Providencia Spp Research Articles

Clinical and Drug Resistance Characteristics of Providencia Infections

Background: Providencia is a G ram-negative bacillus that most frequently colonizes the urinary tract and is often resistant to many antimicrobials. This study aimed to evaluate the resistance patterns of Providencia spp. and clinical outcomes due to the paucity of data. Methods: A multi-center, descriptive, retrospective chart review of adult patients with Providencia spp. infections was conducted from 1 January 2020 to 31 May 2022. The primary outcome was to describe the drug resistance patterns of Providencia spp. isolates. This study’s secondary outcome was to evaluate the clinical outcomes of patients with Providencia spp. infections. Results: Of the 312 patients screened, 244 were excluded primarily for polymicrobial infections. The mean age was 70 years, and 39 (56.5%) were males. Of the 68 included cases, 46 (67.6%) were P. stuartii, 20 (29.4%) were P. rettgeri, and 2 (2.9%) were P. alcalifaciens. The most common infections were bacteremia 38 (55.8%), followed by 27 (39.7%) urinary tract infections and 3 (4.4%) wound infections. In this study, 45 patients (65.2%) had urinary catheters. The primary antibiotics used for treatment consisted of ceftriaxone (25 (36.2%)), cefepime (20 (29%)), and meropenem (10 (14.5%)). Only 5 of 68 (7.2%) cases were multidrug- resistant and required meropenem. In total, 19 patients (27.1%) died during their admission, but none were related to Providencia infections. A total of 10 of the 68 patients (14.5%) were readmitted within 30 days for reasons unrelated to the progression or recurrence of Providencia infections. Conclusions:Providencia bacteremia is predominantly seen in elderly patients. Third- generation cephalosporins remain an appropriate choice of antibiotics for Providencia spp. Providencia stuartii was the only species with multidrug resistance.

An Outbreak of Pan-drug Resistant Providencia Species in an Intensive Care Unit: A Case-Series

Background: Providencia species are opportunistic pathogens that can rarely cause nosocomial infections. They possess numerous virulence characteristics, such as intrinsic antibiotic resistance, which enable them to cause lethal outbreaks. The emergence of pan-drug resistant (PDR) isolates amplifies the threat of Providencia spp. to human health. Objectives: We described an outbreak caused by PDR Providencia spp. in the intensive care unit (ICU) of our medical center. Methods: This outbreak occurred at Imam Hossein Hospital in Tehran, Iran, between 20 June and 28 July 2023. The majority of the 14 patients experienced ventilator-associated pneumonia (VAP); however, two others had surgical site infections (SSI) and peritoneal abscesses. Samples were subcultured on Blood agar, Chocolate agar, and MacConkey agar, as well as differential gallery mediums. Additionally, susceptibility to antimicrobial agents was determined by the disk diffusion protocol using Mueller-Hinton (MH) agar. Results: The rapid diagnosis of the outbreak and practical measures recommended by the infection prevention and control (IPC) committee (e.g., sampling from other patients, hands of healthcare workers, and the environment to identify further cases and the source of the infection, contact isolation, disinfection of the ICU with 1% chlorine solution, and combined antibiotic therapy) assisted us in managing it. Nevertheless, the outbreak resulted in the mortality of eight patients, despite these preventive and therapeutic measures. Conclusions: Clinicians should be aware of nosocomial infections caused by opportunistic pathogens such as Providencia spp., especially in ICU-admitted patients with prolonged hospitalizations and broad-spectrum antibiotic administration. Strong clinical suspicion and timely detection of outbreaks, investigation of further cases, contact isolation of infected patients, disinfection of the environment, treatment with combined antibiotic regimens, and re-sampling of patients and the environment are the cornerstones of managing outbreaks caused by Providencia spp.

Biodiversity of carbapenem-resistant bacteria in clinical samples from the Southwest Amazon region (Rondônia/Brazil)

Brazil is recognized for its biodiversity and the genetic variability of its organisms. This genetic variability becomes even more valuable when it is properly documented and accessible. Understanding bacterial diversity through molecular characterization is necessary as it can improve patient treatment, reduce the length of hospital stays and the selection of resistant bacteria, and generate data for health and epidemiological surveillance. In this sense, in this study, we aimed to understand the biodiversity and molecular epidemiology of carbapenem-resistant bacteria in clinical samples recovered in the state of Rondônia, located in the Southwest Amazon region. Retrospective data from the Central Public Health Laboratories (LACEN/RO) between 2018 and 2021 were analysed using the Laboratory Environment Manager Platform (GAL). Seventy-two species with carbapenem resistance profiles were identified, of which 25 species carried at least one gene encoding carbapenemases of classes A (blaKPC-like), B (blaNDM-like, blaSPM-like or blaVIM-like) and D (blaOXA-23-like, blaOXA-24-like, blaOXA-48-like, blaOXA-58-like or blaOXA-143-like), among which we will highlight Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, Serratia marcescens, and Providencia spp. With these results, we hope to contribute to the field by providing epidemiological molecular data for state surveillance on bacterial resistance and assisting in public policy decision-making.

Mortality and Risk Factors of Death in Patients with AmpC β-Lactamase Producing Enterobacterales Bloodstream Infection: A Cohort Study.

ESCPM bacteria include Enterobacter spp, Serratia, Citrobacter spp, Providencia spp, and Morganella spp. These Gram-negative bacilli harbor chromosomally encoded AmpC-type β-lactamases that cause resistance to β-lactam antibiotics, such as penicillins, β-lactam/β-lactamase inhibitors, and first-, second-, and third-generation cephalosporins. Bloodstream infections caused by ESCPM group bacteria (BSI-ESCPM) are difficult to treat. To describe 30-day mortality and analyze potential risk factors for death in patients with BSI-ESCPM. A cohort study of patients aged ≥ 18 years with BSI-ESCPM was conducted at a University Hospital in Brazil, from January 2013 and December 2018. Potential risk factors for death within 30 days of bloodstream infection BSI diagnosis were analyzed using multivariable logistic regression. Among 138 patients with BSI-ESCPM, 63.0% were males, with a median age of 61 years. Of 155 BSI-ESCPM episodes, 61.3% were hospital-acquired. Primary BSI-ESCPM associated with short-term central venous catheter (37.4%) and BSI-ESCPM secondary to respiratory infection (19.4%) occurred mainly. Mostly, Enterobacter spp. (49.7%) and Serratia spp. (29.0%) were isolated. Multidrug-resistance occurred in 27.7% of BSI-ESCPM episodes, involving Enterobacter spp. (16.1%) and Serratia spp. (7.7%) mainly. The mortality was 24.5%. Developing septic shock within 72 h of BSI-ESCPM diagnosis (OR: 70.26; 95% CI: 16.69-295.77; P<0.01) was risk factor for death. Conversely, combined antibiotic therapy (OR: 0.23; 95% CI: 0.05-0.94; P:0.04), BSI-ESCPM secondary to urinary infection (OR: 0.11; 95% CI: 0.01-0.99; P:0.05), and Enterobacter spp. BSI (OR: 0.16; 95% CI: 0.05-0.56; P0<0.01) was protective factor against death. Tendency of association between inadequate antibiotic therapy and death (OR: 2.19; 95% CI: 0.51-9.42; P:0.29) was observed. BSI-ESCPM is severe and has serious outcomes such as sepsis-associated deaths. Combined antibiotic therapy was a protective factor against death in patients with BSI-ESCPM. There is a suggestive association between inadequate antibiotic therapy and mortality. The ESCPM group bacteria that are considered to be at moderate to high risk of clinically significant AmpC production were not associated with death.

1222. Impact of Microbiology Reporting Changes in Treatment of AmpC Bloodstream Infections

Abstract Background Recent literature suggests that AmpC production may be overcalled in Enterobacterales, leading to unnecessary broad-spectrum antimicrobial utilization. The Infectious Diseases Society of America (IDSA) has since reassessed classification of high and low risk organisms with inducible AmpC expression. With this updated guidance, our health system approved changes to our microbiology reporting of AmpC producers in an effort to guide prescribing of appropriate antibiotics. The primary objective of this project was to compare antibiotic prescribing patterns for high and low risk AmpC producers in patients with bloodstream infections (BSI) based on the addition of appended comments to antimicrobial susceptibility results. Methods This multicenter, retrospective, cohort study included patients with BSI from October 2022 to March 2023who received at least 48 hours of antimicrobial therapy for the following high and low risk AmpC producers: Citrobacter spp., Enterobacter spp., Klebsiella aerogenes, Serratia spp., Morganella spp., Providencia spp. The primary endpoint was the number of patients placed on optimal therapy based on adherence to the appended microbiology comment and IDSA guidance. Secondary endpoints included time to effective treatment, time to optimal treatment, duration of therapy, 30 day mortality, microbiological failure, microbiological relapse, 30 day readmission, length of stay, and hospital acquired Clostridioides difficile infection. Results A total of 191 positive blood cultures were identified with 93 patients (pre-appended comment = 57; post-appended comment = 36) meeting inclusion criteria. Patients were more likely to receive optimal therapy post-appended comment based on IDSA guidance for BSI (38.6% vs 72.2%, OR 4.14; 1.68-10.21). When stratified by high risk and low risk organism, the number of patients on optimal therapy increased in the post-appended comment group but was not statistically significant (high risk: 70.3% vs 88%, OR 3.08; 0.72-13.32; low risk: 10% vs 36.3%, 5.14; 0.92-28.50). No difference in secondary outcomes were detected. Conclusion Implementation of an appended microbiology note has the potential to have a positive impact on antimicrobial prescribing patterns in treatment of AmpC bloodstream infections. Disclosures All Authors: No reported disclosures

An Integrative Approach to Study the Inhibition of Providencia vermicola FabD Using C2-Quaternary Indolinones.

The present study investigates the potential bioactivity of twelve experimentally designed C-2 quaternary indolinones against Providencia spp., a bacterial group of the Enterobacteriaceae family known to cause urinary tract infections. The study aims to provide insights into the bioactive properties of the investigated compounds and their potential use in developing novel treatments against Providencia spp. The experimental design of indolinones, combined with their unique chemical structure, makes them attractive candidates for further investigation. The results of this research may contribute to the development of novel therapeutic agents to combat Providencia spp. infections. The synthesized indolinones (moL1-moL12) are evaluated to identify any superior activity, particularly focusing on moL12, which possesses aza functionality. The antimicrobial activities of all twelve compounds are tested in triplicates against six different Gram-positive and Gram-negative organisms, including P. vermicola (P<0.05). Computational methods have been employed to assess the pharmacokinetic properties of the compounds. Among the synthesized indolinones, moL12 exhibits superior activity compared to the other compounds with similar skeleton but different functional moieties. All six strains tested, including P. vermicola, demonstrated sensitivity to moL12. Computational studies support the pharmacokinetic properties of moL12, indicating acceptable absorption, distribution, metabolism, excretion, and toxicity characteristics. Utilizing the PPI approach, we have identified a promising target, FabD, in Gram-negative bacteria. Our analysis has shown that moL12 exhibits significant potential in binding with FabD, thereby, might inhibit cell wall formation, and display superior antimicrobial activity compared to other compounds. Consequently, moL12 may be a potential therapeutic agent that could be used to combat urinary tract infections caused by Providencia spp. The findings of this research hold significant promise for the development of new and effective treatments for bacterial infections.

Physiochemical and Microbiological Investigation of Surface and Ground Water Contaminants of Bhojpur Municipality

Water is an essential resource for life evolution. 75% of the whole earth is covered by water. The water sources that flow through the social periphery represent the development and awareness of that society. This paper focuses on investigating contaminants of different water sources within Bhojpur Municipality. The six different water samples, based on their different latitudes, were collected following all the guidelines. The physiochemical parameters and microbiological organisms like E. Coli were tested and analyzed. The results revealed that the physiochemical parameters were mostly found to be within the guideline and standardization of the World Health Organization (WHO), but in the Silichung water sample, the number of bacteria was found to be out of the WHO limit. Physiochemical parameters like total dissolved solids (TDS), total solids (TS), and chloride content were not found under the guideline of WHO. The dissolved oxygen (DO) content was found more in the water sample of Bahundhara, whereas Bhandari well sample had a low amount of DO among the other samples. The biological oxygen demand (BOD) level in Sera Khola sample was found more, while Silichung sample had a low amount of BOD, indicating Sera Khola water sample is a bit more polluted than others. On microbiological testing, the Silichung water sample was tested with Providencia spp, indicating not useful for drinking purposes. Thus, it reveals that the Silichung water should not take directly, which is rich in Providencia spp. Other physiochemical parameters of other samples were found to be within the range of WHO.

Physicochemical and Microbial Properties of the Soil Samples Collected from Auto-Mechanic Workshop, Orubor-Agbor, Delta State, Nigeria

Auto-mechanic workshops are major concerns due to the repeated discharge of spent engine oil to the receiving soil. This study investigated the qualities of soil samples from an auto-mechanic workshop located in Orubor, Abgor, Delta State, Nigeria. The collected soil (n=36) was characterized for physicochemical and bacteriological quality using standard procedures. The physicochemical results wet season were pH (5.25 ± 0.07 to 6.15 ± 0.07), electrical conductivity (45.0 ± 7.07 to 165 ± 7.07 µS/cm), organic carbon (1.53 ± 0.42 to 10.1 ± 0.16 %), nitrogen (0.05 ± 0.00 to 0.44 ± 0.01 %), phosphorus (0.69 ± 0.05 to 5.20 ±0.02 mg/kg) and total hydrocarbon content (151 ± 1.41 to 572 ± 3.53 mg/kg). The dry season recorded pH (4.78 ± 0.04 to 5.73 ± 0.04), electrical conductivity (44.1 ± 6.29 to 1.62 ± 4.60 µS/cm), organic carbon (1.21 ± 0.07 to 7.52 ± 0.13 %), nitrogen (0.47 ± 0.00 to 0.58 ± 0.00 %), phosphorus (0.90 ± 0.57 to 6.79 ± 0.09 mg/kg) and total hydrocarbon content (98.9 ± 0.44 to 373 ± 6.36 mg/kg). There was no significant difference (p˃0.05) in the physicochemical parameters concerning the sampling periods. The total heterotrophic bacterial and total naphthalene utilizing bacterial counts were 9.67 ± 1.04 × 105 cfu/g and 5.40 ± 0.88 × 105 cfu/g respectively. The major bacterial isolates were Serratia, Pseudomonas, Enterococcus, and Providencia spp. Findings from this study revealed the necessity for public education and stricter waste management practices within auto-mechanic workshops to stem the negative effects of spent auto-engine oil pollution in the

Analysis of the Vulvar Skin Microbiota in Asymptomatic Women and Patients With Vulvar Lichen Sclerosus Based on 16S rRNA Sequencing

Vulvar lichen sclerosus (VLS) is a chronic inflammatory skin disease that brings life-long and psychological distress to patients. It remains unclear whether this condition is related to changes in the skin microbial community. The aim of this study was to evaluate the compositional characteristics of the vulvar skin microbiota between VLS patients and asymptomatic postmenopausal women. We included 60 cases of postmenopausal patients in the outpatient vulvar clinic of Peking University First Hospital from August 2020 to October 2020. Thirty-one patients were diagnosed with VLS by vulvar skin biopsy (VLS group), while 29 women were asymptomatic volunteers (control group). DNA was extracted from vulvar skin swabs of the VLS and control groups. The V3-V4 fragments of 16S rRNA were targeted for high-throughput sequencing and gene sequence analysis. The sequencing results were analysed by α diversity, β diversity, species composition, LEfSe analysis to compare the compositional differences of the vulvar skin microbiota between the two groups. Our study revealed that at the phylum level, patients with VLS had a lower relative abundance of Firmicutes (p < 0.0001) and a higher relative abundance of Proteobacteria than the control group (p < 0.0001). At the genus level, Lactobacillus spp. accounted for the largest proportion of the microflora in the asymptomatic controls, while the proportion of Prevotella spp. in the VLS group was the highest. In the VLS group, the relative abundance of Finegoldia spp., Ralstonia spp., Peptoniphilus spp., Anaerococcus spp., Campylobacter spp., Providencia spp. Kelbsiella spp., Ezakiella spp., and Escherichia-Shigella spp. was significantly increased compared with the control group. Although there was no significant difference in the α diversity of the vulvar skin microbiota, the β diversity differed significantly between the two groups.

Association with oral microbial alteration and oral disease among patients attending ruhengeri referral hospital, Rwanda: A case–control study

Background: Dental disease remains a public health concern of this era. In 2020, World Health Organization reported that 3.5 billion of oral disease occurs every year. About 2.3 billion case is attributed to dental caries while gum disease affects 10% of the global population. Methods: This was a case control study carried out from November 2020 to February 2021. About 120 participants were recruited, of them, 60 were oral diseased, while the remaining 60 were selected as a control group. Oral swab samples were collected with the swab stick, and put into plastic sterile container to avoid external microbial contamination. Samples were transported to INES clinical microbiology laboratory for microbial identification. chi square was performed to test for association, while odd ratios and relative risk were performed to test for pathogenic microbial fraction. Results: The common oral diseases were tooth decay (56.6%) and gum disease (43.4%). the most affected age range was 5-19years (53.33%), while females (63.3%) were the most affected sex. The most isolated microorganism was Lactobacillus spp (15.8%) for patients, while Staphylococcus aureus (11.2%) was the most isolate in the control group. The statistical significant association with oral microbial alteration and oral disease was observed on Streptococcus mutans (x2=8.9, P= 0.002852), Lactobacillus spp (x2=9.84, P=0.001708), Candida spp (x2=5.2, P=0.02258), Staphylococcus aureus (x2 = 15.6, P= 0.000078), and Providencia spp (x2 = 6, P=0.014306). The overall oral microbial alteration (x2=53, P< 0.00001) was statistically significant. The ratio of pathogenic microorganisms (OR=4, 95%CI:2.3786-7.062 and RR=1.477, 95%CI:1.2478-1.7153) was significantly associated with oral disease. Conclusion: Oral microbial alteration contributes to oral disease. Early detection of oral microbial alteration, and oral diseases are recommended.

Resistance pattern of infected chronic wound isolates and factors associated with bacterial resistance to third generation cephalosporins at Mbarara Regional Referral Hospital, Uganda.

The objectives of this study were; (I) to determine the proportion of pathogens isolated from patients with infected chronic wounds in the surgical ward of MRRH that are resistant to the third-generation cephalosporins and (II) to determine the factors associated with resistance to third-generation cephalosporins in the surgical ward of MRRH. This study was a descriptive analytical survey of bacterial isolates from infected chronic wounds among patients admitted in the surgical ward of MRRH, Uganda. Seventy five (75) study participants were recruited in the study using convenient sampling technique. Bacterial culture and identification was performed using standard microbiology laboratory procedures whereas broth microdilution method was used to establish the susceptibility of the identified pathogens. Data for objective one (1) was summarized as proportions while the categorized variables were analyzed using logistic regression to determine whether they were associated with the resistance patterns. The level of significance was preset at 5% and p-values less than 0.05 were considered statistically significant. Generally, all isolates had complete susceptibility (100%) to Cefoperazone+Sulbactam 2g except 7.1% of proteus spp that were resistant. Of all the bacterial isolates studied, Staphylococcus aureus, Enterobacter agglomerans, providencia spp and pseudomonas earuginosa had complete resistance (100%) to Cefopodoxime 200mg while providencia spp and pseudomomas earuginosa had complete resistance (100%) to Cefixime 400mg and cefotaxime 1g. Finally, higher odds of bacterial resistance to more 2 brands of the third generation cephalosporins were observed among participants who had prior exposure to the third generation cephalosporins (OR, 2.22, 95% CI, 0.80-6.14), comorbidities (OR, 1.76, 95% CI, 0.62-4.96) and those who had more than two hospitalizations in a year (OR, 1.39, 95% CI 0.46-4.25). However, multivariate logistic regression was not performed since no factor was significantly associated with resistance to more than two brands of third generation cephalosporins (p >0.05). This study found that cefixime and cefpodoixme had high rates of resistance and should not be used in routine management of infected chronic wounds. In addition, the factors investigated in this study were not significantly associated with bacterial resistance to more than two brands of third generation cephalosporins.

Changes in the fecal microbiota in dogs with acute hemorrhagic diarrhea during an outbreak in Norway.

BackgroundA severe form of acute hemorrhagic diarrhea syndrome (AHDS) occurred in dogs in the Oslo region of Norway during autumn 2019.ObjectivesTo characterize the fecal microbiota of dogs with AHDS during the outbreak and compare it to that of healthy dogs from the same period and before the outbreak.AnimalsDogs with AHDS (n = 50), dogs with nonhemorrhagic diarrhea (n = 3), and healthy dogs (n = 11) were sampled during the outbreak. In addition, 78 healthy dogs from the same region were sampled before the outbreak between 2017 and 2018.MethodsRetrospective case‐control study. The fecal microbiotas were characterized using 16S rRNA gene amplicon sequencing.ResultsDogs with AHDS had significantly different microbiota composition (R 2 = .07, P < .001) and decreased intestinal diversity relative to healthy dogs from the outbreak period (median, 2.7; range, 0.9‐3.5 vs median, 3.2; range, 2.6‐4.0; P < .001). The microbiota in dogs with AHDS was characterized by a decrease of Firmicutes and an outgrowth of Proteobacteria, with increased numbers of Clostridium perfringens and Providencia spp. Among the Providencia spp., 1 showed 100% sequence identity with a Providencia alcalifaciens strain that was cultivated and isolated from the same outbreak. No Providencia spp. was found in healthy dogs sampled before the outbreak.Conclusions and Clinical ImportanceDogs with AHDS had marked changes in fecal microbiota including increased numbers of Providencia spp. and C. perfringens, which may have contributed to the severity of this illness.

Antibiogram of urinary tract pathogens in a tertiary hospital in south-south Nigeria

Background: Antibiograms represent the antimicrobial susceptibility patterns of bacterial isolates in a given healthcare setting and guides the selection of empiric antimicrobial therapy. Repeated antibiograms over time can be used to ascertain resistance trends of microbes. There is paucity of data on the antibiogram of urinary isolates in Nigeria.Objective: This study aimed to determine the antibiogram of urinary isolates in a tertiary hospital.Materials and Methods: A review of records of mid-stream urine samples received in the Medical Microbiology Laboratory and analysed for pathogen identification and subsequent antimicrobial susceptibility testing over a 4 month period, was carried out. Multiple antibiotic resistance (MAR) index for each isolate was calculated and data was summarized on SPSS 20 using descriptive statistics.Results: Out of the 959 urine samples submitted to the laboratory during the study period, 283 (29.5%) had positive cultures. Escherichia coli and Klebsiella pneumonia were the most frequently isolated organisms. The total mean MAR index was 0.61 ± 0.30. Providencia spp had the highest mean MAR index of 0.82 ± 0.26, followed by Klebsiella spp and Pseudomonas aeruginosa with mean MAR index of 0.68 ± 0.28 and 0.64 ± 0.32 respectively.Conclusion: There is a high level of resistance to commonly prescribed antibiotics among UTI pathogens in the hospital. Antimicrobial stewardship strategies are needed to address this negative trend.

Bir Üniversite Hastanesinde Kan Kültürlerinden İzole Edilen Enterobacterales Takımı Üyelerinin Dağılımının ve Antimikrobiyal Duyarlılıklarının İncelenmesi

Objective: Members of Enterobacterales can cause various diseases in humans. The objective of this study was to determine the genus/species distribution and antimicrobial susceptibilities of Enterobacterales isolated from blood cultures in Central Laboratory of Hacettepe University Hospital. Method: Enterobacterales isolated from blood between July-2014 and April-2018 were included in the study. MALDI-TOF MS was used for the identification of isolates. Antimicrobial susceptibilities were determined with automated system (VITEK 2 Compact for the isolates between 2014 and 2018; BD Phoenix for the isolates in 2018) and disk diffusion method. Results of antimicrobial susceptibility testing were interpreted according to EUCAST breakpoints. Results: In total, 1765 isolates belonging to the order Enterobacterales were isolated from blood cultures. The most common microorganisms were Escherichia coli (47.6%), Klebsiella (34.1%), Enterobacter (6%), Proteus (4.4%) and Serratia spp. (3.5%), respectively. The remaining isolates included Salmonella, Citrobacter, M. morganii, Pantoea, Raoultella and Providencia spp. The lowest resistance rates among E. coli, Klebsiella and Enterobacter spp. isolates were observed against meropenem and amikacin. However, 21.1% of Klebsiella isolates were resistant to meropenem. The most active antimicrobials against Proteus isolates were piperacillintazobactam and meropenem. Resistance was not observed against piperacillin-tazobactam and meropenem among Proteus isolates. The most active antimicrobial against Serratia isolates was trimethoprim/ sulfamethoxazole with a resistance rate of 0%. Resistance was not noted against ampicillin and trimethoprim/ sulfamethoxazole among Salmonella isolates, whereas 26.1% of isolates were resistant to ciprofloxacin. All Citrobacter isolates were susceptible to meropenem, amikacin and cefepime. Conclusion: Findings of our study may guide the selection of proper antimicrobials for the treatment of bacteremia caused by Enterobacterales. Furthermore, this study provides important epidemiological information regarding the distribution of members of Enterobacterales causing bacteremia.

Isolation and genomic characterization of a pathogenic Providencia rettgeri strain G0519 in turtle Trachemys scripta.

Providencia rettgeri infection has occurred occasionally in aquaculture, but is rare in turtles. Here, a pathogenic P. rettgeri strain G0519 was isolated from a diseased slider turtle (Trachemys scripta) in China, and qPCR assay was established for the RTX toxin (rtxD) gene. Histopathological examination showed that many inflammatory cells were infiltrated into heart, liver and intestine, as well as the necrosis of liver, kidney and spleen. The genome consisted of one circular chromosome (4.493Mb) and one plasmid (18.8kb), and predicted to contain 4170 and 19 protein-coding genes, respectively. Multiple pathogenic and virulence factors (e.g., fimbria, adhesion, invasion, toxin, hemolysin, chemotaxis, secretion system), multidrug-resistant genes (e.g., ampC, per-1, oxa-1, sul1, tetR) and a novel genomic resistance island PRI519 were identified. Comparative genome analysis revealed the closest relationship waswith P. rettgeri, and with P. heimbachae closerthan with other Providencia spp. To our knowledge, this was first report on genomic characterization of multidrug-resistant pathogenic P. rettgeri in cultured turtles.

OCCURRENCE OF ENTEROBACTERIACAE IN DAIRY FARM MILK

Raw milk is still consumed by some people especially farm families and farmworkers who believe that it is safe and has benefits over heat treated one. It is always a challenge to produce milk of superior quality , prolonged shelf life safe and wholesome which meet consumer’s expectations by preventing or minimizing the entry of microorganisms from production to consumption, therefore this study aimed to evaluate one of indicator organisms of hygienic and sanitary condition; Enterobacteriacae family , to fulfil that, one hundred cow and buffalo raw milk samples (each of 50) were collected randomly from governmental and private dairy farms at El- Gharbia Governorate, Egypt for enumeration and identification of Enterobacteriacae. The results revealed that the mean values of Enterobacteriacae count in positive samples were 1.05 × 105 ± 3.71 × 104 and 4.21 × 105 ± 9.71 × 104 of examined raw cow milk collected from governmental and private farms, respectively while the respective count in positive samples of raw buffalo milk were 9.71 × 104 ± 4.56 × 104 and 2.95 × 105 ± 5.93 × 104.The major identified Enterobacteriacae was Serratia marscence in positive samples of raw cow milk from governmental and private farms with an incidence of 19.23 and 18.75%,respectively. While, the respective incidence rate of Enterobacter aerogenes which ranked as the most frequent isolates in the positive buffalo milk samples was 14.28 and 17.5%.In addition to, Citrobacter spp, E.coli, Hafnia alveli, Proteus mirabilis, Providencia spp ,salmonella spp and Y.enterocolitica which also identified in different percentages.

Microbiological Study of Diabetic Foot Ulcer

Background: Diabetic foot is one of the most feared complications of diabetes and is the leading cause of hospitalization in diabetic patients. Limb-threatening diabetic infections are usually polymicrobial involving multiple aerobic and anaerobic organisms.&#x0D; Methodology: The present study was a cross sectional study, conducted in the department of surgery and microbiology at BIRDEM General Hospital, Dhaka, over a period of 9 months during January 2017- September' 2017. The study included a total of 77 adult patients of clinically diagnosed diabetic foot patients presenting to outpatient department and emergency ward. The standard case definition of diabetic foot is 'any pathology occurring in the foot of a patient suffering from diabetes mellitus or as a result of long term complication of diabetes mellitus'.&#x0D; Results: Majority 17(22.1%) patients had Klebsiella pneumonia, 14(18.2%) had Pseudomonas aeruginosa, 11(14.3%) had Staphylococcus aureus, 10(13.0%) had Escherichia coli, 6(7.8%) had Coagulase-negative staphylococci and 8(10.4%) had Providencia spp. In Escherichia coli 100% sensitivity to imipenem, 70% to amoxicillin-clavulanic acid, amikacin, piperacillin-tazobactam. In Coagulasenegative Staphylococci 83.3% sensitivity to tetracycline, 66.7% to ceftriaxone. In Proteus mirabilis 100% sensitivity to tetracycline, amikacin, ceftriaxone, imipenem, piperacillin-tazobactam. In Enterococcus spp.75.0% sensitivity to tetracycline. In Citrobacter spp. 100% sensitivity to imipenem.&#x0D; Conclusion: Common organism found in diabetic foot ulcer patients were Klebsiella pneumonia, Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Coagulase-negative staphylococci and Providencia spp. In tetracycline, amikacin, ceftriaxone, imipenem, piperacillin-tazobactam was 100% sensitive in Proteus mirabilis and only imipenem found in Escherichia coli and Citrobacter spp.&#x0D; Anwer Khan Modern Medical College Journal Vol. 10, No. 1: Jan 2019, P 50-55

High prevalence and diversity of extended-spectrum β-lactamase and emergence of OXA-48 producing Enterobacterales in wildlife in Catalonia.

Most of the studies focused on antimicrobial resistance (AMR) performed in wildlife describe Escherichia coli as the principal indicator of the selective pressure. In the present study, several species of Enterobacterales with a large panel of cephalosporin resistant (CR) genes have been isolated from wildlife in Catalonia. A total of 307 wild animals were examined to determine the prevalence of CR enterobacteria, AMR phenotypes and the presence of common carbapenem and CR genes. The overall prevalence of CR-phenotype was 13% (40/307): 17.3% in wild mammals (18/104) and 11.5% in wild birds (22/191) (p<0.01). Hedgehogs showed the highest prevalence (13.5% of 104) of the mammal specimens, and raptors the highest in bird specimen (7.3% of 191). Although CR E. coli was the most frequently isolated (45%), other CR- Enterobacterales like Klebsiella pneumoniae (20%), Citrobacter freundii (15%), Enterobacter cloacae (5%), Proteus mirabilis (5%), Providencia spp (5%) and Serratia marcescens (2.5%) were also isolated. A high diversity of CR genes was identified among the isolates, with 50% yielding blaCMY-2, 23% blaSHV-12, 20% blaCMY-1 and 18% blaCTX-M-15. Additionally, resistance to carbapenems associated to OXA-48 gene was found. Most of the CR isolates, principally K. pneumoniae and C. freundii, were multi-resistant with co-resistance to fluoroquinolones, tetracycline, sulphonamides and aminoglycosides. This study reports high prevalence of Enterobacterales harbouring a variety of CR genes and OXA-48 mediated-carbapenem resistance, all of them frequently associated to nosocomial human infections, for the first time in wild mammals and wild birds. Implementation of control measures to reduce the impact of anthropogenic pressure in the environment is urgently needed.

Isolation and Characterization of Microbial Diversity of Soil of Dhanbad Coal Mines using Molecular Approach

Soil is the richest ecosystem there is, as far as the diversity and populations of microorganisms is concerned. It is known that there could be over ten billion microbes per gram of soil, making soil the ideal ecosystem for mining different genes, ORFs etc. Microbial Diversity forms the lifeline of an ecosystem, interfering, regulating and participating in the biogeochemical activities therein. The present study was conducted to identify key extremophilic species residing in the coal mines of Dhanbad plateau in Bihar, India. Dhanbad plateau soil presents a unique niche, rich in coal and minerals. Soil from the coal mines was analysed through metagenomic as well as culture-dependent approach to enlist the micro-organisms native to the place. The culturable fraction lead to the identification of Klebsiella spp, Enterobacteriaceae, Serratia marcescens, and Providencia spp

Occurrence of Highly Resistant Microorganisms in Ruai Wastewater Treatment Plant and Dandora Dumpsite in Nairobi County, Kenya

Wastewater treatment plants and solid dump sites act as potential reservoirs of highly resistant bacterial strains. This study presents information on the patterns of antimicrobial resistance among pathogenic bacteria in the sewage treatment plants and solid dump site in Nairobi County, Kenya. We employed standard microbiological methods to isolate and identify bacteria from these selected sites. Members of Escherichia, Klebsiella, Serratia, Shigella, Pseudomonas, Citrobacter spp, Enterobacter, Salmonella, Staphylococcus, Bacillus, Yersinia, Vibro cholera, Providencia, Morganella and Proteus spp were isolated. Escherichia and Klebsiella recorded the highest occurrence at 13.9% and 10.3% in wastewater. Shigella, Serratia Citrobacterfreundii, Pseudomonas, Staphylococcus, Escherichia and Klebsiella recorded the highest level of occurrence at 15.1%, 14.1%, 12%, 11%, 10.4%, 10.3%, and 8.3% in dumpsite respectively. Drug sensitivity using the Disc diffusion method showed that Ampicillin, Ceftazidime, Cefotaxime, Amoxicillin, and Cefepime had the highest levels of inactivity at (68.5%, 89.5%), (64.2%, 87%), (54.5%, 80.2%), (52%, 74%) and (49.1%, 72.4%) respectively while Levofloxacin and Gentamicin showed the smallest level of antibiotic resistance at (4.8%, 4.7%) and (4.2%, 2.6%) in both sites. Members of Escherichia, Klebsiella, Proteus vulgaris, Salmonella, Pseudomonas, Shigella and Serratia showed the highest level of ESBLs production at 28.9%, 18.4%, 15.8%, 10.5%, 7.9%, 7.9%, 7.9% and 7.9% in the wastewater whereas Shigella, Escherichia, Serratia, Pseudomonas, Klebsiella, and Proteus vulgaris showed the highest level ESBLs production at 45.5%, 10.9%, 9.1%, 9.1%, 7.3% and 7.3% from the dump site. All the antibiotics tested except for Gentamicin, Chloramphenicol and Ciprofloxacin differed significantly in terms of resistance levels (p < 0.05). The study concluded that, wastewater treatment plant and dump sites bear heavy burdens of potentially virulent resistant bacterial strains which may constitute major public health hazards to scavengers and those living near these sites. There is need therefore to educate people on the use of appropriate protective materials and the settlement patterns of individuals and communities near these sites.