RESUMEN
Vibrio vulnificus infection is associated with high morbidity and mortality in high-risk patients. Poor prognoses could lead to >50% mortality rate. The present report describes a case of V. vulnificus bacteremia in a cirrhotic patient with underlying hepatitis C. He presented with generalised abdominal pain associated with distention and could not ambulate for one week. He also complained of fever for six days and pruritus for 10 days. Tea-coloured urine was noted in continuous bag drainage. The abdomen was distended but soft, with mild tenderness palpated over the left lumbar and iliac region. Blood investigation indicated ongoing infection and inflammation. The aerobic blood culture was identified using the matrix-assisted laser desorption/ionisation-time of flight mass spectrometry and confirmed via 16S rDNA sequencing as V. vulnificus. Multilocus sequence typing of the isolated V. vulnificus revealed a novel sequence type, ST540. The patient responded well to the intravenous cefoperazone and was then discharged with a four day-course of oral ciprofloxacin, 500 mg twice daily after completing the intravenous cefoperazone for 10 days. Clinical history and physical examination are important for early antibiotic therapy initiation and appropriate surgical intervention. Furthermore, bacterial strain typing is also essential for epidemiological surveillance and potentially anticipating the pathogen's virulence traits, which are vital in controlling and preventing the spread of infection.
Asunto(s)
Vibriosis , Vibrio vulnificus , Humanos , Masculino , Vibrio vulnificus/aislamiento & purificación , Vibriosis/microbiología , Bacteriemia/microbiología , Antibacterianos/uso terapéutico , ARN Ribosómico 16S/genética , Hepatitis C/complicaciones , Tipificación de Secuencias Multilocus , Persona de Mediana Edad , Cirrosis Hepática/complicacionesRESUMEN
Motile enterococci such as Enterococcus gallinarum has the ability to acquire and transfer antibiotic resistance genes to other enterococci. Even though infections caused by E. gallinarum are rare, the discovery of this bacteria in food sources and in clinical environments is disturbing. Here, we report the isolation and identification of E. gallinarum from the wound of a hospital in-patient. The isolate was identified using 16S rDNA sequencing. Isolate 146 harboured the vanA and vanC1 gene clusters, was vancomycin-susceptible, and displayed resistance to ampicillin, penicillin, erythromycin and teicoplanin. This isolate also showed intermediate resistance to linezolid and sequencing of the 23S rRNA peptidyl transferase region did not unveil any known mutations associated to the conferment of linezolid resistance. The presence of vanA did not confer resistance to vancomycin. Structural analyses into the Tn1546 transposon carrying the vanA gene revealed distinct genetic variations in the vanS, vanY and vanS-vanH intergenic region that could be associated to the atypical antibiotic resistance phenotypes of isolate 146. Finding from this study are suggestive of the occurrence of interspecies horizontal gene transfer and that similarities in genotypic characteristic may not necessarily correlate with actual antibiotic resistance pattern of E. gallinarum.
RESUMEN
Members of the genus Kocuria are commonly found in the environment and they are also commensals of the mammalian skin and oropharynx mucosa. Human infections, although rare, are increasingly being reported recently suggesting that this genus has mostly been overlooked or misidentified. Its transmission route however, is still not known. We report here the isolation and identification of a Kocuria marina isolate from the lung of a wild urban rat (Rattus rattus diardii) caught at a wet market. The isolate was susceptible to most of the commonly used antibiotics. The finding suggests a possibility that rats could be a vector for K. marina.
RESUMEN
The ability to acquire antibiotic resistance and virulence has propelled Enterococcus faecalis to become a major nosocomial pathogen. In Malaysia, data on the antibiotic resistance determinants and virulence of Enterococcus circulating strains are still scarce. This study aimed to assess the genotype of an E. faecalis isolate initially identified as Streptococcus uberis, examine the antibiotic resistance genotypes, analyze the genetic variations within Tn1546 and investigate the presence of virulence genes. The E. faecalis isolate was genetically characterized using multilocus sequence typing (MLST). Minimum inhibitory concentrations to vancomycin and teicoplanin were determined. Antibiotic resistance and other virulence genes were amplified using nucleic acid polymerase chain reaction. Mapping of the Tn1546 transposon was performed and compared to the prototype sequences. The E. faecalis isolate was found to have a MLST profile corresponding to sequence type 6. The isolate was resistant to teicoplanin but susceptible to vancomycin. Its genome consisted the vanA and vanC1 genes. Novel genetic variations in the vanS, vanS-vanH intergenic region and vanY genes were present and six virulence genes were detected. The detection of the vanC1 gene, thought to be non-transferable, suggests the potential emergence of inter-species enterococcal vanC1 gene transfer. The peculiar antibiotics resistance phenotype of this E. faecalis isolate could be associated to the novel genetic variations found. This study highlights the presence of E. faecalis belonging to the high-risk clonal complex with multiple virulence factors in Malaysia.
RESUMEN
Members of the genus Kocuria are commonly found in the environment and they are also commensals of the mammalian skin and oropharynx mucosa. Human infections, although rare, are increasingly being reported recently suggesting that this genus has mostly been overlooked or misidentified. Its transmission route however, is still not known. We report here the isolation and identification of a Kocuria marina isolate from the lung of a wild urban rat (Rattus rattus diardii) caught at a wet market. The isolate was susceptible to most of the commonly used antibiotics. The finding suggests a possibility that rats could be a vector for K. marina.
RESUMEN
Motile enterococci such as Enterococcus gallinarum has the ability to acquire and transfer antibiotic resistance genes to other enterococci. Even though infections caused by E. gallinarum are rare, the discovery of this bacteria in food sources and in clinical environments is disturbing. Here, we report the isolation and identification of E. gallinarum from the wound of a hospital in-patient. The isolate was identified using 16S rDNA sequencing. Isolate 146 harboured the vanA and vanC1 gene clusters, was vancomycin-susceptible, and displayed resistance to ampicillin, penicillin, erythromycin and teicoplanin. This isolate also showed intermediate resistance to linezolid and sequencing of the 23S rRNA peptidyl transferase region did not unveil any known mutations associated to the conferment of linezolid resistance. The presence of vanA did not confer resistance to vancomycin. Structural analyses into the Tn1546 transposon carrying the vanA gene revealed distinct genetic variations in the vanS, vanY and vanS-vanH intergenic region that could be associated to the atypical antibiotic resistance phenotypes of isolate 146. Finding from this study are suggestive of the occurrence of interspecies horizontal gene transfer and that similarities in genotypic characteristic may not necessarily correlate with actual antibiotic resistance pattern of E. gallinarum.