The Gram-Negative Bacilli Isolated from Caves-Sphingomonas paucimobilis and Hafnia alvei and a Review of Their Involvement in Human Infections

The opportunistic infections with Gram-negative bacilli are frequently reported. The clinical studies are focused on the course of human infectious and very often the source of infection remain unclear. We aim to see if the Gram-negative bacilli isolated from a non-contaminated environment—the caves—are reported in human infections. Eleven samples were collected from six Romanian caves. We used the standard procedure used in our clinical laboratory for bacterial identification and for antibiotic susceptibility testing of the cave isolates. Out of the 14 bacterial strains, three isolates are Gram-negative bacilli—one isolate belong to Hafnia alvei and two strains belong to Sphingomonas paucimobilis. We screened for the published studies—full-text original articles or review articles—that reported human infections with S. paucimobilis and H. alvei. Data sources—PubMed and Cochrane library. We retrieved 447 cases from 49 references—262 cases (58.61%) are S. paucimobilis infections and 185 cases (41.39%) are H. alvei infections. The types of infections are diverse but there are some infections more frequent; there are 116 cases (44.27%) and many infections of the bloodstream with S. paucimobilius (116 cases) and 121 cases (65.41%) are urinary tract infections with H. alvei. The acquired source of the bloodstream infections is reported for 93 of S. paucimobilis bloodstream infections—50 cases (43%) are hospital-acquired, and 40 cases (37%) are community-acquired. Most of the infections are reported in patients with different underlying conditions. There are 80 cases (17.9%) are reported of previously healthy persons. Out of the 72 cases of pediatric infections, 62 cases (86.11%) are caused by S. paucimobilis. There are ten death casualties—three are H. alvei infections, and seven are S. paucimobilis infections.

Paeoniflorin inhibits proliferation and promotes autophagy and apoptosis of sweat gland cells

Axillary bromhidrosis is sweat excreted by apocrine glands in the armpits, mouth corners and other parts. The clinical manifestation includes excessive sweating and heavy odor, leading to the growth of bacteria and skin disease. The present study investigated the mechanism underlying the effect of paeoniflorin (PF) in the treatment of bromhidrosis. PF was injected into the feet of rats, and the foot skin was dissected for histological analysis. Primary human sweat gland cells (hSGCs) were isolated from patients with bromhidrosis. After 24 h treatment with PF or 3-methyladenine, the production of reactive oxygen species (ROS), autophagy, apoptosis, proliferation and cell cycle distribution were determined. PF induced nuclear pyknosis in rat SGCs. In vitro PF treatment inhibited cell proliferation with a 25% inhibitory concentration of 9.530 µM. Treatment with 9.530 µM PF for 24 h significantly increased apoptosis, ROS production and autophagy in hSGCs. PF promoted LC3B and Beclin 1 expression, but inhibited p62, phosphorylated (p)-PI3K and p-Akt expression. 3-methyladenine treatment reversed PF-induced changes in hSGCs. PF-induced inhibition of hSGC proliferation was associated with ROS production, apoptosis, and autophagy. These findings provide a basis for treating bromhidrosis.

Treatment of bromhidrosis with a glycine-soja sterocomplex topical product

AIMS

Bromhidrosis is a common problem with a severe negative impact on the patient's social and emotional life. The objective of this open-label study was to evaluate the efficacy and safety of a local product with the main active ingredient of glycine-soja sterocomplex in the treatment of local bromhidrosis.

PATIENTS/METHODS

Eighteen patients with axillary bromhidrosis and eight patients with bromhidrosis of the genital area were included. Bromhidrosis was evaluated through a sniff test of a worn garment on a four-point scale. Patients applied a glycine-soja sterocomplex topical agent twice daily on the affected areas for 15 days and bromhidrosis was evaluated again.

RESULTS

Subjective mean level of bromhidrosis at baseline was 3.50 ± 0.50 and after treatment 1.53 ± 0.51. Mean impact on quality of life at baseline was 3.30 ± 0.48 and after treatment 1.30 ± 0.49. Investigators objective evaluation revealed an improvement in intensity of odor from 3.23 ± 0.83 to 1.53 ± 0.53 and in acceptability of odor from 3.1 ± 1.01 to 1.65 ± 0.76.

CONCLUSIONS

The glycine-soja sterocomplex topical agent shows encouraging improvement on both the intensity and quality of odor in patients with bromhidrosis and has a profound improvement on the patients' quality of life without any side effects.

Risk factors associated with Sphingomonas paucimobilis infection

BACKGROUND

Sphingomonas paucimobilis is rarely isolated from clinical specimens and it is associated with a great variety of infections. The aim of this study is to investigate the microbiological and clinical features of S paucimobilis infection in southern Taiwan.

METHODS

S paucimobilis isolates from the microbiology laboratory of Chi-Mei Medical Center and their relevant clinical data from October 2005 to October 2009 were retrospectively reviewed.

RESULTS

A total of 55 patients with documented S paucimobilis infections were identified. Among them, 29 (52.7%) have community-acquired infections and 13 of them presented with primary bacteremia (44.8%). Multivariate logistic regression showed that community-acquired infection [adjusted odds ratio 13.473, 95% confidence interval (CI) 1.79-101.41, p = 0.01], diabetes mellitus (adjusted odds ratio 7.03, 95% CI 1.16-42.66, p = 0.03), and alcoholism (adjusted OR 10.87, 95% CI 1.00-117.69, p = 0.05) were significant risk factors for S paucimobilis primary bacteremia. Most of those who have health care-associated S paucimobilis infections presented with pneumonia (10 of 26, 38.5%) and only 7.7% presented with catheter-related infection. The overall mortality rate was 5.5%.

CONCLUSION

Community-acquired S paucimobilis infections were not uncommon, mainly presenting with primary bacteremia. Multivariate analysis showed that community-acquired infection, diabetes mellitus, and alcoholism were significant risk factors for primary bacteremia.