Neonatal plesiomonas shigelloides septicemia: case report and literature review / 中国新生儿科杂志

Objective:To study the clinical characteristics of neonatal plesiomonas shigelloides (P. shigelloides) septicemia.Methods:The clinical data of a neonate with P.shigelloides septicemia admitted to the Department of Neonatology of our hospital were reviewed. Literature on this subject were searched in the following databases: CNKI, CQVIP database, Wanfang Database, SinoMed, PubMed and Web of Science (up to April 2022).The clinical characteristics of reported cases of neonatal P.shigelloides septicemia were analyzed.Results:Our patient was a full-term female neonate with symptoms of tachypnea, groaning, hypotension, septic shock and poor intestinal peristalsis. The cardiac and pulmonary ultrasound indicated pulmonary hypertension and right pleural effusion (empyema). The X-ray suggested pneumothorax. The blood culture showed P.shigelloides. Lumbar puncture and brain imaging showed no central nervous system involvement. After meropenem, penicillin and symptomatic treatment, the patient was cured and discharged without sequelae. In the literature review, 14 articles and 14 cases of neonatal P.shigelloides septicemia were found (a total of 15 cases including our case).All 15 cases had fever, 10 with convulsion/seizure, 8 had jaundice, 8 with respiratory distress/respiratory failure, 6 had feeding difficulty and 6 were irritable. Brain imaging features were hydrocephalus and panencephalitis. Antibiotics and symptomatic treatment were the main therapy. 8 cases died and 7 cases survived including 2 cases with neurological sequelae.Conclusions:Neonatal P.shigelloides septicemia has nonspecific manifestations, often involves multiple organs with significant neurological involvement and a high mortality rate.

Plesiomonas shigelloides exports a lethal cytotoxic-enterotoxin (LCE) by membrane vesicles

ABSTRACT Plesiomonas shigelloides isolated from water in Brazil was previously described as a hemorrhagic heat-labile cytotoxic-enterotoxin producer. We purified this toxin from culture supernatants using ion metallic affinity chromatography (IMAC) followed by molecular exclusion chromatography. The pure toxin presented molecular mass of 50 kDa and isoelectric point (pI) around 6.9 by 2D electrophoresis. When injected intravenously, the purified cytotoxic-enterotoxin induced also severe spasms followed by sudden death of mice. Hence, we entitled it as lethal cytotoxic-enterotoxin (LCE). The presence of membrane vesicles (MVs) on cell surfaces of P. shigelloides was observed by scan electron microscopy (SEM). From these MVs the LCE toxin was extracted and confirmed by biological and serological assays. These data suggest that P. shigelloides also exports this cytotoxic-enterotoxin by membrane vesicles, a different mechanism of delivering extra cellular virulence factors, so far not described in this bacterium.

Caracterización de factores de virulencia y susceptibilidad antimicrobiana en cepas de Plesiomonas shigelloides aisladas de pacientes con diarrea aguda en Cuba / Virulence factors and in vitro susceptibility of Plesiomonas shigelloides isolated from diarrhea episodes in Cuba

Acute diarrhea is still one of the main causes of disease in developing countries. At the National Reference Laboratory for Acute Diarrhoeal Diseases, of the "Pedro Kourí" Tropical Medicine Institute, 54 Plesiomonas shigelloides strains were serotyped. As a result, the circulation of four new serotypes (O20:H2, 056:H18, 071 :H31,081 :H22) was detected. The most common antigenic variant was 094:H3. In addition, the susceptibility pattern to 21 antimicrobial agents (AA) was studied. Highest percentages of resistance were observed to ampicillin (77.7 percent), tetracycline (29.2 percent), and erythromycin (18.5 percent) while, to all other AA the resistance percentages were under 33 percent. There was no evidence of association between the serotypes and the multi-resistance patterns present in the strains under study. The frequency of virulence factors was determined: 21.15 percent of the strains turned out to be ß-haemolytic; 73.7 percent showed the presence of biofilm and 92.31 percent were hydrophobic. In 17.3 percent of the strains, the three virulence factors analysed were present. When establishing the relationship among the different virulence factors and the serotypes of the strains through cross reaction with the Shigella genus, there was evidence that 93.3 percent of the strains showed at least one of the virulence factors studied. Likewise, at least one of the virulence factors analysed was present in 90.9 percent of the multi-resistant strains.

La diarrea aguda (DA) continúa siendo una de las principales causas de consulta en los países en vías de desarrollo. Un agente de baja prevalencia en DA es Plesiomonas shigelloides. En el Laboratorio Nacional de Referencia de Enfermedad Diarreica Aguda del IPK se estudiaron 54 cepas conservadas de P. shigelloides. Se determinó el serotipo detectándose por primera vez en el país la circulación de cuatro serotipos (O20:H2, 056:H18, 07LH31, 08LH22) así como la vanante antigénica de mayor prevalencia (094:H3). Se estudió el comportamiento de las cepas frente a 21 agentes antimicrobianos obteniéndose los mayores porcentajes de resistencia frente a ampicilina (77,7 por ciento), tetraciclina (29,2 por cientoo) y eritromicina (18,5 por ciento) mientras que para el resto se obtuvieron porcentajes de resistencia inferior a 33 por cientoo. No se evidenció asociación entre los serotipos y los patrones de multi-resistencia presentes en las cepas del estudio. Se estudiaron los factores de virulencia: actividad hemolítica, producción de exo-polisacáridos y adherencia a hidrocarburos. El 22,2 por ciento de las cepas resultaron B hemolíticas, 72,2 por cientoo presentó bio-película y 92,31 por ciento fueron hidrofóbicas. El 17,3 por ciento de las cepas presentaron los tres factores de virulencia. Estableciendo una relación entre los factores de virulencia y los serotipos de las cepas con reacción cruzada con el género Shigella se evidenció que 93,3 por cientoo de las cepas presentaron al menos uno de los factores de virulencia. El 90,9 por cientoo de las cepas multi-resistentes presentó al menos uno de ellos.

Suceptibilidad antimicrobiana de bacilos gramnegativos anaerobios facultativos oxidasa positiva / Susceptibility antimicrobial of bacilli gram negative facultative anaerobes positive oxidase

El carácter autolimitado de las infecciones entéricas provocadas por los bacilos gramnegativos anaerobios facultativos oxidasa positiva reserva la terapia antimicrobiana para los casos de disentería severa, enfermedad parecida al cólera o en las diarreas prolongadas, para los pacientes inmunocomprometidos con enfermedades subyacentes y ante una evidencia de infección extraintestinal. En esta investigación se estudió la susceptibilidad antimicrobiana de 89 cepas de bacilos gramnegativos anaerobios facultativos oxidasa positiva aislados de pacientes con enfermedad diarreica aguda enviados al Laboratorio Nacional de Referencias de Enfermedad Diarreica Aguda del Instituto de Medicina Tropical Pedro Kouri aislados de heces de pacientes con enfermedad diarreica aguda, frente a 23 antimicrobianos utilizando el método de Bauer-kirby con el fin de conocer en nuestro país la susceptibilidad antimicrobiana de estos microorganismos. El estudio de la susceptibilidad antimicrobiana mostró elevados porcentajes de resistencia de Aeromonas spp. frente a la cefazolina, cafalotina y cefalexina, la mayoría de las cepas de Vibrio cholerae no-01 y Plesiomonas shigelloides fueron resistentes al trimetoprim sulfametoxazol y cefazolina, respectivamente. Mientras que, la resistencia a la ampicilina fue común para los tres géneros. No se observaron cepas de Vibrio cholerae no-01 multirresistentes. Los resultados obtenidos señalan la importancia de implementar una continua y sistemática vigilancia microbiológica de estos agentes

The self limit character of the enteric infections caused by the gramnegative bacilli anaerobes medical oxidasa positive reservation the therapy antimicrobiana for the cases of severe dysentery, similar illness to the cholera or in the lingering diarrhoeas, for the patient inmunocomprometidos with underlying illnesses and before an evidence of infection extraintestinal. In this investigation the susceptibility antimicrobiana of 89 stumps of bacilli gramnegativos isolated anaerobes medical positive oxidasa was studied of patient with illness diarrheic sharp correspondents to the National Laboratory of References of Illness Sharp Diarrheic of the Institute of Tropical Medicine Pedro isolated Kouri of grounds of patient with illness sharp diarrheic, in front of 23 antimicrobianos using the method of Bauer-kirby with the purpose of knowing in our country the susceptibility antimicrobiana of these microorganisms. The study of the susceptibility antimicrobiana showed high percentages of resistance of Aeromonas spp. in front of the cefazolina, cafalotina and cefalexina, most of the stumps of Vibrio cholerae no-01 and Plesiomonas shigelloides went resistant to the trimetoprim sulfametoxazol and cefazolina, respectively. While, the resistance to the ampicilina was common for the three goods. Strains of Vibrio cholerae were not observed no-01 multirresistentes. The obtained results point out the importance of implementing a continuous and systematic surveillance microbiological of these agents

Novo meio seletivo-indicador para detecção de Aeromonas e Plesiomonas: ágar UNISC / New selective indicator medium for detection of Aeromonas and Plesiomonas: UNISC agar

Avaliou-se um novo meio seletivo-indicador (ágar UNISC) para o isolamento de enteropatógenos clássicos e Aeromonas e Plesiomonas shigelloides. A capacidade de fermentação da xilose é indicada pela coloração amarela (fermentadores) ou azul (não fermentadores) que, aliada à prova da oxidase, constitui-se em indicador para a detecção de Aeromonas spp e Plesiomonas shigelloides. A produtividade e seletividade, avaliadas pelos índice de contagem absoluta e índice de contagem relativa indicam-no como uma alternativa aos coprocultivos clássicos porque permite, num só meio, o isolamento de Escherichia coli, Shigella spp, Salmonella spp, bem como, Aeromonas spp e Plesiomonas shigelloides, favorecendo o diagnóstico laboratorial das gastroenterites.

We evaluated a new selective indicator medium (UNISC Agar) for isolation of classical enteropathogens, Aeromonas spp and Plesiomonas shigelloides. The xylose fermentation capacity is indicated by a yellow color (fermenting agents) or blue (no fermenting agent). This, together with the oxidase test, establishes it as an indicator for detecting Aeromonas and Plesiomonas shigelloides. Its productivity and selectivity, as assessed using the absolute count index and relative count index, indicate it as an alternative to the classical feces culturing media. This is because, in a single medium, it enables isolation of Escherichia coli, Shigella spp and Salmonella spp, in addition to Aeromonas and Plesiomonas shigelloides, thereby favoring the laboratory diagnosis of gastroenteritis.

Aislamiento e identificación de Aeromonas y Plesiomonas en el embalse Niña Bonita, Ciudad de La Habana, Cuba / Isolation and identification of Aeromonas and Plesiomonas in Niña Bonita dam in City of Havana province, Cuba

Objetivo: se realizó un estudio del agua del embalse Niña Bonita situado en Ciudad de La Habana para conocer la circulación de microorganismos de los géneros Aeromonas y Plesiomonas. Métodos: se colocaron 10 hisopos de Moore en diferentes puntos del embalse en 2002, los cuales fueron trabajados en el Laboratorio Nacional de Referencia de Enfermedades Diarreicas Agudas del Instituto de Medicina Tropical Pedro Kourí. Las especies del género Aeromonas se determinaron aplicando los esquemas Aerokey II y Aeroesquema, este último fue además utilizado para la identificación de Plesiomonas. El serotipaje se realizó según el Esquema de Serotipaje Internacional. Resultados: de los hisopos se aislaron 23 cepas, de las cuales 18 (78 por ciento) pertenecían al género Aeromonas y 5 (22 por ciento) al género Plesiomonas. Las especies de Aeromonas identificadas en orden de frecuencia resultaron: A. veronii bv sobria (33 por ciento), A. trota (28 por ciento), A. jandaei (22,5 por ciento), A. hydrophila (11 por ciento) y A. caviae (5,5 por ciento). De las 5 cepas de Plesiomonas shigelloides, 3 resultaron no tipables y 2 pertenecían a los serotipos O9:H2 y O76:H39; este último circulaba por primera vez en Cuba. Conclusiones: se demostró la presencia de cepas de Aeromonas y Plesiomonas en el embalse Niña Bonita, que pudieran constituir un riesgo para la salud humana.

Objective: A study on Niña Bonita reservoir waters located in City of Havana province was conducted to find out the circulation of Aeromonas and Plesiomonas genus microorganisms. Methods: Ten Moore swabs were placed at different points of this reservoir in 2002, which were examined in the National Reference Laboratory of Diarrheal Diseases of Pedro Kourí Institute. Aeromonas species were determined through Aerokey II and Aeroesquema schemes, being the latter also used for Plesiomonas detection. Serotyping was performed according to the International Serotyping Scheme. Results: twenty three strains were isolated from the swabs of which 18 (78 por ciento) belonged to the Aeromonas genus and 5 (22 percent) to Plesiomonas genus. In order of frequency, the identified Aeromonas species were A. veroniir bv sobria (33 por ciento), A. trota (28 percent), A. jandaei (22.5 percent), A. hydrophila (11 percent) and A. caviae (5.5 percent). Out of the 5 Plesiomonas shigelloides strains, 3 were non-typable and 2 corresponded to serotypes O9:H2 and O76:H39, being the latter detected for the first time in our country. Conclusions: The circulation of Aeromonas and Plesiomonas strains in Niña Bonita reservoir was confirmed, which could pose a risk for human health.

Aislamiento e identificación de especies pertenecientes a los géneros Aeromonas, Vibrio y Plesiomonas procedentes de muestras extra-intestinales en Cuba / Isolation and identification of species from the genera Aeromonas, Vibrio, and Plesiomonas from extraintestinal samples in Cuba

Las infecciones extra-intestinales producidas por los géneros Aeromonas, Vibrio y Plesiomonas presentan una elevada tasa de morbimortalidad en diferentes áreas geográficas. De enero 2002 a diciembre 2003 se recibieron en el Laboratorio Nacional de Referencia de Enfermedades Diarreicas Agudas del Instituto de Medicina Tropical Pedro Kourí, 95 cepas de bacilos gramnegativos, anaerobios facultativos, oxi-dasa positiva, procedentes de muestras extra-intestinales (hemocultivos, exudados óticos, pus de heridas, exudados conjuntivales, urocultivos, catéter, entre otras) remitidas de diferentes provincias del país. Se demostró la presencia de Aeromonas caviae, Aero-monas veronii bv sobria, Aeromonas jandaei, Vibrio cholerae no -O1, Vibrio vulnificus, Vibrio fluvialis y Plesiomonas shigelloides en las muestras estudiadas.

Extraintestinal infections caused by the genera Aeromonas, Vibrio and Plesiomonas have high morbidity and mortality rates in different areas of world. From January 2002 to December 2003, the National Reference Laboratory for Acute Diarrhoeal Diseases of the Pedro Kourí Tropical Medicine Institute received 95 gramnegative, facultative anaerobic, oxidase positive bacilli strains from different extraintestinal specimen (blood, ear exudates, infected wounds, conjunctive exudates, urine, and catheters, among others) sent by different provincial laboratories along the country. Aeromonas caviae, Aeromonas veronii bv sobria, Aeromonas jandaei, Vibrio cholerae no-O1, Vibrio vulnificus, Vibrio fluvialis and Plesiomonas shigelloides were the species most frequently found in the sample analysed.

Detección de plesiomonas shigelloides mediante la pcr en tilapias silvestres (oreochromis mossambicus) y cultivadas (tetrahíbrido o. Mossambicus × o. Urolepis hornorum × o. Niloticus × o. Aureus) en venezuela / Detection of plesiomonas shigelloides by pcr in feral (oreochromis mossambicus) and cultured tilapias (tetrahybrid of o. Mossambicus × o. Urolepis hornorum × o. Niloticus × o. Aureus) in venezuela

Plesiomonas shigelloides es un bacilo Gram negativo, anaerobio facultativo, móvil, que pertenece a la familia Enterobactereaceae. No forma parte de la flora normal del humano, mientras que los peces dulceacuícolas como las tilapias se tienen como su reservorio primario. Considerando: a) La implicación cada vez más frecuente de este microorganismo como agente causal de enfermedades intra y extra intestinales, b) El incremento de la comercialización de tilapias silvestres y de cultivo a nivel nacional y c) La necesidad de métodos de detección e identificación rápidos y efectivos de patógenos, se aplicó el método biomolecular de la Reacción en Cadena de la Polimerasa (PCR). Se procesaron mediante la PCR, cepas de P. shigelloides y homogeneizados de pools de bazo, riñón y cerebro, y de intestino de tilapias, utilizándose oligonucleótidos iniciadores específicos para el gen 23S ARNr de P. shigelloides. Se obtuvo el reconocimiento del 75% de las 20 cepas identificadas por pruebas fenotípicas convencionales, detectándose además en 27% de los homogeneizados frescos y en 18% de los congelados. Estos resultados confirman la especificidad del método para la identificación de diversas bacterias potencialmente patógenas, su utilidad en el mejoramiento del sistema de control de calidad de granjas dulceacuícolas y en el estudio de casos clínicos, aumentando la efectividad del sistema de salud relacionado con estas áreas.

Plesiomonas shigelloides is a Gram negative rod, facultative anaerobic, motile, that belongs to the Enterobacteriaceae. It’s not part of the normal human flora, while fresh water fish like tilapias are thought to be its primary reservoir. Considering: a) The more frequent implication of this microorganism as the causal agent of intra and extraintestinal infections, b) The wide spread of national commercialization of feral and cultured tilapias and c) The need for rapid and effective detection and identification methods, the biomolecular technique of Polymerase Chain Reaction (PCR) was applied. Strains of P. shigelloides and pools of homogenates from spleen, kidney and brain and the intestine of tilapias were processed by PCR, using specific primers for the gene 23S rRNA of P. shigelloides. The 20 strains identified by conventional phenotypic traits were identified in 75%, additionally it was detected in 27% of the fresh homogenates and in 18% of the frozen ones. These results confirm the specificity of the technique for the identification of a diverse range of potential pathogenic bacteria, its usefulness in the improvement of quality control in freshwater farms and in the study of clinical cases, improving the effectiveness of health systems related with these areas.

A Case of Septicemia by Plesiomonas shigelloides / 대한임상미생물학회지

Plesiomonas shigelloides is an oxidase-positive, fermentative, gram-negative rod currently classified as a member of the family Vibrionaceae. P. shigelloides has been implicated as the causative agents of gastroenteritis as well as extraintestinal infections such as septicemia, neonatal meningitis, cellulitis, and cholecystitis. Septicemia due to P. shigelloides is very rare but is severe and has been associated with a high mortality rate. We report a case of septicemia caused by P. shigelloides in a 66-year-old male with diabetes mellitus who had diagnosed as liver cirrhosis 7 years before.

A Case of Septicemia by Plesiomonas shigelloides / 대한임상병리학회지

Plesiomonas shigelloides with positive reactions of oxidase and indole production is a species of facultative anaerobic gram-negative bacilli. It is an inhabitant of fresh surface water and has been isolated from surface water, fresh water fish, oysters, and various animals. It is not considered to be a part of normal human intestinal flora. In human, P. shigelloides has been associated with gastroenteritis and extraintestinal infection. There have been no previous reports of extraintestinal disease due to P. shigelloides in Korea. Rare extraintestinal infections include neonatal meningitis and septicemia, cellulitis pyometra and acute cholecystitis. The patients may take fatal courses even though they receive antiboiotic therapy. We report a case of sepsis caused by P. shigelloides in a 60-year-old male with diabetes mellitus who had undergone subtotal gastrectomy 8 years before. The patient presented with diarrhea, abdominal cramps, high fever and jaundice. Enlargement of the gallbladder was noted in an abdominal ultrasonogram. He had a history of drinking surface water 5 days ago. P. shigelloides was isolated from his blood, but he recovered after cephalosporin and aminoglycoside infusion and supportive therapy. To our knowledge, this is the first report of septicemia due to P. shigelloides in Korea.

Plesiomonas shigelloides-associated diarrhea in Thai pediatric patients.

Plesiomonas shigelloides-associated diarrhea was studied in 5,221 pediatric patients at Siriraj Hospital from August 1990 to June 1992. The average occurrence of Plesiomonas shigelloides-associated diarrhea in this group of children was 1.6%. This occurrence was not affected by seasonal variation. Plesiomonas shigelloides-associated diarrhea was studied in 62 pediatric patients. Thirty-eight were male and 24 were female. Forty-three were under 2 years of age (70%). Twenty-nine were out-patients and 32 were in-patients. Of the out-patients, 24 in 29 were normal host (83%) and 20 in 29 showed normal nutritional status (69%). Of the in-patients 18 in 32 had underlying disease (55%) and 25 in 32 showed third degree malnutrition (64%). Clinical presentations were: watery diarrhea 58%; mucous 42%; mucous bloody stool 20%; vomiting 39% and abdominal pain 66%. Fever lasted 0-7 days, average 1.8 days and diarrhea 2-15 days, average 5.3 days.