ABSTRACT
AIM: To investigate the occurrence of ESBL and colistin-resistant E. coli and its genotypic characterization and identification of virulence determinants in cases of bovine mastitis in three provinces of China. MATERIALS AND METHODS: Five hundred and thirty-five milk samples presenting mastitis symptoms were screened for the presence of ESBL, colistin-resistant and different virulence genes. Susceptibility testing was identified by the micro-dilution method. Escherichia coli isolates were used to detect ESBL genes (blaCTX-M , blaSHV and blaTEM ) and colistin-resistant genes mcr-(1-9). Multiplex PCR approach was used for the detection of major blaCTX-M groups, different phylogroups and virulence genes. The clonal relationship was then evaluated with MLST, MLSA and PFGE. RESULTS: Multi-drug resistance (MDR) was found in more than 85% of ESBL and colistin-resistant E. coli isolates. Genotypic characterization showed a dominance of the blaCTX-M-1 group, and the most prevalent alleles observed were blaCTX-M-28 (38·37%), blaCTX-M-14 (17·44%), blaCTX-M-66 (13·95%) and blaCTX-M-55 (10·46%). The targeted virulence genes were detected in 97·89% of isolates. Sequence types ST58 and ST410 were the most predominant (2/20 = 20%). The majority of the E. coli isolates carrying ESBL and mcr-1 were clonally unrelated. CONCLUSION: High level of association was observed between ESBL-producing and COL-resistance in E. coli of bovine mastitis. SIGNIFICANCE AND IMPACT OF THE STUDY: To the best of our knowledge, this is the first report which shows the genetic diversity of ESBL and mcr-1, and various virulent features of E. coli strains isolated from bovine clinical mastitis in three different provinces of China. The major carriers of the blaCTX-M-1 and blaCTX-M-9 were blaCTX-M-28 and blaCTX-M-14 alleles respectively. The association of ESBL-producing E. coli with mcr-1 is of particular concern.
Subject(s)
Escherichia coli Infections , Escherichia coli Proteins , Escherichia coli , Mastitis, Bovine , Virulence Factors , Animals , Anti-Bacterial Agents/pharmacology , Cattle , China , Escherichia coli/genetics , Escherichia coli/pathogenicity , Escherichia coli Infections/veterinary , Escherichia coli Proteins/genetics , Female , Mastitis, Bovine/microbiology , Milk/microbiology , Multilocus Sequence Typing , Plasmids , Virulence Factors/genetics , beta-Lactamases/geneticsABSTRACT
We describe a 30-year-old male who presented with acute onset of breathlessness, tachycardia, and palpitations associated with distension of jugular vein and clear lungs on physical examination. The chest X-ray was normal and ECG was showing S1Q3T3 and right ventricular strain pattern. His 2-D echocardiography was showing dilated right atrium, right ventricular dilatation and moderate pulmonary arterial hypertension. He was found to have thrombosis involving left side of deep venous system with normal superficial venous system (Doppler proved). All routine blood investigations for etiology of recurrent DVT were normal except serum homocyteine level, which was significantly raised. Megaloblastic anemia on peripheral smear and hyperhomocysteinemia prompted us to search for its cause, which was subsequently found to be vitamin B12 deficiency. Such an association of megaloblastic anemia due to vitamin B12 deficiency leading to hyperhomocysteinemia and subsequent thrombosis in left venous system presenting as acute pulmonary embolism has not been described earlier in the medical literature.
Subject(s)
Anemia/etiology , Diagnosis , Hyperhomocysteinemia/diagnosis , Pulmonary Embolism/diagnosis , Venous Thrombosis/etiology , Vitamin B 12 Deficiency/complications , Adult , Anemia/complications , Diagnosis, Differential , Humans , Hyperhomocysteinemia/etiology , Hyperhomocysteinemia/therapy , Male , Venous Thrombosis/complications , Venous Thrombosis/therapySubject(s)
Adverse Drug Reaction Reporting Systems , Angioedema/chemically induced , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Asthma/chemically induced , Sulfonamides/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Data Collection , Dose-Response Relationship, Drug , Humans , India , Sulfonamides/therapeutic useABSTRACT
A partially obstructing lesion of the splenic flexure was discovered during a barium enema examination, and subsequent colonoscopy and biopsy demonstrated a squamous cell carcinoma. This is the first reported instance of squamous cell carcinoma of the colon in which the splenic flexure has been involved. The case is discussed, and the recent literature on this entity is reviewed.
