Cutaneous infection caused by Corynebacterium pseudodiphtheriticum: a microbiological report.

We report here a rare case of cutaneous infection due to Corynebacterium pseudodiphtheriticum. The patient presented to the clinical laboratory with a skin ulcer on his left leg. Gram-stained preparation of the purulent secretion revealed the presence of numerous rod-shaped Gram-positive organisms in the absence of any other species. The organism was grown in pure culture on sheep blood agar and was further identified as C. pseudodiphtheriticum using a commercial identification system (API-Coryne, BioMérieux, France). The infection was successfully treated with ciprofloxacin. This case emphasizes the importance of the clinical microbiology laboratory in correctly identifying Gram-positive organisms obtained in pure culture from skin ulcers.

Cutaneous infection caused by Corynebacterium pseudodiphtheriticum: a microbiological report / Infecção cutânea causada por Corynebacterium pseudodiphtheriticum: relato microbiológico

We report here a rare case of cutaneous infection due to Corynebacterium pseudodiphtheriticum. The patient presented to the clinical laboratory with a skin ulcer on his left leg. Gram-stained preparation of the purulent secretion revealed the presence of numerous rod-shaped Gram-positive organisms in the absence of any other species. The organism was grown in pure culture on sheep blood agar and was further identified as C. pseudodiphtheriticum using a commercial identification system (API-Coryne, BioMérieux, France). The infection was successfully treated with ciprofloxacin. This case emphasizes the importance of the clinical microbiology laboratory in correctly identifying Gram-positive organisms obtained in pure culture from skin ulcers.

Reportamos o isolamento de Corynebacterium pseudodiphtheriticum de um caso de infecção cutânea. O paciente apresentou-se ao laboratório clínico com uma úlcera na perna esquerda. A coloração de Gram do material revelou a presença de bacilos Gram-positivos e ausência de outras espécies bacterianas. O organismo foi isolado em cultura pura no ágar sangue de carneiro e foi identificado como C. pseudodiphtheriticum através de um sistema de identificação comercial (API-Coryne, BioMérieux, França). A infecção foi tratada com sucesso através do uso de ciprofloxacina. Este caso reforça a importância do laboratório de microbiologia clínica na identificação de organismos Gram-positivos isolados de cultura pura de amostras de úlceras cutâneas.

Utility of the ceftazidime-imipenem antagonism test (CIAT) to detect and confirm the presence of inducible AmpC beta-lactamases among enterobacteriaceae.

Detection of AmpC beta-lactamase production by enterobacteria has been problematic. Contrary to ESBLs, no specific guidelines are available for detection and confirmation of AmpC production by clinical relevant microorganisms. Moreover, some bacterial species may produce inducible AmpC beta-lactamases that can be easily overlooked by routine susceptibility tests. We reported here a new test based on the strong inducible effect of imipenem on AmpC genes and the consequent antagonism with ceftazidime. This test is very simple and proved to be helpful in detecting AmpC-inducible enzymes among several species of clinical isolates.

Utility of the ceftazidime-imipenem antagonism test (CIAT) to detect and confirm the presence of inducible AmpC beta-lactamases among enterobacteriaceae

Detection of AmpC beta-lactamase production by enterobacteria has been problematic. Contrary to ESBLs, no specific guidelines are available for detection and confirmation of AmpC production by clinical relevant microorganisms. Moreover, some bacterial species may produce inducible AmpC beta-lactamases that can be easily overlooked by routine susceptibility tests. We reported here a new test based on the strong inducible effect of imipenem on AmpC genes and the consequent antagonism with ceftazidime. This test is very simple and proved to be helpful in detecting AmpC-inducible enzymes among several species of clinical isolates.

Fatal case of bacteremia caused by an atypical strain of Corynebacterium mucifaciens

Corynebacterium species have often been considered normal skin flora or contaminants; however, in recent years they have been increasingly implicated in serious infections. Moreover, many new species have been discovered and old species renamed, especially after molecular biology techniques were introduced. Corynebacterium mucifaciens is mainly isolated from blood and from other normally-sterile body fluids; it forms slightly yellow, mucoid colonies on blood agar. We report a fatal case of bacteremia due to an atypical strain of C. mucifaciens. This strain had atypical colony morphology; analysis of the 16S rRNA gene was used to define the species.

Fatal case of bacteremia caused by an atypical strain of Corynebacterium mucifaciens.

Corynebacterium species have often been considered normal skin flora or contaminants; however, in recent years they have been increasingly implicated in serious infections. Moreover, many new species have been discovered and old species renamed, especially after molecular biology techniques were introduced. Corynebacterium mucifaciens is mainly isolated from blood and from other normally-sterile body fluids; it forms slightly yellow, mucoid colonies on blood agar. We report a fatal case of bacteremia due to an atypical strain of C. mucifaciens. This strain had atypical colony morphology; analysis of the 16S rRNA gene was used to define the species.

Fatal bacteremia due to Anaerobiospirillum succiniciproducens: first description in Brazil.

Anaerobiospirillum succiniciproducens is an anaerobic, Gram-negative, spiral shaped bacteria, which is motile by means of bipolar tuffs of flagella. This organism appears to be a rare cause of bacteremia in humans, and it usually affects patients submitted to immunosuppressive therapy. Anaerobiospirillum succiniciproducens resembles Campylobacter spp. in Gram-stained preparations, however, it is considered resistant to most antimicrobial drugs that are used to treat Campylobacter infections. We observed Gram-negative, spiral shaped bacteria in Gram-stained preparations from blood culture flasks. Growth occurred only under anaerobic incubation, and identification to the species level was achieved by PCR amplification of the 16S rRNA gene, followed by direct sequencing and a GenBank homology search. To the best of our knowledge, this is the first reported Brazilian case of Anaerobiospirillum succiniciproducens bacteremia.

Fatal bacteremia due to Anaerobiospirillum succiniciproducens: first description in Brazil

Anaerobiospirillum succiniciproducens is an anaerobic, Gram-negative, spiral shaped bacteria, which is motile by means of bipolar tuffs of flagella. This organism appears to be a rare cause of bacteremia in humans, and it usually affects patients submitted to immunosuppressive therapy. Anaerobiospirillum succiniciproducens resembles Campylobacter spp. in Gram-stained preparations, however, it is considered resistant to most antimicrobial drugs that are used to treat Campylobacter infections. We observed Gram-negative, spiral shaped bacteria in Gram-stained preparations from blood culture flasks. Growth occurred only under anaerobic incubation, and identification to the species level was achieved by PCR amplification of the 16S rRNA gene, followed by direct sequencing and a GenBank homology search. To the best of our knowledge, this is the first reported Brazilian case of Anaerobiospirillum succiniciproducens bacteremia.

Quality control for microbiological culture media: Is it enough to follow the NCCLS M22-A2 procedures?

O uso de protocolos de controle de qualidade com padrões rígidos devem ser utilizados para garantir o isolamento dos microrganismos. Nosso objetivo foi o de avaliar um procedimento alternativo que nos permitisse detectar falhas de crescimento bacteriano em termos quantitativos, e comparação com o protocolo estabelecido pelo documento M22-A2 do NCCLS. Haemophilus influenzae apresentou diferença significativa de crescimento entre meio de cultivo de fontes distintas. Nos concluímos que, para alguns microrganismos fastidiosos, seja feita uma verificação quantitativa da capacidade de crescimento de cada meio de cultivo.

Quality control for microbiological culture media: Is it enough to follow the NCCLS M22-A2 procedures?

Stringent quality control protocols must be used in order to guaranty that a particular medium is able to recover all sort of organism that may be present in clinical samples. Our aim was to evaluate an alternative protocol that would allow us to detect medium failure to yield quantitative growth of selected pathogens, and compare with the document M22-A2 from NCCLS. The detection limit of Haemophilus influenzae was significantly different depending on media source. We conclude that for some fastidious microorganisms, quantitative verification of the growth capacity of the culture medium is advised.

O uso de protocolos de controle de qualidade com padrões rígidos devem ser utilizados para garantir o isolamento dos microrganismos. Nosso objetivo foi o de avaliar um procedimento alternativo que nos permitisse detectar falhas de crescimento bacteriano em termos quantitativos, e comparação com o protocolo estabelecido pelo documento M22-A2 do NCCLS. Haemophilus influenzae apresentou diferença significativa de crescimento entre meio de cultivo de fontes distintas. Nos concluímos que, para alguns microrganismos fastidiosos, seja feita uma verificação quantitativa da capacidade de crescimento de cada meio de cultivo.

Fasciolíase humana na Brasil diagnosticada por colangiografia endoscópica retrógrada / Human fascioliasis in BRasil diagnosed with endoscopic retrograde cholangiography

A fasciolíase humana é rara. O homem é um hospedeiro acidental da Fasciola hepatica. O parasita se instala nos canais bibliares e na vesícula bibliar simulando um cálculo biliar. Neste relato, descrevemos situaçäo em que a infestaçäo pela F. hepatica resultou em complicaçöes biliares, como icterícia e cólica biliar. O diagnóstico por imagem foi realizado por meio de colangiografia endoscópica retrógrada, que demonstrou a presença de estrutura no ducto bibliar extra-hepático. Foi efetuada esfincterotomia e remoçäo da mesma com cesta, havendo resoluçäo dos sintomas. O diagnóstico laboratorial demonstrou que o parasita era F. hepatica