Occurrence of NDM-1, VIM-1, and OXA-10 Co-Producing Providencia rettgeri Clinical Isolate in China

Providencia rettgeri is a nosocomial pathogen associated with urinary tract infections related to hospital-acquired Infections. In recent years, P. rettgeri clinical strains producing New Delhi Metallo-β-lactamase (NDM) and other β-lactamase which reduce the efficiency of antimicrobial therapy have been reported. However, there are few reports of P. rettgeri co-producing two metallo-β-lactamases in one isolate. Here, we first reported a P. rettgeri strain (P138) co-harboring blaNDM-1, blaVIM-1, and blaOXA-10. The specie were identified using MALDI-TOF MS. The results of antimicrobial susceptibility testing by broth microdilution method indicated that P. rettgeri P138 was resistant to meropenem (MIC = 64μg/ml), imipenem (MIC = 64μg/ml), and aztreonam (MIC = 32μg/ml). Conjugation experiments revealed that the blaNDM-1-carrying plasmid was transferrable. The carbapenemase genes were detected using PCR and confirmed by PCR-based sequencing. The complete genomic sequence of the P. rettgeri was identified using Illumina (Illumina, San Diego, CA, USA) short-read sequencing (150bp paired-end reads), and many common resistance genes had been identified, including blaNDM-1, blaVIM-1, blaOXA-10, aac(6’)-Il, aadA5, ant(2’’)-Ia, aadA1, aac(6’)-Ib3, aadA1, aph(3’)-Ia, aac(6’)-Ib-cr, qnrD1, qnrA1, and catA2. The blaNDM-1 gene was characterized by the following structure: IS110–TnpA–IntI1–aadB–IS91–GroEL–GroES–DsbD–PAI–ble–blaNDM-1–IS91–QnrS1–IS110. Blast comparison revealed that the blaNDM-1 gene structure shared >99% similarity with plasmid p5_SCLZS62 (99% nucleotide identity and query coverage). In summary, we isolated a P. rettgeri strain coproducing blaNDM-1, blaVIM-1, and blaOXA-10. To the best of our acknowledge, this was first reported in the world. The occurrence of the strain needs to be closely monitored.

Perfil de sensibilidade a antibióticos de um isolado de Providencia rettgeri proveniente de equino

Introdução: a meningite bacteriana em equinos é uma enfermidade frequente em animais jovens. Streptococcus spp., Staphylococcus aureus e Escherichia coli são as bactérias mais comumente isoladas nesses casos. Apesar da bactéria Providencia rettgeri já ter sido isolada em casos de meningite humana e de crocodilo, não há relatos de seu isolamento em equinos. Objetivo: relatar o isolamento e a identificação da bactéria P. rettgeri de um potro com sintomas neurológicos e avaliar o perfil de sensibilidade a antibióticos deste isolado. Metodologia: o isolamento foi realizado a partir do líquido cefalorraquidiano do potro, por meio de cultivo em meio ágar chocolate. Após isolamento, as colônias formadas foram identificadas por equipamento Biotyper, baseado em espectrometria de massa. O perfil de sensibilidade foi definido por teste de difusão em discos, seguindo metodologia relatada pelo CLSI M2-A8 em 2003, sendo a bactéria classificada como resistente, padrão indeterminado ou sensível aos antibióticos, de acordo com o descrito pelo EUCAST em 2021. Resultados: este é o primeiro relato do isolamento de P. rettgeri como agente etiológico de meningite em potro. Dos 15 antibióticos testados, a bactéria foi resistente a 9, sensível a 5 e com padrão indeterminado a 1 antibiótico. Conclusão: nossos resultados indicam que P. rettgeri deve ser considerada entre possíveis agentes etiológicos de quadros neurológicos em equinos e que testes de sensibilidade a antibiótico são fundamentais, uma vez que essa bactéria já apresenta resistência a diversos antibióticos disponíveis comercialmente.

Diversity And Antibiograms of Secondary Bacterial Isolates From Cutaneous Leishmaniasis Wounds

Background: Leishmaniasis is a vector borne disease caused by an intracellular protozoan parasite. The presence of secondary bacterial infections in cutaneous leishmaniasis wounds exacerbate lesion development and could lead to delay in the healing process. Little is also known about the different bacteria species co-infecting leishmaniasis wounds and their sensitivity patterns in Ghana. This study sought to determine the resistance patterns of bacteria co-infecting cutaneous leishmaniasis wounds from selected communities in the Nkwanta district.Methods: Various bacteria were isolated and characterized from exudates obtained from wound swabs collected with sterile cotton tipped applicators. Confirmation of bacterial identity was done using the analytical profile index and the matrix-assisted laser desorption/ionization time of flight mass spectrometry. Antibiotic susceptibility tests were performed using agar disc diffusion method according to the Clinical and Laboratory Standards Institute breakpoint values.Results: A total of 42 secondary bacteria were isolated from the wounds among which S. aureus was the most predominant (31%). Other pathogenic bacteria that colonized the wounds included Bacillus subtilis (23.8%), Pantoea spp(11.9%), Klebsiella pneumoniea (7.1%), Enterobacter cloacae (7.1%), Aeromonas spp (4.8%), Serratia marcescens (4.8%),Serratia liquefacien (2.4%), Serratia plymutheca (2.4%), Providencia rettgeri (2.4%) and Cronobacter spp (2.4%). Majority of the isolates were obtained from Agoufie (21.4%), Baasare (19%), and Gekrong (16.7%). Most of the isolates were resistant to beta-lactam antibiotics and the third generation cephalosporin. Notably, 84.6% of the S. aureus isolates were methicillin and ciprofloxacin resistant whilst 92.3% were resistant to ampicllin. About sixty-nine percent (69.2%) showed intermediate susceptibility to Erythromycin. Additionally, S. plymutheca was resistant to all the test antibiotics. All the K. pneumoniae and E. cloacae isolates showed resistance to ampicillin, cefotaxime, ceftriaxone, ciprofloxacin, amikacin, aztreonam and meropenem but only 66.7% of these isolates were resistant to piperacillin. All isolates of Providencia rettgeri, Cronobacter spp, S. marcescen, S. liquefacien were resistant to all the beta-lactam antibiotics.Conclusion: This study suggests colonization of cutaneous leishmaniasis wounds with varied bacterial species that are mostly resistant to beta-lactam group of antibiotics.

Interaction Between Halotolerant Phosphate-Solubilizing Bacteria (Providencia rettgeri Strain TPM23) and Rock Phosphate Improves Soil Biochemical Properties and Peanut Growth in Saline Soil

Soil salinity has adverse effects on soil microbial activity and nutrient cycles and therefore limits crop growth and yield. Amendments with halotolerant phosphate-solubilizing bacteria (PSB) and rock phosphate (RP) may improve properties of saline soil. In this study, we investigated the effects of RP either alone or in combination with PSB (Providencia rettgeri strain TPM23) on peanut growth and soil quality in a saline soil. With the combined application of RP and PSB, plant length and biomass (roots and shoots) and uptake of phosphorus (P), nitrogen (N), and potassium (K) increased significantly. Soil Na+ and Cl– contents decreased in the PR alone or PR combined with PSB treatment groups. There were strongly synergistic effects of RP and PSB on soil quality, including a decrease in pH. The soil available N, P, and K contents were significantly affected by the PSB treatments. In addition, the alkaline phosphomonoesterases, urease, and dehydrogenase activities increased significantly compared with the untreated group; highest alkaline phosphomonoesterases activity was observed in the RP and PSB treatment groups. The composition of rhizosphere soil bacterial communities was determined using 454-pyrosequencing of the 16S rRNA gene. In the PR alone or PR combined with PSB treatment groups, the structure of the soil bacterial community improved with increasing richness and diversity. With PSB inoculation, the relative abundance of Acidobacteria, Chloroflexi, and Planctomycetes increased. The three phyla were also positively correlated with soil available N and root dry weight. These results suggested microbiological mechanisms by which the combined use of RP and PSB improved saline soil and promoted plant growth. Overall, the study indicates the combined use of RP and PSB can be an economical and sustainable strategy to increase plant growth in P-deficient and salt-affected soils.

Hydrocarbon Degrading Potentials and Antibiotic Susceptibility Test of Bacteria Isolated from Amended Soil in Ilorin

This study used bacteria from hydrocarbon-contaminated soil that had been treated. Organic amendments included cassava peels, plantain peels, eggshells, and poultry droppings, while inorganic amendments included NPK and Urea. In this study, three (3) bacteria were characterized and dealt with: Bacillus amyloliquefaciens, Bacillus proteolyticus, and Providencia rettgeri. To determine their biodegradative capabilities, these isolates were tested on a variety of hydrocarbons. In addition, the antibacterial activity of the bacteria was tested in vitro against extracts of Moringa oleifera, Vernonia amygdalina (Bitter leaf), Ocimum gratissimum (Scent lLeaf), and Telifairia occidentalis (Ugwu) at different concentrations (20%, 13%, 10%, 7%, and 3%). Using the maceration procedure, the plant materials were extracted with ethanol and methanol. The bacteria were resistant to the various concentrations of plant extracts, according to the results. The methanolic and ethanolic extracts of Vernonia amygdalina (bitter leaf) had the maximum inhibition zone, measuring 6.00 ± 0.00 mm. Furthermore, all isolates were resistant to crude oil, engine oil, heptane, and benzene in antimicrobial tests on hydrocarbons, with Bacillus amyloliquefaciens having the highest level of susceptibility (18 mm) to pyridine. However, the bacteria all demonstrated broad spectrum susceptibility to the commercial antibiotics used as a control, with the exception of Providencia rettgeri, which proved resistant (5 mm) to Ampiclox (APX), Zinnacef (Z) and Amoxacillin (AM).

Pan-drug resistant Providencia rettgeri contributing to a fatal case of COVID-19

Following prolonged hospitalization that included broad-spectrum antibiotic exposure, a strain of Providencia rettgeri was cultured from the blood of a patient undergoing extracorporeal membrane oxygenation treatment for hypoxic respiratory failure due to COVID-19. The strain was resistant to all antimicrobials tested including the novel siderophore cephalosporin, cefiderocol. Whole genome sequencing detected ten antimicrobial resistance genes, including the metallo-β-lactamase bla NDM-1, the extended-spectrum β-lactamase bla PER-1, and the rare 16S methyltransferase rmtB2.

Providencia rettgeri infection complicating cranial surgery: illustrative cases

BACKGROUND Providencia rettgeri is a rare cause of nosocomial infection in humans. These organisms are capable of biofilm production and are intrinsically resistant to commonly used antibiotics, leading to high rates of morbidity and mortality. P. rettgeri may very rarely cause postneurosurgical infection. OBSERVATIONS In this report, the authors describe two patients in whom P. rettgeri infection complicated the postoperative course. Both the patients underwent craniotomy at approximately the same time under similar environments. The organism isolated was resistant to most of the commonly used antibiotics, and therapy tailored to the results of susceptibility testing led to resolution of infection in both cases. LESSONS P. rettgeri is a rare cause of postneurosurgical nosocomial infection. Timely identification and early tailoring of antibiotic therapy based on susceptibility testing is the key to treatment. Every effort should be made to identify the source of infection and rectify it so that mortality, morbidity, and financial burden are reduced. Contact isolation and use of sterile gloves after each patient contact are effective in preventing its spread, as in most cases of nosocomial infection.

Ventilator-associated pneumonia due to carbapenem-resistant Providencia rettgeri

Ventilator-associated pneumonia (VAP) is one of the leading cause of mortality and morbidity in critically ill patients on mechanical ventilation. We report a case of VAP caused by Providencia rettgeri in a postoperative 58-year-old man with prepyloric perforation. The patient’s ICU stay was complicated by VAP. As the organism was carbapenem resistant, high-dose extended infusion of meropenem along with cefepime was started. Early identification and treatment helped in successful weaning of the patient from the ventilator. Providencia is an emerging nosocomial pathogen with an increase in resistance pattern. This case highlights the rarity and importance of Providencia as a cause of VAP.

Genomes of Gut Bacteria from Nasonia Wasps Shed Light on Phylosymbiosis and Microbe-Assisted Hybrid Breakdown

ABSTRACT Phylosymbiosis is a cross-system trend whereby microbial community relationships recapitulate the host phylogeny. In Nasonia parasitoid wasps, phylosymbiosis occurs throughout development, is distinguishable between sexes, and benefits host development and survival. Moreover, the microbiome shifts in hybrids as a rare Proteus bacterium in the microbiome becomes dominant. The larval hybrids then catastrophically succumb to bacterium-assisted lethality and reproductive isolation between the species. Two important questions for understanding phylosymbiosis and bacterium-assisted lethality in hybrids are (i) do the Nasonia bacterial genomes differ from other animal isolates and (ii) are the hybrid bacterial genomes the same as those in the parental species? Here, we report the cultivation, whole-genome sequencing, and comparative analyses of the most abundant gut bacteria in Nasonia larvae, Providencia rettgeri and Proteus mirabilis. Characterization of new isolates shows Proteus mirabilis forms a more robust biofilm than Providencia rettgeri and that, when grown in coculture, Proteus mirabilis significantly outcompetes Providencia rettgeri. Providencia rettgeri genomes from Nasonia are similar to each other and more divergent from pathogenic, human associates. Proteus mirabilis from Nasonia vitripennis, Nasonia giraulti, and their hybrid offspring are nearly identical and relatively distinct from human isolates. These results indicate that members of the larval gut microbiome within Nasonia are most similar to each other, and the strain of the dominant Proteus mirabilis in hybrids is resident in parental species. Holobiont interactions between shared, resident members of the wasp microbiome and the host underpin phylosymbiosis and hybrid breakdown. IMPORTANCE Animal and plant hosts often establish intimate relationships with their microbiomes. In varied environments, closely related host species share more similar microbiomes, a pattern termed phylosymbiosis. When phylosymbiosis is functionally significant and beneficial, microbial transplants between host species and host hybridization can have detrimental consequences on host biology. In the Nasonia parasitoid wasp genus, which contains a phylosymbiotic gut community, both effects occur and provide evidence for selective pressures on the holobiont. Here, we show that bacterial genomes in Nasonia differ from other environments and harbor genes with unique functions that may regulate phylosymbiotic relationships. Furthermore, the bacteria in hybrids are identical to those in parental species, thus supporting a hologenomic tenet that the same members of the microbiome and the host genome impact phylosymbiosis, hybrid breakdown, and speciation.

Fatores de risco e perfil do uso de antimicrobianos entre pacientes com infecção no trato urinário em uma unidade de terapia intensiva

A Infecção no Trato Urinário (ITU) acometendo pacientes em Unidades de Terapia Intensiva (UTIs) é uma realidade preocupante, agravada pelo uso irracional de antimicrobianos e a alarmante multirresistência em microrganismos. Nós avaliamos o nível de assertividade quanto ao uso de antimicrobianos durante à antibioticoterapia empírica (ATE), em pacientes diagnosticados com ITU, comparando tal tratamento farmacológico empírico e o realizado após o antibiograma (antibioticoterapia direcionada), além disto, estimamos a prevalência dos agentes etiológicos e analisamos os fatores de risco associados. Este é um estudo observacional e transversal, realizado em 2015, no qual foram avaliados pacientes de ambos os sexos e todas as idades apresentando ITU e submetidos à antibioticoterapia, internados em uma UTI de um hospital no sul de Minas Gerais, Brasil. Dos 49 pacientes avaliados (28 mulheres [M] e 21 homens [H]), a média de idade foi 55±19 anos (IC(95) 49-61) e a faixa etária ≥70 anos foi a predominante. Quatorze diferentes microrganismos foram causadores de ITUs, sendo que 28,3% (IC(95%) 16,2-40,4) dos isolados clínicos tiveram Escherichia coli como o agente etiológico (33,3% H e 28,6% M); 18,9% (IC(95%) 8,3-29,4) Acinetobacter baumannii (33,3% H e 10,7% M); 15,1% (IC(95%) 5,5-24,7) Klebsiella pneumoniae (19% H e 14,3% M); 11,3% Pseudomonas aeruginosa (9,5% H e 14,3% M); 5,7% Enterobacter aerogenes (14,3% H); 3,8% Klebsiella oxytoca; 3,8% Staphylococcus aureus (7,1% M); e 1,9% para cada um dos seguintes microrganismos: Enterococcus faecalis (4,8% H); Proteus mirabilis (3,6% M); Enterobacter cloacae (3,6% M); Providencia rettgeri (4,8% H); Citrobacter koseri (3,6% M); Citrobacter freundii (3,6% M); e Fungos leveduriformes (4,8% H). As prevalências de ITUs causadas por A. baumannii e P. aeruginosa foram influenciadas pelo sexo (χ² com p<0,001). No sexo masculino, houve correlações positivas “substanciais” entre o aumento da idade (em anos) e a prevalência de ITU causada por E. coli (r = 0,69) ou entre idades menos avançadas e a prevalência de ITU causada por A. baumannii (r = -0,7). No sexo feminino, houve uma correlação positiva “extremamente forte” entre o aumento da idade e a prevalência de ITU causada por E. coli (r = 0,94; IC(95) 0,66-0,99; p<0,0014). Os antibióticos mais utilizados de forma empírica (ATE) foram: Ciprofloxacina (14,3% IC(95%) 4,7-24,1), Cefepima (14,3%) e Vancomicina (10%), e após o antibiograma (antibioticoterapia direcionada): Ceftazidima (16,3% IC(95%) 6-26,7), Ciprofloxacina (14,3% IC(95%) 4,5-24,1), Polimixina B (10,2%), Imipenem (10,2%) e Ampicilina + Sulbac. (8,2%). Em 20% dos casos, as terapias empíricas (ATE) foram consideradas “inapropriadas/não acertadas”. Contudo, também devemos ter ciência da necessidade clínica e quanto ao imediatismo para o tratamento de uma ITU em UTI, uma vez que a doença pode ser fatal se uma terapia não for instituída, portanto, nós aconselhamos avaliações mais minuciosas, tanto da racionalidade do uso de antibióticos, quanto dos fatores de risco para o desenvolvimento de ITUs em UTIs.