Specific Bile Microorganisms Caused by Intra-Abdominal Abscess on Pancreaticoduodenectomy Patients: A Retrospective Cohort Study

We retrospectively collected PD patients with a performance of bile culture between 2007 and 2019 in our institute. As to bile culture, we used a swab to do intraoperative bile cultures after transection of the CBD. IAA was defined as the documental bacteriological culture from either a turbid discharge from the intraoperatively placed drain in patients with a clinical picture consistent with infection or a postoperative fluid collection managed by CT-guided placement of drains. A total of 1244 PD patients were identified, and 539 (43.3%) subjects with bile sampling were included for analysis. Among these study patients, 433 (80.3%) developed bile contamination (positive bile culture). Bile contamination showed a significantly higher rate of IAA compared to non-bile contamination (17.1% vs. 0.9%, p < 0.001). The rate of co-shared microorganisms in both bile and abscess was 64.1%. On the multivariate analysis, age and specific bile microorganisms (Enterococcus species, Escherichia Coli, Streptococcus species, Citrobacter species, and Candida) are significantly associated with development of IAA. Specific bile microorganisms are the highly significant factors associated with development of IAA. The strategy to prevent bile spillage during PD should be considered to minimize afterward contamination of the abdominal cavity and prevent IAA.

Prevalence and Antimicrobial Resistance of Enterococcus Species: A Retrospective Cohort Study in Italy

Antimicrobial resistance represents one of the main threats to healthy ecosystems. In recent years, among the multidrug-resistant microorganisms responsible for nosocomial infections, the Enterococcus species have received much attention. Indeed, Enterococcus have peculiar skills in their ability to acquire resistance genes and to cause severe diseases, such as endocarditis. This study showed the prevalence and antimicrobial resistance rate of Enterococcus spp. isolated from clinical samples, from January 2015 to December 2019 at the University Hospital “San Giovanni di Dio e Ruggi d’Aragona” in Salerno, Italy. A total of 3236 isolates of Enterococcus faecalis (82.2%) and Enterococcus faecium (17.8%) were collected from urine cultures, blood cultures, catheters, respiratory tract, and other samples. Bacterial identification and antibiotic susceptibility were performed with VITEK 2. E. faecium showed a high resistance rate against ampicillin (84.5%), ampicillin/sulbactam (82.7%), and imipenem (86.7%), while E. faecalis showed the highest resistance rate against gentamicin and streptomycin high level, but both were highly sensitive to such antibiotics as tigecycline and vancomycin. Studies of surveillance are an important tool to detect changes in the resistance profiles of the main pathogens. These antimicrobial susceptibility patterns are necessary to improve the empirical treatment guideline of infections.

The Kinocidin Interleukin-26 Shows Immediate Antimicrobial Effects Even to Multi-resistant Isolates

The cationic proinflammatory cytokine Interleukin 26 (IL-26) shows antibacterial activity and inhibits the replication of cytomegalovirus and hepatitis C virus. This study evaluates the early microbicidal activities of IL-26 against major bacterial species including multi-resistant variants and Candida albicans. Recombinant IL-26 was bacterially expressed and studied for its microbicidal effects in culture. We show that IL-26 has strong 90% bactericidal activities against Enterococcus faecalis, Enterococcus faecium, Staphylococcus aureus, and Acinetobacter baumannii. Similarly, IL-26 sensitivity was also detectable in vancomycin-resistant Enterococcus species, methicillin-resistant S. aureus, and carbapenem-resistant A. baumannii clinical isolates. Additionally, a significant, albeit weak fungicidal effect against Candida albicans was observed. Activities against Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa were not detectable. The proinflammatory cytokine and kinocidin IL-26 shows strong bactericidal activities against A. baumannii and, almost selectively, against Gram-positive bacteria.

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.

Comparison of Different Phenotypic Methods for Detection of Vancomycin Drug Resistance in Enterococcus Species

Introduction: Vancomycin resistant enterococci have emerged as an important cause of nosocomial infection worldwide. Vancomycin drug resistance needs to be detected accurately in all Enterococcus species in order to prevent its spread in health care setting. Present study was conducted to compare three different phenotypic methods for detection of vancomycin resistance in enterococci. Material and methods: Study was conducted in a tertiary care hospital over a period of one year. Enterococcus species isolated from clinical samples like urine, pus, blood and sterile body fluids were tested by three different methods namely disk diffusion, E-strip and Phoenix automated system for detection of vancomycin resistance. Results: 400 Enterococcus species were isolated from clinical samples. 19(4.8%) Enterococcus species were found to be vancomycin resistant and one (0.25%) strain was found to be intermediate resistant to vancomycin by all three methods resulting in 100% sensitivity and 100%specificity. Conclusion: Present study recommends vancomycin disk diffusion as screening and E-strip as good confirmatory tests in resource poor settings for detection of vancomycin drug resistance. Keywords: VRE, vancomycin, disk diffusion, E strip, Phoenix automated system..

Biofilm Producing Enterococcus Isolates from Vaginal Microbiota

Background: Enterococcus is an important cause of infection in the hospital as well as in the community. Methods: A prospective study was done in Medical College, Kolkata for a period of 2 years (from January 2018 to December 2019). After obtaining clearance from the Institutional Ethics Committee, Enterococcus isolates from cases of vaginitis were included in the study. Identification of Enterococcus species was done by Gram stain and conventional biochemical tests along with automated identification by VITEK 2 Compact. These isolates were tested for antimicrobial susceptibility to different antibiotics by Kirby Bauer disc diffusion method and minimum inhibitory concentration (MIC) by VITEK 2 Compact. Interpretation of susceptibility was done according to the Clinical and Laboratory Standards Institute (CLSI) 2017 guidelines. Biofilm detection for Enterococcus species was done. Results: During the period of 2 years, 39 isolates of Enterococcus spp. were obtained from vaginitis cases. Among these, 27 were Enterococcus faecalis and 12 Enterococcus faecium. All isolates were highly susceptible to vancomycin, teicoplanin, and linezolid. Biofilm was detected in eight isolates of which five were strong biofilm producer and three moderate biofilm producers. Conclusion: Biofilm production is an important virulence factor in Enterococcus isolates from vaginitis.