1
|
Mohamed EI, Turkey MS, Meshref RA, Ghazal AA, Shawky SM, Aboulela AG. Electronic nose versus VITEK 2 system for the rapid diagnosis of bloodstream infections. Braz J Microbiol 2023; 54:2857-2865. [PMID: 37872278 PMCID: PMC10689606 DOI: 10.1007/s42770-023-01154-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 10/12/2023] [Indexed: 10/25/2023] Open
Abstract
Infectious diseases that spread through the bloodstream, known as bloodstream infections (BSIs), are a major global health problem. Positive outcomes for patients with sepsis are typically the result of prompt treatment started after an early diagnosis of BSIs. In this study, we evaluated the capabilities of a portable electronic nose (E-Nose) to detect BSIs with two commonly isolated Gram-negative bacterial species, E. coli and K. pneumonia. One hundred and five blood samples were randomly collected for blood culture examinations using BACTEC and VITEK 2 system, and headspace analysis by an E-Nose from June to December 2021. Classification accuracy of E. coli, K. pneumonia, and negative controls was measured using principal component analysis, area under the receiver operating characteristic curve, sensitivity, and specificity analysis. After incubation for 24 h, cluster plots generated using principal component analysis demonstrated that E-Nose could accurately diagnose the presence of E. coli and K. pneumonia in BACTEC blood culture bottles with a sensitivity and specificity of 100% in just 120 s. The E-Nose method has been shown to be an immediate, precise, and cost-effective alternative to automated blood culture BACTEC and VITEK 2 systems for the fast detection of the causative bacterial pathogens of BSIs in clinical practice. Thus, patients with such Gram-negative bacteremia can have guided empirical antimicrobial therapy on the same day of BSIs diagnosis, which can be lifesaving.
Collapse
Affiliation(s)
- Ehab I Mohamed
- Medical Biophysics Department, Medical Research Institute, Alexandria University, Alexandria, Egypt.
| | - Mohamed S Turkey
- Microbiology Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
- Microbiology and Immunology Department, Faculty of Pharmacy, October 6 University, Sixth of October City, Giza, Egypt
| | - Radwa A Meshref
- Medical Equipment Technology Department, Faculty of Applied Health Sciences Technology, Pharos University, Alexandria, Egypt
| | - Abeer A Ghazal
- Microbiology Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Sherine M Shawky
- Microbiology Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Aliaa G Aboulela
- Microbiology Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| |
Collapse
|
2
|
Kumaran D, Laflamme C, Ramirez-Arcos S. A multiphasic approach to solve misidentification of Cutibacterium acnes as Atopobium vaginae during routine bacterial screening of platelet concentrates using the VITEK 2 system. Access Microbiol 2023; 5:acmi000539.v3. [PMID: 37424557 PMCID: PMC10323807 DOI: 10.1099/acmi.0.000539.v3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 04/16/2023] [Indexed: 07/11/2023] Open
Abstract
Skin flora bacteria, such as Cutibacterium acnes , are the predominant contaminants of blood products used for transfusion. Platelet concentrates (PCs), a therapeutic product used to treat patients with platelet deficiencies, are stored at ambient temperature under agitation, providing ideal conditions for bacterial proliferation. At Canadian Blood Services, PCs are screened for microbial contamination using the automated BACT/ALERT culture system. Positive cultures are processed and contaminating organisms are identified using the VITEK 2 system. Over a period of approximately 2 years, several PC isolates were identified as Atopobium vaginae to a high level of confidence. However, since A. vaginae is associated with bacterial vaginosis and is not a common PC contaminant, a retrospective investigation revealed that in all cases C. acnes was misidentified as A. vaginae . Our investigation demonstrated that the media type used to grow PC bacterial isolates can have a significant impact on the results obtained on the VITEK 2 system. Furthermore, other identification methods such as matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALD-TOF MS) and PCR amplification of the 16S RNA gene were only partially successful in the identification of C. acnes . Therefore, our findings support a multiphasic approach when PC isolates are identified as A. vaginae by the VITEK 2 system for proper identification of C. acnes using macroscopic, microscopic and other biochemical analyses.
Collapse
Affiliation(s)
- Dilini Kumaran
- Canadian Blood Services, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| | | | - Sandra Ramirez-Arcos
- Canadian Blood Services, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| |
Collapse
|
3
|
Kim SH, Chon JW, Jeong HW, Song KY, Kim DH, Bae D, Kim H, Seo KH. Identification and phylogenetic analysis of Enterococcus isolates using MALDI-TOF MS and VITEK 2. AMB Express 2023; 13:21. [PMID: 36813859 PMCID: PMC9947212 DOI: 10.1186/s13568-023-01525-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 02/07/2023] [Indexed: 02/24/2023] Open
Abstract
The bacterial genus Enterococcus encompasses 38 species. Two of the most common species are E. faecalis and E. faecium. Recently, however, there has been an increase in clinical reports concerning less prevalent Enterococcus species, such as E. durans, E. hirae, and E. gallinarum. Rapid and accurate laboratory methods are needed to facilitate the identification of all these bacterial species. In the present study, we compared the relative accuracy of matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS), VITEK 2, and 16S rRNA gene sequencing using 39 enterococci isolates from dairy samples, and compared the resultant phylogenetic trees. We found that MALDI-TOF MS correctly identified all isolates at the species level except for one, whereas the VITEK 2 system, which is an automated identification system using biochemical characteristics of species, misidentified ten isolates. However, phylogenetic trees constructed from both methods showed all isolates in similar positions. Our results clearly showed that MALDI-TOF MS is a reliable and rapid tool for identifying Enterococcus species with greater discriminatory power than the biochemical assay method of VITEK 2.
Collapse
Affiliation(s)
- Se-Hyung Kim
- grid.258676.80000 0004 0532 8339Center for One Health, Department of Veterinary Public Health, College of Veterinary Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029 Korea
| | - Jung-Whan Chon
- grid.258676.80000 0004 0532 8339Center for One Health, Department of Veterinary Public Health, College of Veterinary Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029 Korea
| | - Hyo-Won Jeong
- grid.484628.4 0000 0001 0943 2764Seoul Metropolitan Government Research Institute of Public Health and Environment, Gyonggi-Do, 13818 Korea
| | - Kwang-Young Song
- grid.258676.80000 0004 0532 8339Center for One Health, Department of Veterinary Public Health, College of Veterinary Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029 Korea
| | - Dong-Hyeon Kim
- grid.258676.80000 0004 0532 8339Center for One Health, Department of Veterinary Public Health, College of Veterinary Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029 Korea
| | - Dongryeoul Bae
- grid.258676.80000 0004 0532 8339Center for One Health, Department of Veterinary Public Health, College of Veterinary Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029 Korea
| | - Hyunsook Kim
- grid.49606.3d0000 0001 1364 9317Department of Food and Nutrition, College of Human Ecology, Hanyang Univeristy, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763 Korea
| | - Kun-Ho Seo
- Center for One Health, Department of Veterinary Public Health, College of Veterinary Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, Korea.
| |
Collapse
|
4
|
Kopf A, Bunk B, Coldewey SM, Gunzer F, Riedel T, Schröttner P. Identification and Antibiotic Profiling of Wohlfahrtiimonas chitiniclastica, an Underestimated Human Pathogen. Front Microbiol 2021; 12:712775. [PMID: 34630346 PMCID: PMC8496446 DOI: 10.3389/fmicb.2021.712775] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 08/27/2021] [Indexed: 12/13/2022] Open
Abstract
In the past 12 years, several case reports have clearly demonstrated that Wohlfahrtiimonas chitiniclastica is capable of causing sepsis and bacteremia in humans. However, since most clinicians are not familiar with this species, little is known about its pathogenicity and treatment options while it is as rare but underestimated human pathogen. Therefore, a larger strain collection is required so that methods can be identified that are most suitable to obtain rapid and reliable identification. Moreover, the antimicrobial resistance profile needs to be elucidated in order to explore possible treatment options. Over a period of 6 years, we therefore have collected a total of 14 W. chitiniclastica isolates in routine diagnostics, which now served as the basis for a comprehensive characterization with respect to identification and antibiotic profiling. We compared the accuracy and convenience of several identification techniques in which MALDI-TOF MS and sequencing of the 16S rRNA gene have proven to be suitable for identification of W. chitiniclastica. In addition, whole genome sequencing (WGS)-based digital DNA-DNA hybridization (dDDH) was used as a reference method for strain identification, and surprised with the detection of a novel W. chitiniclastica subspecies. A combination of in silico and in vitro analyses revealed a first insight into the antimicrobial resistance profile and the molecular basis of antimicrobial resistance. Based on our findings, trimethoprim/sulfamethoxazole, levofloxacin, and cephalosporins (e.g., ceftazidime) may be the best antibiotics to use in order to treat infections caused by W. chitiniclastica, while resistance to fosfomycin, amikacin and tobramycin is observed.
Collapse
Affiliation(s)
- Anna Kopf
- Institute of Medical Microbiology and Virology, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Boyke Bunk
- Leibniz Institute DSMZ-German Collection of Microorganisms and Cell Cultures GmbH, Braunschweig, Germany
| | - Sina M Coldewey
- Clinic for Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany.,Septomics Research Center, Jena University Hospital, Jena, Germany
| | - Florian Gunzer
- Department of Hospital Infection Control, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Thomas Riedel
- Leibniz Institute DSMZ-German Collection of Microorganisms and Cell Cultures GmbH, Braunschweig, Germany.,German Center for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
| | - Percy Schröttner
- Institute of Medical Microbiology and Virology, University Hospital Carl Gustav Carus, Dresden, Germany
| |
Collapse
|
5
|
Bollam R, Yassin M, Phan T. Detection of Enterococcus hirae in a case of acute osteomyelitis. Radiol Case Rep 2021; 16:2366-2369. [PMID: 34306283 PMCID: PMC8258775 DOI: 10.1016/j.radcr.2021.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/04/2021] [Accepted: 06/06/2021] [Indexed: 11/03/2022] Open
Abstract
Enterococci are important microorganisms of the gut microbiome in many mammals and cause millions of infections annually. An increasing resistance to antibiotics has led to their emergence as superinfecting nosocomial pathogens in humans. Enterococcus hirae is rarely identified in humans. In this study, we present a case of the polymicrobial osteomyelitis involving Enterococcus hirae in a 33-year-old male patient with traumatic tibia-fibula fracture after a motor vehicle accident. He underwent a right below-the-knee amputation and antibiotics with excellent improvement. Our case study helps to confirm the unexpected presence of Enterococcus hirae in a human specimen. Further studies are needed to elucidate the clinical implications of Enterococcus hirae.
Collapse
Affiliation(s)
- Rahul Bollam
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Mohamed Yassin
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Tung Phan
- Division of Clinical Microbiology, University of Pittsburgh and University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
6
|
Abo-Zed A, Yassin M, Phan T. A rare case of polymicrobial brain abscess involving Actinomyces. Radiol Case Rep 2021; 16:1123-1126. [PMID: 33732405 PMCID: PMC7937940 DOI: 10.1016/j.radcr.2021.02.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/16/2021] [Accepted: 02/20/2021] [Indexed: 11/02/2022] Open
Abstract
Brain abscess is a focal intracranial infection that may present as a life-threatening emergency. Brain abscess can present with a wide range of clinical syndromes, and it results in high morbidity and mortality worldwide. Here we describe a rare case of the polymicrobial right parietal brain abscess, especially associated with Actinomyces in a 59-year-old male who presented with acute onset of left-sided weakness and altered mental status. The patient underwent surgical treatment (burrhole aspiration) and antibiotics with good improvement. Prompt diagnosis and treatment are critical for brain abscess and ultimately lead to better patient outcomes.
Collapse
Affiliation(s)
- Abdelrhman Abo-Zed
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Mohamed Yassin
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Tung Phan
- Division of Clinical Microbiology, University of Pittsburgh and University of Pittsburgh Medical Center, 3477 Euler Way, Pittsburgh, PA 15213, USA,Corresponding author.
| |
Collapse
|
7
|
Alsaab F, Wahdan A, Saeed EMA. Phenotypic detection and genotyping of Clostridium perfringens associated with enterotoxemia in sheep in the Qassim Region of Saudi Arabia. Vet World 2021; 14:578-584. [PMID: 33935400 PMCID: PMC8076464 DOI: 10.14202/vetworld.2021.578-584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 01/27/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND AIM Enterotoxemia caused by Clostridium perfringens toxinotypes is an often fatal disease of sheep of all ages, with a substantial economic loss to the sheep industry. This study was conducted to isolate C. perfringens from suspected cases of enterotoxemia in sheep in the central part of the Qassim Region, Saudi Arabia, and to determine the prevalent toxinotype by detecting alpha (cpA), beta (cpB), and epsilon (etX) toxin genes, which might help control this disease locally. MATERIALS AND METHODS A total of 93 rectal swabs and intestinal content samples were collected from diseased and animals suspected of having died of enterotoxemia in early 2020. Samples were subjected to bacteriological examination, biochemical analysis of isolates by VITEK 2, and molecular toxinotyping of isolates by LightCycler® real-time polymerase chain reaction (RT-PCR). RESULTS Our results revealed that only 14 isolates were confirmed by VITEK 2 as being C. perfringens, with excellent identification (probability of 95% and 97%). According to the toxinotyping of isolates by RT-PCR, all 14 isolates possessed both the cpA and etX toxin genes, while the cpB toxin gene was not detected in any of the isolates. CONCLUSION Our findings demonstrated that C. perfringens type D was the only toxinotype found in the central part of the Qassim Region in 2020; moreover, according to the culture method, only 15% (14/93) of the suspected cases of enterotoxemia were confirmed to be caused by C. perfringens infection, which highlighted the importance of clinical and laboratory differential diagnosis of enterotoxemia in sheep.
Collapse
Affiliation(s)
- Fehaid Alsaab
- Veterinarian at Ministry of Environment, Water and Agriculture, Kingdom of Saudi Arabia
| | - Ali Wahdan
- Department of Bacteriology, Immunology and Mycology, Faculty of Veterinary Medicine, Suez Canal University, Egypt
| | - Elhassan M. A. Saeed
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim University, Buraydah, Saudi Arabia
- Department of Microbiology, Faculty of Veterinary Medicine, Khartoum University, Sudan
| |
Collapse
|
8
|
Liu JL, Li TM, Zhong N, Wang X, Jiang J, Zhang WX, Tang R, Guo YJ, Liu Y, Hu J, He LH, Tang J, Wu WJ, Li M. Current status of oxacillin-susceptible mecA-positive Staphylococcus aureus infection in Shanghai, China: A multicenter study. J Microbiol Immunol Infect 2020:S1684-1182(20)30178-X. [PMID: 32819837 DOI: 10.1016/j.jmii.2020.07.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 07/18/2020] [Accepted: 07/30/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Oxacillin-susceptible mecA-positive Staphylococcus aureus (OS-MRSA) represents an important issue, as its oxacillin susceptibility has contributed to misidentification by conventional susceptibility tests and consequently potential therapeutic failure, but limited data on the current status of OS-MRSA infection in Chinese hospitals are available. METHODS This multicenter study performed a battery of susceptibility tests and diagnostic tests for 956 S. aureus isolates from 10 hospitals, including automated susceptibility testing on VITEK 2, broth microdilution, disk diffusion, and detection of PBB2a, mecA gene and mecC gene. For all identified OS-MRSA, multi-locus sequence typing (MLST), together with spa typing, SCCmec typing and PVL detecting, was carried out. RESULTS OS-MRSA, most of which were from pediatric inpatients, represented 1.8% (17/956) of total isolates. Of these 17 OS-MRSA, 10 were ST59, followed by ST965 (3/17), and 11 carried SCCmec type IV, while 5 carried SCCmec type V, but only one was Panton-Valentine leucocidin (PVL)-positive, also, 16 had one or two point mutations within mecA promoter. OS-MRSA had inducible oxacillin resistance and significantly lower MDR (Multi-Drug Resistant) rate. We observed that the VITEK 2 system exhibited some deficiency in OS-MRSA detection, whereas cefoxitin disk diffusion was shown to be a reliable and cost-saving alternative and should be supplemented in detecting S. aureus with borderline oxacillin susceptible MICs. CONCLUSION This study has characterized phenotypically and molecularly OS-MRSA in China, and provided insights into more effective management of OS-MRSA.
Collapse
|
9
|
Yoo IY, Kang OK, Shim HJ, Huh HJ, Lee NY. Linezolid Resistance in Methicillin-Resistant Staphylococcus aureus in Korea: High Rate of False Resistance to Linezolid by the VITEK 2 System. Ann Lab Med 2020; 40:57-62. [PMID: 31432640 PMCID: PMC6713661 DOI: 10.3343/alm.2020.40.1.57] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 06/17/2019] [Accepted: 07/26/2019] [Indexed: 11/21/2022] Open
Abstract
As various linezolid resistance mechanisms have been identified in methicillin-resistant Staphylococcus aureus (MRSA), we investigated the molecular characteristics of MRSA with elevated linezolid minimum inhibitory concentrations (MICs), using the VITEK 2 system (bioMérieux, Marcy-l'Étoile, France). Twenty-seven MRSA isolates from 14 patients exhibiting linezolid MICs ≥8 µg/mL were examined by broth microdilution (BMD) test as well as by sequencing for mutations in the 23S rRNA gene or ribosomal proteins (L3, L4, and L22) and the presence of the optrA, cfr, and cfr(B) genes. Of the 27 isolates, four (14.8%) from one patient were confirmed as linezolid resistant by BMD and harbored a 23S rRNA T2500A mutation. The remaining 23 were confirmed as linezolid susceptible, indicating that the linezolid-resistant results were major errors generated by VITEK 2. The most commonly detected mutation (19/27, 70.4%), L3 Gly152Asp, was detected in only linezolid-susceptible isolates. No isolates contained optrA, cfr, or cfr(B) or any L4 or L22 protein alterations. Our results show that the 23S rRNA T2500A mutation was mainly associated with linezolid resistance, while the L3 Gly152Asp mutation was not related to linezolid resistance. A confirmatory test is recommended for VITEK 2 linezolid-resistant results owing to the high probability of false resistant results.
Collapse
Affiliation(s)
- In Young Yoo
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - On Kyun Kang
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyang Jin Shim
- Center for Clinical Medicine, Samsung Biomedical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Jae Huh
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Nam Yong Lee
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| |
Collapse
|
10
|
Sailo CV, Pandey P, Mukherjee S, Zami Z, Lalremruata R, Nemi L, Kumar NS. Pathogenic microbes contaminating mobile phones in hospital environment in Northeast India: incidence and antibiotic resistance. Trop Med Health 2019; 47:59. [PMID: 31889887 PMCID: PMC6905087 DOI: 10.1186/s41182-019-0190-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 12/02/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The present study attempts to identify and determine the pattern of drug susceptibility of the microorganisms present in mobile phones of health care workers (HCWs) and non-HCWs in a hospital environment. Mobile phones of 100 participants including both genders were randomly swabbed from nine different wards/units and the bacterial cultures were characterized using VITEK 2 system. RESULTS Forty-seven mobile phones were culture positive and a total of 57 isolates were obtained which consisted of 28 Gram-positive organisms and 29 Gram-negative organisms. The predominating organisms were Acinetobacter baumannii and Staphylococcus hominis. Among all the isolates from the mobile phones of HCW and non-HCWs, five isolates had ESBL and three isolates had colistin resistance. Incidentally, MRSA was not found on the mobile phones tested. The isolated organisms showed 100% susceptibility to linezolid, daptomycin, vancomycin, imipenem, meropenem, gentamicin, amikacin, ciprofloxacin and tigecycline, while high resistance was shown against benzylpenicillin (75.0%), cefuroxime and cefuroxime axetil (56.5%). Non-HCWs' mobile phones were more contaminated as compared to HCWs (P = 0.001) and irrespective of individuals' gender or toilet habits, both Gram-positive and Gram-negative organisms were present on the mobile phones. CONCLUSION This study reports for the first time that the mobile phones of non-health care workers harbour more bacterial diversity and are more prone to cause transmission of pathogens. This study can serve to educate the public on personal hand hygiene practices and on maintaining clean mobile phones through antiseptic measures.
Collapse
Affiliation(s)
| | - Puja Pandey
- 0000 0000 9217 3865grid.411813.eDepartment of Biotechnology, Mizoram University, Aizawl, Mizoram 796004 India
| | - Subhajit Mukherjee
- 0000 0000 9217 3865grid.411813.eDepartment of Biotechnology, Mizoram University, Aizawl, Mizoram 796004 India
| | - Zothan Zami
- 0000 0000 9217 3865grid.411813.eDepartment of Biotechnology, Mizoram University, Aizawl, Mizoram 796004 India
| | - Ralte Lalremruata
- grid.460962.fDepartment of Microbiology, Synod Hospital, Durtlang, Aizawl, Mizoram 796025 India
| | - Lalnun Nemi
- grid.460962.fDepartment of Pathology, Synod Hospital, Durtlang, Aizawl, Mizoram 796025 India
| | - Nachimuthu Senthil Kumar
- 0000 0000 9217 3865grid.411813.eDepartment of Biotechnology, Mizoram University, Aizawl, Mizoram 796004 India
| |
Collapse
|
11
|
Ambaraghassi G, Dufresne PJ, Dufresne SF, Vallières É, Muñoz JF, Cuomo CA, Berkow EL, Lockhart SR, Luong ML. Identification of Candida auris by Use of the Updated Vitek 2 Yeast Identification System, Version 8.01: a Multilaboratory Evaluation Study. J Clin Microbiol 2019; 57:e00884-19. [PMID: 31413079 DOI: 10.1128/JCM.00884-19] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 08/06/2019] [Indexed: 01/18/2023] Open
Abstract
Candida auris is an emerging multidrug-resistant yeast that has been systematically incorrectly identified by phenotypic methods in clinical microbiology laboratories. The Vitek 2 automated identification system (bioMérieux) recently included C. auris in its database (version 8.01). We evaluated the performance of the Vitek 2 YST ID card to identify C. auris and related species. A panel of 44 isolates of Candida species (C. auris, n = 35; Candida haemulonii, n = 5; Candida duobushaemulonii, n = 4) were tested by three different hospital-based microbiology laboratories. Among 35 isolates of C. auris, Vitek 2 yielded correct identification in an average of 52% of tested samples. Low-discrimination (LD) results with an inability to distinguish between C. auris, C. duobushaemulonii, and Candida famata were obtained in an average of 27% of samples. Incorrect identification results were obtained in an average of 21% of samples, the majority (91%) of which were reported as C. duobushaemulonii and the remaining 9% of which were reported as Candida lusitaniae /C. duobushaemulonii. The proportion of correct identification was not statistically different across different centers (P = 0.78). Stratification by genetic clades demonstrated that 100% (n = 8) of the strains of the South American clade were correctly identified compared to 7% (n = 10) and 0% (n = 4) from the African and East Asian clades, respectively. None of the non-auris Candida strains (n = 9) were incorrectly identified as C. auris Our results show that the Vitek 2 (version 8.01) yeast identification system has a limited ability to correctly identify C. auris These data suggest that an identification result for C. duobushaemulonii should warrant further testing to rule out C. auris The overall performance of the Vitek 2 seems to differ according to C. auris genetic clade, with the South American isolates yielding the most accurate results.
Collapse
|
12
|
Lellouche J, Schwartz D, Elmalech N, Ben Dalak MA, Temkin E, Paul M, Geffen Y, Yahav D, Eliakim-Raz N, Durante-Mangoni E, Iossa D, Bernardo M, Daikos GL, Skiada A, Pantazatou A, Antoniadou A, Mouton JW, Carmeli Y. Combining VITEK ® 2 with colistin agar dilution screening assist timely reporting of colistin susceptibility. Clin Microbiol Infect 2018; 25:711-716. [PMID: 30291971 DOI: 10.1016/j.cmi.2018.09.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 09/17/2018] [Accepted: 09/18/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The rise in carbapenem resistance among Gram-negative bacteria has renewed interest in colistin. Recently, the EUCAST-CLSI Polymyxin Breakpoints Working Group declared that broth microdilution (BMD) is the only valid method for colistin susceptibility testing. BMD is not easily incorporated into the routine work of clinical laboratories, and usually this test is incorporated serially, resulting in delayed susceptibility reporting. We tested a strategy of combining VITEK® 2 with a 2 μg/mL colistin agar dilution (VITEK® 2/AD) screening plate to improve performance and time to reporting of colistin susceptibility. METHODS Colistin susceptibility for 364 clinical isolates was determined by VITEK® 2/AD and compared with the reference standard BMD according to the ISO 20776-1:2007 and CLSI guidelines. The EUCAST colistin susceptibility breakpoint of ≤2 μg/mL was used. Escherichia coli NCTC 13846 served as quality control strain. Agreement, very major error (VME) and major error rates were determined using ISO 20776-2:2007. RESULTS The VME rate for VITEK® 2 alone was 30.6% (15/49, 95% CI 18.3-45.4%), and was reduced to 10.2% (5/49, 95% CI 3.4-22.2%) using the VITEK® 2/AD combined testing. The combined testing had categorical agreement with BMD of 97% (354/364, 95% CI 95.0-98.7%), and a major error (ME) rate of 1.6% (5/315, 95% CI 0.5-3.7%). Using the combined testing, even against challenging strains, 349 (95.8%, 95% CI 93.3-97.7%) colistin susceptibility results could be reported, and only 15 isolates required further analysis by BMD. DISCUSSION Our method is simple to apply and allows rapid reporting of colistin susceptibility.
Collapse
Affiliation(s)
- J Lellouche
- Molecular Epidemiology Laboratory, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; National Laboratory for Antibiotic Resistance and Investigation of Outbreaks in Medical Institutions, National Institute for Antibiotic Resistance and Infection Control, Ministry of Health, Israel.
| | - D Schwartz
- Molecular Epidemiology Laboratory, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; National Laboratory for Antibiotic Resistance and Investigation of Outbreaks in Medical Institutions, National Institute for Antibiotic Resistance and Infection Control, Ministry of Health, Israel
| | - N Elmalech
- Molecular Epidemiology Laboratory, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; National Laboratory for Antibiotic Resistance and Investigation of Outbreaks in Medical Institutions, National Institute for Antibiotic Resistance and Infection Control, Ministry of Health, Israel
| | - M A Ben Dalak
- Molecular Epidemiology Laboratory, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; National Laboratory for Antibiotic Resistance and Investigation of Outbreaks in Medical Institutions, National Institute for Antibiotic Resistance and Infection Control, Ministry of Health, Israel
| | - E Temkin
- Molecular Epidemiology Laboratory, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; National Laboratory for Antibiotic Resistance and Investigation of Outbreaks in Medical Institutions, National Institute for Antibiotic Resistance and Infection Control, Ministry of Health, Israel
| | - M Paul
- Institute of Infectious Diseases, Rambam Health Care Campus, Israel; Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Y Geffen
- Clinical Microbiology Laboratory, Rambam Health Care Campus, Haifa, Israel
| | - D Yahav
- Unit of Infectious Diseases, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat-Aviv, Israel
| | - N Eliakim-Raz
- Unit of Infectious Diseases, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat-Aviv, Israel; Department of Medicine E, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
| | - E Durante-Mangoni
- Department of Precision Medicine, University of Campania 'L Vanvitelli' and AORN dei Colli-Monaldi Hospital, Napoli, Italy
| | - D Iossa
- Department of Precision Medicine, University of Campania 'L Vanvitelli' and AORN dei Colli-Monaldi Hospital, Napoli, Italy
| | - M Bernardo
- Department of Precision Medicine, University of Campania 'L Vanvitelli' and AORN dei Colli-Monaldi Hospital, Napoli, Italy
| | - G L Daikos
- First Department of Medicine, Laikon General Hospital, Greece; National and Kapodistrian University of Athens, Athens, Greece
| | - A Skiada
- First Department of Medicine, Laikon General Hospital, Greece; National and Kapodistrian University of Athens, Athens, Greece
| | - A Pantazatou
- National and Kapodistrian University of Athens, Athens, Greece; Clinical Microbiology Laboratory, Laikon General Hospital, Greece
| | - A Antoniadou
- National and Kapodistrian University of Athens, Athens, Greece; Fourth Department of Medicine, Attikon University General Hospital, Athens, Greece
| | - J W Mouton
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam, the Netherlands
| | - Y Carmeli
- Molecular Epidemiology Laboratory, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; National Laboratory for Antibiotic Resistance and Investigation of Outbreaks in Medical Institutions, National Institute for Antibiotic Resistance and Infection Control, Ministry of Health, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat-Aviv, Israel
| |
Collapse
|
13
|
Mathur P, Hasan F, Singh PK, Malhotra R, Walia K, Chowdhary A. Five-year profile of candidaemia at an Indian trauma centre: High rates of Candida auris blood stream infections. Mycoses 2018; 61:674-680. [PMID: 29738604 DOI: 10.1111/myc.12790] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 04/27/2018] [Accepted: 04/27/2018] [Indexed: 01/16/2023]
Abstract
Candidaemia is a potentially fatal infection with varied distribution of Candida species and their antifungal susceptibility profiles. The recent emergence of Candida auris in invasive candidiasis is a cause for concern. This study describes the profile of candidaemia at an Indian tertiary care hospital and reports the emergence of C. auris. All patients diagnosed with candidaemia between 2012 and 2017 were studied. The isolates were identified using conventional methods, VITEK 2 and MALDI-TOF MS. The isolates not identified by MALDI-TOF were sequenced. Antifungal susceptibility testing was done by the CLSI broth microdilution method and VITEK 2. A total of 114 isolates of Candida species were analysed. Candida tropicalis (39.4%) was the most common species, followed by C. auris (17.5%), C. albicans (14%) and C. parapsilosis (11.4%). Notably, Diutina mesorugosa isolates (n = 10) were not identified by MALDI-TOF and were confirmed by sequencing. Furthermore, 45% (n = 9) C. auris strains exhibited low MICs of FLU (0.05-4 μg/mL) and the remaining 55% (n = 11) isolates had high MICs ≥ 64 μg/mL. Also, D. mesorugosa exhibited high MICs of FLU (32 μg/mL) in 2 isolates. A high rate of errors in antifungal susceptibility was noted with the VITEK 2 as compared to the CLSI method. Candida auris was the second most prevalent species causing candidaemia warranting infection control practices to be strengthened to prevent its spread.
Collapse
Affiliation(s)
- Purva Mathur
- Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Fahmi Hasan
- Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Pradeep K Singh
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | - Rajesh Malhotra
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.,JaiPrakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India
| | - Kamini Walia
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Anuradha Chowdhary
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| |
Collapse
|
14
|
Kim S, Kim MH, Lee WI, Kang SY, Jeon YL. Misidentification of Acinetobacter baumannii as Alcaligenes faecalis by VITEK 2 System; Case Report. Lab Med 2017; 49:e14-e17. [PMID: 29206938 DOI: 10.1093/labmed/lmx062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Acinetobacter baumannii (A. baumannii) is widely known as an opportunistic bacterial pathogen that causes infection more frequently among immunocompromised individuals. Our case demonstrated the limitation of the current VITEK 2 system for the idendification of A. baumannii. Four clinical isolates of A. baumannii were identified as Alcaligenes faecalis by the VITEK 2 system. Misidentification might lead to unnecessary tests and inappropriate treatments. Additional methods appear to be helpful for the accurate identification of A. baumannii for clinical microbiology laboratories.
Collapse
Affiliation(s)
- Suekyeung Kim
- From the Departments of Laboratory Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Myeong Hee Kim
- From the Departments of Laboratory Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Woo In Lee
- From the Departments of Laboratory Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - So Young Kang
- From the Departments of Laboratory Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - You La Jeon
- From the Departments of Laboratory Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| |
Collapse
|
15
|
Mauri C, Principe L, Bracco S, Meroni E, Corbo N, Pini B, Luzzaro F. Identification by mass spectrometry and automated susceptibility testing from positive bottles: a simple, rapid, and standardized approach to reduce the turnaround time in the management of blood cultures. BMC Infect Dis 2017; 17:749. [PMID: 29207967 PMCID: PMC5717835 DOI: 10.1186/s12879-017-2851-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 11/22/2017] [Indexed: 11/19/2022] Open
Abstract
Background Speeding up identification and antimicrobial susceptibility testing (AST) is of foremost importance in the management of blood cultures. Here, we describe a simple, rapid, and standardized approach based on a very short-term incubation on solid medium from positive blood cultures followed by MALDI-TOF mass spectrometry identification and automated AST. The aim of the study was to evaluate the impact in the laboratory practice of this new procedure with respect to that previously used (standard method) by comparing TAT and cumulative percentage of final reports to clinicians. Results Compared with the standard method, the new procedure gave correct organism identification at genus or species level in 98.4% of monomicrobial samples. AST resulted in 97.7% essential agreement and 98.1% categorical agreement, with 0.9% minor errors, 1.0% major error, and 1.5% very major errors. The mean turnaround time to identification and AST was 61.4 h by using the new method compared to 83.1 h by using standard procedure. Concerning cumulative percentages of final reports, approximately a third of results were available at 48 h from the check-in of the sample when using the new procedure, whereas no final reports were ready at the same time with the standard method. Conclusions The new procedure allows faster and reliable results using a simple and standardized approach. Thus, it represents an important tool for a more rapid management of blood cultures when molecular methods are not available in the laboratory.
Collapse
Affiliation(s)
- Carola Mauri
- Microbiology and Virology Unit, A. Manzoni Hospital, Lecco, Italy
| | - Luigi Principe
- Microbiology and Virology Unit, A. Manzoni Hospital, Lecco, Italy
| | - Silvia Bracco
- Microbiology and Virology Unit, A. Manzoni Hospital, Lecco, Italy.,Present address: Clinical Pathology Unit, Vimercate Hospital, Vimercate, Italy
| | - Elisa Meroni
- Microbiology and Virology Unit, A. Manzoni Hospital, Lecco, Italy
| | - Nicoletta Corbo
- Microbiology and Virology Unit, A. Manzoni Hospital, Lecco, Italy
| | - Beatrice Pini
- Microbiology and Virology Unit, A. Manzoni Hospital, Lecco, Italy
| | | |
Collapse
|
16
|
de Carvalho Filho ÉB, Marson FAL, Levy CE. Challenges in the identification of Chryseobacterium indologenes and Elizabethkingia meningoseptica in cases of nosocomial infections and patients with cystic fibrosis. New Microbes New Infect 2017; 20:27-33. [PMID: 29062487 PMCID: PMC5643076 DOI: 10.1016/j.nmni.2017.09.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 09/04/2017] [Accepted: 09/06/2017] [Indexed: 12/30/2022] Open
Abstract
Rare nonfermenting Gram-negative bacilli, such as Chryseobacterium indologenes and Elizabethkingia meningoseptica, have clinical importance in nosocomial infections and cystic fibrosis (CF), and their identification is a challenge to microbiology laboratories. Thus, the objective of this study was to verify the performance of phenotypic and mass spectrometry (matrix-assisted desorption ionization–time of flight mass spectrometry, MALDI-TOF MS) methods to identify C. indologenes and E. meningoseptica. In this context, the results obtained with phenotypic methods—namely manual biochemical and automated VITEK 2 (bioMérieux, Marcy l’Etoile, France) and Phoenix tests (Becton Dickinson (BD), San Diego, CA, USA)—and by MALDI-TOF MS—namely MALDI-TOF VITEK MS (MALDI-MS; bioMérieux) and MALDI-TOF BioTyper (MALDI-BD; BD)—of 22 isolates (blood cultures of patients with nosocomial infection (n = 15) and from patients with CF (n = 7)), initially identified as C. indologenes and E. meningoseptica, were compared. As result, using the manual phenotypic method, it was possible to identify the species level in 18/22; no identification was found in 4/22. There was a low agreement level between manual and VITEK 2 automated phenotypic methods when considering the genus level. The greatest agreement for genus-level identification occurred in MALDI-TOF MS equipment (15/22). When comparing all methods to identify the 22 isolates, there was agreement of 4/22 at the genus level and of 4/22 at the species level. In conclusion, there is low agreement level among identification methods of C. indologenes and E. meningoseptica. Although MALDI-TOF MS equipment shows a higher agreement level among them, results present low levels of confidence.
Collapse
Affiliation(s)
- É B de Carvalho Filho
- Department of Pediatrics, School of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - F A L Marson
- Department of Pediatrics, School of Medical Sciences, University of Campinas, São Paulo, Brazil.,Department of Medical Genetics, School of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - C E Levy
- Department of Clinical Pathology, School of Medical Sciences, University of Campinas, São Paulo, Brazil
| |
Collapse
|
17
|
Ko JH, Baek JY, Peck KR, Cho SY, Ha YE, Kim SH, Huh HJ, Lee NY, Kang CI, Chung DR, Song JH. Discrepant susceptibility to gentamicin despite amikacin resistance in Klebsiella pneumoniae by VITEK 2 represents false susceptibility associated with the armA 16S rRNA methylase gene. J Med Microbiol 2017; 66:1448-1450. [PMID: 28893358 DOI: 10.1099/jmm.0.000583] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Because we experienced gentamicin failure in Klebsiella pneumoniae bacteraemia that was susceptible to gentamicin despite amikacin resistance, as determined by VITEK 2, we evaluated the true susceptibility and mechanism of resistance. We screened 2818 K. pneumoniae isolates during a 1-year period at a university hospital and reviewed anti-microbial susceptibility reports using the VITEK 2 system. The minimum inhibitory concentration was substantiated by broth microdilution (BMD), and the presence of 16S rRNA methylase genes and aminoglycoside-modifying enzymes was also investigated. A total of 131 amikacin-resistant isolates from 19 patients were gentamicin non-resistant according to the VITEK 2 system. Among these, we were able to collect isolates from 12 patients (63.2 %), and a single isolate from each patient was tested. Eleven of the gentamicin non-resistant isolates (91.7 %) showed high-level resistance to both amikacin and gentamicin by BMD in association with the armA gene. Gentamicin is not an adequate treatment option for amikacin-resistant K. pneumoniae, even if VITEK 2 reports susceptibility.
Collapse
Affiliation(s)
- Jae-Hoon Ko
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea.,Present address: Division of Infectious Diseases, Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Republic of Korea
| | - Jin Yang Baek
- Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, Republic of Korea
| | - Kyong Ran Peck
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
| | - Sun Young Cho
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
| | - Young Eun Ha
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
| | - So Hyun Kim
- Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, Republic of Korea
| | - Hee Jae Huh
- Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Nam Yong Lee
- Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Cheol-In Kang
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
| | - Doo Ryeon Chung
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
| | - Jae-Hoon Song
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
| |
Collapse
|
18
|
Agarwal S, Kakati B, Khanduri S, Gupta S. Emergence of Carbapenem Resistant Non-Fermenting Gram-Negative Bacilli Isolated in an ICU of a Tertiary Care Hospital. J Clin Diagn Res 2017; 11:DC04-DC07. [PMID: 28273965 DOI: 10.7860/jcdr/2017/24023.9317] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 11/28/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The emergence and spread of Multi-Drug Resistant (MDR) Non-Fermenting Gram-Negative Bacilli (NFGNB) in Intensive Care Units (ICU) and their genetic potential to transmit diverse antibiotic resistance regardless of their ability to ferment glucose poses a major threat in hospitals. The complex interplay of clonal spread, persistence, transmission of resistance elements and cell-cell interaction leads to the difficulty in controlling infections caused by these multi drug-resistant strains. Among non-fermenting Gram-negative rods, the most clinically significant species Pseudomonas aeruginosa, Acinetobacter baumannii and Stenotrophomonas maltophilia are increasingly acquiring resistant to carbapenems. Carbapenems once considered as a backbone of treatment of life threatening infections appears to be broken as the resistance to carbapenems is on rise. AIM To document the prevalence of carbapenem resistance in non-fermenting Gram-negative bacilli isolated from patients with respiratory tract infections in the ICU of Himalayan Institute of Medical Sciences, Dehradun. MATERIALS AND METHODS This is a cross-sectional study conducted in ICU patients between October 2015 to March 2016. A total of 366 lower respiratory tract samples were collected from 356 patients with clinical evidence of lower respiratory tract infections in form of Endotracheal (ET) aspirate, Tracheal Tube (TT) aspirate and Bronchoalveolar Lavage (BAL) specimen. Organism identification and the susceptibility testing was done by using an automated system VITEK 2. RESULTS Out of 366 samples received 99 NFGNB were isolated and most common sample was ET aspirate sample 256 (64.5%). Acinetobacter baumannii was the most common NFGNB isolated 63 (63.63%) followed by Pseudomonas aeruginosa 25 (25.25%), Elizabethkingia meningoseptica seven (7.07%) and Strenotrophomonas maltophilia four (4.04%). We observed that 90.5% Acinetobacter baumannii were resistant to imipenem and 95.2% resistant to meropenem, Pseudomonas aeruginosa came out to be 52% resistant to imipenem and 56% resistant to meropenem while Stenotrophomonas maltophilia and Elizabethkingia meningoseptica were 100% resistant to carbapenems as they are intrinsically resistant to carbapenems. CONCLUSION The resistance rate of carbapenems for NFGNB infections is very high in our study and variable in different regions. Overall carbapenem resistance is on rise. So, the infection control team and microbiologist needs to work together to determine the risk carried by multi drug resistant non-fermenting gram-negative infections and the resistance surveillance programs are mandatory to control these bacteria in ICU settings.
Collapse
Affiliation(s)
- Sonika Agarwal
- Assistant Professor, Department of Critical Care Medicine, Himalayan Institute of Medical Sciences, SRHU , Dehradun, Uttarakhand, India
| | - Barnali Kakati
- Associate Professor, Department of Microbiology, Himalayan Institute of Medical Sciences, SRHU , Dehradun, Uttarakhand, India
| | - Sushant Khanduri
- Assistant Professor, Department of Critical Care Medicine, Himalayan Institute of Medical Sciences, SRHU , Dehradun, Uttarakhand, India
| | - Shalini Gupta
- Senior Resident, Department of Microbiology, Himalayan Institute of Medical Sciences, SRHU , Dehradun, Uttarakhand, India
| |
Collapse
|
19
|
AlMogbel MS. Matrix Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry for identification of Clostridium species isolated from Saudi Arabia. Braz J Microbiol 2016; 47:410-3. [PMID: 26991272 PMCID: PMC4874676 DOI: 10.1016/j.bjm.2016.01.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 08/20/2015] [Indexed: 11/27/2022] Open
Abstract
The aim of this study was to identify different Clostridium spp. isolated from currency notes from the Ha'il region of Saudi Arabia in September 2014 using MALDI-TOF-MS. Clostridium spp. were identified by Bruker MALDI-TOF-MS and compared with VITEK 2. The confirmation of the presence of different Clostridium spp. was performed by determining the sequence of the 16S ribosomal RNA gene. In this study, 144 Clostridium spp. were isolated. Among these specimens, MALDI-TOF-MS could identify 88.8% (128/144) of the isolates to the species level and 92.3% (133/144) to the genus level, whereas, VITEK 2 identified 77.7% of the (112/144) isolates. The correct identification of the 144 isolates was performed by sequence analysis of the 500bp 16S rRNA gene. The most common Clostridium spp. identified were Clostridium perfringens (67.36%), Clostridium subterminale (14.58%), Clostridium sordellii (9%) and Clostridium sporogenes (9%). The results of this study demonstrate that MALDI-TOF-MS is a rapid, accurate and user friendly technique for the identification of Clostridium spp. Additionally, MALDI-TOF-MS has advantages over VITEK 2 in the identification of fastidious micro-organisms, such as Clostridium spp. Incorporating this technique into routine microbiology would lead to more successful and rapid identification of pathogenic and difficult to identify micro-organisms.
Collapse
Affiliation(s)
- Mohammed Suliman AlMogbel
- Molecular Diagnostic and Personalized Therapeutics Unit, College of Applied Medical Sciences, University of Ha'il, Hail, Saudi Arabia.
| |
Collapse
|
20
|
Xiong J, Krajden S, Kus JV, Rawte P, Blondal J, Downing M, Zurawska U, Chapman W. Bacteremia due to Pasteurella dagmatis acquired from a dog bite, with a review of systemic infections and challenges in laboratory identification. Can J Infect Dis Med Microbiol 2015; 26:273-6. [PMID: 26600817 DOI: 10.1155/2015/946812] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Pasteurella dagmatis, a Gram-negative coccobacillus, has been isolated from both dogs and cats as normal flora. It is also a fairly new species for many clinicians because it is a pathogen in human infections. The authors present a case of bacteremia in a 74-year-old man that was caused by P dagmatis. A comparison of other reported cases of bacteremia due to P dagmatis is provided, along with a discussion of the challenges of standard automatic identification including alternative methodologies. A case of bacteremia in a 74-year-old man, which was caused by Pasteurella dagmatis and complicated by thrombocytopenia, is presented. Microorganism identification was performed by the provincial reference laboratory using traditional biochemical profiling, completmented with both the sequencing of the 16S ribosomal RNA gene and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry; antibiotic-susceptibility testing was also performed. After treatment with the appropriate antibiotics, the patient fully recovered. Systemic infections attributed to this organism are rarely reported in the literature. Other reported cases of bacteremia due to P dagmatis are reviewed and compared with the present case. The challenges of relying on standard automatic identification are discussed, with alternative methodologies provided.
Collapse
|
21
|
Lee SY, Shin JH, Kim SH, Shin MG, Suh SP, Ryang DW. Evaluation of matrix-assisted laser desorption ionization-time of flight mass spectrometry-based VITEK MS system for the identification of Acinetobacter species from blood cultures: comparison with VITEK 2 and MicroScan systems. Ann Lab Med 2014; 35:62-8. [PMID: 25553282 PMCID: PMC4272967 DOI: 10.3343/alm.2015.35.1.62] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 04/30/2014] [Accepted: 10/19/2014] [Indexed: 11/19/2022] Open
Abstract
Background Acinetobacter species are the leading cause of bloodstream infection (BSI), but their correct identification is challenging. We evaluated the matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS)-based VITEK MS (bioMérieux, France), and two automated systems, VITEK 2 (bioMérieux) and MicroScan (Siemens, USA) for identification of Acinetobacter BSI isolates. Methods A total of 187 BSI isolates recovered at a university hospital in Korea between 2010 and 2012 were analyzed. The identification results obtained using VITEK MS and two automated systems were compared with those of rpoB sequencing. Results Of 187 isolates analyzed, 176 were identified to the species level by rpoB sequencing: the Acinetobacter baumannii group (ABG; 101 A. baumannii, 43 A. nosocomialis, 10 A. pittii isolates) was most commonly identified (82.4%), followed by Acinetobacter genomic species 13BJ/14TU (5.3%), A. ursingii (2.1%), A. soli (2.1%), A. bereziniae (1.1%), and A. junii (1.1%). Correct identification rates to the species group (ABG) level or the species level was comparable among the three systems (VITEK MS, 90.3%; VITEK 2, 89.2%; MicroScan, 86.9%). However, VITEK MS generated fewer misidentifications (0.6%) than VITEK 2 (10.8%) and MicroScan (13.1%) (P<0.001). In addition, VITEK MS demonstrated higher specificity (100%) for discrimination between ABG and non-ABG isolates than the other systems (both, 31.8%) (P<0.001). Conclusions The VITEK MS system is superior to the VITEK 2 and MicroScan systems for identification of Acinetobacter BSI isolates, with fewer misidentifications and better discrimination between the ABG and non-ABG isolates.
Collapse
Affiliation(s)
- Seung Yeob Lee
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Jong Hee Shin
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Soo Hyun Kim
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Myung Geun Shin
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Soon Pal Suh
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Dong Wook Ryang
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| |
Collapse
|
22
|
Schröttner P, Rudolph WW, Eing BR, Bertram S, Gunzer F. Comparison of VITEK2, MALDI-TOF MS, and 16S rDNA sequencing for identification of Myroides odoratus and Myroides odoratimimus. Diagn Microbiol Infect Dis 2014; 79:155-9. [PMID: 24666701 DOI: 10.1016/j.diagmicrobio.2014.02.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 01/30/2014] [Accepted: 02/01/2014] [Indexed: 11/17/2022]
Abstract
The genus Myroides comprises the 2 medically relevant species Myroides odoratus and Myroides odoratimimus that are rare opportunistic pathogens and cause infections in immunocompromised patients. A fast identification of Myroides is of importance because these bacterial strains show multiple resistance against antibiotics and therefore limit treatment options. They are associated, for instance, with urinary tract infections, sepsis, meningitis, pneumonia, and infectious cellulitis. Since more and more Myroides spp. are being described, additional potentially pathogenic bacteria may be identified in the future demanding the need for fast and reliable identification methods at species level. However, to date, only molecular approaches meet these demands. In this study, we, therefore, attempt to define an appropriate method other than DNA fingerprinting that will permit a comparable efficacy and, possibly, a more economical strain identification. For this purpose, we compared 2 widely used automated diagnostic systems (VITEK 2 [bioMérieux, Nürtingen, Germany] and Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) [Bruker Daltonics, Bremen, Germany]) and correlated the results to 16S rDNA sequencing data. In total, we analyzed 22 strains collected in the course of routine diagnostics. In this study, we demonstrate that VITEK 2 reliably identifies the genus Myroides but cannot differentiate between M. odoratimimus and M. odoratus. In contrast to this, both MALDI-TOF MS and 16S rDNA sequencing efficiently distinguish between the 2 species.
Collapse
Affiliation(s)
- Percy Schröttner
- Institut für Medizinische Mikrobiologie und Hygiene, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Wolfram W Rudolph
- Institut für Virologie, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307 Dresden, Germany
| | - Bodo R Eing
- Synlab Medizinisches Versorgungszentrum Augsburg GmbH, Gubener Straße 39, 86156 Augsburg, Germany
| | - Sebastian Bertram
- Synlab Medizinisches Versorgungszentrum Augsburg GmbH, Gubener Straße 39, 86156 Augsburg, Germany
| | - Florian Gunzer
- Institut für Medizinische Mikrobiologie und Hygiene, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307 Dresden, Germany; Institut für Virologie, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307 Dresden, Germany
| |
Collapse
|
23
|
Schröttner P, Schultz J, Rudolph W, Gunzer F, Thürmer A, Fitze G, Jacobs E. Actinobacillus equuli ssp. haemolyticus in a semi-occlusively treated horse bite wound in a 2-year-old girl. Ger Med Sci 2013; 11:Doc14. [PMID: 24068980 PMCID: PMC3782719 DOI: 10.3205/000182] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 09/16/2013] [Indexed: 11/30/2022]
Abstract
We report on the isolation of Actinobacillus equuli ssp. haemolyticus from wound smears of a 2-year-old girl who was admitted to the hospital due to partial amputation of the distal phalanx of her right middle finger caused by a horse bite. A. equuli typically causes diseases in horses and only very few reports describing human infections (mostly associated with wounds) are available in the literature. Interestingly, although the bacteria could be found in consecutive samples taken at different points in time, there were no signs of advancing infection or inflammation. Moreover, the fingertip regenerated after 74 days under semi-occlusive dressings with very pleasant results. For strain identification two automated systems were employed producing discrepant results: VITEK 2 described the pathogens as Pasteurella pneumotropica while MALDI-TOF MS analysis revealed A. equuli. Sequence analysis of 16S rDNA gene finally confirmed A. equuli ssp. haemolyticus as the isolated strain. The antimicrobial susceptibility testing was performed according to the CLSI criteria for Pasteurella spp. Additionally we conducted a test according to the EUCAST criteria.
Collapse
Affiliation(s)
- Percy Schröttner
- Faculty of Medicine, Institute of Medical Microbiology and Hygiene,Universitätsklinikum Carl-Gustav-Carus, Dresden, Germany
| | | | | | | | | | | | | |
Collapse
|
24
|
Lo Cascio G, Bazaj A, Maccacaro L, Fontana R, Centonze AR, Sorrentino A, Mazzariol A. Performance of different commercial methods for determining minimum inhibitory concentrations of glycopeptides and linezolid against blood isolates of Staphylococcus aureus. J Glob Antimicrob Resist 2013; 1:163-169. [PMID: 27873627 DOI: 10.1016/j.jgar.2013.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 05/07/2013] [Accepted: 05/15/2013] [Indexed: 11/27/2022] Open
Abstract
The aim of this study was to determine the accuracy of commercial systems (VITEK® 2, Etest and Sensititre®) in determining the minimum inhibitory concentrations of vancomycin, teicoplanin and linezolid of Staphylococcus aureus strains and to evaluate the reproducibility of each system in a clinical microbiology laboratory. In total, 115 strains of S. aureus isolated from blood cultures were tested with all three commercial methods as well as the broth microdilution method, which is designated as the standard for glycopeptides and linezolid. Fourteen different S. aureus strains were included in a reproducibility test for all methods and antibiotics. For these strains, antimicrobial susceptibility testing was repeated 10 times on different days with all four methods, each time using the same inoculum. All three commercial methods exhibited similar performance in categorisation of nearly all of the meticillin-susceptible S. aureus (MSSA) isolates. Discrepancies were registered for meticillin-resistant S. aureus (MRSA); 2.5% of the strains in the intermediate or resistant category with the VITEK 2 system were not recognised as resistant by Etest and Sensititre. Moreover, none of the three commercial methods provided accurate results compared with homemade broth microdilution. Reproducibility of vancomycin and teicoplanin was 100% with VITEK 2 and Sensititre and 98.75% with Etest. Microdilution showed a reproducibility of 95.6% with vancomycin and 83.1% with teicoplanin. In contrast to previous reports, the best agreement with microdilution was exhibited by VITEK 2 both for MSSA and MRSA. For the antibiotics tested, the best reproducibility was obtained with the VITEK 2 and Sensititre systems.
Collapse
Affiliation(s)
- G Lo Cascio
- Department of Pathology and Diagnostics, Servizio di Microbiologia e Virologia, Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale Stefani 1, 37100 Verona, Italy
| | - A Bazaj
- Department of Pathology and Diagnostics, Verona University, Strada Le Grazie 8, 37134 Verona, Italy
| | - L Maccacaro
- Department of Pathology and Diagnostics, Servizio di Microbiologia e Virologia, Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale Stefani 1, 37100 Verona, Italy
| | - R Fontana
- Department of Pathology and Diagnostics, Verona University, Strada Le Grazie 8, 37134 Verona, Italy
| | - A R Centonze
- Department of Pathology and Diagnostics, Verona University, Strada Le Grazie 8, 37134 Verona, Italy
| | - A Sorrentino
- Department of Pathology and Diagnostics, Servizio di Microbiologia e Virologia, Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale Stefani 1, 37100 Verona, Italy
| | - A Mazzariol
- Department of Pathology and Diagnostics, Verona University, Strada Le Grazie 8, 37134 Verona, Italy.
| |
Collapse
|