Assuntos
Amoxicilina/farmacologia , Amoxicilina/uso terapêutico , Ceftriaxona/farmacologia , Ceftriaxona/uso terapêutico , Farmacorresistência Bacteriana Múltipla , Salmonella typhi/efeitos dos fármacos , Febre Tifoide/tratamento farmacológico , Amoxicilina/efeitos adversos , Antibacterianos/efeitos adversos , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Bactérias/efeitos dos fármacos , Bactérias/genética , Bactérias/isolamento & purificação , Ceftriaxona/efeitos adversos , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Farmacorresistência Bacteriana Múltipla/genética , Fezes/microbiologia , Genoma Bacteriano/genética , Humanos , Adesão à Medicação , Plasmídeos/genética , Recidiva , Salmonella typhi/genética , Salmonella typhi/isolamento & purificação , Febre Tifoide/microbiologiaRESUMO
BACKGROUND: The transmission of fungi via transplant, although well-known, has not often been molecularly proven. We describe a case of donor-derived candidiasis verified by whole genome sequencing. CASE DESCRIPTION: The multiorgan donor was a 42-year-old woman with subdural hemorrhage. Procurement of the thoracic organs was performed followed by the abdominal organs. Tissue from the left bronchus grew Candida dubliniensis. The liver recipient was a 63-year-old woman with cryptogenic liver cirrhosis. She was noted to have worsening leukocytosis on postoperative day (POD) 9. Computed tomography of the abdomen and pelvis showed multiple rim-enhancing collections around the graft. Percutaneous drainage was performed. Fluid cultures grew C dubliniensis. C dubliniensis isolated from the donor's left bronchus and the liver recipient's abscesses were verified to be related by whole genome sequencing. We postulate that C dubliniensis colonizing the donor's transected trachea could have contaminated the inferior vena cava when the former was left open after explant of the donor's lungs. A portion of the donor's contaminated inferior vena cava was transplanted along with the liver graft, resulting in the infected collections in the recipient. CONCLUSIONS: Our case report highlights the importance of maintaining a sterile field during organ procurement, especially in a multiorgan donor whose organs are explanted in succession.
Assuntos
Candidíase/etiologia , Transplante de Fígado/efeitos adversos , Doadores de Tecidos , Obtenção de Tecidos e Órgãos/métodos , Transplantes/microbiologia , Candida , Feminino , Humanos , Abscesso Hepático/microbiologia , Transplante de Fígado/métodos , Pessoa de Meia-Idade , Veia Cava Inferior/microbiologia , Sequenciamento Completo do GenomaRESUMO
The emergence of carbapenemase-producing Enterobacteriaceae is a rapidly evolving threat worldwide. Here, we report the molecular characterization of two Klebsiella pneumoniae isolates carrying both bla(OXA -181) and bla(NDM -1) or bla(NDM -5) isolated from epidemiologically unrelated patients in Singapore. The bla(OXA -181) genes were found existing in different genetic environments.
Assuntos
Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/enzimologia , Klebsiella pneumoniae/genética , beta-Lactamases/genética , beta-Lactamases/metabolismo , Adolescente , Técnicas de Tipagem Bacteriana , Pré-Escolar , Enterobacteriaceae/genética , Feminino , Humanos , Klebsiella pneumoniae/isolamento & purificação , Testes de Sensibilidade Microbiana , Tipagem de Sequências Multilocus , Estudos Prospectivos , SingapuraRESUMO
Rickettsiae survival implicates adaptation to different environmental conditions. We hypothesized that multiple copies of genes in bacteria with reduced genomes might account for such a process. Transcription of spoT and sca paralogs was thus analyzed in R. conorii and R. felis.
