Influence of Cell Surface Hydrophobicity on Adhesion and Biofilm Formation in Candida albicans and Several Bacterial Species

The purpose of this study is to investigate the correlation of cell surface hydrophobicity (CSH) and biofilm formation or adhesion in Candida albicans (C. albicans) and several pathogenic bacteria. All of C. albicans (n=82) and 7 bacterial species (Escherichia coli, n=25; Klebsiella pneumoniae, n=33; Morganella morganii, n=21; Proteus mirabilis, n=33; Proteus vulgaris, n=12; Pseudomonas aeruginosa, n=31; Staphylococcus aureus, n=31) were isolated clinically. CSH was quantified with microbial adhesion to hydrocarbons. Biofilm formation was determined by tetrazolium salt reduction assay. Adhesion assay was performed by counting colonies after culture the microbes adhered to HeLa cells. Although high CSH-expressing bacterial species showed greater adherence to HeLa cells and larger amounts of biofilm formation on polystyrene, the significant relationships within same species were not shown. In C. albicans, however, strong positive correlations were observed between CSH and biofilm formation (r =0.708; p < 0.05) or cell adhesion (r =0.509; p < 0.05). These results suggest that hydrophobic force of bacteria may play a minor role in adhesion and biofilm formation, but CSH of C. albicans may be an important factor for adherence on surface and biofilm forming process.

Infección por morganella morganii en paciente postransplantado de riñón: reporte de caso y revisión de literatura / Morganella morganii infection in post-transplant kidney patient: Case Report and literature review

Las infecciones humanas por Morganella morganii es poco frecuente hasta el 3% de las infecciones del tracto urinario, puede producir diversos tipos de infecciones, su papel etiológico es dudoso. Hay pocos reportes a nivel mundial en la literatura sobre infecciones causadas por este patógeno y ninguna en Honduras. Descripción de Caso. Masculino 46 años con antecedentes de trasplante renal hace 4 años por IRC, manejado con prednisona, micofelonato y sirulimus, diabético e hipertensión arterial crónica tratado con Insulina NPH 20 u. cada día y Carvedilol 12.5 mg, referido por el servicio de Nefrología a la Emergencia del HEU por iebre de una semana, continua, sugestivamente alta, no cuantiicada, diaforesis con escalofrío, con disuria de un día de evolución y un episodio de vomito. Con signos vitales P/A 90/60 mmHg, FC 88 x ́, FR 22 x ́, afebril, examen físico normal. Cuatro horas posteriores al ingreso; comenzó con iebre de 38.9 °C agregando antipiréticos al manejo establecido, con hiponatremia, falla renal aguda, uroanálisis patológico. Ecografía renal: Riñón trasplantado de corteza engrosada correspondiendo a pielonefritis aguda, sin masas, colecciones, litos e hidronefrosis, midiendo 12.7x5.8x4.9 cm. Urocultivo: crecimiento de Morganella morganii, resistente a fosfosil, nitrofurantoina, sensible a ciproloxacino y ceftazidime. Paciente se mantuvo afebril, mejorando al manejo establecido con ciproloxacino IV se da alta al quinto día posterior a su ingreso con seguimiento estricto por servicio de nefrología. Conclusiones. Reportamos una patología vista con frecuencia, pero en un paciente especial como es un post trasplante renal que pudo traer múltiples complicaciones para el paciente sumado al que el patógeno es conocida como agente infección de la vía urinaria pero rara vez causa infecciones en personas inmunocompetentes, pero si puedes llegar a ser causa de infección nosocomiales en personas inmunocomprometidas. Debemos de tener seguimiento estricto de este tipo de pacientes desde el más mínimo síntoma para evitar secuelas y/o complicaciones severas

Cristaluria masiva asociada a infección urinaria ureolítica: un caso exepcional / Massive crystalluria associated whit ureolitic urynary infection: an exceptional

Introducción y Objetivos. Las infecciones urinarias por gérmenes ureolíticos se asocian generalmente con la eliminación y/o formación de cálculos infectivos de estruvita (fosfato amónico magnésico, fosfato triple). Sin embargo no tenemos conocimiento de que se haya comunicado ningún caso de emisión masiva de cristales con visualización macroscópica y recuperación de las arenillas en el "poso seco" del sedimento de la orina. El objetivo de este breve artículo es comunicar un infrecuente caso de cristaluria masiva de fosfato amónico magnésico secundaria a infección urinaria por la asociación de dos gérmenes: Citrobacter freundii (no ureolítico) y Morganella morgagnii (ureolítica). Caso Clínico. Mujer de 72 años sin antecedentes urológicos previos que consultó por presentar desde hace 1 año expulsión de gran cantidad de arenillas en las micciones, hasta el punto de que en alguna ocasión le ocluían momentáneamente la uretra. La paciente aportó una muestra de la cristaluria (arenilla) recuperada del poso seco del sedimento de su orina, donde se aprecia un gran volumen de polvo y arena (microcristales). El estudio del sedimento urinario mostró PH 8, densidad de 1035 (n 1005-1030), nitritos (+), bacteriuria y abundante cantidad de cristales incoloros en forma de prisma o "ataúd" sugestivos de corresponder a cristales de fosfato amónico magnésico. En el urinocultivo existían 500.000 UFC/ml y se aislaron 2 gérmenes uno no ureolítico (Citrobacter freundii) y otro ureolítico (Morganella morgagnii). Radiografía simple de aparato urinario y ecografía normales. El análisis químico de la arenilla mostró una composición de 80 por ciento fosfato amónico magnésico y 20 por ciento oxalato cálcico. Se instauró tratamiento según antibiograma con ciprofloxacino 500 mg cada 12 horas 7 días y se acidificó la orina con vitamina C (ácido ascórbico) 500 mg día 20 días, consiguiendo erradicar la infección urinaria, normalizar el PH urinario a 5, y frenar definitivamente la expulsión de cristales. En un control a los 6 meses permanecía asintomática y con urinocultivo estéril. Conclusiónes. Este caso es una forma de presentación excepcional de una infección urinaria ureolítica, sin los síntomas clásicos habituales. Su única manifestación clínica fue la expulsión de gran cantidad de cristales (arenilla) en las micciones que en ocasiones provocaban obstrucciones intermitentes de uretra de resolución espontánea. Este singular caso demuestra que escuchando a los pacientes, a veces nos cuentan hechos casi imposibles y la mayoría de las veces son verídicos (AU)

Background and Objetives. Ureolytic urinary tract infections are generally associated with the elimination and / or formation of struvite infective stones (magnesium ammonium phosphate, triple phosphate). However, we are not aware of any reports of massive emission of crystals with macroscopic visualization and recovery of the sand in the "dry" sediment of the urine. The objective of this brief article is to report an infrequent case of massive crystalluria of magnesium ammonium phosphate secondary to urinary infection due to the association of two germs: Citrobacter freundii (non ureolytic) and Morganella morgagnii (ureolytic). Clinical Case. A 72-year-old woman with no prior urological history who consulted for the past 1 year of expulsion of a large amount of sand in the micturition, to the point that she had occasion ally occluded the urethra. The patient provided a sample of the crystalluria (sand) recovered from the dry sediment of her urine, where a large volume of dust and sand (microcrystals) was seen. The study of the urine sediment showed PH 8, density of 1035 (n 1005-1030), nitrites (+), bacteriuria and abundant amount of colorless crystals in the form of prism or "coffin" suggestive of corresponding magnesium ammonium phosphate crystals. In the urinoculture there were 500,000 CFU / ml and two non-ureolytic (Citrobacter freundii) and one ureolytic (Morganella morgagnii) were isolated. Simple x-ray of normal urinary system and ultrasound. The chemical analysis of the grit showed a composition of 80 pertcent magnesium ammonium phosphate and 20 pertcent calcium oxalate. Therapy was initiated according to antibiogram with ciprofloxacin 500 mg every 12 hours 7 days and the urine was acidified with vitamin C (ascorbic acid) 500 mg day 20, succeeding in eradicating the urinary tract infection, normalizing the urinary pH to 5, and finally stopping expulsion Of crystals. In a control at 6 months, he remained asymptomatic and with sterile urine culture. Conclusions. This case is an exceptional presentation of a urethritic urinary infection, without the usual classic symptoms. Its only clinical manifestation was the expulsion of large amounts of crystals (sand) in micturitions that occasionally caused intermittent urethral obstructions of spontaneous resolution. This unique case demonstrates that listening to patients, sometimes tell us almost impossible facts and most of the time are true.(AU)

Impact of Revised Broad-Spectrum Cephalosporin Clinical and Laboratory Standards Institute Breakpoints on Susceptibility in Enterobacteriaceae producing AmpC β-Lactamase / 감염과화학요법

We evaluated the impact of revised Clinical and Laboratory Standards Institute (CLSI) breakpoints for broad-spectrum cephalosporins (BSCs) on the susceptibilities of 1,742 isolates of Enterobacter species, Serratia marcescens, Citrobacter freundii, and Morganella morganii. The 2011 CLSI criteria for cefotaxime and ceftazidime reduced the rates of susceptibility by 2.9% and 5.9%, respectively. The 2014 CLSI criteria for cefepime reduced the rate of susceptibility by 13.9%, and categorized 11.8% isolates as susceptible-dose dependent (SDD) for cefepime. Among 183 isolates with extended-spectrum ß-lactamase (ESBL) phenotype, implementation of the new criteria reduced the rates of susceptibility to cefotaxime, ceftazidime, and cefepime by 2.8%, 14.8%, and 53.6%, respectively. The proportion of ESBL phenotype among BSC-susceptible isolates was low (0.9% for cefotaxime, 3.0% for ceftazidime, and 3.3% for cefepime). In summary, implementation of new CLSI criteria led to little change in susceptibility to cefotaxime and ceftazidime but a substantial change in susceptibility to cefepime. The recognition of revised CLSI criteria for BSC and SDD will help clinicians to select the optimal antibiotic and dosing regimen.

Multi-resistant Enterococci and Morganella morganii: a rare cause of complicated keratitis

An eighty-five-year-old female presented with preexisting conditions of benign essential hypertension, dyslipidemia, chronic renal failure and diabetes mellitus type 2. She had gastroenteritis, pain and redness in right [blind] eye with corneal decompensation, scarring and right-eye corneal ulcer with hypopyon. Corneal scrapings sent for culture report revealed growth of Morganella Morganii and Enterococci Corneal ulcer was successfully treated with topical and oral antibiotics

Purification and characterization of esterase from Morganella morganii ZJB-09203 / 生物工程学报

Enantioselective hydrolysis of 2-carboxyethyl-3-cyano-5-methylhexanoic acid (CNDE) is the key step in chemoenzymatic synthesis of pregabalin. We purified an intracellular carboxyl esterase from Morganella morganii ZJB-09203, which exhibited high enantioselectivity and activity towards CNDE. The carboxyl esterase was purified to electrophoretic homogeneity by ammonium sulfate fraction precipitation, Phenyl Sepharose 6 FF hydrophobic interaction chromatography, anion exchange with DEAE Sephadex A-50 and Bio-Scale CHT column. The purified enzyme was a monomer with molecular mass of 68 kDa determined by SDS-PAGE and gel chromatography. Substrate specificity of the enzyme towards p-nitrophenyl esters suggested that the purified enzyme was an esterase. The optimal reaction pH for CNDE hydrolysis was 9.0, and optimal temperature was 45 degrees C. The esterase was stable between pH 7.0 and 9.0, and at 40 degrees C. The enzyme activity was enhanced by Ca2+, Cu2+ and Mn2+, whereas strongly inhibited by Co2+, Fe3+, Ni2+ and EDTA. Meanwhile, we investigated the kinetic parameters of the esterase towards p-nitrophenyl esters and effect of CNDE concentration on conversion. The present study reported the esterase capable of stereospecific hydrolysis of CNDE for the first time. Our research will provide foundations for industrial production of Pregabalin using the new biocatalyst.

Bioautography-guided isolation of antibacterial compounds of essential oils from Thai spices against histamine-producing bacteria

The outbreak of histamine fish poisoning has been being an issue in food safety and international trade. The growth of contaminated bacterial species including Morganella morganii which produce histidine decarboxylase causes histamine formation in fish during storage. Histamine, the main toxin, causes mild to severe allergic reaction. At present, there is no well-established solution for histamine fish poisoning. This study was performed to determine the antibacterial activity of essential oils from Thai spices against histamine-producing bacteria. Among the essential oils tested, clove, lemongrass and sweet basil oils were found to possess the antibacterial activity. Clove oil showed the strongest inhibitory activity against Morganella morganii, followed by lemongrass and sweet basil oils. The results indicated that clove, lemongrass and sweet basil oils could be useful for the control of histamine-producing bacteria. The attempt to identify the active components using preparative TLC and GC/MS found eugenol, citral and methyl chavicol as the active components of clove, lemongrass and sweet basil oils, respectively. The information from this study would be useful in the research and development for the control of histamine-producing bacteria in fish or seafood products to reduce the incidence of histamine fish poisoning

First characterisation of plasmid-mediated quinolone resistance-qnrS1 co-expressed bla CTX-M-15 and bla DHA-1 genes in clinical strain of Morganella morganii recovered from a Tunisian Intensive Care Unit.

Purpose: Aim of this study was to show the emergence of the qnr genes among fluoroquinolone-resistant, AMPC and ESBL (extended-spectrum-beta-lactamase) co-producing Morganella morganii isolate. Materials and Methods: A multi resistant Morganella morganii SM12012 isolate was recovered from pus from a patient hospitalized in the intensive care unit at the Military hospital, Tunisia. Antibiotic susceptibility was tested with the agar disk diffusion method according to Clinical and Laboratory Standards Institute guidelines. ESBLs were detected using a standard double-disk synergy test. The characterization of beta-lactamases and associated resistance genes were performed by isoelectric focusing, polymerase chain reaction and nucleotide sequencing. Results: The antimicrobial susceptibility testing showed the high resistance to penicillins, cephalosporins (MICs: 64-512 μg/ml) and fluoroquinolones (MICs: 32-512 μg/ml). But M. morganii SM12012 isolate remained susceptible to carbapenems (MICs: 4-<0.25 μg/ml). The double-disk synergy test confirmed the phenotype of extended-spectrum β-lactamases (ESBLs). Three identical β-lactamases with pI values of 6.5, 7.8 and superior to 8.6 were detected after isoelectric focusing analysis. These β-lactamases genes can be successfully transferred by the conjugative plasmid. Molecular analysis demonstrated the co-production of bla DHA-1, bla CTX-M-15 and qnrS1 genes on the same plasmid. The detection of an associated chromosomal quinolone resistance revealed the presence of a parC mutation at codon 80 (Ser80-lle80). Conclusion: This is the first report in Tunisia of nosocomial infection due to the production of CTX-M-15 and DHA-1 β-lactamases in M. morganii isolate with the association of quinolone plasmid resistance. The incidence of these strains invites continuous monitoring of such multidrug-resistant strains and the further study of their epidemiologic evolution.

Frequency of urinary tract infection [UTI] and commonest causative organisms in spinal cord injury patients with various voiding modes

To determine the frequency of urinary tract infection and commonest causative organisms in spinal cord injury patients with various modes of voiding in rehabilitation setup in Pakistan. A descriptive study of 100 spinal cord injury patients. The Armed Forces Institute of Rehabilitation Medicine [AFIRM] Rawalpindi from September 2007 to March 2008 on clinical samples received from admitted patients in CMH Rawalpindi and AFIRM. In 100 patients of spinal cord urine samples were subjected to Urine Routine examination and Urine Culture sensitivity. Urine culture revealing a bacterial colony count of 105 cfu/ml or higher were considered positive for urinary tract infection [UTI] if present with symptoms. Significant bacteriuria was investigated for spectrum and sensitivity pattern as well. Of all 100 spinal cord patients 52 patients [52%] had symptoms suggestive of UTI but only 37 patients [37%] had significant bacteriuria on urine culture supported by high level pyuria were declared to have UTI. E-coli was the most commonly isolated organism with total no of 20 cases [54.1%] followed by Pseudomonas 6 cases [16.2%], Klebsiella pneumoniae 3 cases [8.1%], Proteus mirabilis 3 cases [8.1%], Citrobacter freundi 2 cases [5.4%] and the least frequent was Morganella morganii with 1 case [2.7%]. UTI was most frequent in patients with indwelling catheter and was least associated with self voiding. Urinary Tract Infection was commonly observed among spinal cord injury patients. E-coli was the commonest isolated pathogen followed by Pseudomonas, Klebsiella pneumoniae, Proteus mirabilis, Citrobacter freundi, Candida and Morganella morganii in descending order of frequency. UTI was most frequent in patients using indwelling catheter as a mode of voiding

Spontaneous Eyeball Rupture in a 94-Year-Old Patient

PURPOSE: To report a case of spontaneous eye ball rupture without trauma in a 94-year-old patient. CASE SUMMARY: A 94-year-old female patient diagnosed with cataract in both eyes 20 years was referred to this ophthalmologic department for treatment consultation of a painful left eye with spontaneous bleeding. She has used anti-cataract eye drops and artificial tears three times a day for several years without consulting a doctor. Fifteen days prior to presentation, the patient suffered severe left eyeball pain and headache and was diagnosed with acute angle-closure glaucoma secondary to hypermature cataract. She underwnet eviceration after ocular examination and systemic evaluation. Surgical findings included a thin cornea at the inferior limbus and protruding intraocular tissues. Additionally, the eyeball was filled with a blood clot from a choroidal hemorrhage. Morganella morganii were grown in a bacterial swap culture, and a corneal biopsy revealed suppurative inflammation. CONCLUSIONS: In old age, a thin corneal limbus due to infection and complicated acute angle-closure glaucoma can cause massive suprachoroidal hemorrhage with spontaneous eyeball rupture.

Prevalence of Extended-spectrum beta-lactamase among Enterobacteriacae Blood Isolates with Inducible AmpC beta-lactamase / 감염과화학요법

BACKGROUND: Among the inducible AmpC beta-lactamase-producing members of the family Enterobacteriaceae such as Enterobacter spp., Citrobacter spp., Serratia spp., and Morganella morganii (ECSM), the prevalence of ESBL-producing isolates are increasing. However, there have been only a limited number of studies that have investigated the prevalence for ESBL-production in blood isolates of these organisms. MATERIALS AND METHODS: We performed a prospective observational study to evaluate the prevalence for ESBL production among ECSM blood isolates. All consecutive blood isolates in the Samsung Medical Center were included from Oct 2006 to Mar 2008. Antimicrobial susceptibility test was performed by broth microdilution method. ESBLs were confirmed by double-disk synergy test and ESBL phenotypes were determined by PCR. RESULTS: The 124 isolates (94 Enterobacter spp., 18 Citrobacter spp., 8 Serratia spp. and 4 Morganella spp.) were investigated. Among 124 ESCM isolates, 30 isolates (24.2%) showed ESBL-producing activity. Derepressed or partially derepressed AmpC mutants and derepressed AmpC mutants with ESBL production accounted for 36.3% (45/124) and 16.9% (21/124), respectively. Of ESBL producers, the most prevalent ESBL was SHV-12 (5/24, 20.8%). CONCLUSIONS: The prevalence of ESBL-producing isolates is high in Enterobacter spp., Serratia marcescens and Citrobacter spp. clinical isolates. It suggested that routine screening test for ESBLs among Enterobacteriacae blood isolates with inducible AmpC beta-lactamase should be needed.

Sepsis neonatal precoz causada por transmisión vertical de Morganella morganii, en un embarazo de término / Fatal neonatal sepsis caused by vertical transmission of Morganella morganii. Report of one case

We report a term neonate who developed early-onset sepsis due to Morganella morganii. The child was vaginally delivered after a short labor, and presented signs of perinatal asphyxia. Blood cultures taken soon after birth and from mother's lochia were positive for this microorganism. The infection was unresponsive to treatment with cefotaxime, to which the microorganism was susceptible, and the infant died at 17 days of age. M morganii is an opportunistic and uncommon pathogen, causing disease mainly in patients with underlying illness or after surgery. It is a rare perinatal pathogen, causing severe disease in premature infants, in association with maternal chorioamnionitis and premature rupture of the membranes (RevMéd Chile 2009; 137: 1201-4).

Características de los pacientes con accidente ofídico y complicaciones infecciosas atendidos en el Hospital Pablo Tobón Uribe entre los años 2000 y 2006 / Characteristics of patients with ophidic accidents (snakebites) and infectious complications at the Pablo Tobon Uribe Hospital between the years 2000 and 2006

Introducción: los accidentes ofídicos en Colombia son relativamente frecuentes, especialmente en zonas selváticas, y alrededor de una quinta parte de ellos se complican por infecciones relacionadas con la mordedura. El manejo adecuado de las infecciones tempranas depende de la elección antibiótica adecuada de acuerdo con las bacterias más frecuentemente aisladas.Objetivo: identificar las características y las complicaciones infecciosas de los pacientes atendidos con accidente ofídico bothrópico en el Hospital Pablo Tobón Uribe.Material y métodos: revisión retrospectiva de historias clínicas de pacientes atendidos con accidente ofídico entre los años 2000 y 2006. Se seleccionaron los pacientes que desarrollaron complicaciones infecciosas y en quienes se obtuvo aislamiento microbiológico por técnicas asépticas.Resultados: treinta y tres por ciento de los pacientes atendidos presentaron complicaciones infecciosas, más frecuentemente fascitis y abscesos. El germen más comúnmente aislado fue Morganella morganii y ocasionalmente bacterias gram positivas.Conclusiones: los resultados sugieren una alta frecuencia de complicaciones infecciosas derivadas de la mordedura de serpientes del género Bothrops y que los gérmenes habituales son los gram negativos. El uso empírico de ciprofloxacina y clindamicina parecería ser adecuado en pacientes con infecciones de tejidos blandos secundarios a mordeduras de este grupo de serpientes.

Detection of CTX-M-Type Extended-Spectrum beta-Lactamase in Clinical Isolates of Chromosomal AmpC beta-Lactamase-Producing Enterobacteriaceae from Korea and Their Molecular Characteristics / 대한임상미생물학회지

BACKGROUND: Clinical isolates of AmpC beta-lactamase- producing Enterobacteriaceae were evaluated to determine the prevalence of CTX-M extended-spectrum beta-lactamases (ESBLs) and their genetic environments. METHODS: A total of 250 non-duplicate isolates of Eneterobacter aerogenes, E. cloacae, Citrobacter freundii, Serratia marcescens and Morganella morganii were collected at a Korean hospital. ESBL production was determined by double disk synergy test. For ESBL producers, bla genes were sequenced and blaCTX-M environment was characterized by PCR mapping and sequencing. RESULTS: Among the 250 isolates 29 (11.6%) produced ESBL, and 14 of the 29 isolates produced CTX-M ESBLs, including CTX-M-9 by 8 isolates, CTX-M-3 by 4 isolates, CTX-M-12 by 1 isolate, and CTX-M-14 by 1 isolate. ISEcp1 was present upstream of blaCTX-M-3, 12, and 14. Three of the four CTX- M-3 producers had the same genetic environment (pemK-ISEcp1-blaCTX-M-3-orf477-mucA). An IS903-like element was found downstream of blaCTX-M-14. ISCR1 was identified upstream of blaCTX-M-9 and ISCR1 and blaCTX-M-9 were located on sul1-type class 1 integron. The variable region between the 5'-CS and the first 3'-CS contained dfrA16 and aadA2. Its structure was similar to that of In60, but our isolates did not have IS3000 or second 3'-CS. CONCLUSION: CXT-M type ESBL was prevalent in AmpC beta-lactamase-producing Enterobacteriaceae, particularly E. cloacae. blaCTX-M genes were associated with ISEcp1 or ISCR1. This is the first report on the genetic environment of blaCTX-M in Korean isolates.

Enterobacterias productoras de ß-lactamasas de espectro extendido aisladas de hemocultivos en un Hospital Universitario de Venezuela / Extended-spectrum ß-lactamase producers isolated from hemocultures at the University Hospital in Venezuela

La producción de ß-Lactamasas de espectro extendido (BLEE) es un mecanismo importante de resistencia a los agentes antimicrobianos en los miembros de la familia Enterobacteriaceae. El objetivo del presente estudio es determinar la frecuencia de enterobacterias productoras de BLEE aisladas de hemocultivos. Se procesaron 21.023 hemocultivos en el Centro de Referencia Bacteriológica del Servicio Autónomo Hospital Universitario de Maracaibo durante el período Junio 2002 a Junio 2006. Fueron estudiados siguiendo la técnica convencional descrita por Murray (2003) y la identificación de las enterobacterias fue mediante la metodología de Edward e Ewing. Para las pruebas de susceptibilidad se siguió la metodología sugerida por Bauer y Kirby (1996) según normas del CLSI (2006) y la producción de BLEE por Jarlier(1988). Del total de hemocultivos procesados, 2.371 (11,28 por ciento) dieron positivos y en 384 (16,20 por ciento) de ellos se aislaron enterobacterias, y resultaron ser BLEE + 152 cepas (39,48 por ciento). Klebsiella pneumoniae fue la especie predominante y de 158 cepas, 97 (61,39 por ciento) fueron BLEE+, seguida de Escherichia coli con 122 aislamientos, 37 (30,33 por ciento) fueron BLEE+. Otras especies encontradas fueron: Morganella morgannii (1/4: 25,0 por ciento), Enterobacter cloacae (11/45: 24,44 por ciento), Serratia marcescens (2/9: 22,22 por ciento), Klebsiella oxytoca (3/14: 21,43 por ciento), y Enterobacter aerogenes (1/5: 20,0 por ciento). Se observó una resistencia elevada a los aminoglicosidos y una baja resistencia a las quinolonas en las cepas de Enterobacterias BLEE positivos estudiadas. La producción de BLEE en las enterobacterias se ha tornado un problema terapéutico en el ámbito mundial, principalmente si éstas producen bacteriemia.

Purification and characterization of carbonyl enantioselective reductase from Morganella morganii J-8 / 生物工程学报

The purification and the characteristics of an enzyme from Morganella morganii J-8, which could produce d-pseudoephedrine from 1-phenyl-2-methylamine-acetone, were performed in this study. In this research, first, cells were disrupted by ultrasonic treatment at 4 degrees C. The carbonyl enantioselective reductase was purified with a combination of ammonium precipitation, Phenyl Superose hydrophobic chromatography, DEAE anion exchange, and native polyacrylamide gel electrophoresis. The molecular mass of the purified enzyme subunit was estimated to be 42.5kD on sodium dodecyl sulfate-polyacrylamide electrophoresis (SDS-PAGE). The native molecular mass of the enzyme that was analyzed by high-performance liquid chromatography was found out to be 84.1 kD, which indicated that the enzyme was a dimmer. The purified enzyme was analyzed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and the result showed that the purified enzyme had high homology with leucine dehydrogenase.

Morganella Morganii Sepsis with Massive Hemolysis

Morganella morganii is a facultative gram-negative and anaerobic rod. It may be a cause of devastating infections in neonates and immunocompromised hosts. Some bacterial infections such as Clostridium and Vibrio are associated with hemolysis. However, massive hemolysis caused by M. morganii sepsis has not yet been reported. We observed a 59-yr-old man who had chemotherapy-induced neutropenia and was found to have massive hemolysis and metabolic acidosis due to sepsis. He died 6 hr after admission in spite of aggressive treatment. Two sets of blood cultures revealed the growth of M. morganii. We report here that M. morganii sepsis can cause fatal massive hemolysis leading to death.

Bacteremia in Pediatric Cancer Patients: Causative Organisms and Antibiotic Sensitivities / 소아과

PURPOSE: Bacteremia in immunocompromised pediatric cancer patients can lead to high morbidity and mortality, if not treated early and properly. The incidence and antibiotic sensitivities to common pathogens of bacteremia in pediatric cancer patients are liable to change, according to region and time. We investigated the causative organisms and antibiotic sensitivities of bacteremia in pediatric cancer patients to assess the adequacy of empiric antimicrobial therapy. METHODS: From September 1995 to August 2003, we retrospectively evaluated 58 episodes in 39 pediatric cancer patients with bacteremia treated at the Pediatric Department of Yeungnam University Hospital. We investigated and analyzed the causative organisms and the antibiotic sensitivity test results by reviewing the records of the microbiologically proven positive blood culture results. RESULTS: The incidence of bacteremia in pediatric cancer patients in this study was 5.7 percent (58 episodes out of 1, 022 occasions of blood cultures). Gram-positive organisms were isolated more often than gram-negative organisms (63.8 percent vs 36.2 percent) in the following order: Staphylococcus epidermidis (37.9 percent), Staphylococcus aureus (17.3 percent), Escherichia coli (12 percent), Streptococcus (8.6 percent), Enterobacter (6.9 percent), Klesiella (6.9 percent), Serratia (3.5 percent), Acinetobacter (3.5 percent), Proteus (1.7 percent) and Morganella morganii (1.7 percent). In antibiotic sensitivity tests, only six of 37 isolates (16 percent) of gram positive bacteria were sensitive to penicillin and 15 of 37 isolates (40 percent) were sensitive to oxacillin. All except one Staphylococcus aureus were sensitive to vancomycin and all except one Staphylococcus epidermidis were sensitive to teicoplanin among 37 isolates of gram positive bacteria. In the case of gram negative bacteria, two of 21 isolates (10 percent) and four of 21 isolates (19 percent) were sensitive to cefotaxime and ceftazidime, respectively. Only six of 21 isolates (29 percent) were sensitive to aminoglycoside, but all 21 isolates (100 percent) were sensitive to imipenem. All seven isolates tested after the year 2000 were sensitive to meropenem. CONCLUSION: In conclusion, we should choose the proper antimicrobials in treating pediatric cancer patients with suspected bacteremia, reflecting the increasing episodes of gram positive bacteremia and polymicrobial resistance of gram positive and negative organisms.

Early onset neonatal sepsis due to Morganella morganii.

Two neonates, both 32-weekers, developed Morganella morganii sepsis on the first day of life. They presented within a day of each other, primarily with respiratory signs. In both cases there was a history of spontaneous premature rupture of membranes, exposure to a single dose of ampicillin ante-partum, and similar antibiograms. No common source could be identified.

Sensitivity patterns in patients of acute secondary bacterial peritonitis, and suggested empirical treatment

The objective of this study was to determine the common pathogens in acute secondary bacterial peritonitis patients in tertiary care hospitals and their sensitivity to the antibiotics commonly prescribed for acute bacterial peritonitis. We conducted culture sensitivity studies on 25 consecutive laprotoniies for secondary peritonitis presented to our Surgical-A ward through Accident and Emergency Department without any advance knowledge of their prior antibiotic therapy or culture sensitivity of the pathogens involved. We were able to get the results for 19 out of 25 cases. They yielded mixed cultures of Gram negative rods and staphylococci. There were three cases of MRSA. They were tested against various antibiotics. Resistance of the Gram negative rods to various antibiotics was also high. Our study revealed a very disturbing trend of occurrence of high resistance strains in patient coming directly from the community. We suggest empirical therapies in view of our results and current medical literature. The high bacterial resistance encounteted necessitates use of broad-spectrum and expensive antibiotics