scholarly journals Cardiac Microlesions Form During Severe Bacteremic Enterococcus faecalis Infection

2020 ◽  
Author(s):  
Armand O. Brown ◽  
Kavindra V. Singh ◽  
Melissa R. Cruz ◽  
Karan Gautam Kaval ◽  
Liezl E. Francisco ◽  
...  
Keyword(s):  
Immune Response ◽  
Enterococcus Faecalis ◽  
Pneumococcal Disease ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Virulence Determinants ◽  
C Elegans ◽  
Bond Forming ◽  
Hospital Acquired ◽  
Pro Inflammatory Cytokines

AbstractEnterococcus faecalis is a significant cause of hospital-acquired bacteremia. Herein, the discovery is reported that cardiac microlesions form during severe bacteremic E. faecalis infection in mice. The cardiac microlesions were identical in appearance to those formed by Streptococcus pneumoniae during invasive pneumococcal disease (IPD). However, E. faecalis does not encode the virulence determinants implicated in pneumococcal microlesion formation. Rather, disulfide bond forming protein DsbA was found to be required for E. faecalis virulence in a C. elegans model and was necessary for efficient cardiac microlesion formation. Furthermore, E. faecalis promoted cardiomyocyte apoptotic and necroptotic cell death at sites of microlesion formation. Additionally, loss of DsbA caused an increase in pro-inflammatory cytokines unlike the wild-type strain, which suppressed the immune response. In conclusion, we establish that E. faecalis is capable of forming cardiac microlesions and identify features of both the bacterium and the host response that are mechanistically involved.SUMMARYThis work presents the observation of cardiac microlesion formation during severe blood stream infection with Enterococcus faecalis in mice. Moreover, we identify the contribution of a novel enterococcal virulence determinant in modulating microlesion formation and the host immune response.

scholarly journals Cardiac Microlesions Form During Severe Bacteremic Enterococcus faecalis Infection

2020 ◽  
Author(s):  
Armand O Brown ◽  
Kavindra V Singh ◽  
Melissa R Cruz ◽  
Karan Gautam Kaval ◽  
Liezl E Francisco ◽  
...  
Keyword(s):  
Enterococcus Faecalis ◽  
Host Response ◽  
Type Strain ◽  
Pneumococcal Disease ◽  
Wild Type Strain ◽  
Protein A ◽  
Virulence Determinants ◽  
Wild Type ◽  
Bond Forming ◽  
Hospital Acquired

Abstract Enterococcus faecalis is a significant cause of hospital-acquired bacteremia. Herein, the discovery is reported that cardiac microlesions form during severe bacteremic E. faecalis infection in mice. The cardiac microlesions were identical in appearance to those formed by Streptococcus pneumoniae during invasive pneumococcal disease. However, E. faecalis does not encode the virulence determinants implicated in pneumococcal microlesion formation. Rather, disulfide bond forming protein A (DsbA) was found to be required for E. faecalis virulence in a Caenorhabditis elegans model and was necessary for efficient cardiac microlesion formation. Furthermore, E. faecalis promoted cardiomyocyte apoptotic and necroptotic cell death at sites of microlesion formation. Additionally, loss of DsbA caused an increase in proinflammatory cytokines, unlike the wild-type strain, which suppressed the immune response. In conclusion, we establish that E. faecalis is capable of forming cardiac microlesions and identify features of both the bacterium and the host response that are mechanistically involved.

scholarly journals 772. Effect of Selective Digestive Decontamination Using Oral Colistin on HAI Rates and All-Cause Mortality Among Cardiovascular Surgery Patients - A Single Centre Experience from India

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S483-S483
Author(s):  
Sneha R ◽  
Arun Wilson ◽  
Anup R Warrier ◽  
Shilpa Prakash ◽  
Reima Elizabeth ◽  
...  
Keyword(s):  
Blood Stream Infection ◽  
Tertiary Care ◽  
Blood Stream ◽  
Selective Digestive Decontamination ◽  
Care Hospital ◽  
Intervention Period ◽  
All Cause Mortality ◽  
Study Participants ◽  
Hospital Acquired ◽  
Interventional Group

Abstract Background Hospital acquired infections affect the morbidity and mortality of ICU patients considerably. Selective digestive decontamination (SDD) is defined as the prophylactic application of topical, non-absorbable antimicrobials in the oropharynx and stomach, with the goal of eradicating potentially pathogenic microorganisms but preserving the protective anaerobic microbiota. SDD has been applied in trials among critically ill patients and found to be effective in reducing HAI. Methods This cohort study was conducted in our cardiothoracic vascular surgery ICU of a tertiary care hospital, where patients were given oral colistin syrup (100mg 6th hourly for 5 days) in the immediate post op during the intervention period. We compared the clinical and microbiological outcomes of patients before (5 months, pre-intervention arm) and after (5 months, intervention arm) the implementation of SDD (Oral colistin syrup). Results A total of 78 patients were included in the interventional arm with a mean age of 58.7 years whereas the pre-interventional group consisted of 94 study participants with a median age of 57.5 years. 11 out of 94 had positive respiratory sample culture (11.7%) in the preintervention group which mandated antibiotic therapy for HAP compared to one culture positive in the interventional period (OR 0.0980, 95% CI: 0.0124 to 0.777 and P=0.0279). One patient had blood stream infection in the pre-intervention period compared to none in the intervention phase. All-cause mortality in the pre-interventional group was 7.44% (7 in 94) vs 1.28% (1 in 78) in the interventional group (OR 0.1614, 95% CI: 0.0194 to 1.3416, P= 0.0914). Adverse events (nausea, vomiting & loose stools) were observed in a total of 24 study patients, but necessitated withdrawal of regimen only in nine patients. Conclusion An SDD regimen of Colistin alone in Cardiac Surgery patients resulted in statistically significant reduction in incidence of Hospital Acquired Pneumonia, along with a reduction in all-cause mortality (though not statistically significant). Disclosures All Authors: No reported disclosures

scholarly journals Hospital-Acquired Blood Stream Infection in an Adult Intensive Care Unit

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Jeffrey Harte ◽  
Germander Soothill ◽  
John Glynn David Samuel ◽  
Laurence Sharifi ◽  
Mary White
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Blood Stream Infection ◽  
Case Series ◽  
Blood Stream ◽  
Apache Ii Score ◽  
Invasive Procedures ◽  
Adult Intensive Care Unit ◽  
Hospital Acquired

Background. Hospital-acquired blood stream infections are a common and serious complication in critically ill patients. Methods. A retrospective case series was undertaken investigating the incidence and causes of bacteraemia in an adult intensive care unit with a high proportion of postoperative cardiothoracic surgical and oncology patients. Results. 405 eligible patients were admitted to the intensive care unit over the course of nine months. 12 of these patients developed a unit-acquired blood stream infection. The average Acute Physiology And Chronic Health Evaluation II (APACHE II) score of patients who developed bacteraemia was greater than that of those who did not (19.8 versus 16.8, respectively). The risk of developing bacteraemia was associated with intubation and higher rates of invasive procedures. The mortality rate amongst the group of patients that developed bacteraemia was 33%; this is in contrast to the mortality rate in our unit as 27.2%. There was a higher proportion of Gram-negative bacteria isolated on blood cultures (9 out of 13 isolates) than in intensive care units reported in other studies. Conclusion. Critical-care patients are at risk of secondary bloodstream infection. This study highlights the importance of measures to reduce the risk of infection in the intensive-care setting, particularly in patients who have undergone invasive procedures.

Antibiotic Sensitivity /Resistance Pattern of Hospital Acquired Blood Stream Infection in Children Cancer Patients: A Retrospective Study

2021 ◽  
Author(s):  
Naema Salah Mohamed Elseady ◽  
Nagwa Abdel Ghani Ahmed Khamis ◽  
Sameh AbdelGhani ◽  
Hoda Mohamed Rabea ◽  
Mervat Gaber Elanany ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Cancer Patients ◽  
Blood Stream Infection ◽  
Antibiotic Sensitivity ◽  
Blood Stream ◽  
Resistance Pattern ◽  
Hospital Acquired

scholarly journals Genomic Characterization of MDR Escherichia coli Harboring blaOXA-48 on the IncL/M-type Plasmid Isolated from Blood Stream Infection

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
S. Alousi ◽  
T. Salloum ◽  
H. Arabaghian ◽  
G. M. Matar ◽  
G. F. Araj ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Blood Stream Infection ◽  
Genomic Analysis ◽  
Blood Stream ◽  
Population Movements ◽  
E Coli ◽  
Resistance Determinants ◽  
Genomic Characterization ◽  
Hospital Acquired

Escherichia coli is responsible for a wide variety of community and hospital acquired extraintestinal infections, and the emergence of ESBL resistant isolates is a major clinical concern. In this study, we characterized the genomic attributes of an OXA-48 and CTX-M-3 producing E. coli EC-IMP153. Whole-genome initial assembly produced 146 contigs with a combined 5,504,170 bp in size and a G+C content of 50.5%. wgSNPs-based phylogenetic comparison with 36 publically available genomes was also performed. Comprehensive genomic analysis showed that EC-IMP153 belonged to sequence type ST-405 and harbored several resistance determinants including the β-lactam resistance genes blaOXA-48, blaCTX-M-3, blaTEM-1B, blaOXA-1, and blaCMY-70, aminoglycoside fyuA and aac(3)IId, tetracycline tet(A) and tet(R), and fluoroquinolone gyrA, parC, and mfd resistance determinants. Plasmids with the following incompatibility groups were detected in silico and confirmed using PBRT: IncI1-α, IncL, IncW, Col (BS512), and IncF. To our knowledge this is the first in-depth genomic analysis of an OXA-48 producing E. coli ST-405 isolated from a patient in Lebanon and linked to a blood stream infection. Continuous monitoring is necessary to better understand the continued diffusion of such pathogens, especially in view of the population movements triggered by unrest in the Middle East.

scholarly journals CRISPR-cas system in the acquisition of virulence genes in dental-root canal and hospital-acquired isolates of Enterococcus faecalis

2019 ◽  
Author(s):  
Pourya Gholizadeh ◽  
Mohammad Aghazadeh ◽  
Reza Ghotaslou ◽  
Mohammad Ahangarzadeh Rezaee ◽  
Tahereh Pirzadeh ◽  
...  
Keyword(s):  
Enterococcus Faecalis ◽  
Root Canal ◽  
Biofilm Formation ◽  
Virulence Genes ◽  
Virulence Determinants ◽  
Root Canals ◽  
Causative Agents ◽  
Life Threatening ◽  
Selective Forces ◽  
Hospital Acquired

Abstract Introduction Enterococcus faecalis is one of the important causative agents of nosocomial and life-threatening infections in human. Several studies have demonstrated that the presence of CRISPR- cas is associated with antibiotic susceptibility and lack of virulence traits. In this study, we aimed to assess the phenotypic and genotypic virulence determinants in relation to CRISPR elements from the dental-root canals and hospital-acquired isolates of E. faecalis .Methods and materials Eighty-eight hospital-acquired and 73 dental-root canal isolates of E. faecalis were assessed in this study. Phenotypic screening of the isolates included biofilm formation, and gelatinase and hemolysis activities. Genotypical screening using PCR was further used to evaluate the presence of CRISPR elements and different virulence-associated genes such as efaA , esp , cylA , hyl , gelE , ace , ebpR , and asa1 .Results Biofilm formation, and gelatinase and hemolysis activity were detected in 93.8%, 29.2% and 19.2% of the isolates, respectively. The most prevalent virulence-associated gene was ace , which was followed by efaA , whereas cylA was the least identified. The presence of CRISPR1- cas , orphan CRISPR2 and CRISPR3- cas was determined in 13%, 55.3% and 17.4% of the isolates, respectively. CRISPR elements were significantly more prevalent in the dental-root canals isolates. An inverse significant correlation was found between CRISPR- cas loci, esp and gelE , while direct correlations were observed in the case of cylA , hyl , gelE (among CRISPR-loci 1 and 3), asa1 , ace , biofilm formation, and hemolysis activity.Conclusion Findings, therefore, indicate that CRISPR- cas might prevent the acquisition of some respective pathogenicity factors in some isolates, though not all; so selective forces could not influence pathogenic traits.

scholarly journals CRISPR-cas system in the acquisition of virulence genes in dental-root canal and hospital-acquired isolates of Enterococcus faecalis

2019 ◽  
Author(s):  
Pourya Gholizadeh ◽  
Mohammad Aghazadeh ◽  
Reza Ghotaslou ◽  
Mohammad Ahangarzadeh Rezaee ◽  
Tahereh Pirzadeh ◽  
...  
Keyword(s):  
Enterococcus Faecalis ◽  
Root Canal ◽  
Biofilm Formation ◽  
Virulence Genes ◽  
Virulence Determinants ◽  
Root Canals ◽  
Causative Agents ◽  
Life Threatening ◽  
Selective Forces ◽  
Hospital Acquired

Abstract Introduction Enterococcus faecalis is one of the important causative agents of nosocomial and life-threatening infections in human. Several studies have demonstrated that the presence of CRISPR- cas is associated with antibiotic susceptibility and lack of virulence traits. In this study, we aimed to assess the phenotypic and genotypic virulence determinants in relation to CRISPR elements from the dental-root canals and hospital-acquired isolates of E. faecalis .Methods and materials Eighty-eight hospital-acquired and 73 dental-root canal isolates of E. faecalis were assessed in this study. Phenotypic screening of the isolates included biofilm formation, and gelatinase and hemolysis activities. Genotypical screening using PCR was further used to evaluate the presence of CRISPR elements and different virulence-associated genes such as efaA , esp , cylA , hyl , gelE , ace , ebpR , and asa1 .Results Biofilm formation, and gelatinase and hemolysis activity were detected in 93.8%, 29.2% and 19.2% of the isolates, respectively. The most prevalent virulence-associated gene was ace , which was followed by efaA , whereas cylA was the least identified. The presence of CRISPR1- cas , orphan CRISPR2 and CRISPR3- cas was determined in 13%, 55.3% and 17.4% of the isolates, respectively. CRISPR elements were significantly more prevalent in the dental-root canals isolates. An inverse significant correlation was found between CRISPR- cas loci, esp and gelE , while direct correlations were observed in the case of cylA , hyl , gelE (among CRISPR-loci 1 and 3), asa1 , ace , biofilm formation, and hemolysis activity.Conclusion Findings, therefore, indicate that CRISPR- cas might prevent the acquisition of some respective pathogenicity factors in some isolates, though not all; so selective forces could not influence pathogenic traits.

scholarly journals CRISPR-cas system in the acquisition of virulence genes in the dental-root canal and hospital-acquired isolates of Enterococcus faecalis

2019 ◽  
Author(s):  
Pourya Gholizadeh ◽  
Mohammad Aghazadeh ◽  
Reza Ghotaslou ◽  
Mohammad Ahangarzadeh Rezaee ◽  
Tahereh Pirzadeh ◽  
...  
Keyword(s):  
Enterococcus Faecalis ◽  
Root Canal ◽  
Biofilm Formation ◽  
Inverse Correlation ◽  
Virulence Determinants ◽  
Gene Encoding ◽  
Virulence Traits ◽  
Causative Agents ◽  
Life Threatening ◽  
Hospital Acquired

Abstract Introduction: Enterococcus faecalis is one of the important causative agents of nosocomial and life-threatening infections in human. Several studies demonstrated that the presence of CRISPR-cas is associated with the antibiotic susceptibility and lack of virulence traits. In this study, we aimed to assess the relation between the phenotypic and genotypic virulence determinants of E. faecalis with the CRISPR elements in the dental-root canal and hospital-acquired isolates.Methods and materials: Eighty-eight hospital-acquired and 73 dental-root canal isolates of E. faecalis were subjected for study. The phenotype tests including biofilm formation, gelatinase and hemolysis activity were performed and the genotype characteristics including efaA, esp, cylA, hyl, gelE, ace, ebpR, and asa1 were performed by PCR methods. Presences of different types of CRISPR-cas system were determined by PCR.Results: Biofilm formation, gelatinase and hemolysis activity were detected in 93.8%, 29.2% and 19.2% of the isolates, respectively. The most gene encoding virulence traits were ace, followed by efaA and the lowest was cylA. The presence of CRISPR1-cas, orphan CRISPR2 and CRISPR3-cas were determined in 13%, 55.3%, and 17.4% of isolates, respectively, which were present in proportionally more in the dental-root canal. Inverse correlation were found significantly between CRISPR-cas loci, esp and gelE, and direct correlations were found in cylA, hyl, gelE (between some CRISPR-loci), asa1, ace, biofilm formation, gelatinase and hemolysis activitiesConclusion: Findings indicates that CRISPR-cas might prevent the acquisition of some respective pathogenicity factors in some isolates not all, and could not be selective forces to influence pathogenic traits.

scholarly journals Hospital Acquired Blood Stream Infection in an Adult Intensive Care Unit: a Retrospective Case Series

2020 ◽  
Author(s):  
Jeffrey Harte ◽  
Germander Soothill ◽  
Jack Samuel ◽  
Laurence Sharifi ◽  
Mary White
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Stream Infection ◽  
Case Series ◽  
Blood Stream ◽  
Apache Ii Score ◽  
Invasive Procedures ◽  
Retrospective Case ◽  
Retrospective Case Series ◽  
Hospital Acquired

Abstract Introduction: Hospital acquired blood stream infections are a common and serious complication in critically ill patients. Methods: A retrospective case series was undertaken investigating the incidence and causes of bacteraemia on an intensive care unit with a high proportion of postoperative cardiothoracic surgical and oncology patients. Results: 405 eligible patients were admitted to the intensive care unit over the course of nine months. 12 of these patients developed a unit acquired blood stream infection. The average Acute Physiology And Chronic Health Evaluation II (APACHE II) score of patients, who developed bacteraemia was greater than those who did not (19.8 versus 16.8 respectively). The risk of developing bacteraemia was associated with intubation and higher rates of invasive procedures. The mortality rate amongst the group of patients that developed bacteraemia was 33%. There was a higher proportion of Gram-negative bacteria isolated on blood cultures than in intensive care units reported in other studies.Conclusion: Critical care patients are at risk of secondary bloodstream infection. This study highlights the importance of measures to reduce the risk of infection in the intensive care setting particularly in patients who have undergone invasive procedures.

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