Mechanisms of Bacterial (Serratia marcescens) Attachment to, Migration along, and Killing of Fungal Hyphae.

We have found a remarkable capacity for the ubiquitous Gram-negative rod bacterium Serratia marcescens to migrate along and kill the mycelia of zygomycete molds. This migration was restricted to zygomycete molds and several basidiomycete species. No migration was seen on any molds of the phylum Ascomycota. S. marcescens migration did not require fungal viability or surrounding growth medium, as bacteria migrated along aerial hyphae as well.S. marcescens did not exhibit growth tropism toward zygomycete mycelium. Bacterial migration along hyphae proceeded only when the hyphae grew into the bacterial colony. S. marcescens cells initially migrated along the hyphae, forming attached microcolonies that grew and coalesced to generate a biofilm that covered and killed the mycelium. Flagellum-defective strains of S. marcescens were able to migrate along zygomycete hyphae, although they were significantly slower than the wild-type strain and were delayed in fungal killing. Bacterial attachment to the mycelium does not necessitate type 1 fimbrial adhesion, since mutants defective in this adhesin migrated equally well as or faster than the wild-type strain. Killing does not depend on the secretion of S. marcescens chitinases, as mutants in which all three chitinase genes were deleted retained wild-type killing abilities. A better understanding of the mechanisms by which S. marcescens binds to, spreads on, and kills fungal hyphae might serve as an excellent model system for such interactions in general; fungal killing could be employed in agricultural fungal biocontrol.

The impact of improper empirical usage of antipseudomonals on admission to an acute care hospital.

BACKGROUND: Many septic patients are receiving empirical antipseudomonal (or Gram-negative non-glucose fermenting [GNNGF]) coverage on admission to acute care hospitals, despite the fact that the indications are not scientifically established. Overuse of antipseudomonals might contribute to the burden of resistance. MATERIALS AND METHODS: Retrospective observational analyses of the characteristics of septic adult patients who received empirical antipseudomonals, along with its impact on outcomes, were executed at Shamir Medical Center, Zerifin, Israel (08-12/2016). Proper empirical antipseudomonal usage was defined by the following: (1) if the patient received the agents as per Infectious Disease Society of America (IDSA) guidelines; (2) if the patient had a positive multidrug-resistant organism (MDRO) test on his or her admission score (https://assafharofe.azurewebsites.net); or (3) if a GNNGF was the eventual causative pathogen. Risk factors and outcomes were queried by logistic and Cox regression. RESULTS: GNNGF was the causative pathogen in only 57 (3.7%) of 1536 patients with acute sepsis. There were 192 (13%) who received empirical antipseudomonals, of whom 161 (84%) were defined as proper. Patients who received empirical antipseudomonals were significantly older (P < 0.001), with higher indices of chronic and acute conditions, and higher rates of past MDRO carriage; 24 patients received empirical antipseudomonals only because of IDSA guidelines (15%), and that was an independent predictor for later acquisition (up to 90 days) of carbapenem-resistant A. baumannii (CRAB; odds ratio [aOR] = 7.1; P = 0.03). CONCLUSIONS: Improper empirical usage of antipseudomonals in acute care hospitals is common. Instituting empirical antipseudomonals solely due to IDSA guidelines was independently associated with later acquisition of CRAB. Empirical antipseudomonal usage should be based on scientifically established prediction tools and not on IDSA guidelines.