Serratia, No Longer an Uncommon Opportunistic Pathogen - Case Series & Review of Literature.

BACKGROUND: Serratia spp. is a common enteric bacterium generally thought not to be pathogenic in the gastrointestinal tract. Serratia marcescens is a member of the genus Serratia, which is a part of the family Enterobacteriales. Of all Serratia species, S. marcescens is the most common clinical isolate and the most important human pathogen. OBJECTIVE: We discuss here four cases of Serratia marcescens which were reported in our laboratory at the Department of Microbiology Government Medical College and Hospital Chandigarh within six months of duration. METHOD: All the samples were processed and identified using standard microbiological techniques. The isolates of Serratia marcescens were identified, depending upon their biochemical and morphological characteristics, and further confirmed by MALDI-TOF-MS, PGIMER Chandigarh. RESULT: In one of the four cases, polymicrobial infection was observed, and among the cases, one patient was diabetic and the rest three patients were immunocompetent. The importance of detection of Serratia marcescens is related to the concern regarding its increased spread in hospital settings as nosocomial infection. CONCLUSION: We need to identify and isolate this pathogen not thinking of it only as a contaminant and opportunistic pathogen but as a pathogen which can lead to serious infections in hospital settings.

Fournier's Gangrene Due to Salmonella Typhimurium in a Healthy Male: A Rare Aberrant Infection.

INTRODUCTION: Human Salmonella infections have been classically distinguished into diseases caused by typhoidal and non-typhoidal salmonella (NTS). Typhiodal salmonella includes S. enterica serovars Typhi and Paratyphi that cause the systemic disease but are restricted to human infections, while NTS consists mainly of other serovars that predominantly cause self-limiting gastroenteritis in humans. Localisation of foci with persisting infection occurs due to dissemination of the bacteria throughout the body and can cause a variety of rare clinical syndromes at aberrant sites. Fournier's gangrene, a rapidly progressive, often fatal, necrotizing fasciitis of the external genitalia and perineum due to Salmonella typhimurium, is a rare manifestation and has never been reported. CASE: A 22-year-old male, apparently healthy patient with no relevant past medical history, was presented to surgical emergency with chief complaints of swelling of bilateral scrotal area. Infective etiology was considered and a diagnosis of Fournier's gangrene was made. Pure growth of Salmonella typhimurium was obtained after repeated subculture and was identified biochemically and on serotyping, as Salmonella enterica, Serotype typhimurium using specific antisera. CONCLUSION: In our case report, we describe a case of Fournier's gangrene due to Salmonella Typhimurium in an otherwise healthy male to highlight the unusual presentation of Non typhoidal salmonellae at an aberrant site. We also emphasize the importance of using selective media like Selenite F broth for isolation of Salmonella typhimurium from a pus sample.

Corynebacterium Striatum, an Emerging Nosocomial Pathogen: Case Reports.

BACKGROUND: Corynebacterium striatum is an emerging nosocomial pathogen, capable of causing a variety of infections in immunocompromised and hospitalized patients. ; Case Presentation: We describe three cases of infection by C. striatum that were initially considered as contamination. Clinical suspicion in the wake of predisposing factors and accurate identification, using the Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS), were key to implicate this commensal bacterium as a cause of infection.

Quinolone Susceptibility in Salmonella Isolates Based on Minimum Inhibitory Concentration Determination.

Introduction Typhoid fever, caused by Salmonella typhi and paratyphi , is a generalized infection with case fatality of about 10%. The symptoms may be severe, with life threatening sequelae of infection in a proportion of cases. Antimicrobial agents are the mainstay of therapy in enteric fever so as to prevent the complications associated with severe illness and mortality in the patients. Fluoroquinolones (e.g., ciprofloxacin) are very effective against completely susceptible Salmonella bacteria. However, their efficacy is doubtful once any resistance is detected. Pefloxacin testing has ultimately helped in the accurate identification of quinolone susceptibility for a better therapeutic success rate. In the present study we have tried to evaluate the quinolone susceptibility in Salmonella isolates based on minimum inhibitory concentration (MIC) determination. Materials and Methods The method used in the study is quinolone susceptibility in Salmonella isolates based on MIC determination. Salmonella isolates show intermediate susceptibility to ciprofloxacin using disk diffusion. Both ciprofloxacin and pefloxacin MIC evaluation has been done to corroborate the results with pefloxacin disk diffusion testing. Results There was a positive correlation between the susceptibility to ciprofloxacin and pefloxacin. However, the isolates with intermediate susceptibility had variations in terms of susceptibility to pefloxacin. MIC values for pefloxacin and our findings suggested that pefloxacin susceptible on disk diffusion as per Clinical and Laboratory Standards Institute guidelines showed lower values for MIC using Pefloxacin HICOMB test and pefloxacin resistant isolates showed higher MIC values.