Xanthogranulomatous Pyelonephritis Caused by Stenotrophomonas maltophilia—The First Case Report and Brief Review

Xanthogranulomatous pyelonephritis (XGP) represents a rare and severe pathology secondary to chronic urinary obstruction and recurrent infections. Commonly, this condition leads to loss of kidney function, and frequently, surgical approach is the only optional treatment. Proteus mirabilis and Escherichia coli are the most frequent pathogens associated with XGP. The actual changes in the pathogen’s characteristics increased the risk of newly acquired infections once considered opportunistic. Stenotrophomonas malthophilia is one of those agents more related to immunocompromised patients, presenting an increased incidence and modified antibiotic resistance profile in the modern era. This case report presents a healthy female patient with an underlying renal stone pathology diagnosed with XGP related to S. maltophilia urinary infection. After a complete biological and imagistic evaluation, the case was treated as pyonephrosis. Empirical antibiotic administration and a surgical approach were considered. A total nephrectomy was performed, but the patient’s condition did not improve. The patient’s status improved when specific antibiotics were administered based on the bacterial identification and antibiotic susceptibility pattern of drained perinephric fluid. Levofloxacin and Vancomycin were considered the optimal combination in this case. The histopathological examination revealed XGP secondary to chronic renal stone. The present study describes the first case of XGP related to an aerobic Gram-negative pathogen such as S. maltophilia, once considered opportunistic, in an apparently healthy female adult.

Antibiotic resistance profiling of clinical isolates of Salmonella enterica Serovar Paratyphi A in Dhaka, Bangladesh

The study was conducted to detect the antibiotic resistance profile of the clinical isolates of Salmonella enterica Serovar Paratyphi A from 100 blood samples of patients from different age groups suspected to be suffering from enteric fever. The pure cultures of the bacterial isolates were collected from some renowned diagnostic centers of Dhaka and they were further characterized through the conventional culture, microscopy and biochemical examinations. These isolates were cross checked for the antibiogram profile by the Kirby-Bauer disc diffusion method against ten different types of antibiotics. Most of the isolates were found resistant against azithromycin (100%), nalidixic acid (100%) and ceftazidime (75%). However, isolates showed sensitivity to ciprofloxacin (95%), levofloxacin (97%), cotrimoxazole (96%) and chloramphenicol (95%). These findings highlight the need for continuous monitoring of the drug resistance pattern of S. enterica Serovar Paratyphi A for better public health management. Stamford Journal of Microbiology, Vol.11 (1) 2021: 14-16

Whole Genome Sequencing and Beta-Lactam Resistant Genes in Klebsiella pneumoniae Strains Clinically Isolated from CU Shah Hospital, Gujarat, India

A simple explanation for antimicrobial-resistant opportunistic infections in immunocompromised patients is Klebsiella pneumoniae which gradually being associated in insidious infections globally with high mortality rate. Eight hundred fifty-six antibiotic resistant K. pneumoniae isolates were collected over 3 years period (from different wards and different specimens) from the Microbiology department of C.U. Shah hospital, whose AST checked by Kirby Bauer disk diffusion method. To study AMR genes, virulome, interference of virulence gene with resistance gene, phylogenomic; 6 clinical isolates were proceeded for whole genome sequencing and bio informatics analysis. Klebsiella pneumoniae is a multidrug-resistant (MDR) opportunistic and one of delegate of ESKAPE pathogens groups. This pathogen causes nosocomial infections, urinary tract infections, liver abscesses, wound infections, meningitis. These strains obtain a multidrug resistant phenotype by way of horizontal transfer of ARG transported by either transposons or plasmids. This transfer is generally facilitated by Integrons. In this study antibiotic resistance profile and antibiotic resistance genes analysis as well as virulence gene of K. pneumoniae strains were investigated. The study was carried out using 853 clinical isolates collected during 3 years from C.U. Shah hospital of Surendranagar. Antibiotic resistance profile test was carried out by the VITEK 2 against 21 antibiotics. Out of that 6 samples were proceed for DNA extraction, WGS illumina sequencer and analysis of those raw sequences by TORMES pipeline. In this study antibiotic resistance profile included 13 beta lactam antibiotics which classified under 3 class (Penicillin, Cephalosporin, Carbapenem) of beta lactam and in AMR gene study got total 15 different ESBL resistance genes from 6 different klebsiella pneumoniae strain. All these genes detected with more than 90% identity by CARD. (TORMES Pipeline) CTX-M-15, NDM-5, OKP-B-6, PDC-2, OXA-1, OXA-181, OXA-362, OXA-50, OXA-9, SHV-1, SHV-11, SHV-187, TEM-1, TEM-150. In this study, we’ve analyzed the pattern of antibiotic resistance pattern as a phenotypic characteristic and antibiotic resistance genes as genotypic characteristic and co related the results. As multidrug resistance is a worrying matter, constant observation and regular clinical recognition of resistant bacteria are essential to avoid terrible public health incidents. So, our data should be inferred as a warning for need for prevention and control of the MDR K. pneumoniae in hospital settings.

Prevalence and antibiotic resistance profile of Staphylococcus aureus and Eschericia coli among patients attending urology clinic of Dalhatu Araf specialist hospital (DASH) Lafia, Nasarawa State, Nigeria

No abstract.

The Prevalence of blaNDM-1 in Clinical Isolates of Carbapenem-resistant Pseudomonas Aeruginosa: A Systematic Review

Background: Pseudomonas aeruginosa (P. aeruginosa) is a gram negative bacteria that is known to cause nosocomial infections. Carbapenem is used to treat the damage caused by P. aeruginosa, however it is becoming resistant to carbapenems because of the production of β-lactamases. The objectives of the study were to systematically review the prevalence of blaNDM-1 in carbapenem-resistant Pseudomonas aeruginosa (CRPA) and to review and analyze the clinical sources as well as the antibiotic resistance profile of CRPA carrying blaNDM-1. Methods: The researchers systematically searched PubMed, ScienceDirect, and Google Scholar. Studies that met the inclusion criteria were included in the review. In assessing the methodological quality of the included studies, the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data and the JBI Critical Appraisal Checklist for Case Reports were used. Results: A total of nine studies were included in which eight were cross-sectional studies and one was a case report. The highest prevalence rate reported was 54.55% in blaNDM-1 positive CRPA isolates among the cross-sectional studies. The three most frequent sources of clinical isolates of CRPA carrying blaNDM-1 include urine, wound discharge, and tissue, among the included studies. Lastly, this review showed that among the included studies, CRPA isolates carrying blaNDM-1 were most resistant to ceftazidime and gentamicin. Conclusions: There is varying prevalence of blaNDM-1 in CRPA in different countries. Urine, wound discharge, and tissue specimens being the most frequent sources of CRPA isolates carrying blaNDM-1 poses a challenge that must be given attention by the infection control committee, thus the need for proper handling and processing of clinical specimens. Resistance to ceftazidime and gentamicin among the CRPA isolates carrying blaNDM-1highlights the growing challenge of successfully treating infections caused by this bacteria. This challenge reminds us of the importance and purpose of antibiotic stewardship that emphasizes the improvement of proper antibiotic prescription by the physicians and proper antibiotic use by the patients that can help in preventing harm and antibiotic resistance. Doi: 10.28991/SciMedJ-2021-0304-9 Full Text: PDF

Prevalence and Characterization of Antibiotic-Resistant Staphylococcus aureus Recovered from Pasteurized Cheese Commercialized in Panama City Markets

Foodborne bacteria, with a high degree of antibiotic resistance, play an important role in the morbidity and mortality of gastrointestinal diseases worldwide. Among 250 disease-causing bacteria, Staphylococcus aureus is one of the major causes of food poisoning, and its resistance to multiple antimicrobials remains of crucial concern. Cheese is often contaminated when proper sanitary procedures are not followed during its production and marketing. This work aimed to evaluate the microbiological quality of pasteurized white cheese commercialized in Panama City. Cheese from five different brands sold in local supermarkets were selected to determine the presence of S. aureus as well as its antibiotic resistance profile. The results showed significant contamination of S. aureus with a geometric median sample of 104–107 CFU/g. Four out of five (4/5) cheese brands analyzed presented risk of food poisoning by exceeding the allowed range of consumption with a geometric median sample of 1,8 × 106–1,4 × 107 CFU/g. Fourteen different resistance phenotypes were found. Fifty-five percent (55%) of the analyzed strains were resistant to erythromycin. The data confirm a relatively high prevalence and high levels of S. aureus, most likely originated during handling in Panama City retail markets. Further studies are needed to reduce bacterial contamination and to decrease the risk of food poisoning in the consumption of pasteurized cheese.

Frequency of bacterial isolates and antibiotics resistance patterns in urine and pus samples.

Objectives: The present study is aimed to determine frequency of bacteria in urine and pus sample along with the antibiotic resistance profile of isolated bacteria. Study Design: Cross-Sectional Study. Setting: Real-Time PCR Laboratory at Dabgari Garden, Peshawar with the Collaboration of Health Biotechnology Laboratory, Department of Biotechnology, Abdul Wali Khan University, Mardan. Period: June 2018 to July 2019. Material & Methods: The urine and pus samples were collected from suspected patients and were cultured on appropriate culture media. The biochemical tests were also performed after growing on culture plates for identification and confirmation of bacterial isolates. The disc diffusion technique was used to evaluate the antibiotic pattern of retrieved isolates. Result: A total of 525 samples of pus and urine samples were collected from different regions of Peshawar. Out of the total, 237 (45.1%) samples were found positive for bacterial growth whereas the remaining (54.9%) were observed negative. Among total positive isolates, 220 (92.8%) were from urine samples, and 17 (7.2%) were from pus samples. The predominant isolate was Escherichia coli (E. coli) (90.3%) retrieved from positive samples, followed by Pseudomonas aeruginosa (7.2%), Klebsiella pneumonia (1.3%), and Staphylococcus aureus (1.3%). The most effective antibiotic was Fosfomycin against bacteria whereas Nalidixic acid, Nitrofurantoin, and Amoxicillin/clavulanic acid were found less effective against bacterial isolates. Conclusion: Most frequent bacteria isolated was E. coli and the most efficient drug was Fosmomycin and the least was Nitrofurantoin, and Amoxicillin.

Occurrence of Hybrid Diarrhoeagenic Escherichia coli Associated with Multidrug Resistance in Environmental Water, Johannesburg, South Africa

This study was undertaken to determine the virulence and antibiotic resistance profiles of diarrhoeagenic Escherichia coli (DEC) in environmental waters of Johannesburg, South Africa. Samples were collected and cultured on selective media. An 11-plex PCR assay was used to differentiate five DEC, namely: enteroaggregative (EAEC), enterohaemorrhagic (EHEC), enteroinvasive (EIEC), enteropathogenic (EPEC) and enterotoxigenic (ETEC). The antibiotic resistance profile of isolates was determined using the VITEK®-2 automated system. The virulence profiles of 170 E. coli tested showed that 40% (68/170) were commensals and 60% (102/170) were pathogenic. EPEC had a prevalence of 19.2% (32/170), followed by ETEC 11.4% (19/170), EAEC 6% (10/170) and EHEC 3% (5/170). Hybrid DEC carrying a combination of simultaneously two and three pathogenic types was detected in twenty-eight and nine isolates, respectively. The antibiotic susceptibility testing showed isolates with multidrug resistance, including cefuroxime (100%), ceftazidime (86%), cefotaxime (81%) and cefepime (79%). This study highlighted the widespread occurrence of DEC and antibiotic resistance strains in the aquatic ecosystem of Johannesburg. The presence of hybrid pathotypes detected in this study is alarming and might lead to more severe diseases. There is a necessity to enhance surveillance in reducing the propagation of pathogenic and antibiotic-resistant strains in this area.