scholarly journals Finegoldia magna Isolated from Orthopedic Joint Implant-Associated Infections

2017 ◽  
Vol 55 (11) ◽  
pp. 3283-3291 ◽  
Author(s):  
Bo Söderquist ◽  
Sanna Björklund ◽  
Bengt Hellmark ◽  
Anders Jensen ◽  
Holger Brüggemann
Keyword(s):  
Surgical Treatment ◽  
Core Genome ◽  
Phylogenomic Analysis ◽  
Orthopedic Implant ◽  
Nucleotide Polymorphisms ◽  
Gram Positive ◽  
Content Type ◽  
Flight Mass Spectrometry ◽  
Joint Implant

ABSTRACTThe anaerobic Gram-positive coccusFinegoldia magnais a rare cause of infections of bone and joints. The aim of this study was to describe the microbiological and clinical characteristics of orthopedic implant-associated infections caused byF. magna. We retrospectively analyzed samples consisting of anaerobic Gram-positive cocci and samples already identified asF. magnafrom patients with orthopedic infections. The isolates found were determined to the species level using matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS). The antibiotic susceptibility pattern was determined by Etest. Whole-genome sequencing (WGS) was performed. Clinical data were extracted from each patient's journal. In nine patients, orthopedic joint implant-associated infections were identified as being caused byF. magna. The isolates were susceptible to most of the antibiotics tested, with the exception of rifampin and moxifloxacin in a few cases. Five of the nine infections were monomicrobial. The most common antibiotic used to treat the infection was penicillin V, but five of the nine patients received a combination of antibiotics. Eight patients underwent surgical treatment, with extraction of the implant performed in seven cases and reimplantation in only two cases. The WGS showed a relatively small core genome, with 126,647 single nucleotide polymorphisms identified within the core genome. A phylogenomic analysis revealed that the isolates clustered into two distinct clades. Orthopedic implant-associated infections caused byF. magnaare rare, but the bacteria are generally susceptible to antibiotics. Despite this, surgical treatment combined with long-term antibiotics is often necessary. The WGS analysis revealed a high heterogeneity and suggested the existence of at least two differentFinegoldiaspecies.

scholarly journals First Report of Human Infection by Agromyces mediolanus, a Gram-Positive Organism Found in Soil

2015 ◽  
Vol 53 (10) ◽  
pp. 3377-3379 ◽  
Author(s):  
Siddharth Sridhar ◽  
Angela Y. M. Wang ◽  
Jasper F. W. Chan ◽  
Cyril C. Y. Yip ◽  
Susanna K. P. Lau ◽  
...  
Keyword(s):  
Venous Catheter ◽  
Rapid Identification ◽  
Human Infection ◽  
Gram Positive ◽  
Ionization Time ◽  
Content Type ◽  
Gram Positive Bacteria ◽  
Flight Mass Spectrometry ◽  
Susceptible Isolate

We report the first human infection by a member of theAgromycesgenus, a group of Gram-positive bacteria found in soil. A patient with a long-term venous catheter developed bacteremia due to a non-vancomycin-susceptible isolate ofAgromycesmediolanus. Rapid identification was possible by matrix-assisted laser desorption ionization–time of flight mass spectrometry.

scholarly journals Emergence of Mobile Colistin Resistance (mcr-8) in a Highly Successful Klebsiella pneumoniae Sequence Type 15 Clone from Clinical Infections in Bangladesh

mSphere ◽  
2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Refath Farzana ◽  
Lim S. Jones ◽  
Andrew Barratt ◽  
Muhammad Anisur Rahman ◽  
Kirsty Sands ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
South Asia ◽  
Core Genome ◽  
Treatment Options ◽  
Conjugative Plasmid ◽  
Poultry Feed ◽  
Feed Additive ◽  
Nucleotide Polymorphisms ◽  
Colistin Resistance ◽  
Content Type

ABSTRACT The emergence of mobilized colistin resistance genes (mcr) has become a serious concern in clinical practice, compromising treatment options for life-threatening infections. In this study, colistin-resistant Klebsiella pneumoniae harboring mcr-8.1 was recovered from infected patients in the largest public hospital of Bangladesh, with a prevalence of 0.3% (3/1,097). We found mcr-8.1 in an identical highly stable multidrug-resistant IncFIB(pQil) plasmid of ∼113 kb, which belonged to an epidemiologically successful K. pneumoniae clone, ST15. The resistance mechanism was proven to be horizontally transferable, which incurred a fitness cost to the host. The core genome phylogeny suggested the clonal spread of mcr-8.1 in a Bangladeshi hospital. Core genome single-nucleotide polymorphisms among the mcr-8.1-positive K. pneumoniae isolates ranged from 23 to 110. It has been hypothesized that mcr-8.1 was inserted into IncFIB(pQil) with preexisting resistance loci, blaTEM-1b and blaCTX-M-15, by IS903B. Coincidentally, all resistance determinants in the plasmid [mcr-8.1, ampC, sul2, 1d-APH(6), APH(3′′)-Ib, blaTEM-1b, blaCTX-M-15] were bracketed by IS903B, demonstrating the possibility of intra- and interspecies and intra- and intergenus transposition of entire resistance loci. This is the first report of an mcr-like mechanism from human infections in Bangladesh. However, given the acquisition of mcr-8.1 by a sable conjugative plasmid in a successful high-risk clone of K. pneumoniae ST15, there is a serious risk of dissemination of mcr-8.1 in Bangladesh from 2017 onwards. IMPORTANCE There is a marked paucity in our understanding of the epidemiology of colistin-resistant bacterial pathogens in South Asia. A report by Davies and Walsh (Lancet Infect Dis 18:256–257, https://doi.org/10.1016/S1473-3099(18)30072-0, 2018) suggests the export of colistin from China to India, Vietnam, and South Korea in 2016 was approximately 1,000 tons and mainly used as a poultry feed additive. A few reports forecast that the prevalence of mcr in humans and livestock will increase in South Asia. Given the high prevalence of blaCTX-M-15 and blaNDM in India, Bangladesh, and Pakistan, colistin has become the invariable option for the management of serious infections, leading to the emergence of mcr-like mechanisms in South Asia. Systematic scrutiny of the prevalence and transmission of mcr variants in South Asia is vital to understanding the drivers of mcr genes and to initiate interventions to overcome colistin resistance.

Intracranial aneurysm in infancy

1977 ◽  
Vol 46 (6) ◽  
pp. 832-834 ◽  
Author(s):  
Robert J. Morelli ◽  
Frederick Laubscher
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Surgical Treatment ◽  
Intracranial Aneurysm ◽  
Anterior Cerebral Artery ◽  
Content Type ◽  
Long Term Follow Up ◽  
Surgical Cure ◽  
Fine Print

✓ Angiography demonstrated an aneurysm of the left anterior cerebral artery in a 4-month-old baby who was admitted for subarachnoid hemorrhage. A surgical cure with long-term follow-up course was achieved. Clinical and pathogenetic aspects are presented. The rarity of such lesions in childhood and their successful surgical treatment are discussed briefly.

scholarly journals Evaluation of whole-genome sequencing-based subtyping methods for the surveillance of Shigella spp. and the confounding effect of mobile genetic elements in long-term outbreaks

2021 ◽  
Vol 7 (11) ◽  
Author(s):  
Isabelle Bernaquez ◽  
Christiane Gaudreau ◽  
Pierre A. Pilon ◽  
Sadjia Bekal
Keyword(s):  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Type Species ◽  
Core Genome ◽  
Outbreak Detection ◽  
Whole Genome ◽  
Content Type ◽  
Link Type ◽  
Interpretation Criteria

Many public health laboratories across the world have implemented whole-genome sequencing (WGS) for the surveillance and outbreak detection of foodborne pathogens. PulseNet-affiliated laboratories have determined that most single-strain foodborne outbreaks are contained within 0–10 multi-locus sequence typing (MLST)-based allele differences and/or core genome single-nucleotide variants (SNVs). In addition to being a food- and travel-associated outbreak pathogen, most Shigella spp. cases occur through continuous person-to-person transmission, predominantly involving men who have sex with men (MSM), leading to long-term and recurrent outbreaks. Continuous transmission patterns coupled to genetic evolution under antibiotic treatment pressure require an assessment of existing WGS-based subtyping methods and interpretation criteria for cluster inclusion/exclusion. An evaluation of 4 WGS-based subtyping methods [SNVPhyl, coreMLST, core genome MLST (cgMLST) and whole-genome MLST (wgMLST)] was performed on 9 foodborne-, travel- and MSM-related retrospective outbreaks from a collection of 91 Shigella flexneri and 232  Shigella sonnei isolates to determine the methods’ epidemiological concordance, discriminatory power, robustness and ability to generate stable interpretation criteria. The discriminatory powers were ranked as follows: coreMLST<SNVPhyl<cgMLST<wgMLST (range: 0.970–1.000). The genetic differences observed for non-MSM-related Shigella spp. outbreaks respect the standard 0–10 allele/SNV guideline; however, mobile genetic element (MGE)-encoded loci caused inflated genetic variation and discrepant phylogenies for prolonged MSM-related S. sonnei outbreaks via wgMLST. The S. sonnei correlation coefficients of wgMLST were also the lowest at 0.680, 0.703 and 0.712 for SNVPhyl, coreMLST and cgMLST, respectively. Plasmid maintenance, mobilization and conjugation-associated genes were found to be the main source of genetic distance inflation in addition to prophage-related genes. Duplicated alleles arising from the repeated nature of IS elements were also responsible for many false cg/wgMLST differences. The coreMLST approach was shown to be the most robust, followed by SNVPhyl and wgMLST for inter-laboratory comparability. Our results highlight the need for validating species-specific subtyping methods based on microbial genome plasticity and outbreak dynamics in addition to the importance of filtering confounding MGEs for cluster detection.

scholarly journals Hash-Based Core Genome Multilocus Sequence Typing for Clostridium difficile

2019 ◽  
Vol 58 (1) ◽  
Author(s):  
David W. Eyre ◽  
Tim E. A. Peto ◽  
Derrick W. Crook ◽  
A. Sarah Walker ◽  
Mark H. Wilcox
Keyword(s):  
Clostridium Difficile ◽  
Multilocus Sequence Typing ◽  
Core Genome ◽  
Genetic Relationships ◽  
Nucleotide Polymorphisms ◽  
Content Type ◽  
Recent Transmission ◽  
A Genome ◽  
Performance Penalty

ABSTRACT Pathogen whole-genome sequencing has huge potential as a tool to better understand infection transmission. However, rapidly identifying closely related genomes among a background of thousands of other genomes is challenging. Here, we describe a refinement to core genome multilocus sequence typing (cgMLST) in which alleles at each gene are reproducibly converted to a unique hash, or short string of letters (hash-cgMLST). This avoids the resource-intensive need for a single centralized database of sequentially numbered alleles. We test the reproducibility and discriminatory power of cgMLST/hash-cgMLST compared to those of mapping-based approaches in Clostridium difficile, using repeated sequencing of the same isolates (replicates) and data from consecutive infection isolates from six English hospitals. Hash-cgMLST provided the same results as standard cgMLST, with minimal performance penalty. Comparing 272 replicate sequence pairs using reference-based mapping, there were 0, 1, or 2 single-nucleotide polymorphisms (SNPs) between 262 (96%), 5 (2%), and 1 (<1%) of the pairs, respectively. Using hash-cgMLST, 218 (80%) of replicate pairs assembled with SPAdes had zero gene differences, and 31 (11%), 5 (2%), and 18 (7%) pairs had 1, 2, and >2 differences, respectively. False gene differences were clustered in specific genes and associated with fragmented assemblies, but were reduced using the SKESA assembler. Considering 412 pairs of infections with ≤2 SNPS, i.e., consistent with recent transmission, 376 (91%) had ≤2 gene differences and 16 (4%) had ≥4. Comparing a genome to 100,000 others took <1 min using hash-cgMLST. Hash-cgMLST is an effective surveillance tool for rapidly identifying clusters of related genomes. However, cgMLST/hash-cgMLST generate more false variants than mapping-based approaches. Follow-up mapping-based analyses are likely required to precisely define close genetic relationships.

Long-term results of the surgical treatment of 129 intramedullary spinal gliomas

1981 ◽  
Vol 54 (3) ◽  
pp. 323-330 ◽  
Author(s):  
Beniamino Guidetti ◽  
Sandro Mercuri ◽  
Roberto Vagnozzi
Keyword(s):  
Surgical Treatment ◽  
Late Results ◽  
Long Term Results ◽  
Postoperative Results ◽  
Content Type ◽  
Fine Print ◽  
Spinal Gliomas

✓ The authors report the late results of surgical treatment of 129 intramedullary gliomas (48 ependymomas, 53 astrocytomas, 13 spongioblastomas, five glioblastomas, one oligodendroglioma, and nine others), with follow-up periods ranging from 1 to 27 years. The value of surgical treatment is considered in relation to the postoperative results.

Vertebral hydatid disease

1976 ◽  
Vol 44 (1) ◽  
pp. 72-76 ◽  
Author(s):  
Werner L. Apt ◽  
Juan L. Fierro ◽  
Ciro Calderón ◽  
Carlos Pérez ◽  
Patricio Mujica
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Postoperative Period ◽  
Long Term Results ◽  
Common Procedure ◽  
Laboratory Findings ◽  
Content Type ◽  
Surgical Interventions ◽  
Fine Print

✓ The authors present 27 cases of vertebral hydatidosis with clinical and laboratory findings. The most frequent location of the lesion was the lumbar spine. Principal neurological symptoms were paraparesis, sphincter disturbances, paresthesia and paraplegia. The average number of surgical interventions per patient was 2.6; the most common procedure was laminectomy with extirpation of the cyst and surgical toilet. The results of surgical treatment were generally good in the immediate postoperative period, but long-term results were poor.

scholarly journals Next-Generation-Sequencing-Based Hospital Outbreak Investigation Yields Insight intoKlebsiella aerogenesPopulation Structure and Determinants of Carbapenem Resistance and Pathogenicity

2019 ◽  
Vol 63 (6) ◽  
Author(s):  
Adel Malek ◽  
Kelly McGlynn ◽  
Samantha Taffner ◽  
Lynn Fine ◽  
Brenda Tesini ◽  
...  
Keyword(s):  
Intensive Care ◽  
Carbapenem Resistance ◽  
Phylogenomic Analysis ◽  
Nucleotide Polymorphisms ◽  
Content Type ◽  
Hospital Outbreak ◽  
Carbapenem Resistant ◽  
Emerging Trends ◽  
Scaling Analyses ◽  
Human Infections

ABSTRACTKlebsiella aerogenesis a nosocomial pathogen associated with drug resistance and outbreaks in intensive care units. In a 5-month period in 2017, we experienced an increased incidence of cultures for carbapenem-resistantK. aerogenes(CR-KA) from an adult cardiothoracic intensive care unit (CICU) involving 15 patients. Phylogenomic analysis following whole-genome sequencing (WGS) identified the outbreak CR-KA isolates to group together as a tight monoclonal cluster (with no more than six single nucleotide polymorphisms [SNPs]), suggestive of a protracted intraward transmission event. No clonal relationships were identified between the CICU CR-KA strains and additional hospital CR-KA patient isolates from different wards and/or previous years. Carbapenemase-encoding genes and drug-resistant plasmids were absent in the outbreak strains, and carbapenem resistance was attributed to mutations impacting AmpD activity and membrane permeability. The CICU outbreak strains harbored an integrative conjugative element (ICE) which has been associated with pathogenicKlebsiella pneumoniaelineages (ICEKp10). Comparative genomics with globalK. aerogenesgenomes showed our outbreak strains to group closely with global sequence type 4 (ST4) strains, which, along with ST93, likely represent dominantK. aerogeneslineages associated with human infections. For poorly characterized pathogens, scaling analyses to include sequenced genomes from public databases offer the opportunity to identify emerging trends and dominant clones associated with specific attributes, syndromes, and geographical locations.

scholarly journals Modulators of Enterococcus faecalis Cell Envelope Integrity and Antimicrobial Resistance Influence Stable Colonization of the Mammalian Gastrointestinal Tract

2017 ◽  
Vol 86 (1) ◽  
Author(s):  
Ismael L. Banla ◽  
Sushma Kommineni ◽  
Michael Hayward ◽  
Marinelle Rodrigues ◽  
Kelli L. Palmer ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Antimicrobial Resistance ◽  
Enterococcus Faecalis ◽  
Core Genome ◽  
Cell Envelope ◽  
Signaling Proteins ◽  
Content Type ◽  
Conserved Genes ◽  
High Concentrations

ABSTRACT The Gram-positive bacterium Enterococcus faecalis is both a colonizer of the gastrointestinal tract (GIT) and an agent of serious nosocomial infections. Although it is typically required for pathogenesis, GIT colonization by E. faecalis is poorly understood. E. faecalis tolerates high concentrations of GIT antimicrobials, like cholate and lysozyme, leading us to hypothesize that resistance to intestinal antimicrobials is essential for long-term GIT colonization. Analyses of E. faecalis mutants exhibiting defects in antimicrobial resistance revealed that IreK, a determinant of envelope integrity and antimicrobial resistance, is required for long-term GIT colonization. IreK is a member of the PASTA kinase protein family, bacterial transmembrane signaling proteins implicated in the regulation of cell wall homeostasis. Among several determinants of cholate and lysozyme resistance in E. faecalis, IreK was the only one found to be required for intestinal colonization, emphasizing the importance of this protein to enterococcal adaptation to the GIT. By studying ΔireK suppressor mutants that recovered the ability to colonize the GIT, we identified two conserved enterococcal proteins (OG1RF_11271 and OG1RF_11272) that function antagonistically to IreK and interfere with cell envelope integrity, antimicrobial resistance, and GIT colonization. Our data suggest that IreK, through its kinase activity, inhibits the actions of these proteins. IreK, OG1RF_11271, and OG1RF_11272 are found in all enterococci, suggesting that their effect on GIT colonization is universal across enterococci. Thus, we have defined conserved genes in the enterococcal core genome that influence GIT colonization through their effect on enterococcal envelope integrity and antimicrobial resistance.

scholarly journals Lack of Association of the S769N Mutation in Plasmodium falciparum SERCA (PfATP6) with Resistance to Artemisinins

2012 ◽  
Vol 56 (5) ◽  
pp. 2546-2552 ◽  
Author(s):  
Long Cui ◽  
Zenglei Wang ◽  
Hongying Jiang ◽  
Daniel Parker ◽  
Haiyan Wang ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
French Guiana ◽  
Parasite Clearance ◽  
Nucleotide Polymorphisms ◽  
Single Nucleotide ◽  
Content Type ◽  
Recent Emergence ◽  
Transgenic Lines ◽  
Parasite Populations

ABSTRACTThe recent emergence of artemisinin (ART) resistance inPlasmodium falciparumin western Cambodia, manifested as delayed parasite clearance, is a big threat to the long-term efficacy of this family of antimalarial drugs. Among the multiple candidate genes associated with ART resistance inP. falciparum, the sarcoplasmic/endoplasmic reticulum Ca2+-ATPase PfATP6 has been postulated as a specific target of ARTs. ThePfATP6gene harbors multiple single-nucleotide polymorphisms in field parasite populations, and S769N has been associated with decreased sensitivity to artemether in parasite populations from French Guiana. In this study, we used an allelic exchange strategy to engineer parasite lines carrying the S769N mutations inP. falciparumstrain 3D7 and evaluated whether introduction of this mutation modulated parasite sensitivity to ART derivatives. Using three transgenic lines carrying the 769N mutation and two transgenic lines carrying the wild-type 769S as controls, we found that S769N did not affectPfATP6gene expression. We compared the sensitivities of these parasite lines to three ART derivatives, artemether, artesunate, and dihydroartemisinin, in 18 biological experiments and detected no significant effect of the S769N mutation on parasite response to these ART derivatives. This study provides further evidence for the lack of association of PfATP6 with ART resistance.

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