Chronic Diarrhea Caused by a Klebsiella oxytoca Toxin Producer Strain Following Antibiotic-Associated Hemorrhagic Colitis: Successful Treatment by Fecal Microbiota Transplant

Klebsiella oxytoca is a gram-negative bacterium found in fecal microbiota and known to cause several infections in humans, including antibiotic-associated hemorrhagic colitis. We present here a case of colitis caused by K. oxytoca toxin-producing strains that evolved in chronic diarrhea successfully treated by fecal microbiota transplant.

The effect of exposure to non-ionising radiofrequency field on Escherichia coli, Klebsiella oxytoca and Pseudomonas aeruginosa biofilms

An environment with a higher accumulation of electromagnetic non-ionising radiofrequency (RF) emissions generated by various telecommunication, data transport and navigation devices (mobile phones, Wi-Fi, radar, etc.) may have a major impact on biological systems. This study aimed to evaluate the incidence of an electromagnetic field (EMF) on the development of bacterial biofilm. Quantification of biofilm production was done by using microtiter plate assay. Bacterial isolates of Escherichia coli, Klebsiella oxytoca and Pseudomonas aeruginosa were exposed with EMF of frequencies 1-5 and 2.4 GHz with an exposure time 3 or 24 h, respectively. Exposure of bacteria to EMF produced a statistically significant increase in biofilm production mainly at 1, 2 and 4 GHz, and in contrast, a significant inhibition of biofilm development occurred at frequencies 3 and 5 GHz, both with exception of K. oxytoca and P. aeruginosa. Wi-Fi operating at 2.4 GHz caused biofilm reduction. The results indicate that EMF exposure act on bacteria in both ways, depending on the frequency: as stressful by enhancing bacterial biofilm formation (under environmental stress, bacteria produce a polysaccharide matrix and aggregate to form biofilms to increase virulence and resistance), although some frequencies leading to biofilm damage could be caused by changes to the physicochemical properties of bacteria.

Prevalence, molecular characterization of integrons and its associated gene cassettes in Klebsiella pneumoniae and K. oxytoca recovered from diverse environmental matrices

The high prevalence of infections arising from Klebsiella species is related to their ability to acquire and disseminate exogenous genes associated with mobile genetic elements such as integrons. We assessed the prevalence, diversity, and associated gene cassettes (GCs) of integrons in Klebsiella species. The isolates recovered from wastewater and hospital effluents, rivers, and animal droppings were identified using the conventional Polymerase Chain Reaction (PCR) with primers targeting the gryA, pehX, and 16S-23S genes. The antimicrobial resistance profile and the Extended-Spectrum and Metallo β-lactamases production were carried out using standard microbiological techniques. PCR, DNA sequencing analyses, and Restriction Fragment Length Polymorphism were used to characterize the integrons and their associated GCs. Furthermore, the genotypic relationships between the different isolated K. pneumoniae were determined using Enterobacterial Repetitive Intergenic Consensus (ERIC)-PCR. About 98% (51/52) of the confirmed isolates harboured an integrase gene, with 80% intI1, while the remaining 20% concurrently harboured intI1 and intI2, with no intI3 observed. About 78% (40/51) of the bacterial strains were positive for a promoter, the P2R2, investigated, while 80% (41/51) harboured at least one of the qacEΔ1 and sul1. Three different GCs arrangements identified were aac(6')-Ib, aadA1-dfrA1, and dfrA1-sat2. At a similarity index of 60%, the ERIC-PCR fingerprints generated were categorized into nine clusters. Our study is the first to reveal the features of integrons in Klebsiella spp. recovered from environmental sources in the Eastern Cape Province, South Africa. We conclude that the organisms' sources are repositories of integrons harbouring various gene cassettes, which can be readily mobilized to other microorganisms in similar or varied niches.

Genomic features of Klebsiella isolates from artisanal ready-to-eat food production facilities

Increasing reports on K. pneumoniae strains with antimicrobial resistance and virulence traits from food and farm animals are raising concerns about the potential role of Klebsiella spp. as a foodborne pathogen. This study aimed to report and characterize Klebsiella spp. isolates from two artisanal ready-to-eat food (soft cheese and salami) producing facilities, and to track similar genotypes in different ecological niches. Over 1170 samples were collected during the whole production chain of different food batches. The overall Klebsiella prevalence was 6%. Strains were classified into the three Klebsiella species complexes: K. pneumoniae (KpSC, n = 17), K. oxytoca (KoSC, n = 38) and K. planticola (KplaSC, n = 18). Despite high genetic diversity we found in terms of known and new sequence types (STs), core genome phylogeny revealed clonal strains persisting in the same processing setting for over 14 months, isolated from the environment, raw materials and end-products. Strains showed a natural antimicrobial resistance phenotype-genotype. K. pneumoniae strains showed the highest virulence potential, with sequence types ST4242 and ST107 strains carrying yersiniabactin ybt16 and aerobactin iuc3. The latter was detected in all K. pneumoniae from salami and was located on a large conjugative plasmid highly similar (97% identity) to iuc3+ plasmids from human and pig strains circulating in nearby regions of Italy. While identical genotypes may persist along the whole food production process, different genotypes from distinct sources in the same facility shared an iuc3-plasmid. Surveillance in the food chain will be crucial to obtain a more comprehensive picture of the circulation of Klebsiella strains with pathogenic potential.

In vitro susceptibility of common Enterobacterales to eravacycline in Taiwan

BACKGROUND

New tetracycline derivatives exhibit broad-spectrum antimicrobial activities. This study aimed to assess the in vitro activity of eravacycline against common Enterobacterales.

METHODS

Clinical Enterobacterales isolates were collected between 2017 and 2021. The minimum inhibitory concentration (MIC) was determined using a broth microdilution test.

RESULTS

We identified Klebsiella pneumoniae (n = 300), Escherichia coli (n = 300), Klebsiella oxytoca (n = 100), Enterobacter cloacae complex (n = 100), Citrobacter freundii (n = 100), and Proteus mirabilis (n = 100). All P. mirabilis strains were resistant to eravacycline. Excluding P. mirabilis, the susceptibility rates to eravacycline, omadacycline, and tigecycline were 75.2%, 66.9%, and 73%, respectively. The MIC₅₀ and MIC₉₀ (mg/L) of eravacycline were 0.5 and 4 for K. pneumoniae, 0.5 and 1 for E. coli, 0.5 and 1 for K. oxytoca, 0.5 and 2 for E. cloacae complex, and 0.25 and 1 for C. freundii. In cefotaxime non-susceptible and meropenem susceptible Enterobacterales, excluding P. mirabilis, the susceptibility rates of eravacycline, omadacycline, and tigecycline were 69.7%, 57.1%, and 66.2%. We found decreased susceptibility rates of three new tetracycline derivatives against meropenem non-susceptible Enterobacterales (eravacycline: 47.1%, omadacycline: 39.4%, and tigecycline: 39.4%). Eravacycline showed a high susceptibility rate against cefotaxime non-susceptible and meropenem susceptible K. oxytoca (100%), C. freundii (93.2%), E. coli (85.9%), and meropenem non-susceptible E. coli (100%).

CONCLUSION

This study provides the MIC and susceptibility rate of eravacycline for common Enterobacterales. Eravacycline could be a therapeutic choice for cefotaxime non-susceptible or meropenem non-susceptible Enterobacterales, especially K. oxytoca, C. freundii, and E. coli.

Klebsiella oxytoca (EN-B2): A novel type of simultaneous nitrification and denitrification strain for excellent total nitrogen removal during multiple nitrogen pollution wastewater treatment

The poor total nitrogen (TN) removal rate achieved using microorganisms to treat wastewater polluted with multiple types of nitrogen was improved using a novel simultaneous nitrification and denitrification strain (Klebsiella oxytoca EN-B2). Strain EN-B2 rapidly eliminated ammonium, nitrate, and nitrite, giving maximum elimination rates of 4.58, 7.46, and 7.83 mg/(L h), respectively, equivalent to TN elimination rates of 4.35, 6.92, and 7.11 mg/(L h), respectively. The simultaneous nitrification and denitrification system gave ammonium and nitrite elimination rates of 7.14 and 9.17 mg/(L h), respectively, and a TN elimination rate ≥ 9.0 mg/(L h). Nitrogen balance calculations indicated that 51.22 %, 31.62 % and 46.82 % of TN in systems containing only ammonium, nitrite, and nitrate, respectively, were lost as nitrogenous gases. The ammonia monooxygenase, hydroxylamine oxidoreductase, nitrate reductase and nitrite reductase enzyme activities were determined. The results indicated that strain EN-B2 can be used to treat wastewater polluted with multiple types of nitrogen.

Simultaneous gut colonization by Klebsiella grimontii and Escherichia coli co-possessing the blaKPC-3-carrying pQil plasmid

Only two plasmid-mediated carbapenemases (KPC-2 and VIM-1) are reported in Klebsiella grimontii. Here, we report two bla_KPC-3-positive isolates that were identified as K. oxytoca and E. coli by MALDI-TOF MS in the same rectal swab. Whole-genome sequencing indicated that K. oxytoca was actually K. grimontii of ST391, whereas E. coli was of ST10. In both, bla_KPC-3 was carried by a pQil conjugative plasmid. The core-genome analysis identified additional bla_KPC-positive K. grimontii strains from public databases, most of which were misidentified as K. oxytoca. Since K. grimontii represents an emerging reservoir of resistance traits, routine tools should improve their ability to detect this species.

Assessment of ß-lactams and Carbapenems Antimicrobials Resistance in Klebsiella Oxytoca Isolated from Patients with Urinary Tract Infections in Najaf, Iraq

Antimicrobial resistance is becoming an arising global issue. Until recent years, more than 50% of commercially available antibiotics were ß-lactam. Pathogenic bacteria which are resistant to antibiotics include all ß-lactams except for cephamycin and carbapenems. This study aimed to evaluate some ß-lactams and carbapenems antimicrobials resistance in Klebsiella oxytoca. In total, 177 urinary tract infection samples were collected for the purposes of the study. Isolates were identified using morphological features and routine biochemical testing. All isolates were tested for susceptibility to 11 antibiotics using the usual disc diffusion method. The result showed that 155 (87.57%) and 20 (11.29%) out of 177 collected urine samples were gram-negative bacterial isolates and gram-positive bacterial isolates, respectively. The findings also showed that there were two samples (1.12 %) with no growth. The results proved no susceptibility to Ampicillin, Cloxacillin, Ceftazidime, Penicillin, Piperacillin with a resistance rate of 100%.

Cu transport and distribution in different cellular fractions of Klebsiella oxytoca strain CAV 1374

This study elucidated copper (Cu) transport and trafficking mechanisms at the cellular interface using the Cu-resistant strain Klebsiella oxytoca CAV 1374. The optimum conditions for biosorption were determined by investigating uptake rates due to initial pH, initial Cu concentrations, and maximum tolerated concentrations (MTC) of Cu. Cellular fraction analysis and depth-profiling XPS were used to comprehensively evaluate the spatial-temporal distribution of Cu on cellular interfaces during biosorption. Potential uptake mechanisms were then further examined by biosorption kinetics analyses, ion exchange experiments, FTIR analysis, and K⁺ channel blocking experiments. The results indicated that Cu was primarily absorbed by extracellular polymeric substances through chemical interactions and little Cu penetrated inside cells under low Cu stress conditions (≤20 mg/L). In contrast, an intracellular rate-controlling physical interaction was predominant under high Cu stress conditions (≥30 mg/L). Further, Cu²⁺ could be bound by functional groups, followed first by replacement of Ca²⁺ at the cell surface. Subsequently, some of the Cu²⁺ in cell walls was reduced to Cu⁺, and only Cu⁺ could then penetrate into cell membranes. These results indicate that strain Klebsiella oxytoca CAV 1374 is a suitable biosorbent agent for Cu removal and can provide critical insights into Cu-uptake mechanisms of microorganisms.

1H, 15 N and 13C resonance assignments of the C-terminal domain of PulL, a component of the Klebsiella oxytoca type II secretion system

Type II secretion systems (T2SS) allow Gram-negative bacteria to transport toxins and enzymes from the periplasm to the external milieu, and are thus important for the pathogenicity of bacteria. To drive secretion, T2SS assemble filaments called pseudopili closely related to bacterial type IV pili. These filaments are non-covalent polymers of proteins that are assembled by an inner membrane complex called the assembly platform connected to a cytoplasmic ATPase motor. In the Klebsiella oxytoca T2SS, the PulL protein from the assembly platform is essential for pseudopilus assembly and protein secretion. However, its role in these processes is not well understood. To decipher the molecular basis of PulL function, we used solution NMR to study its structure and interactions with other components of the machinery. Here as a first step, we report the ¹H, ¹⁵ N and ¹³C backbone and side-chain chemical shift assignments of the C-terminal periplasmic domain of PulL and its secondary structure based on NMR data.

Patient with systemic emboli in the setting of Klebsiella oxytoca tricuspid valve endocarditis and patent foramen ovale treated with NobleStitch and AngioVac

A 34-year-old man with a medical history of injection drug use presented with 2 weeks of weakness, nausea, vomiting and septic shock secondary to infective endocarditis of a native tricuspid valve. On admission, CT chest demonstrated multiple cavitary lesions as well as numerous small infarcts seen on MRI brain concerning for systemic septic emboli. Subsequent transthoracic echo with bubble study revealed a large patent foramen ovale (PFO). The patient later received surgical debulking of his tricuspid valve vegetation with AngioVac. Subsequently, PFO closure was performed with a NobleStitch device. The case presented here demonstrates the importance of having a high index of suspicion with right-sided endocarditis and the development of other systemic signs and symptoms. It also underscores the necessity of a multidisciplinary team of cardiologists, surgeons, infectious disease specialists and intensivists in the treatment of these complicated patients.

Plant metabolomics integrated with transcriptomics and rhizospheric bacterial community indicates the mitigation effects of Klebsiella oxytoca P620 on p-hydroxybenzoic acid stress in cucumber

Accumulation of p-hydroxybenzoic acid (PHBA) in soil causes autotoxicity stress in cucumber. When the stress is mitigated by PHBA-degrading bacteria, plant metabolites have not been detected. To explore mechanisms underlining the mitigation, plant metabolites have not been combined with rhizospheric microbes, antioxidant and soil enzymes. In this study, a strain P620 of Klebsiella decomposed PHBA to acetyl CoA. Cucumber was sown into soil supplemented with P620 and/or PHBA. After addition with P620, P620 colonization and the enriched bacterial genera were observed in rhizosphere. Compared to PHBA stress alone, the combination of P620 application and PHBA stress improved plant growth, decreased PHBA concentration in soil, and increased the activities of five soil enzymes and eight antioxidant enzymes in leaves. Metabolomic and transcriptomic analysis highlighted that P620 application decreased the intensities of MAG(18:3) isomer 4, MAG(18:3) isomer 2, lysoPC 18:3 (2n isomer), 2'-deoxyadenosine-5'-monophosphate, pyridoxine, and glucarate O-phosphoric acid in PHBA-stressed leaves and down-regulated the expression of genes related to these metabolites. We propose a mechanism that P620 application alters microbial communities in PHBA-contaminated soil. Thus, the application reduces PHBA concentration in soil, activates antioxidant and soil enzymes, and also influences metabolites in leaves by affecting plant transcriptome, mitigating PHBA stress in cucumber.

Isolation, biosynthesis and antimicrobial activity of gold nanoparticles produced with extracts of Anabaena spiroides

Multidrug-resistant (MDR) pathogenic bacteria have become dangerous in bringing sporadic outbreaks in public health and nosocomial spreads from the addition of antibacterials/antibiotics continually. Obviously, the pharmacy world is in search of antibacterials that would be invincible by the evolved bacteria. Green synthesis of gold-nanoparticles (AuNps) was focused on the use of aqueous chloroauric acid (HAuCl₄) and cell-free aqueous extract of the N₂-fixing cyanobacterium (blue-green alga) Anabaena spiroides collected from a brackish-water, Bay of Bengal at Puri, Odisha; green-synthesized AuNps could be used as antibacterials against MDR bacteria. The synthesized AuNps were subjected to the following characterizations, UV-Vis spectrophotometry, SEM-EDX, XRD and ART-FTIR analysis. An absorption peak at 538 nm by UV-Vis spectrophotometry and the FTIR analysis confirmed the presence of AuNps. A. spiroides-AuNps were monitored for antibacterial activities against MDR pathogenic bacterial strains isolated from clinical samples, namely, Klebsiella oxytoca, MRSA and Streptococcus pyogenes, in vitro; the individual antibiograms of those bacteria were known. The recorded MIC dose values were 25, 20 and 30 mg A. spiroides-AuNps (As-AuNps) against K. oxytoca, MRSA and S. pyogenes, in vitro, respectively. Thus, As-AuNps bear promises as possible antibacterials, in future.

Degradation kinetics of carbendazim by Klebsiella oxytoca, Flavobacterium johnsoniae, and Stenotrophomonas maltophilia strains

The fungicide carbendazim is an ecotoxic pollutant frequently found in water reservoirs. The ability of microorganisms to remove pollutants found in diverse environments, soil, water, or air is well documented. Although microbial communities have many advantages in bioremediation processes, in many cases, those with the desired capabilities may be slow-growing or have low pollutant degradation rates. In these cases, the manipulation of the microbial community through enrichment with specialized microbial strains showing high specific growth rates and high rates and efficiencies of pollutant degradation is desirable. In this work, bacteria of the genera Klebsiella, Flavobacterium, and Stenotrophomonas, isolated from the biofilm attached to the packed zones of a biofilm reactor, were able to grow individually in selective medium containing carbendazim. In the three bacteria studied, the mheI gene encoding the first enzyme involved in the degradation of the fungicide carbendazim was found. Studying the dynamics of growth and carbendazim degradation of the three bacteria, the effect of co-formulants was also evaluated. The pure compound and a commercial formulation of carbendazim were used as substrates. Finally, the study made it possible to define the biokinetic advantages of these strains for amendment of microbial communities.

Engineering of Klebsiella oxytoca for production of 2,3-butanediol via simultaneous utilization of sugars from a Golenkinia sp. hydrolysate

The Klebsiella oxytoca was engineered to produce 2,3-butanediol (2,3-BDO) simultaneously utilizing glucose and galactose obtained from a Golenkinia sp. hydrolysate. For efficient uptake of galactose at a high concentration of glucose, Escherichia coli galactose permease (GalP) was introduced, and the expression of galP under a weak-strength promoter resulted in simultaneous consumption of galactose and glucose. Next, to improve the sugar consumption, a gene encoding methylglyoxal synthase (MgsA) known as an inhibitor of multisugar metabolism was deleted, and the mgsA-null mutant showed much faster consumption of both sugars than the wild-type strain did. Finally, we demonstrated that the engineered K. oxytoca could utilize sugar extracts from a Golenkinia sp. hydrolysate and successfully produces 2,3-BDO.

1H, 15N and 13C resonance assignments and secondary structure of PulG, the major pseudopilin from Klebsiella oxytoca type 2 secretion system

Bacteria use complex transporters to secrete functionally relevant proteins to the extracellular medium. The type 2 secretion system (T2SS) translocates folded proteins involved in bacterial nutrient acquisition, virulence and adaptation. The T2SS pseudopilus is a periplasmic filament, assembled by the polymerization of PulG subunits, the major pseudopilin. Pseudopilin proteins have a conserved N-terminal hydrophobic segment followed by a more variable C-terminal periplasmic and globular domain. To better understand the mechanism of assembly and function of the T2SS, we have been studying the structure and dynamics of PulG by NMR, as well as its interaction with other components of the secretion machinery. As a first step on this study, here we reported the chemical shift assignments of PulG C-terminal domain and its secondary structure prediction based on NMR data.

Abscess-a rare fourth ventricular mass

Midline posterior fossa mass lesions in young adults are usually medulloblastomas, pilocytic astrocytomas, haemangioblastomas or ependymomas. We present clinical, imaging and intraoperative findings of an abscess occurring within the fourth ventricle which was associated with right chronic suppurative otitis media and right transverse sinus thrombosis. The possible pathogenesis is discussed.

Fulminant infection with emphysematous changes in the biliary tract and air-filled liver abscesses

Gas-producing infections are related to anaerobic bacteria and usually associated with immunosuppressive pathologies such as diabetes and have a fulminating course. We present the clinical course of a patient with diabetes whose infection progressed rapidly and ended in her dramatic death in a short period; surgical therapy was impossible, and the disease behaved similarly to type I emphysematous pyelonephritis.

[A 52 year-old woman with fever, cough and dyspnoea]

A 52 year-old woman with gastric cancer treated with surgery and chemotherapy, is admitted in our Internal Medicine Department because of the presence of fever (max 41.2 degrees C), dyspnoea, non-productive cough and mental confusion. The anamnesis and the physical examination address to the diagnosis of CAP (Community-Acquired Pneumonia); in particular the alteration of consciousness and the onset of symptoms after the insertion of a nose-gastric tube let us to consider the diagnosis of aspiration pneumonia. The clinical presentation and radiological imaging (Rx and CT of thorax) suggest the pattern of bronchiolitis obliterans with organizing pneumonia (BOOP). BOOP is not a disease, but a non specific pattern of answer to a lung injury. It can be either idiopathic or associated with a variety of causes, such as infections, drugs, radiations and connective tissue diseases. Besides the clinical course is complicated by the onset of an ARDS (Adult Respiratory Distress Syndrome). The gold standard for the diagnosis is represented by lung biopsy with hystopathologic confirmation but, if it cannot be done, it's necessary to start immediately steroid therapy because BOOP may be fatal. The patient received antibiotic and steroid therapy with success.

Struvite Penile Urethrolithiasis in a Pygmy Sperm Whale (Kogia breviceps)

Massive urolithiasis of the penile urethra was observed in an adult pygmy sperm whale (Kogia breviceps) stranded on Topsail Island, North Carolina, USA. Calculi occupied the urethra from just distal to the sigmoid flexure to the tip of the penis for a length of 43 cm. A urethral diverticulum was present proximal to the calculi. The major portion of the multinodular urolith weighed 208 g and was 16 cm long x 3.7 cm diameter at the widest point. The urolith was composed of 100% struvite (magnesium ammonium phosphate) and on culture yielded Klebsiella oxytoca, a urease-positive bacterium occasionally associated with struvite urolith formation in domestic animals. Reaction to the calculi was characterized histologically by moderate multifocal to coalescing plasmacytic balanitis and penile urethritis. Role of the urethrolithiasis in the whale's stranding is speculative but could have involved pain or metabolic perturbations such as uremia or hyperammonemia.

[Specific biological features of opportunistic bacteria determining dysbacteriosis in the composition of the large intestine normal microflora]

Dysbiotic manifestations in the gastrointestinal tract are widely spread. They are characterized by a prolonged, persistent course with the tendency to transition to the chronic form and poorly respond to corrective treatment. The occurrence of high concentrations is 70% for Klebsiella oxytoca, while for K. pneumoniae--within the limit of 30%. The most topical problem is colonization of the intestinal mucosa in children aged up to 1 year by Klebsiella, the seeded bacteria retaining their capacity for growth for up to 2-3 years despite the use of probiotics. As shown in this study, the occurrence of Klebsiella and the level of the antilysozyme and "antiinterferon" activity of these bacteria, their resistance to antimicrobial preparations increase, correlating with the level of dysbiotic disturbances.

[Epidemiological and clinical studies of ovine caseous lymphadenitis]

A field survey was undertaken, to determine epidemiological, clinical and biological data on Ovine Caseous Lymphadenitis disease in 54 flocks originated from Sfax area in Tunisia. The mean morbidity rate of the cutaneous form was 5.1%. This form affected sheep over 3 months and under 2 years old. On the other hand, the mean morbidity rate of the visceral form, encountered in abattoirs, was 11.02%. The clinical aspect of the superficial (or cutaneous) form was often corresponding to one abscess, located particularly in the lymphatic nodes of the animal's head; while visceral (or internal) form of the disease was represented by the presence of a unique abscess found in the pulmonary lymphatic nodes. The macroscopic aspect of lesions showed that the size of abscess was comprised between 4 and 10 cm in diameter. At the cut, colour of the pus was white yellowish to yellow greyish with a fluid or a thick aspect like onion peels; pus was microscopic. Lesions were characterised by a fibrous shell, a pyogenic membrane and a necrotic center. Bacteriological research revealed that Corynebacterium pseudotuberculosis was the pathogen the most frequently isolated, followed by Staphylococcus aureus subsp anaerobius which was particularly found in sheep aged between 3 months and 2 years old.