Frequency and predictors of colonization of the respiratory tract by VIM-2-producing Pseudomonas aeruginosa in patients of a newly established intensive care unit
Maria HorianopoulouN.J. LegakisMaria KanellopoulouS. LambropoulosAthanassios TsakrisMatthew E. Falagas
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Abstract:
The aim of this study was to examine the frequency and predictors of colonization of the respiratory tract by metallo- β -lactamase (MBL)-producing Gram-negative bacteria in patients admitted to a newly established intensive care unit (ICU) of a tertiary care hospital. Specimens of tracheobronchial aspirates for microbiological studies were obtained every day for the first 3 days of the ICU stay and subsequently every third day for the rest of the ICU stay. PCR analysis and nucleotide sequencing were performed to identify bacteria that had MBL genes. Thirty-five patients (20 male, 15 female) were hospitalized during the initial 3 month period of functioning of the ICU. Colonization of the lower respiratory tract by Gram-negative bacteria was found in 29 of 35 patients (83 %) during the first 6–20 days (median 13 days) following admission to the ICU (13 patients with Acinetobacter baumannii , ten with Pseudomonas aeruginosa , three with Enterobacter aerogenes , two with Klebsiella pneumoniae and one with Stenotrophomonas maltophilia ). Six of 29 patients (21 %) colonized with Gram-negative bacteria had bla VIM-2 -positive P. aeruginosa isolates; one of these patients developed clinical infection due to this micro-organism. Previous use of carbapenems ( P =0.01) or other β -lactams ( P =0.03), as well as a stay in the ICU of >20 days ( P <0.001), were associated with colonization with bla VIM-2 -producing P. aeruginosa . In conclusion, colonization by Gram-negative bacteria of the respiratory tract of patients in this newly established ICU was common (83 %). Use of β -lactams, including carbapenems, was associated with subsequent colonization of the respiratory tract with MBL-positive P. aeruginosa .Keywords:
Stenotrophomonas maltophilia
Acinetobacter baumannii
Enterobacter aerogenes
Respiratory tract
Stenotrophomonas
Gram-Negative Bacteria
Stenotrophomonas maltophilia
Stenotrophomonas
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Η μελέτη του σηπτικού φαινομένου σε ανοσοκατασταλμένους επίμυες, στους οποίους προκλήθηκε λοίμωξη μαλακών μορίων με την Stenotrophomonas maltophilia, αποτέλεσε το σκοπό της πειραματικής εργασίας. Χρησιμοποιήθηκαν 55 επίμυες τύπου Wistar. Σαράντ (40) από αυτούς χωρίστηκαν σε 4 ισάριθμες ομάδες (Α, Β, Γ, Δ). Στις ομάδες αυτές προκλήθηκε ουδετεροπενία με χορήγηση ενδοπεριτοναϊκά κυκλοφωσφαμίδης σε δόσεις 100 mg/kg ΒΣ την πρώτη μέρα και 150 mg/kg ΒΣ την Τρίτη μέρα. Την Πέμπτη μέρα ενέθηκε ενδομυϊκά στον δεξιό μηρό τους το μικροβιακό στέλεχος της Stenotrophomonas maltophilia σε συγκέντρωση 1x108 cfu/kg ΒΣ. Οι επίμυες των παραπάνω ομάδων θυσιάστηκαν 2, 4, 6, 8 ώρες αντίστοια από την ένεση του μικροβίου. Μετρήθηκαν σε λήψεις αίματος η TNFα, η LPS, η MDA, πάρθηκαν δείγματα αίματος, πνευμόνων, ήπατος και σπληνος για καλλιέργεια μικροβίων, ενώ ιστοτεμάχια πνεύμονος, ήπατος και σπληνός εξετάστηκαν παθολογοανατομικά. Οι υπόλοιποι 15 επίμυες, χωρίστηκαν σε δύο ομάδες ελέγχου επιβίωσης, την Ε1 (8 επίμυες) και την Ε2 (7 επίμυες). Στους επίμυες της Ε1 προκλήθηκε ανοσοκαταστολή και λοίμωξη με τον παραπάνω τρόπο ενώ στους επίμυες της Ε2 μόνο ανοσοκαταστολή. Η μέση τιμή (±SD) επιβίωσης στην ομάδα ελέγχου Ε1 ήταν 34,6±5,56 ώρες και στην Ε2 ήταν 142,2±7,1 ώρες. Δεν ανεβρέθηκαν συγκεντρώσεις TNFα σε κανέναν επίμυ. Οι συγκεντρώσεις LPS και MDA ήταν παράλληλα αυξανόμενες και με στατιστικά θετικη συσχέτιση στις τέσσερις ομάδες του πειράματος. Οι καλλιέργειες αίματος και ιστών έδειξαν την ύπαρξη Stenotrophomonas maltophilia αλλά και πλήθος άλλων μικροβίων (Eneterococcus Spp, Escherichia coli, Enterobacter cloacae), τα οποία ανεβρέθηκαν και στις καλλιέργειες κοπράνων φυσιολογικών επίμυων. Τέλος, η παθολογοανατομική εξέταση των ιστοτεμαχίων δεν κατέδειξε την ύπαρξη σοβαρών αλλοιώσεων ενδεικτικών σήψης ή ανεπάρκειας πολλαπλών οργάνων. Συμπερασματικά, η φλεγμονώδης αντίδραση που εξελίχτηκε στο πειραματικό μας μοντέλο οφείλεται κατά κύριο λόγο στο φαινόμενο της βακτηριακής αλλόθεσης, που η λοίμωξη πυροδοτεί σε καταστάσεις ανοσοανεπάρκειας. Το παραπάνω φαινόμενο οδηγεί σε αύξηση της LPS και του οξειδωτικού φόρτου (MDA) και μέσω αυτών στην εκδήλωση του σηπτικού φαινομένου. Επομένως, σε ουδετεροπενικές καταστάσεις η μείωση του σηπτικού φόρτου του πεπτικού σωλήνα και η επιθετική αντιμετώπιση κάθε λοιμώδους εστίας αποτελούν τα κλινικά συμπεράσματα που προκύπτουν από την πειραματική εργασία και τα οποία χρήζουν επιπλέον έρευνας με πιο στοχευμένες κλινικές μελέτες.
Stenotrophomonas maltophilia
Enterobacter cloacae
Stenotrophomonas
Gram-negative bacterial infections
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Stenotrophomonas maltophilia
Stenotrophomonas
Marine invertebrates
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In consideration of the criticisms of the transfer of Pseudomonas maltophilia to the genus Xanthomonas proposed by J. Swings p. De Vos, M. Van den Mooter, and J. De Ley (Int. J. Syst. Bacteriol. 33:409-413, 1983), a new generic name is created for this taxon. The name Stenotrophomonas is here proposed for the new genus, which includes a single species, Stenotrophomonas maltophilia. This proposal restores the genus Xanthomonas to its former definition (J. Bradbury p. 199-210, in N. R. Krieg and J. G. Holt, ed., Bergey’s Manual of Systematic Bacteriology, 1984) The arguments on which this proposal is based are presented.
Stenotrophomonas maltophilia
Xanthomonas
Stenotrophomonas
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Background: Stenotrophomonas species are multi-resistant bacteria with ability to cause opportunistic infections.
Objective: We isolated 45 Stenotrophomonas species from soil, sewage and the clinic with the aim of investigating their susceptibility to commonly used antimicrobial agents.
Methodology: The identities of isolates were confirmed with 16S rRNA gene sequence and MALDI-TOF analysis. Anti-mi- crobial resistance, biofilm production and clonal diversity were also evaluated. The minimum inhibitory concentration technique as described by Clinical & Laboratory Standards Institute: CLSI Guidelines (CLSI) was employed for the evaluation of isolate susceptibility to antibiotics.
Result: Forty-five Stenotrophomonas species which include 36 environmental strains and 9 clinical strains of S. maltophilia were considered in this study. 32 (88.9 %) environmental strains were identified to be S. maltophilia, 2 (5.6 %) were Stenotrophomonas nitritireducens, and 2 (5.6 %) cluster as Stenotrophomonas spp. Stenotrophomonas isolates were resistant to at least six of the antibiotics tested, including Trimethoprim/Sulfamethoxazole (SXT).
Conclusion: Environmental isolates from this study were resistant to SXT which is commonly used for the treatment of S. maltophilia infections. This informs the need for good public hygiene as the environment could be a reservoir of multi-resistant bacteria. It also buttresses the importance of surveillance study in the management of bacterial resistance.
Keywords: Stenotrophomonas; environmental; biochemical characterization; clonal diversity; anti-microbial susceptibility.
Stenotrophomonas maltophilia
Stenotrophomonas
Sulfamethoxazole
Trimethoprim
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Stenotrophomonas maltophilia
Stenotrophomonas
Gram-negative bacterial infections
Burkholderia cepacia complex
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Stenotrophomonas sepilia strain SM16975 (= JCM 32102; = KCTC 62052) is a new species isolated from the blood culture of a hospitalized patient. The biochemical characterization, phenotypic criteria, phylogenomic reconstruction, and genomic analysis were carried out to differentiate it from its phylogenetic neighbours, establishing novel species status in the genus Stenotrophomonas and within Stenotrophomonas maltophilia complex (Smc).
Stenotrophomonas maltophilia
Stenotrophomonas
Blood Culture
Strain (injury)
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목적 : Stenotrophomonas maltophilia 각막염의 원인과 임상양상, 치료결과 및 예후에 대해 알아보고자 하였다. 대상과 방법 : 각막도말 및 배양검사 상 Stenotrophomonas maltophilia 각막염으로 진단 받고 3개월 이상 추적관찰이 가능하였던 환자를 대상으로 과거력, 시력, 발생부위 및 크기, 전방축농 및 치료에 대한 반응 등을 조사하였다. 결과 : Stenotrophomonas maltophilia 각막염 10명 10안 중 남자는 7명, 여자는 3명이었으며, 평균 연령은 62.9±11.3세였다. 2안(20.0%)에서만 각막외상력이 있었고 7안(70.0%)에서 복합감염이었는데 그 중 3안에서 Pseudomonas종, 2안에서 Fusarium종이었다. 6안에서 각막중심부에 발생하였고, 병변의 크기는 평균 28.5±19.6 mm2였으며, 9안에서 전방축농이 있었다. 7안(70.0%)에서는 수술적 치료를 시행하였다. 초진시 시력은 9안(90.0%)에서 0.02미만이었고, 치료 후 3안(30.0%)에서 시력 호전이 있었으나, 7안(70.0%)에서는 안전수동 이하로 시력이 불량하였다. 결론 : Stenotrophomonas maltophilia 각막염은 주로 안구표면의 방어기전이 손상된 환자들에서 복합감염으로 발생하여 불량한 예후를 보인다.
Stenotrophomonas maltophilia
Stenotrophomonas
Gram-negative bacterial infections
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This study reports the presence of the blaNDM-1 gene in an isolate of Stenotrophomonas maltophilia obtained from a Brazilian soil, inside an IncA/C plasmid with ~ 45 Kb. To the best of our knowledge, this is the second report in the world and the first in Brazil of NDM-producing bacterium isolated from soil.
Stenotrophomonas maltophilia
Stenotrophomonas
Gram-negative bacterial infections
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To assess the influence of Stenotrophomonas on plants, the interaction of 16 Stenotrophomonas strains from clinical and environmental sources with strawberry plant seedlings was analysed.In vitro, all Stenotrophomonas strains influenced plant growth when applied to seedlings. Whereas most of the Stenotrophomonas strains promoted root growth and hair development, a statistically significantly negative influence on the length of stem was found. Although strains from a clinical origin also showed statistically significant effects on plants, this was generally lower when compared with environmental strains. For three selected strains, a strong dose-dependent effect was observed for all parameters. In vitro, a correlation was found between plant growth promotion and production of a plant growth hormone, indole-3-acetic acid (IAA). Xanthomonas campestris, a phylogenetically very closely related species to Stenotrophomonas, was used as a phytopathogenic control. It too confirmed the reduction of plant growth in this in vitro system.Independent of their origin, Stenotrophomonas strains can produce IAA in vitro and subsequently, influence plant growth. The effect of Stenotrophomonas presence on plants was dose-dependent.The dose-dependent effect of Stenotrophomonas, a bacterium of both biotechnological and medical interest, is of great interest for biocontrol applications of plant-associated strains. This paper is the first report that clearly demonstrates the phytopathogenic capacity of Stenotrophomonas.
Stenotrophomonas
Stenotrophomonas maltophilia
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