Asunto(s)
Amoxicilina/farmacología , Amoxicilina/uso terapéutico , Ceftriaxona/farmacología , Ceftriaxona/uso terapéutico , Farmacorresistencia Bacteriana Múltiple , Salmonella typhi/efectos de los fármacos , Fiebre Tifoidea/tratamiento farmacológico , Amoxicilina/efectos adversos , Antibacterianos/efectos adversos , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Bacterias/efectos de los fármacos , Bacterias/genética , Bacterias/aislamiento & purificación , Ceftriaxona/efectos adversos , Farmacorresistencia Bacteriana Múltiple/efectos de los fármacos , Farmacorresistencia Bacteriana Múltiple/genética , Heces/microbiología , Genoma Bacteriano/genética , Humanos , Cumplimiento de la Medicación , Plásmidos/genética , Recurrencia , Salmonella typhi/genética , Salmonella typhi/aislamiento & purificación , Fiebre Tifoidea/microbiologíaRESUMEN
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.
Asunto(s)
Candidiasis/etiología , Trasplante de Hígado/efectos adversos , Donantes de Tejidos , Obtención de Tejidos y Órganos/métodos , Trasplantes/microbiología , Candida , Femenino , Humanos , Absceso Hepático/microbiología , Trasplante de Hígado/métodos , Persona de Mediana Edad , Vena Cava Inferior/microbiología , Secuenciación Completa del GenomaRESUMEN
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.
Asunto(s)
Proteínas Bacterianas/genética , Proteínas Bacterianas/metabolismo , Infecciones por Klebsiella/microbiología , Klebsiella pneumoniae/enzimología , Klebsiella pneumoniae/genética , beta-Lactamasas/genética , beta-Lactamasas/metabolismo , Adolescente , Técnicas de Tipificación Bacteriana , Preescolar , Enterobacteriaceae/genética , Femenino , Humanos , Klebsiella pneumoniae/aislamiento & purificación , Pruebas de Sensibilidad Microbiana , Tipificación de Secuencias Multilocus , Estudios Prospectivos , SingapurRESUMEN
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.
