the non-Enterococcal group D streptococci such as Streptococcus bovis by distinctive biochemical

Pharmacokinetic Drug Interaction of Mycophenolate With Co-Amoxiclav in Renal Transplant Patients

Pharmacokinetic Drug Interaction of Mycophenolate With Co-Amoxiclav in Renal Transplant Patients