Molecular Identification of TEM-1 β-Lactamase in a Pasteurella multocida Isolate of Human Origin

Two clinical strains of Pasteurella multocida were isolated from an HIV-infected patient who developed arthritis. Strain FB-1, which was isolated from a dog-bite wound, was resistant to narrow-spectrum penicillins. The second strain, FB-2, which was present in blood cultures as well as the dog-bite wound, was susceptible to all beta-lactam agents. Arbitrarily primedpolymerase chain reaction and pulsed-field gel electrophoresis revealed that these two isolates were genetically indistinguishable. 16S rDNA gene sequencing facilitated identification at the subspecies level. Amoxicillin resistance determinant was located on a highly unstable 4.3-kb plasmid, pFAB-1. Isoelectrofocusing and polymerase chain reaction amplification followed by sequencing revealed the presence of a pI 5.4 TEM-1 beta-lactamase. This description is the first of a TEM-1 Beta-lactamase' in a Pasteurella multocida strain of human origin.

Integron-located VEB-1 extended-spectrum beta-lactamase gene in a Proteus mirabilis clinical isolate from Vietnam

A clinical isolate of Proteus mirabilis Lil-1 was obtained from a Vietnamese patient hospitalized in Paris, France. This isolate was resistant to cephalosporins, and there was marked synergy between cephalosporins and clavulanic acid together with unusual synergy between cefoxitin and cefuroxime. PCR analysis revealed the presence of blaVEB-1, an integron-located gene coding for an extended-spectrum beta-lactamase (ESBL) identified previously in an Escherichia coli isolate MG-1 from Vietnam. Using class 1 integron primers and blaVEB-1 intragenic primers, the insert region of the blaVEB-1-containing integron along with flanking sequences were amplified from P. mirabilis Lil-1 whole-cell DNA. A novel class 1 integron, In55, was identified that contained, in addition to intI1, qacEDelta1, sul1 and Orf5 genes, an 8 kb variable region. This region was comparable in size to that found previously in E. coli MG-1, but different from those previously identified in two Pseudomonas aeruginosa isolates from Thailand. In55 was located on a 190 kb self-transferable plasmid, which was different in size and structure from that found in E. coli MG-1. The finding of blaVEB-1 on different plasmids and integrons in enterobacterial isolates underlines the interspecies spread of this novel ESBL gene.

Exophiala (Wangiella) dermatitidis keratitis after keratoplasty

We report the first French case of an intraocular infection due to Exophiala (Wangiella) dermatitidis. Two months after a second corneal transplant for congenital hereditary endothelial dystrophy, the patient presented with ocular pain and corneal infiltrates leading to the graft rejection. Diagnosis was established by positive direct examination and cultures of the same fungus from corneal buttons, iris biopsies and ablated sutures.

Microbial flora of the cervix assessed at the time of embryo transfer adversely affects in vitro fertilization outcome

OBJECTIVE

To investigate whether the presence of cervical microorganisms, as detected on catheters used for ET, alters the outcome of IVF-ET.

DESIGN

Prospective analysis.

SETTING

The assisted reproduction unit of a hospital in Clamart, France.

PATIENT(S)

Two hundred seventy-nine controlled ovarian hyperstimulation (COH) cycles performed for IVF-ET. Inclusion criteria were a patient age of < or =38 years, a morphologically normal uterus, and > or =2 good-quality embryos transferred.

INTERVENTION(S)

The tips of catheters used for ruling out possible cervical obstruction before ET were subjected to quantitative (> or =10 colonies = positive culture group; <10 colonies = negative culture group) and qualitative microbial assessment.

MAIN OUTCOME MEASURE(S)

Pregnancy and implantation rates.

RESULT(S)

In 143 (51%) of 279 ETs, cultures were positive, predominantly for Escherichia coli (64%) and Streptococcus species (8%). Although data on patients, COH, and embryology were similar in both culture groups, clinical and ongoing pregnancy rates as well as implantation rates were significantly lower in the positive culture group than in the negative culture group (24% versus 37%; 17% versus 28%; and 9% versus 16%, respectively).

CONCLUSION(S)

The presence of microbial flora of the cervix on ET catheters is associated with poor IVF-ET outcome.

Evidence for the genetic unrelatedness of nosocomial Alcaligenes xylosoxidans strains in a pediatric hospital

Restriction fragment-length polymorphism of ribosomal DNA and random amplified polymorphic DNA analysis were used to study the relationships among nine isolates of Alcaligenes xylosoxidans obtained from seven children in a pediatric hospital. All the children harbored only genotypically unrelated strains, thus excluding a common source of exposure or patient-to-patient strain transfer.