Estimation of antimicrobial resistance of Mycoplasma genitalium, Belgium, 2022.

BackgroundAntimicrobial resistance (AMR) of Mycoplasma genitalium (MG) is a growing concern worldwide and surveillance is needed. In Belgium, samples are sent to the National Reference Centre of Sexually Transmitted Infections (NRC-STI) on a voluntary basis and representative or robust national AMR data are lacking.AimWe aimed to estimate the occurrence of resistant MG in Belgium.MethodsBetween July and November 2022, frozen remnants of MG-positive samples from 21 Belgian laboratories were analysed at the NRC-STI. Macrolide and fluoroquinolone resistance-associated mutations (RAMs) were assessed using Sanger sequencing of the 23SrRNA and parC gene. Differences in resistance patterns were correlated with surveillance methodology, socio-demographic and behavioural variables via Fisher's exact test and logistic regression analysis.ResultsOf the 244 MG-positive samples received, 232 could be sequenced for macrolide and fluoroquinolone RAMs. Over half of the sequenced samples (55.2%) were resistant to macrolides. All sequenced samples from men who have sex with men (MSM) (24/24) were macrolide-resistant. Fluoroquinolone RAMs were found in 25.9% of the samples and occurrence did not differ between socio-demographic and sexual behaviour characteristics.ConclusionAlthough limited in sample size, our data suggest no additional benefit of testing MG retrieved from MSM for macrolide resistance in Belgium, when making treatment decisions. The lower occurrence of macrolide resistance in other population groups, combined with emergence of fluoroquinolone RAMs support macrolide-resistance testing in these groups. Continued surveillance of resistance in MG in different population groups will be crucial to confirm our findings and to guide national testing and treatment strategies.

A first case of Chimaeribacter species catheter-related bloodstream infection.

We present a case of a 80-year-old patient with a catheter-related bloodstream infection caused by Chimaeribacter species. The Chimaeribacter genus represents a novel genus within the Yersiniaceae family. To the best of our knowledge, as of today, nothing is known about the pathogenicity of Chimaeribacter species, nor about the appropriate antimicrobial management. In the present case, we demonstrate, for the first time, a potential clinical relevance of the Chimaeribacter species. Antimicrobial susceptibility data are presented.

First case of Wohlfahrtiimonas chitiniclastica isolation from a patient with a foot ulcer infection in Belgium.

We present the first documented isolation of Wohlfahrtiimonas chitiniclastica from a patient in Belgium. The isolate was identified as W. chitiniclastica using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing. Our methodology corresponds with the previous conclusions on the superior performance of MALDI-TOF MS for bacterial identification. The patient was treated with amoxicillin/clavulanate and was discharged home after wound management. Although the clinical relevance of the isolate in our case is inconclusive, the pathogenicity of such isolate has been described and therefore must be considered as a potential pathogen in chronic and ulcerating wound cultures.

Two Years of Genomic Surveillance in Belgium during the SARS-CoV-2 Pandemic to Attain Country-Wide Coverage and Monitor the Introduction and Spread of Emerging Variants.

An adequate SARS-CoV-2 genomic surveillance strategy has proven to be essential for countries to obtain a thorough understanding of the variants and lineages being imported and successfully established within their borders. During 2020, genomic surveillance in Belgium was not structurally implemented but performed by individual research laboratories that had to acquire the necessary funds themselves to perform this important task. At the start of 2021, a nationwide genomic surveillance consortium was established in Belgium to markedly increase the country's genomic sequencing efforts (both in terms of intensity and representativeness), to perform quality control among participating laboratories, and to enable coordination and collaboration of research projects and publications. We here discuss the genomic surveillance efforts in Belgium before and after the establishment of its genomic sequencing consortium, provide an overview of the specifics of the consortium, and explore more details regarding the scientific studies that have been published as a result of the increased number of Belgian SARS-CoV-2 genomes that have become available.

Pyelonephritis and bacteremia caused by Haemophilus parainfluenzae: case-report of an unusual pathogen.

We present a case of a young man with known urinary tract abnormalities who developed pyelonephritis and bacteremia caused by Haemophilus parainfluenzae. Since routine urine culture usually does not include enriched media for Haemophilus spp., the true incidence of urinary tract infections caused by H. parainfluenzae is currently unknown. Our case, however, demonstrates that H. parainfluenzae is a potential urinary pathogen, at least in patients with urinary tract anomalies. Clinical laboratories should consider expanding their culture efforts to detect unusual pathogens in patients with underlying risk factors.