Posts filed under ‘Bacterias’

Distribution of Fatal Vibrio Vulnificus Necrotizing Skin and Soft-Tissue Infections: A Systematic Review and Meta-Analysis.

Medicine (Baltimore). 2016 Feb;95(5):e2627.

Huang KC1, Weng HH, Yang TY, Chang TS, Huang TW, Lee MS.

Author information

1 From the College of Medicine, Chang Gung University, Taoyuan (K-CH, H-HW, T-SC, T-WH, MSL); Department of Orthopaedic Surgery (K-CH, T-YY, T-WH); Department of Diagnostic Radiology (H-HW); Department of Gastroenterology, Chang Gung Memorial Hospital, Chaiyi (T-SC); and Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan (MSL).


Vibrio vulnificus necrotizing skin and soft tissue infections (VNSSTIs), which have increased significantly over the past few decades, are still highly lethal and disabling diseases despite advancing antibiotic and infection control practices. We, therefore, examined the spatiotemporal distribution of worldwide reported episodes and associated mortality rates of VNSSTIs between 1966 and 2014. The PubMed and Cochrane Library databases were systematically searched for observational studies on patients with VNSSTIs. The primary outcome was all-cause mortality. We did random-effects meta-analysis to obtain estimates for primary outcomes; the estimates are presented as means plus a 95% confidence interval (CI). Data from the selected studies were also extracted and pooled for correlation analyses.Nineteen studies of 2227 total patients with VNSSTIs were analyzed. More than 95% of the episodes occurred in the subtropical western Pacific and Atlantic coastal regions of the northern hemisphere. While the number of cases and the number of deaths were not correlated with the study period (rs = 0.476 and 0.310, P = 0.233 and 0.456, respectively), the 5-year mortality rate was significantly negatively correlated with them (rs = -0.905, P = 0.002). Even so, the pooled estimate of total mortality rates from the random-effects meta-analysis was as high as 37.2% (95% CI: 0.265-0.479).These data suggest that VNSSTIs are always an important public health problem and will become more critical and urgent because of global warming. Knowing the current distribution of VNSSTIs will help focus education, policy measures, early clinical diagnosis, and appropriate medical and surgical treatment for them.


August 18, 2017 at 3:51 pm

Clinical features and treatment of patients with Vibrio vulnificus infection

Int J Infect Dis. 2017 Jun;59:1-6.

Yu W1, Shen X1, Pan H2, Xiao T1, Shen P1, Xiao Y3.

Author information

1 State Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

2 Department of Infectious Diseases, Zhejiang Provincial People’s Hospital, Hangzhou, China.

3 State Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China. Electronic address:



Infections with Vibrio vulnificus are commonly fatal, and the speed and accuracy of diagnosis and treatment is directly linked to mortality. The main aims of this study were to investigate the clinical characteristics of six patients with V. vulnificus infections retrospectively and to determine the effect of treatment with tigecycline (TGC) alone compared with doxycycline plus ceftazidime (DOX/CAZ).


The medical records of patients were reviewed. The species-specific and pathogenic gene markers were detected by PCR, and multilocus sequence typing (MLST) was performed. Furthermore, the effects of TGC and of DOX/CAZ were determined using time-kill assays.


MLST revealed six different sequence types and five of them were novel. The complete clinical pattern (vcg type C, CPS operon allele 1, 16S-rRNA type B) was found in one strain and the others had a mixed pattern. The lesion was mainly located at the distal end of the extremities and the most common clinical symptoms were fever, pain, erythema, and local swelling. The in vitro time-kill assay indicated that TGC monotherapy at a concentration of 0.1mg/l had a rapid bactericidal effect against the six tested V. vulnificus strains at 24h.


TGC alone might be a better potential therapeutic option than the traditional combination of DOX/CAZ against V. vulnificus.


August 18, 2017 at 3:50 pm

Vibrio vulnificus: una bacteria al acecho en las playas.

Revista de Enfermedades Infecciosas en Pediatría 2014 V.28 N.110

Iván Renato Zúñiga Carrasco*, Janett Caro Lozano**.

*Jefe del Departamento de Epidemiología. Miembro del Comité Local de Investigación y Ética en Salud (CLIES). H.G.Z. # 18 IMSS Playa del Carmen, Quintana Roo.

**Jefa del Departamento de Epidemiología. Miembro del Comité Local de Investigación y Ética en Salud (CLIES) H.G.Z. C/M.F. 1 IMSS Chetumal, Quintana Roo.

Un patógeno que puede ser transmitido por los ostiones es Vibrio vulnificus. Descrito en 1976, se le denominó “Vibrio lactosa positivo”, posteriormente se le llamó Beneckea vulnificus y finalmente V. vulnificus.

Pertenece a la familia Vibrionaceae, son bacilos Gramnegativos, rectos y curvos, móviles por la presencia de un flagelo polar, oxidasa positivos, no esporulados.

Son termolábiles y se comportan como anaerobios facultativos.

Entre las más de 30 especies del género Vibrio, se han reportado 12 como patógenas para el hombre, entre las que sobresalen V. cholerae, V. parahaemolyticus y V vulnificus.

Crecen a una temperatura de 37°C con un rango de 8°- 43°C, en un pH de: 7.8 con un rango de 5-10, pueden sobrevivir óptimamente a la refrigeración.


August 18, 2017 at 8:15 am

Whole-Genome Sequencing of Human Clinical Klebsiella pneumoniae Isolates Reveals Misidentification and Misunderstandings of Klebsiella pneumoniae, Klebsiella variicola, and Klebsiella quasipneumoniae

mSphere August 2017 V.2 N.4

Wesley Long, Sarah E. Linson, Matthew Ojeda Saavedra, Concepcion Cantu, James J. Davis, Thomas Brettin, Randall J. Olsen

Sarah E. F. D’Orazio, Editor

Klebsiella pneumoniae is a major threat to public health, causing significant morbidity and mortality worldwide. The emergence of highly drug-resistant strains is particularly concerning.

There has been a recognition and division of Klebsiella pneumoniae into three distinct phylogenetic groups: Klebsiella pneumoniae, Klebsiella variicola, and Klebsiella quasipneumoniae.

K. variicola and K. quasipneumoniae have often been described as opportunistic pathogens that have less virulence in humans than K. pneumoniae does.

We recently sequenced the genomes of 1,777 extended-spectrum-beta-lactamase (ESBL)-producing K. pneumoniae isolates recovered from human infections and discovered that 28 strains were phylogenetically related to K. variicola and K. quasipneumoniae.

Whole-genome sequencing of 95 additional non-ESBL-producing K. pneumoniae isolates recovered from patients found 12 K. quasipneumoniae strains. Matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) analysis initially identified all patient isolates as K. pneumoniae, suggesting a potential pitfall in conventional clinical microbiology laboratory identification methods.

Whole-genome sequence analysis revealed extensive sharing of core gene content and plasmid replicons among the Klebsiella species.

For the first time, strains of both K. variicola and K. quasipneumoniae were found to carry the Klebsiella pneumoniae carbapenemase (KPC) gene, while another K. variicola strain was found to carry the New Delhi metallo-beta-lactamase 1 (NDM-1) gene. K. variicola and K. quasipneumoniae infections were not less virulent than K. pneumoniae infections, as assessed by in-hospital mortality and infection type.

We also discovered evidence of homologous recombination in one K. variicola strain, as well as one strain from a novel Klebsiella species, which challenge the current understanding of interrelationships between clades of Klebsiella….



August 16, 2017 at 8:29 am

Activity of ceftolozane/tazobactam against surveillance and ‘problem’ Enterobacteriaceae, Pseudomonas aeruginosa and non-fermenters from the British Isles

Journal of Antimicrobial Chemotherapy August 2017 V.72 N.8 P.2278–2289

David M. Livermore; Shazad Mushtaq; Daniele Meunier; Katie L. Hopkins; Robert Hill …


We assessed the activity of ceftolozane/tazobactam against consecutive isolates collected in the BSAC Bacteraemia Surveillance from 2011 to 2015 and against ‘problem’ isolates sent to the UK national reference laboratory from July 2015, when routine testing began.


Susceptibility testing was by BSAC agar dilution with resistance mechanisms identified by PCR and interpretive reading.


Data were reviewed for 6080 BSAC surveillance isolates and 5473 referred organisms. Ceftolozane/tazobactam had good activity against unselected ESBL producers in the BSAC series, but activity was reduced against ertapenem-resistant ESBL producers, which were numerous among reference submissions. AmpC-derepressed Enterobacter spp. were widely resistant, but Escherichia coli with raised chromosomal AmpC frequently remained susceptible, as did Klebsiella pneumoniae with acquired DHA-1-type AmpC. Carbapenemase-producing Enterobacteriaceae were mostly resistant, except for ceftazidime-susceptible isolates with OXA-48-like enzymes. Ceftolozane/tazobactam was active against 99.8% of the BSAC Pseudomonas aeruginosa isolates; against referred P. aeruginosa it was active against 99.7% with moderately raised efflux, 94.7% with strongly raised efflux and 96.6% with derepressed AmpC. Resistance in P. aeruginosa was largely confined to isolates with metallo-β-lactamases (MBLs) or ESBLs. MICs for referred Burkholderia spp. and Stenotrophomonas maltophilia were 2–4-fold lower than those of ceftazidime.


Ceftolozane/tazobactam is active against ESBL-producing Enterobacteriaceae; gains against other problem Enterobacteriaceae groups were limited. Against P. aeruginosa it overcame the two most prevalent mechanisms (up-regulated efflux and derepressed AmpC) and was active against 51.9% of isolates non-susceptible to all other β-lactams, rising to 80.9% if ESBL and MBL producers were excluded.


August 11, 2017 at 9:20 am

Genomic epidemiology of global VIM-producing Enterobacteriaceae

Journal of Antimicrobial Chemotherapy August 2017 V.72 N.8 P.2249–2258


Yasufumi Matsumura; Gisele Peirano; Rebekah Devinney; Patricia A. Bradford; Mary R. Motyl


International data on the molecular epidemiology of Enterobacteriaceae with VIM carbapenemases are limited.


We performed short read (Illumina) WGS on a global collection of 89 VIM-producing clinical Enterobacteriaceae (2008–14).


VIM-producing (11 varieties within 21 different integrons) isolates were mostly obtained from Europe. Certain integrons with blaVIM were specific to a country in different species and clonal complexes (CCs) (In87, In624, In916 and In1323), while others had spread globally among various Enterobacteriaceae species (In110 and In1209). Klebsiella pneumoniae was the most common species (n = 45); CC147 from Greece was the most prevalent clone and contained In590-like integrons with four different blaVIMs. Enterobacter cloacae complex was the second most common species and mainly consisted of Enterobacter hormaechei (Enterobacter xiangfangensis, subsp. steigerwaltii and Hoffmann cluster III). CC200 (from Croatia and Turkey), CC114 (Croatia, Greece, Italy and the USA) and CC78 (from Greece, Italy and Spain) containing blaVIM-1 were the most common clones among the E. cloacae complex.


This study highlights the importance of surveillance programmes using the latest molecular techniques in providing insight into the characteristics and global distribution of Enterobacteriaceae with blaVIMs.


August 11, 2017 at 9:18 am

Evolution and dissemination of the Klebsiella pneumoniae clonal group 258 throughout Israeli post-acute care hospitals, 2008–13

Journal of Antimicrobial Chemotherapy August 2017 V.72 N.8 P.2219–2224


Amos Adler; Ziv Lifshitz; Michal Gordon; Debbie Ben-David; Efrat Khabra


The KPC-producing Klebsiella pneumoniae (KPC-KP) clonal group (CG) 258 has disseminated throughout Israeli post-acute care hospitals (PACHs). The objectives of the study were (i) to describe the evolution and (ii) to understand the dissemination modes of CG 258 in the PACH system in Israel.


KPC-KP surveillance cultures isolates were collected in Israeli PACHs in three national point-prevalence surveys: 2008, 2011 and 2013. CG 258 was identified by pilv-l PCR. WGS was performed for CG 258 isolates from 9 of 14 PACHs and data extracted for core-genome MLST (cgMLST) and for capsule polysaccharide gene cluster analysis.


The proportional representation of CG 258 among the KPC-KP isolates increased from 72 of 104 isolates (69.2%) in 2008 to 113 of 133 isolates (85%) in 2011 (P = 0.004 for 2008 versus 2011) and remained high in 2013 [56 of 67 isolates (83.6%)]. All isolates were related to CG 258 clade 2. cgMLST phylogenetic analysis showed relative convergence in the 2008 survey, with increasing diversification in the subsequent surveys. A predominantly institutional dissemination pattern was observed only in centre F from southern Israel. A predominantly regional dissemination pattern was observed in the two PACHs in Jerusalem. The other PACHs were characterized by a combined institutional and generalized pattern, with the majority of isolates clustering within the same PACH and survey.


CG 258 clade 2 has retained its predominance despite increased diversification. Although interchanging of CG 258 strains occurred between most PACHs, local spread is the leading cause of its dissemination.


August 11, 2017 at 9:17 am

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