Assessment and incidence of fish associated bacterial pathogens at hatcheries of Azad Kashmir, Pakistan / Avaliação e incidência de patógenos bacterianos associados a peixes em incubadoras da Caxemira de Azad, Paquistão

Abstract Fish is the most indispensable source of proteins for individuals and have high nutritional value. On the other hand, the fish culturing raised issues of fish health due to close contact between the aquatic environment and the fish pathogens. So, the aim of the current study was to identify the bacterial pathogens and screen the injured Rainbow trout rearing in different trout hatcheries run under fisheries department of the government of Azad Jammu and Kashmir, Pakistan. Seven bacterial pathogens such as Shigella flexneri, Enterobacter amnigenus, Salmonella Typhimurium, Serratia odorifera, Pseudomonas aeruginosa, Streptococcus pyogenes, and Bacillus cereus were isolated and identified. Results revealed that the injury of fish specimens was due to overcrowding. Instead of rainbow coloration, specimens have darker black in color. The water of ponds was not clean and clear and such conditions was because of the greater quantity of feed thrown in the water. It was concluded that poor hygienic water condition and overloading allowed the opportunistic bacterial contaminations to succeed which cause a serious threat to hatcheries.

Resumo O peixe é a fonte mais indispensável de proteínas para os indivíduos e tem alto valor nutricional. Por outro lado, a cultura dos peixes levantou questões sobre a saúde dos peixes devido ao próximo contato entre o ambiente aquático e os agentes patogênicos desses peixes. Assim, o objetivo do presente estudo foi identificar os patógenos bacterianos e rastrear a criação da truta arco-íris que apresentou lesões em diferentes incubadoras de trutas, com supervisão do departamento de pesca do governo de Azad Jammu e Caxemira, Paquistão. Sete patógenos bacterianos foram isolados e identificados, tais como: Shigella flexneri, Enterobacter amnigenus, Salmonella typhimurium, Serratia odorifera, Pseudomonas aeruginosa, Streptococcus pyogenes e Bacillus cereus. Os resultados revelaram que a lesão de espécimes de peixes foi devido à superlotação. Em vez da coloração do arco-íris, os espécimes tiveram uma coloração preta mais escura. A água das lagoas não era limpa e nem clara, e tais condições ocorreram devido a maior quantidade de alimento lançada na água. Concluiu-se que a precária condição higiênica da água e também a sobrecarga permitiram que as contaminações bacterianas oportunistas fossem bem-sucedidas, causando séria ameaça às incubadoras.

Pseudohemoptisis por Serratia Marcescens / Pseudohemoptisis by Serratia Marcescens

Se denomina hemoptisis a la expulsión de sangre procedente del árbol traqueobronquial, es por ello que siempre habrá que descartar sangrado de cavidad oral, nasofaringe y tracto digestivo. De esta forma, la expectoración de sangre de una fuente que no es el tracto respiratorio inferior se denomina pseudohemoptisis, siendo sus causas la hematemesis, los tumores nasofaríngeos y digestivos, la sobredosis de rifampicina y la neumonía por Serratia marcescens. Esta bacteria patógena es la única descripta en la bibliografía como causa de pseudohemoptisis por ser productora de un pigmento rojizo denominado prodigiosina. En su diagnóstico, además de los cultivos de muestras respiratorias y hemocultivos, juega un rol importante la búsqueda de hematíes en esputo, los cuales se encuentran ausentes cuando el pigmento es el responsable de la coloración de la muestra

Skin Infection Caused by Serratia marcescens in an Immunocompetent Patient with Hidradenitis Suppurativa / 대한피부과학회지

No abstract available.

Serratia marcescens Spinal Epidural Abscess Following Caudal Epidural Injection / 대한정형외과학회잡지

Spinal infection due to Serratia marcescens is very rare. A 78-year-old male patient withoutany risk factor was admitted to our hospital with chief complaints of severe back pain, fever, weakness in both legs, and bowel dysfunction, following caudal epidural injection. Magnetic resonance imaging revealed spondylodiscitis with epidural abscess. Surgical decompression was performed and the epidural abscess was removed. The cultures isolated S. marcescens, which can cause nosocomial infection in immunocompromised patient. However, to the best of our knowledge, we report the first case of S. marcescens spinal epidural abscess following epidural injection, with literature review.

Evaluation of Six Phenotypic Methods for the Detection of Carbapenemases in Gram-Negative Bacteria With Characterized Resistance Mechanisms

BACKGROUND: We compared the performance of the modified Hodge test (MHT), Triton Hodge test (THT), Carba NP test (CNPt), simplified Carba NP test (CNPt-direct), blue-Carba NP test (BCT), and carbapenem inactivation method (CIM) for rapid and accurate carbapenemase detection. METHODS: The methods were evaluated by using 256 gram-negative isolates, including 197 Enterobacteriaceae (79 Enterobacter spp., 74 Klebsiella spp., 33 Escherichia coli, 10 Citrobacter spp., and 1 Serratia marcescens), 51 Acinetobacter baumannii, and 8 Pseudomonas aeruginosa strains. The collection included 117 non-carbapenemase, 18 Klebsiella pneumoniae carbapenemases (KPC) producers, 46 New Delhi metallo-β-lactamases (NDM) producers, 11 imipenemases (IMP) producers, and 51 oxacillinases (OXA) producers, and 13 strains harboring two different carbapenemase genes. RESULTS: The specificity of the THT (91.5%) was significantly lower than other methods, each of which had 100% specificity (P0.999). Because of improved detection of NDM carriers, THT showed significantly higher sensitivity than the MHT (84.9% vs 75.5%, P<0.001). However, poor performances in detecting OXA still influenced the sensitivities of the CNPt (66.2%) and BCT (82.0%), as well as the MHT and THT. CONCLUSIONS: CNPt-direct and CIM demonstrated the best performance for the efficient detection of carbapenemase among the six evaluated methods. Except the MHT and THT, the detection of carbapenemase-producing Enterobacteriaceae by all the other methods was acceptable, when the OXA-type carbapenemase was not prevalent.

[Evaluation of antibacterial properties of alcohol and water extracts of propolis on Bacillus pumilus, Pseudomonas syringae and Serratia plymuthica]

Background and Aim: Propolis is one of the most important bee products which has antibacterial property. This study was conducted to investigate antibacterial activity of propolis on Bacillus pumilus, Pseudomonas syringae and Serratia plymuthica

Material and Method: After propolis collection from different parts of Kurdistan Province and preparation of its alcohol and water extracts, minimum inhibitory concentration [MIC] and minimum bactericidal concentration [MBC] for bacterial strains were determined. Data analysis was carried out by use of SPSS software. To compare mean values we used Duncan test at the significance level of 5%

Results: Use of alcoholic solvent [96% ethanol and dimethyl sulfoxide] resulted in a greater mean diameter of growth inhibitory zone in comparison to water extract solvent [p<0.05]

Inhibitory concentrations [MICs] of alcoholic extract of propolis for Bacillus pumilus, Pseudomonas syringae and Serratia plymuthica were 0.328, 0.656 and 1.31 mg/ml and The MBCs, were 0.328, 0.656 and 1.31 mg/ml respectively. The MICs of dimethyl sulfoxide extract for Bacillus pumilus, Pseudomonas syringae and Serratia plymuthica were 0.656, 1.31 and 1.31 mg/ml and its MBCs for the above mentioned bacteria were 0.656, 1.31 and 1.31 mg/ml respectively. MICs of water extract of propolis for Bacillus pumilus, Pseudomonas syringae and Serratia plymuthica were 1.31, 2.62 and 2.62 and its MBCs for these bacteria were 2.62, 5.25 and 5.25 respectively

Conclusion: According to the results, alcohol and water extracts of propolis showed significant effects against Bacillus pumilus, Pseudomonas syringae and Serratia plymuthica in laboratory condition

Double mutation of Saccharomyces cerevisiae for enhanced β-D-fructofuranosidase fructohydrolase productivity and application of growth kinetics for parametric significance analysis

Abstract The kinetics of an extracellular β-D-fructofuranosidase fructohydrolase production by Saccharomyces cerevisiae in a chemically defined medium, i.e., sucrose peptone agar yeast extract at pH 6, was investigated. The wild-type was treated with a chemical mutagen, methyl methane sulfonate. Among the six mutants isolated, methyl methane sulfonate-V was found to be a better enzyme producing strain (52 ± 2.4a U/mL). The maximum production (74 ± 3.1a U/mL) was accomplished after at 48 h (68 ± 2.7a mg/mL protein). The mutants were stabilized at low levels of 5-fluoro-cytocine and the viable ones were further processed for optimization of cultural conditions and nutritional requirements. The sucrose concentration, incubation period and pH were optimized to be 30 g/L, 28 °C, and 6.5, respectively. The methyl methane sulfonate-V exhibited an improvement of over 10 folds in enzyme production when 5 g/L ammonium sulfate was used as a nitrogen source. Thin layer chromatography and high-performance liquid chromatography analysis illustrated the optimal enzyme activity supported by the higher rate of hydrolysis of sucrose into monosaccharides, particularly α-D-glucose and β-D-fructose. The values for Qp (2 ± 0.12c U/mL/h) and Yp/s (4 ± 1.24b U/g) of the mutant were considerably increased in comparison with other yeast strains (both isolates and viable mutants). The mutant could be exploited for enzyme production over a wider temperature range (26–34 °C), with significantly high enzyme activity (LSD 0.048, HS) at the optimal temperature.

Microorganisms in Vacuum Stored Flower Bee Pollen

Contamination with sanitary microorganisms from Enterobacteriaceae, Pseudomonadaceae, Staphylococcaceae, Micrococcaceae and Bacillaceae families in flower bee pollen from Bulgaria after one-year vacuum-packed cold storage has been found. Dried flower bee pollens intended for human consumption were with high incidence rate of contamination with Pantoea sp. (P. agglomerans and P. agglomerans bgp6) (100%), Citrobacter freundii (47%), Proteus mirabilis (31.6%), Serratia odorifera (15.8%) and Proteus vulgaris (5.3%). Bee pollens were also positive for the culture of microorganisms from Staphylococcaceae, Micrococcaceae and Bacillaceae families: Staphylococcus hominis subsp hominis, Staphylococcus epidermidis, Arthrobacter globiformis, Bacillus pumilis, Bacillus subtilis and Bacillus amyloliquefaciens. It was concluded that, if consumed directly, the vacuum-packed cold stored dried bee pollen, harvested according hygienic requirements from bee hives in industrial pollution-free areas without intensive crop production, is not problem for healthy human.

A Case of Ocular Perforation by an Acupuncture Needle Directly Through the Bulbar Conjunctiva

PURPOSE: To report a case of ocular perforation by an acupuncture needle directly through the bulbar conjunctiva. CASE SUMMARY: A 62-year-old male visited our clinic with acute ocular pain and decreased vision in his left eye. He had received intraocular acupuncture therapy one day earlier. A slit-lamp examination revealed conjunctival hyperemia and vitreous prolapse at the superonasal quadrant of the bulbar conjunctiva. Grade one of anterior chamber cells was found in the left eye. Dilated fundoscopy revealed three retinal hemorrhages at the superonasal quadrant of the retina; vitreous hemorrhage and opacity were also observed. Thus, vitrectomy and injections of intravitreal antibiotics were performed. Intraoperatively, we identified the entry site, located in the superonasal retinal quadrant, immediately behind the ora serratia. At the three-month postoperative follow-up, the patient's visual acuity was 0.9 in the left eye and the retina remained flat with no postoperative complications. CONCLUSIONS: We observed a case of ocular perforation and endophthalmitis following ocular acupuncture treatment. This case illustrates the dangers of intraocular acupuncture therapy.

Gram-Negative Bacterial Keratitis: A 15-Year Review of Clinical Aspects

PURPOSE: In this study we investigated pathogenic organisms, antibiotic susceptibility, and clinical characteristics of patients with Gram-negative bacterial keratitis and elucidated risk factors for poor visual outcomes. METHODS: The authors performed a retrospective chart review of 161 eyes (169 isolates) with Gram-negative bacterial keratitis between January 1998 and December 2012 at Yeungnam University Hospital. The study was divided into 5 periods for analysis of the bacteriological profiles and in vitro antibiotic sensitivity. The epidemiological and clinical characteristics were compared according to 3 groups (Pseudomonas species, Enterobacter species, and Serratia marcescens). Additionally, logistic regression analysis was performed to determine the risk factors. RESULTS: The prevalence of Gram-negative organisms increased from 34.7 to 73.2% between the 1st and 5th periods (p < 0.001). Pseudomonas spp. was the most commonly isolated organism (55 eyes, 32.5%) over the total period, followed by Enterobacter spp. (41 eyes, 24.3%) and Serratia marcescens (33 eyes, 19.5%). The effective antibiotics against Gram-negative bacterial pathogens isolated from culture were cefepime (94.5%), levofloxacin (93.4%), ciprofloxacin (93.0%), and amikacin (92.3%). The incidence was higher in the elderly over 60 years of age and in early adulthood patients in their 20s and 30s. The frequent predisposing factors were contact lens wearing and corneal trauma. S. marcescens had the shortest corneal epithelium healing time (p = 0.012) and the most favorable visual outcome after treatment (p = 0.004) compared with the other species. Risk factors for poor visual outcomes included a best corrected visual acuity less than 0.1 at initial evaluation (p < 0.001) and central corneal lesion (p = 0.027). CONCLUSIONS: Gram-negative bacterial keratitis tended to increase and Pseudomonas spp. was the most common isolate. The clinical prognosis was most favorable in S. marcescens. Early diagnosis of Gram-negative bacterial keratitis and appropriate antibiotic selection including cefepime, quinolone, or amikacin are recommended.

The Story of Serratia Marcescens: Pathologic Risk Factors in Breast Implant Surgery

Serratia marcescens (S. marcescens) emerged as an opportunist in the setting of immunodeficiency in the 1970s, when serious infections occurred in San Francisco hospitals after USA. Navy experiments had aerosolized the bacteria to study biologic warfare. We investigate the risks of S. marcescens in San Franciscans who undergo mastectomy with implant reconstruction. From 2007 to 2011, the senior author took breast capsule cultures for all patients at the time of tissue expander exchange/explant. Of the 142 women who had reconstruction, 23 had positive cultures. Only the two patients who were positive for S. marcescens developed clinical infections that required explantation. Both had postoperative chemotherapy with transient neutropenia, and both had close ties to San Francisco. Clinical signs of infection emerged for both patients months after initial surgery, despite having previously well healed incisions. Other patients were culture positive for Pseudomonas, Proteus, Enterococcus and MRSA and did not develop require explant. While the link between San Francisco and S. marcescens is controversial, a patient's geography is a simple screening tool when considering postoperative risks, especially in the immunocompromised. Closer monitoring for neutropenia during chemotherapy, and a lower threshold to administer S. marcescens targeted antibiotics may be warranted in these patients.

Characteristic of bacterial flora from the uterus in HanWoo cattle / 대한수의학회지

Uterine sterilization is important for improving fertility in cattle. This study compared bacterial flora in the uterus between healthy and repeat breeder cows (RBCs). The uterine flushing of six heifers, 13 healthy HanWoo cows and eight RBCs (HanWoo) were sampled, and 15 frozen semen samples were selected. Overall, 35 bacteria were identified from in HanWoo uterine flushing and semen. The bacterial genera identified from HanWoo uterine flushing were Alloiococcus, Bacillus, Enterobacter, Enterococcus, Erysipelothrix, Gardnerella, Granulicatella, Kocuria, Pantoea, Pasteurella, Rothia, Serratia, Sphingomonas, Staphylococcus, Stenotrophomonas and Streptococcus. The bacterial genera identified from HanWoo semen were Bacillus, Escherichia, Kocuria, Oligella, Pseudomonas, Serratia, Sphingomonas, Staphylococcus, Stenotrophomonas and Streptococcus. The prevalence and presence of the identified bacteria between healthy cows and RBCs differed significantly. Further studies are needed to determine the role of these bacteria in the uterus of HanWoo cattle with reproductive disorder.

A Case of Serratia Marcescens Keratitis Presenting as Radial Keratoneuritis

PURPOSE: To report a case of Serratia marcescens keratitis presenting as radial keratoneuritis. CASE SUMMARY: A 15-year-old female who wore cosmetic and orthokeratology contact lenses but performed inadequate lens care visited our clinic with severe pain and visual disturbance in her left eye. On slit lamp examination, central corneal epithelial defect and stromal infiltration with radial keratoneuritis were observed. Based on clinical findings and past history, Acanthamoeba keratitis was highly suspected. The patient was treated with topical chlorhexidine 0.02% (Sigma-Aldrich Co., MO, USA) and moxifloxacin 0.5% (Vigamox(R), Alcon, TX, USA) per hour with 200 mg of oral itraconazol (Sporaone(R), LG, Seoul, Korea) once a day. Symptoms and corneal lesions did not improve after three days. After Serratia marsenscens was isolated from her contact lenses and solution, topical chlorhexidine 0.02% was discontinued, and intravenous ceftazidime (Tazime(R), Hanmi, Seoul, Korea) and fortified ceftazidime (50 mg/mL) eye drop was added. The corneal lesion dramatically improved, and after six months of follow-up, best-corrected visual acuity was 20/20 in the affected eye. CONCLUSIONS: Radial keratoneuritis can present not only in Acanthamoeba keratitis, but also in Serratia marsenscens keratitis. Confirmation of the isolated organism is useful when treating radial keratoneuritis.

Purification and characterization of 50 kDa extracellular metalloprotease from serratia sp. ZF03

Proteolytic enzymes have an important role in variety of physiological and pathological functions. They have been used in therapeutic and pharmaceutical applications. Characterizations of extracellular proteases from various strains of S. marcescens indicate that most strains produce a very similar major metalloprotease. This metalloprotease [serrapeptidase, serrapeptase] is an important pharmaceutical agent. Serrapeptase has been used in Asian and European countries for the treatment of inflammatory diseases, cardiovascular disorders, and bacterial infections. In the present study, purification and characterization of extracellular metalloprotease from Serratia sp. ZF03 for therapeutic purposes were reported. In this study the protease gene encoding a zinc-metalloprotease was isolated from the previously isolated red-pigmented Serratia sp. ZF03. The gene was sequenced and submitted to the GenBank. Proteolytic activity was detected by skim milk agar plate method and zymography. This fragment was found to encode an extracellular zincmetalloendopeptidase with a molecular weight of approximately 50 kDa. The metalloprotease was purified by ammonium sulfate precipitation and dialysis, and then characterized. The effects of various inhibitors and reagents on protease activity and its kinetic parameters were also determined. The nucleotide sequence demonstrated that deduced amino acid sequence has a higher identity with those of metalloprotease from serralysin family. Production of metalloprotease was highest at 48[th] h of cultivation. Optimum protease activity occurred at a temperature range of 50-55[degree sign]C and a pH range of 8.0-10. EDTA as a metal chelator, significantly inhibited protease activity. Zymography and inhibition assays showed that metalloprotease is the major secreted protease of Serratia sp. ZF03. The kinetic parameters, K[m] and V[m], were 0.00105 mg/ml and 0.0531 mM/min, respectively. Since the metalloprotease of this strain has strong proteolytic properties and good stability, it would be a suitable candidate to be used as an effective drug in the medicine and pharmaceutical industries

Analysis of Inpatients with Contact Lens Related Bacterial Keratitis: Causative Microorganisms, Clinical Aspects, and Prognostic Factors

PURPOSE: To investigate causative microorganisms, clinical characteristics, and prognostic factors for inpatients with contact lens related bacterial keratitis. METHODS: Seventy-three eyes of inpatients with contact lens related bacterial keratitis and hospitalized at Yeungnam University Hospital between January 1998 and December 2011 were reviewed retrospectively. Their bacteriological profiles and clinical characteristics were evaluated. RESULTS: Females in their 20s (35/73 eyes, 47.9%) were the most common gender and age group. Thirty eyes (30/45 eyes, 66.7%) used daily-wear soft contact lenses. The most common predisposing factor was sleeping while wearing contact lenses (30 eyes, 41.1%). Positive culture rate was 53.4%. The ratio of gram-positive and -negative bacteria was 8.3%: 91.6%. The most commonly-isolated microorganisms were Pseudomonas spp. (39.6%), followed by Serratia spp. (29.2%). The characteristics of the corneal lesions were: a central lesion in 49 eyes (67.1%), a lesion less than 5 mm2 in size in 54 eyes (74.0%), and hypopyon in 8 eyes (11.0%). The mean log MAR BCVA improved from 0.93 +/- 0.88 on the initial visit to 0.25 +/- 0.48 on the final visit. Twelve eyes (16.4%) had a BCVA of 0.3 or less after remission medical treatment. A BCVA less than 0.1 on the initial visit was a significant risk factor for poor visual outcome (p = 0.005) after remission medical treatment. CONCLUSIONS: BCVA less than 0.1 on the initial visit, epithelial defect sized over 5 mm2, epithelial healing time over 10 days, and central corneal lesion were associated with poor visual outcome after remission medical treatment in contact lens related bacterial keratitis.

A Case of Corneal Perforation and IOL Prolapsed in Serratia Marcescens Endophthalmitis after Cataract Surgery

PURPOSE: To report a case of Serratia marcescens endophthalmitis following phacoemulsification and posterior chamber intraocular lens implantation. CASE SUMMARY: A 64-year-old male with a history of diabetes, hypertension, cardiovascular disease was referred with right ocular pain and reduced vision 1 day after cataract surgery. On admission, hypopyon on anterior chamber by slit lamp examination and anterior vitreous was hazy according to ultrasonography. We immediately performed intravitreal antibiotics injection and microbiological analysis of anterior chamber and vitreous samples was performed. On day 3, persistent cornea stormal infiltration and cornea perforation were visible and the organism was identified as S. marcescens. Despite appropriate antibiotic treatment the eye continued to deteriorate. CONCLUSIONS: S. marcescens endophthalmitis was diagnosed and treated immediately, but rapid progression and outcome were unsatisfactory.

Postoperative Infectious Complications in Our Early Experience With Holmium Laser Enucleation of the Prostate for Benign Prostatic Hyperplasia

PURPOSE: The objective of this study was to retrospectively investigate postoperative infectious complications (PICs) in our early experience with holmium laser enucleation of the prostate (HoLEP) followed by mechanical morcellation for symptomatic benign prostatic hyperplasia. MATERIALS AND METHODS: A retrospective review was performed of the clinical data for 90 consecutive patients who underwent HoLEP at our institution between February 2008 and March 2011. All patients were evaluated for the emergence of PICs, including prophylactic antibiotic administration (PAA) and the influence of the kind or duration of PAA on PIC. The details of cases with PICs were also examined. RESULTS: The patients' mean age was 71 years (range, 50 to 95 years), and their mean prostate volume was 60 mL (range, 2 to 250 mL). There were 7 cases (7.78%) with PICs; in detail, 3 patients were diagnosed with prostatitis, 2 with pyelonephritis, and 2 with epididymitis. Three patients had positive urine cultures: 1 had Serratia marcescens/Proteus mirabilis, 1 had S. marcescens, and 1 had Klebsiella pneumonia; only one case had urological sepsis. Our statistical data showed no significant differences between 2 or fewer days and 3 or more days of PAA and PIC occurrence. There was also no significant effect on PIC occurrence of sulbactam/ampicillin compared with other antibiotics. CONCLUSIONS: The results of this retrospective study showed that PIC occurrence did not depend on the duration or the kind of PAA. Further prospective study is necessary for the evaluation and establishment of prophylactic measures for PICs.

Serratia marcescens Peritonitis in a Diabetic Patient Receiving Continuous Ambulatory Peritoneal Dialysis

We report a case of Serratia marcescens peritonitis in a 45-year-old man with insulin-dependent diabetes mellitus undergoing continuous ambulatory peritoneal dialysis (CAPD). The patient presented with abdominal pain and cloudy dialysate. Empiric antibiotic therapy was initiated intraperitoneally with cefazolin and ceftazidime for 5 days. Cultures of the dialysate revealed S. marcescens, and the treatment was subsequently changed to gentamicin and ceftazidime. Oral ciprofloxacin was also added. The patient's abdominal pain and the dialysate white blood cell (WBC) count, however, did not improve. The indwelling CAPD catheter was therefore removed. This is an unusual case report in the Korean literature of S. marcescens peritonitis in a patient receiving CAPD.

A Case of Vertebral Osteomyelitis Caused by Serratia grimesii in a Patient without Predisposing Factors / 대한내과학회지

Vertebral osteomyelitis or paraspinal abscess caused by Serratia species is rare and has been reported only in certain groups of people, such as intravenous drug users, immunocompromised hosts, and patients who have undergone invasive procedures. However, we report here that Serratia was recovered from a patient with vertebral osteomyelitis and epidural abscess without predisposing factors. The organism was initially identified as Serratia liquefaciens by a Vitek II-based assessment. It was finally identified as Serratia grimesii by 16S rRNA gene sequence analysis. We present the first case of vertebral osteomyelitis caused by S. grimesii in a patient without risk factors and who was managed successfully.

Acute Ecthyma Caused by Serratia marcescens in a Patient with Diabetes Mellitus / 대한피부과학회지

Despite their existence all around, primary cutaneous infections caused by Serratia marcescens are still fairly rare. In many cases, symptoms caused by S. marcescens usually manifest as opportunistic infections in pulmonary, urinary and digestive organs of immunocompromised patients. It is unusual to find manifestations as "primary" cutaneous infection. A 56-year-old woman presented to our hospital with ulcerative skin lesions. She had a medical history of poorly controlled diabetes mellitus for 5 years. Multiple nodules and ulcerative lesions of various sizes were distributed on the abdomen, both buttocks and thighs. Two biopsy samples revealed deep dermal and subcutaneous suppurative inflammation. Two culture samples from the skin biopsy sites demonstrated S. marcescens. Small-to-medium sized lesions showed improvements with antibiotic treatment for 14 days. However, for large sized lesions, partial-thickness skin grafts were done.