Arcobacter butzleri is an opportunistic pathogen: recurrent bacteraemia in an immunocompromised patient without diarrhoea

Prolonged watery diarrhea and malnutrition caused by Aliarcobacter butzleri (formerly Arcobacter butzleri): the first pediatric case in Croatia and a literature review

Aliarcobacter butzleri (formerly Arcobacter butzleri), is a newly recognized Campylobacter-like emerging foodborne pathogen worldwide, usually causing gastrointestinal symptoms in young children. A 4-year-old boy was admitted to the Department of Pediatrics, University Hospital of Split, Croatia, because of malnutrition, lost appetite and prolonged watery diarrhea. A comprehensive diagnostics, including biochemistry, haematology, allergology, microbiology and radiology, were performed. The only positive microbiology result was unexpected isolation of Aliarcobacter butzleri on selective media for Campylobacter, after 48 hours of incubation on 42°C, among microaerophilic atmosphere. Clinical course was favorable and after symptomatic therapy child was discharged in good clinical condition and normal peristalsis to home care, with the recommendation of taking high-protein preparations to improve nutritional status. In addition, we performed a literature review of clinical cases caused by Aliarcobacter butzleri infection. The first report of Aliarcobacter butzleri isolated from stool sample in a 4-year old boy in Croatia, along with other clinical reports in literature, highlights the importance of standardisation and improvement of microbiological analysis, especially implementation of new methods for the identification of emerging pathogens.

Foodborne and waterborne Arcobacter species exhibit a high virulent activity in Caco-2

Infection mechanisms of Arcobacter remain uncertain. This study aimed to determine whether 65 food and waterborne isolates of at least six species were able to adhere and invade Caco-2 cells; and whether this ability could be related to cadF, cj1349, ciaB, and/or hecA, specific genetic markers related to host cell adhesion and invasion. All adhered and invaded the cells, and harboured at least two virulence markers. The mean virulent activity shown by A. butzleri was superior to that of A. cryaerophilus (p < 0.05); but the mean adhesion and invasion values of A. lanthieri, A. skirrowii, and A. vitoriensis were even higher. Sewage isolates were significantly (p < 0.05) more adherent and invasive than the rest, and their associated gene content was higher (p < 0.05). For the first time, an association between cadF and hecA and a high adhesion capability was identified (p < 0.05). The results provide new data on the pathogenic potential of Arcobacter species present in food and water by highlighting the superiority of A. butzleri over A. cryarophilus; providing evidence on the virulence of minority species as A. lanthieri and A. vitoriensis; and confirming sewage as an important source of potentially more virulent arcobacters.

Widespread Multidrug Resistance of Arcobacter butzleri Isolated from Clinical and Food Sources in Central Italy

The Arcobacter genus comprises a group of bacteria widely distributed in different habitats that can be spread throughout the food chain. Fluoroquinolones and aminoglycosides represent the most common antimicrobial agents used for the treatment of Arcobacter infections. However, the increasing trend of the antimicrobial resistance of this pathogen leads to treatment failures. Moreover, the test implementation and interpretation are hindered by the lack of reference protocols and standard interpretive criteria. The purpose of our study was to assess the antibiotic resistance pattern of 17 A. butzleri strains isolated in Central Italy from fresh vegetables, sushi, chicken breast, and clinical human samples to provide new and updated information about the antimicrobial resistance epidemiology of this species. Antimicrobial susceptibility testing was carried out by the European Committee on Antimicrobial Susceptibility Testing (EUCAST)'s disc diffusion method. All the strains were multidrug resistant, with 100% resistance to tetracyclines and cefotaxime (third generation cephalosporins). Some differences were noticed among the strains, according to the isolation source (clinical isolates, food of animal origin, or fresh vegetables), with a higher sensitivity to streptomycin detected only in the strains isolated from fresh vegetables. Our data, together with other epidemiological information at the national or European Union (EU) level, may contribute to developing homogeneous breakpoints. However, the high prevalence of resistance to a wide range of antimicrobial classes makes this microorganism a threat to human health and suggests that its monitoring should be considered by authorities designated for food safety.

Profiling microalgal cultures growing on municipal wastewater and fertilizer media in raceway photobioreactors

Microalgae cultivation is proposed as an effective system for pathogens reduction and wastewater depuration, however, a full characterisation of the risks is still needed. Two raceways were inoculated with Scenedesmus, one using wastewater and the other using a fertilizer medium. Microbial community and pathogen presence were explored by next generation sequencing (NGS), commercial qPCR array and plate counts. These methods proved to be complementary for a full characterization of community structure and potential risks. Media and sampling locations contributed to shape communities and pathogenic loads. The main pathogenic genera detected were Arcobacter and Elizabethkingia (mainly in wastewater) with an important presence of Aeromonas (all samples). A lower presence of pathogens was detected in fertilizer samples, while wastewater showed a reduction from inlet to outlet. Raceways showed potential as an effective biotreatment, with most of the retained pathogens released in the outlet and only a minor part settled in the biomass.

Detection of potentially pathogenic Arcobacter spp. in Bangkok canals and the Chao Phraya River

The management of pathogenic bacteria in waterways is a public health issue. Here, we investigated the concentrations of potentially pathogenic bacteria, Arcobacter spp. and Campylobacter spp., and Escherichia coli, by quantifying species-specific genes in surface water samples from canals and the Chao Phraya River from June 2017 to June 2018 in Bangkok, Thailand. We assessed the relationship between the specific bacterial concentrations, water quality, and seasonal changes. Arcobacter spp. were detected at high density in all samples and showed seasonal fluctuations according to analyses based on 16S rDNA and the invasion gene ciaB. High levels of 16S rDNA and dut gene of E. coli were detected in the polluted drainage canals. A high correlation was observed between E. coli and chemical and biochemical oxygen demand (COD and BOD), suggesting that untreated domestic wastewater was the source of the E. coli. In contrast, Arcobacter spp. were detected with high density even in water samples with relatively low COD, suggesting that Arcobacter spp. are more likely than E. coli to survive in the water environment. The analysis of 16S rDNA and ciaB gene sequence analyses indicated that the Arcobacter spp. isolated from the drainage canals were A. butzleri and A. cryaerophilus.