Myroides: An Emerging Pathogen Causing Urinary Tract Infections in Hospitalized Patients

Introduction: The genus Myroides comprises of Gramnegative, non-motile, and non- fermenting bacteria. It is arare opportunistic pathogen but many recent case reports,however, underscore the pathogenic potential that Myroidesspp. possesses for humans. Immunocompromised patients areat higher risk for Myroides infection. Diabetes, catheterizationand ICU stay may increase the chances of acquiring Myroidesinfection.Material and Methods: Urine specimens collected frominpatients were cultured as per standards. Myroides spp.were identified and sensitivity was performed on VITEK® 2Compact™.Results: A total of 16 Myroides spp. isolates were obtainedin the study period. All the isolates were from catheterizedpatients residing in intensive care units. Eleven (69%) patientswere suffering from diabetes mellitus. Extensive resistancewas seen in antibiotic sensitivity results. Minocycline was100% sensitive.Conclusion: Myroides spp. should be considered amongpathogens in hospitalized, catheterized patients. They couldbe extremely drug resistant. Minocycline is a useful antibioticwhile treating UTI caused by Myroides spp.

Identification Of Non– Fermenter Gram Negative Bacilli (NFGNB) From Various Clinical Isolates With Special Reference To Carbapenem Resistance In Various Isolates.

Non Fermenter Gram negative bacilli (NFGNB) has emerged as important hospital pathogens they are more significant as they are found to be multi drug resistant. Resistance to carbapenems is common among NFGNB. AIMS & OBJECTIVES: To isolate & identify NFGNB from various clinical samples and to detect resistance to carbapenem in isolates resistant to Imipenem. MATERIAL & METHOD: NFGNB isolated from various samples were speciated using standard tests. Isolates resistant to Imipenem were subjected to detection of MBLs(Metallo-β-lactmase) and Amp-C. RESULTS: Out of 1566 samples received, NFGNB were 200. Among them 112 were Pseudomonas aeruginosa from which 31 were found to be resistant to Imipenem, of which 3 were MBLproducer by Modified Hodge test while 4 were MBLproducer by EDTAdisc synergy test. Out of 200 NFGNB 71 were Acinetobacter baumanii, of which 23 were found to be resistant to Imipenem, of which 6 were MBLproducer by Modified Hodge test, while 4 were seen to be MBL producer by EDTAdisc synergy test. Nineteen isolates of Acinetobacter baumanii were found to be resistant to cefoxitin of which 6 were found to be Amp-C producer by Amp-c disc test. None of the Pseudomonas aeruginosa were Amp-C producer. Other NFGNB isolated were either sensitive to Imipenem or if resistant were not MBLor Amp-C producer.

The Distribution and Drug-resistance of Gram-negative Bacilli among Blood Stream Infection in Yunnan Province of China during 2012 ～ 2014 / 昆明医科大学学报

Objective To learn the species distrilbution and drug-resistance of Gram-negative bacilli among bloodstream infections (BSI) in Yunnan province of China during 2012 to 2014.Methods Bloodstream infected Gram-negative bacilli were collected from 28 general hospitals in Yunan province of China.Data from all hospitals were applied with the same method of bacteria culture,isolation,identification and antibiotic sensitivity tests.WHONET 5.6 was used to perform the statistical analysis.Results A total of 9042 clinical strains of non-repetitive gram-negative bacilli were collected.Enterobacteriaceae and Non-fermenter bacteria accounted for 82.4％ and 17.6％ respectively.Enterobacteriaceae were mainly composed of Escherichia coli and Klebsiella pneumoniae.Non-fermenter bacteria were mainly composed of Acinetobacter baumannii and Pseudomonas aerouginosa.Escherichia coli accounted for the majority 49.29％,other species were Klebsiella pneumoniae 13.17％,Acinetobacter baumannii 4.04％ and Pseudomonas aeroginosa 3.85％.The susceptible rate of Enterobacteriaceae strains to the first generation cephalosporin was lower than 60％.The susceptible rate of E coli and Klebsiella pneumoniae to impenem was close to 100％,to Amikacin was more than 85％,to piperacillin-tazobactam was more than 70％,to Cefepime was more than 70％.But the susceptible rate of Klebsiella pneumoniae to impnem and amikacin decreased year by year from 2012 to 2014.The susceptible rate of Enterobacter cloacae to Amikacin was 86.4％ ～ 93.6％,Ciprofloxacin 70.5 ～ 76％,Cefepime 72.1 ～ 82.8％.It was less than other Enterobacteriaceae.The susceptible rate of Non-fermenter bacteria to normal antibiotics was much lower than Enterobacteriaceae.The susceptible rates of Pseudomonas aeroginosa to Impnem was 58.9％,Tobramycin 85％,Ciprofloxacin 71.7％,Amikacin 82.9％,Piperacillintazobactam 75.3％,Piperacillin59.6％,Atreonam 46.5％,Ceftazidime 69.1％ and Cefepime 68.9％ respectively.Furthermore,Acinetobacter baumannii's durg-resistance was more severe.The susceptible rate of Acinetobacter baumannii was lower than 30％,to the third and fourth generation cephalosporin,the susceptible rate of Ampicillin/Sulbactam,Cefoperazone/Sulbactam,Carbapenems,Piperacillin/Tazuobatan,Quinolones and Carbapenems was less than 40％.Conclusion Gram-negative bacilli have low susceptibilities among BSI.E.coli is the most common pathegon among BSI.The resistant rate of Non-fermenter bacteria to normal antibiotics is severe in hospitals.

Pyonephrosis due to Chryseobacterium gleum: A first case report.

Chryseobacterium spp are widely distributed in nature but data of their isolation from clinical samples is scanty. Here, we report the first case of AmpC producing C. gleum causing pyonephrosis in a patient having bilateral nephrolithiasis on double J (DJ) stent. The present isolate was resistant to vancomycin, erythromycin, clindamycin, carbapenems and ciprofloxacin and susceptible to tetracycline and minocycline. The patient was treated with tetracycline and recovered without the need for removal of the DJ stent. The environmental surveillance carried out to trace the nosocomial origin of the isolate was negative. Since antimicrobial susceptibility of this isolate is different from previous reports, we emphasise that in vitro susceptibility testing should be sought to choose optimal antimicrobial agents for these Nonfermentative Gram-Negative Bacilli (NFGNBs) with different susceptibility patterns.

Non-fermenter isolation and drug resistance analysis of clinical specimens from the year of 2010 to 2012 / 中华实用儿科临床杂志

Objective To study the non-fermenter isolation rate and its drug resistance to more than 10 kinds of antibiotics at the First Affiliated Hospital to Xinxiang Medical University from the year of 2010 to 2012 in order to offer evidences for reasonable use of drugs by doctors and to prevent nonfermenters from becoming common pathogenic bacteria.Methods The infection and drug resistance of different Nonfermenters (Pseudomonas aeruginosa,Acinetobacter baumannii,Pseudomon as mahophilia,Los non Acinetobacter,Pseudomonas stutzeri,Achromobacter,Bacillus steady short,onions Bock cepacia,meningitis septicemia Elizabeth Kim bacteria)during present 3 years were analyzed by using WHONET 5.5 software.Results The infection rate from non-fermenters as pathogenic bacteria was gradually increased,with the rate from 18.2％ to 27.2％,until 31.2％ ; Acinetobacter Baumannii were isolated as higher infection rate and multiple drug resistance (7.1％ to 18.5％ until 28.7％) in pathogenic bacteria; the infection rate of other non-fermenter with infection rate of high and multiple drug resistance in pathogenic bacteria were gradually increased,such as infection rate or the precedence of Achromobacter xylosoxidans and Pseudomonas maltophilia,especially the precedence of Pseudomonas maltophilia ranged the third in non-fermenters,and Pseudomonas maltophiliai had a higher and multiple drug resistance to many antibiotics; infection rate of non-fermenters with low drug resistance gradually decreased,such as Pseudomonas fluorescens; the drug resistance rate of Acinetobacter Baumannii was higher than that of Pseudomonas aeruginosa and its drug resistance rate was over 50％ to common antibiotics used clinically,as well as Pseudomonas maltophiliai and Empedobacter brevis,especially the resistance rate of Pseudomonas maltophiliai to many commonly used antibiotics was more than 90.0％.Conclusions Non-fermenter isolation rate is becoming higher clinically and its drug resistance becomes more severe,so the sanitation administration department should pay more attention to the use of antibiotics in order to prevent and control drug resistance and higher infection rate caused by non-fermenters as a serious consequence.

Neonatal sepsis due to Weeksella virosa.

Weeksella virosa was previously included in group II f of CDC. We here present the Microbiological characteristics of the isolate from a case of neonatal sepsis at our center. The organism is a non-fermenter growing only on blood agar and not on Mac Conkey agar, oxidase and catalase positive, and negative for several other bio-chemical tests, except for indole with Ehrlich’s reagent. The isolate in the present case study was sensitive to aminoglycosides and β- lactams, and resistant to quinolones and carbapenems.