Copaiba oil's bactericidal activity and its effects on health and zootechnical performance for Nile tilapia after oral supplementation.

Tilapia is one of the most important farmed fish in the world and the most cultivated in Brazil. The increase of this farming favors the appearance of diseases, including bacterial diseases. Therefore, the aim of this study was to evaluate the bactericidal activity of copaiba oil, Copaifera duckei, against Streptococcus agalactiae and Flavobacterium columnare and the dietary effect of copaiba oil on zootechnical performance, hematological, biochemical, immunological, and histological analysis before and after an intraperitoneal infection (body cavity) with S. agalactiae in Nile tilapia. For this, fish were randomly distributed into 15 fiber tanks in five treatments (0, 0.25, 0.50, 0.75, and 1.0%) and fed with a commercial diet supplemented with copaiba oil for 30 days. After this period, the fish were randomly redistributed for the experimental challenge with S. agalactiae into six treatments (T0, T1, T2, T3, T4, and T5), the fish were anesthetized, and blood samples were collected to assess hematological, biochemical, immunological, and histological parameters. Copaiba oil showed bactericidal activity against Streptococcus spp. and Flavobacterium spp. in vitro. In addition, concentrations of 0.75 and 1.0% of copaiba oil have an anti-inflammatory effect and improve hematological and immunological parameters, increasing leukocyte numbers, albumin, and serum lytic activity. Furthermore, there is an increase in the intestinal villus length and tissue damage in groups at concentrations of 0.75 and 1.0% of copaiba oil. In conclusion, copaiba oil presented bactericidal activity against Streptococcus spp. and Flavobacterium spp. in vitro, and oral supplementation at concentrations of 0.75 and 1.0% compared to the control group enhanced non-specific immune parameters and digestibility in Nile Tilapia.

Myroides odoratimimus, una causa infrecuente de infección de tejidos blandos y osteomielitis / Myroides odoratimimus, a rare cause of soft tissue infection and osteomyelitis: case report

Resumen Las infecciones por bacterias gramnegativas del género Myroides son muy poco frecuentes y generalmente afectan la piel y tejidos blandos de pacientes con algún grado de inmunocompromiso. Presentamos un caso de una mujer de 23 años, con antecedentes de mielomeningocele operado y pie bot, que cursó con una infección profunda de la extremidad inferior derecha por Myroides odoratimimus. La identificación de especie se realizó con técnica de MALDI-TOF. El tratamiento fue inicialmente con meropenem y ajustado a ciprofloxacina, junto con realizar una amputación supramaleolar derecha.

Abstract Infections due to Gram-negative bacteria of the genus Myroides are very rare and generally affect the skin and soft tissues of patients with some degree of immunocompromise. We present a case of a 23-year-old patient with a history of myelomeningocele surgically resolved at 3 years of age and bot foot, who presented with a deep infection of the right lower extremity by Myroides odoratimimus. The species identification was carried out with MALDI-TOF and the treatment was initially carried out with meropenem and finally then ciprofloxacin, in addition to right supramaleolar amputation.

A Healthcare-Associated Outbreak of Urinary Tract Infections Due to Myroides odoratimimus.

Myroides spp. are low-grade opportunistic pathogens. Outbreaks due to Myroides spp. have rarely been described in the literature to date. We report a healthcare-associated outbreak of urinary tract infections (UTIs), caused by Myroides odoratimimus, in a Turkish hospital. As of March 2019 until May 2019, 6 strains of M. odoratimimus were isolated from the urine samples of patients, all of whom were hospitalized in intensive care units. After identification and antibiotic susceptibility testing using the VITEK 2 system, MALDI-TOF-MS and 16S rRNA-based sequencing methods were performed for confirmation and species-level identification. Pulsed-field gel electrophoresis (PFGE) was performed in order to investigate the clonal relatedness of the isolates. All the patients were immunocompromised and underwent urinary catheterization. None of the patients had urinary neoplasm, surgery, or calculi. VITEK 2 and MALDI-TOF-MS systems revealed that the isolates belonged to the Myroides genus; however, the aforementioned systems neglected to identify the isolates at the species level. The isolates were all successfully identified as M. odoratimimus through 16S rRNA-based sequencing. The isolates were resistant to every antibiotic tested. All isolates had an indistinguishable PFGE pattern, thus indicating cross-transmission between cases. Although M. odoratimimus is rarely isolated from human specimens, clinicians should be aware of its ability to cause UTIs and infectious outbreaks.

Septic Arthritis and Osteomyelitis Caused by Chryseobacterium indologenes in a Mute Swan (Cygnus olor) and a Ring-Billed Gull (Larus delawarensis).

A 20-year-old female mute swan (Cygnus olor) originally in a flock of free-living swans on a Long Island, New York, lake, was presented for facial swelling and decreased appetite. An adult male ring-billed gull (Larus delawarensis) was also presented to the same wildlife rescue center for bilateral lameness of 1-week duration. Once referred for veterinary evaluation and care, both species were diagnosed with septic arthritis and osteomyelitis caused by Chryseobacterium indologenes and treated with orbifloxacin until complete recovery. Chryseobacterium indologenes is infrequently diagnosed as an opportunistic pathogen in human medicine, and less so in veterinary medicine. In human patients, this bacterium is the cause of various infections, including meningitis, pneumonia, and implant failure. However, in veterinary medicine its pathogenicity has only been reported in fish, and sporadically mentioned as a culture result in tree frogs and turtles, where it was generally considered insignificant. In this report a clinical presentation, diagnosis, treatment, and outcome of osteomyelitis and septic arthritis caused by C indologenes is described in 1 anseriforme and in 1 charadriiforme species.

Successful treatments of polyarteritis nodosa cerebral vasculitis and recurrent E lizabethkingia meningoseptica septicaemia in a dialysis patient.

We report a case of cerebral vasculitis in a 31-year-old woman who presented with chronic kidney disease stage 5, labile hypertension and severe headaches. The diagnosis of cerebral vasculitis made on magnetic resonance angiography (MRA) and late diagnosis of polyarteritis nodosa were made by conventional CT angiography. Immunosuppression was complicated by recurrent septicaemia due to Elizabethkingia meningoseptica Treatment of the vasculitis resulted in marked improvement of MRA appearances, headaches and anxiety and stabilisation of blood pressure. The septicaemia required parenteral quinolone treatment and oral cotrimoxazole.

Flavobacteriaceae Bacteremia in Children: A Multicenter Study.

BACKGROUND: The Flavobacteriaceae family includes rare pathogens in children; Chryseobacterium indologenes and Elizabethkingia meningosepticum are the most common pathogenic species, with a wide range of clinical presentations and high mortality rate. Although rare, diagnosis is important due to inherent resistance to multiple antibiotics, especially those typically prescribed for empiric treatment of aerobic Gram-negative bacterial infections. METHODS: A multicenter retrospective study conducted in 5 Israeli hospitals, describing Flavobacteriaceae bacteremia confirmed by positive blood culture from 1998 to 2018. RESULTS: Thirteen cases were included; 9 isolates were C. indologenes. Bacteremia was nosocomial or healthcare-associated in all cases. Bacteremia was associated with young age (median, 1 year, range 24 days-17 years), with only 2 (15.4%) cases in neonates, Central line-associated bloodstream infection as a source (5/13, 38%) and malignancy (7/13, 54.8%). Thirty-day all-cause mortality was 23% (3/13). Ninety-one percent of isolates were susceptible to trimethoprim-sulfamethoxazole, 82% to piperacillin-tazobactam and 92% to ciprofloxacin. CONCLUSIONS: C. indologenes and E. meningosepticum are rare, nosocomial- or healthcare-associated pediatric bacteremia pathogens. Bacteremia was associated with young age, but in contrast to the literature, the majority of our cases were older than the neonatal age period. In addition, they were associated with central line-associated bloodstream infection and malignancy. The most adequate antibiotics according to resistance patterns were ciprofloxacin, trimethoprim-sulfamethoxazole and piperacillin-tazobactam.

[Bullous pneumonia secondary to Elizabethkingia meningoseptica, its clinical and radiological evolution]. / Neumonía bullosa secundaria aElizabethkingia meningoseptica, su evolución clínica y radiológica.

Elizabethkingia meningoseptica is an opportunistic pathogen with a high mortality and an increasing incidence in the intensive care units. We present a 4-year-old patient with a history of atresia of the biliary tract and a liver transplant at 11 months of age, who was admitted for acute respiratory infection with hypoxemia. During the hospitalization, she required mechanical ventilation. Due to persistent fever and hypoxemia, mini bronchoalveolar lavage was performed with a positive culture for Elizabethkingia meningoseptica. She received vancomycin, trimethoprim/sulfamethoxazole and ciprofloxacin for 14 days with a good response. A chest tomography showed the presence of mosaic hypoperfusion, cystic images, and bilateral bronchiectasis. During the following 2 years, she presented good clinical progress, with scarce respiratory infections, isolated symptoms and good tolerance to exercise. The resolution of the majority of the initial lesions was evidenced at 20 months of follow-up.

Elizabethkingia meningoseptica es un patógeno oportunista, con una elevada mortalidad y una incidencia en aumento en las terapias intensivas. Se presenta a una paciente de 4 años con antecedente de atresia de vías biliares y trasplante hepático a los 11 meses de vida, que se internó por infección respiratoria aguda baja con hipoxemia. Durante la internación, sufrió un empeoramiento clínico con requerimiento de asistencia respiratoria mecánica. Por fiebre e hipoxemia persistente, se realizó un minilavado broncoalveolar, con cultivo positivo para Elizabethkingia meningoseptica. Recibió vancomicina, trimetoprima/sulfametoxazol y ciprofloxacina durante 14 días, con buena respuesta. Una tomografía de tórax evidenció la presencia de hipoperfusión en mosaico, imágenes quísticas y bronquiectasias bilaterales. Durante los siguientes 2 años, presentó una buena evolución clínica, con escasas intercurrencias respiratorias, síntomas intercrisis aislados y buena tolerancia al ejercicio. En las imágenes de control, se evidenció la resolución de la mayoría de las lesiones iniciales a los 20 meses de su seguimiento.

Neonato con Ventriculitis causada por Empedobacter Brevis: Reporte de un caso en Perú / Neonate with Ventriculitis caused by Empedobacter Brevis: Report of a case in Peru

RESUMEN Las infecciones causadas por microorganismos poco comunes son objeto de investigación, ya que animar a los investigadores a encontrar las medidas sanitarias necesarias para prevenir y tratar la enfermedad, así como la búsqueda de nuevas luces sobre las interacciones humano-microbios. En este informe se describe el caso de un recién nacido varón diagnosticado de hidrocefalia y mielomeningocele, que desarrolló ventriculitis y sepsis por Empedobacter brevis resistente. Este caso pone de manifiesto la inesperada identificación de esta bacteria en el líquido cefalorraquídeo y su patrón multirresistente, que fue crucial para dar un manejo terapéutico adecuado. Esta bacteria evidencia una mezcla de diferentes etiologías en el análisis del líquido cefalorraquídeo.

ABSTRACT Infections caused by rare micro-organisms are the subject of research, as researchers are encouraged to find the necessary health measures to prevent and treat the disease, as well as the search for new insights into human-microbial interactions. This report describes the case of a newborn boy diagnosed with hydrocephalus and myelomeningocele who developed ventriculitis and sepsis from resistant Empedobacter brevis. This case highlights the unexpected identification of this bacterium in the cerebrospinal fluid and its multi-resistant pattern, which was crucial for proper therapeutic management. This bacterium shows a mixture of different etiologies in the analysis of cerebrospinal fluid.

A rare case of complicated pericardial effusion with Elizabethkingia meningoseptica from Iran.

Infections due to Elizabethkingia meningoseptica, a Gram-negative oxidative bacterium are frequently founded in neonatal and immunocompromised individuals. The notable characteristic of this organism is its multi-drug resistance to common antibiotics used for infections caused by Gram-negative bacteria. We report a rare case of complicated pericardial effusion due to E. meningoseptica in a 2-year-old boy, who was admitted with chief complaints of fever and tachypnea (mentioned by his parents) and suffered from a rare lung malignancy (lymphangioleiomyomatosis). He was successfully treated with vancomycin.  E. meningoseptica infection is a rare situation in immunocompetent hosts, and we concluded that this infection was probably originated from device medicine or even hands of healthcare workers.

A catheter-related bloodstream infection caused by Chryseobacterium indologenes successfully treated with antibiotic-lock rescue therapy.

We report the case of a catheter-related bloodstream infection caused by Chryseobacterium indologenes, an uncommon and multi-resistant pathogen, in a pediatric patient with a long-term vascular access device placed for chemotherapy treatment. The infection was successfully treated with ciprofloxacin antibiotic-lock therapy. This is the first report on successful salvage of a long-term device colonized by multi-resistant Chryseobacterium indologenes.

Chryseobacterium indologenes: an emerging infection in the USA.

Nursing home-associated infections and antibiotic resistant pathogens constitute common and serious problems in the geriatric population.Chryseobacterium indologenes, a non-motile Gram-negative rod, though widely distributed in nature, is an uncommon human pathogen. Typically thought of as an organism of low virulence, it may cause serious infections, particularly among the immunocompromised. The majority of reported cases are nosocomial, often associated with immunosuppression or indwelling catheters. It has been reported as the causative agent in bacteraemia, peritonitis, pneumonia, empyema, pyelonephritis, cystitis, meningitis and central venous catheter-associated infections. We report a rare case of C. indologenesinfection affecting a nursing home resident in the USA and we provide a review of similar cases. This report emphasises the importance of individualised treatment and promotes awareness about this organism as one of several emerging pathogens in immunocompromised adults and in the frail elderly who are often nursing home residents, in the Western Hemisphere.

Protective efficacy of Nigella sativa seeds and oil against columnaris disease in fishes.

Columnaris disease, caused by the bacterium Flavobacterium columnare, is currently the most frequently reported bacterial disease affecting farm-raised channel catfish in the USA. Common treatments against the disease include the use of medicated feed that has led to emergent antibiotic resistant strains of F. columnare. Nigella sativa (Black cumin) is a medicinal herb commonly used by many cultures as a natural remedy for numerous disorders. Recently, we have discovered the antibacterial activity of N. sativa and its oil extract against F. columnare. In this study, we showed N. sativa oil (NSO) strongly inhibited the growth of all of the strains of F. columnare tested and yielded significantly larger zones of inhibition than those produced by oxytetracyclin. We tested the protective effect against columnaris disease in vivo by incorporating NSO (5%) or N. sativa seeds (NSS) (5%) into fish feeds. Fishes (Ictalurus punctatus and Danio rerio) fed amended diets displayed significantly lower mortality than those fed control diets. Per cent mortalities in control groups ranged from 77% to 44% and from 70% to 18% in zebrafish and channel catfish, respectively. A dose study using different NSS concentrations showed that 5% NSS offered the most protection against columnaris disease in channel catfish.

Whole-genome sequence of Chryseobacterium oranimense, a colistin-resistant bacterium isolated from a cystic fibrosis patient in France.

For the first time, we report the whole-genome sequence analysis of Chryseobacterium oranimense G311, a multidrug-resistant bacterium, from a cystic fibrosis patient in France, including resistance to colistin. Whole-genome sequencing of C. oranimense G311 was performed using Ion Torrent PGM, and RAST, the EMBL-EBI server, and the Antibiotic Resistance Gene-ANNOTation (ARG-ANNOT) database were used for annotation of all genes, including antibiotic resistance (AR) genes. General features of the C. oranimense G311 draft genome were compared to the other available genomes of Chryseobacterium gleum and Chryseobacterium sp. strain CF314. C. oranimense G311 was found to be resistant to all ß-lactams, including imipenem, and to colistin. The genome size of C. oranimense G311 is 4,457,049 bp in length, with 37.70% GC content. We found 27 AR genes in the genome, including ß-lactamase genes which showed little similarity to the known ß-lactamase genes and could likely be novel. We found the type I polyketide synthase operon followed by a zeaxanthin glycosyltransferase gene in the genome, which could impart the yellow pigmentation of the isolate. We located the O-antigen biosynthesis cluster, and we also discovered a novel capsular polysaccharide biosynthesis cluster. We also found known mutations in the orthologs of the pmrA (E8D), pmrB (L208F and P360Q), and lpxA (G68D) genes. We speculate that the presence of the capsular cluster and mutations in these genes could explain the resistance of this bacterium to colistin. We demonstrate that whole-genome sequencing was successfully applied to decipher the resistome of a multidrug resistance bacterium associated with cystic fibrosis patients.

[Chryseobacterium spp., a new opportunistic pathogen associated with cystic fibrosis?]. / Chryseobacterium spp., ¿nuevo patógeno oportunista asociado a fibrosis quística?

INTRODUCTION: There is an increase in the isolation of non-fermenting gramnegative bacilli in patients with cystic fibrosis (CF). The present study evaluates the frequency of isolates of Chryseobacterium spp., analyzing its characteristics, resistance patterns and clinical outcome of patients. METHODS: It has been collected all respiratory isolates of Chryseobacterium spp. of patients attended in the CF unit of Hospital de la Princesa for three years (march 2009-march 2012). For phenotypic and genotypic identification and sensitivity study conventional methodology was used. For the assessment of the patients lung function was considered the forced expiratory volume in one second (FEV1) and the results were analyzed with SPSS. RESULTS: There was an increase in the incidence of Chryseobacterium spp. with 17 isolates from 9 patients. Three patients had chronic colonization by this microorganism and one showed significant impairment of lung function. Seven patients showed also colonization with Staphylococcus aureus and 4 of them with Pseudomonas aeruginosa. CONCLUSION: Chryseobacterium spp. should be considered as a new emerging opportunistic pathogen in patients with CF. It is essential the clinical and microbiological monitoring of this group of patients for detection of Chryseobacterium spp. colonization and to prevent the chronic infection. In these circumstances it must assess its possible eradication, though its clinical impact is unknown. Cotrimoxazole being the best treatment option.

Massive lipid keratopathy after Elizabethkingia meningosepticum keratitis.

PURPOSE: To report the occurrence of massive lipid deposition in the cornea after Elizabethkingia meningoseptica keratitis. METHODS: A 52-year-old female presented to the ophthalmology outpatient department of the Hong Kong Eye Hospital in January 2012 with complaints of pain, redness, watering and blurred vision in her left eye for 6 days. Past records showed that the patient underwent radiotherapy for mucoepidermoid carcinoma of the maxillary antrum which was later complicated by radiotherpay associated dry eye syndrome in her left eye. At the time of presentation, her best-corrected visual acuity was 0.7 OD and hand motions close to face OS. Slit lamp examination of the left eye showed a small infiltrate 1.4mm×1.2mm in size with an overlying epithelial defect. Elizabethkingia meningosepticum was isolated on broth. Good clinical response was observed with hourly 5% vancomycin eye drops. RESULTS: At the end of 8 weeks, slit lamp examination of the left eye revealed a corneal scar with mild lipid deposition at the site of previous corneal infiltrate. The lipid deposits increased tremendously over the next 4 weeks. The final visual acuity in the right eye dropped down to perception of light. The patient refused any further surgical intervention and is on regular follow-up in our clinic. CONCLUSIONS: Our case report highlights the occurrence of post-keratitis lipid keratopathy with E. meningosepticum.

Treatment of Chryseobacterium indologenes ventilator-associated pneumonia in a critically ill trauma patient.

OBJECTIVE: To report a case of Chryseobacterium indologenes ventilator-associated pneumonia (VAP) in a critically ill trauma patient. CASE SUMMARY: This report describes a 66-year-old critically ill trauma patient who developed VAP, which was caused by C indologenes. The patient was injured in a riding lawn mower accident that trapped him underwater in a pond. The patient required surgery for intra-abdominal injuries and was mechanically ventilated in the trauma intensive care unit. On hospital day 5, the patient developed signs and symptoms of VAP. A diagnosis of C indologenes VAP was confirmed based on a quantitative culture from a bronchoscopic bronchoalveolar lavage. The patient's infection was successfully treated with moxifloxacin for 2 days followed by cefepime for 7 days. DISCUSSION: Formally known as Flavobacterium indologenes, C indologenes is a Gram-negative bacillus normally found in plants, soil, foodstuffs, and fresh and marine water sources. Recently, worldwide reports of C indologenes infections in humans have been increasing, though reports from the United States are still rare. Bacteremia and pneumonia are the most commonly reported infections, and most patients are immunocompromised. The current case differs from most previous reports because this patient was in the United States and did not have any traditional immunocompromised states (eg, transplant, cancer, HIV/AIDS, or corticosteroid use). CONCLUSION: This case report demonstrates that C indologenes can cause VAP in a trauma ICU patient.

Clinical and epidemiological features of Chryseobacterium indologenes infections: analysis of 215 cases.

PURPOSE: This study investigates the clinical and epidemiological features of Chryseobacterium indologenes infections and antimicrobial susceptibilities of C indologenes. METHODS: With 215 C indologenes isolates between January 1, 2004 and September 30, 2011, at a medical center, we analyzed the relationship between the prevalence of C indologenes infections and total prescription of colistin and tigecycline, clinical manifestation, antibiotic susceptibility, and outcomes. RESULTS: Colistin and tigecycline were introduced into clinical use at this medical center since August 2006. The increasing numbers of patients with C indologenes pneumonia and bacteremia correlated to increased consumption of colistin (p = 0.018) or tigecycline (p = 0.049). Among patients with bacteremia and pneumonia, the in-hospital mortality rate was 63.6% and 35.2% (p = 0.015), respectively. Administration of appropriate antibiotics showed significant benefit in 14-day survival in patients with C indologenes bloodstream infection (p = 0.040). In bacteremic patients, old cardiovascular accident (p = 0.036) and cancer (p = 0.014) were the most common comorbidity. The most common co-infection pathogen in patients with C indologenes pneumonia was Acinetobacter baumannii (36/91, 39.6%), followed by Pseudomonas aeruginosa (23/91, 25.3%), carbapenem-resistant A baumannii (22/91, 24.2%), and Klebseilla pneumoniae (13/91, 14.3%). Antimicrobial susceptibility testing of the 215 isolates showed that trimethoprim-sulfamethoxazole was the most active agent (susceptibility rate: 87.4%), followed by cefoperazone-sulbactam (48.0%). CONCLUSION: The present study showed a trend of increasing prevalence of C indologenes infection after introduction of colistin and tigecycline usage. The bacteremia group had higher mortality rate than the pneumonia group. Increasing resistance to piperacillin-tazobactam, ceftazidime, cefepime, and newer fluoroquinolone were noticed in our analysis. Trimethoprim-sulfamethoxazole was a potential antimicrobial agent in vitro for C indologenes. To avoid collateral damage, we emphasize the importance of antibiotic stewardship program.

Clinical features, antimicrobial susceptibilities, and outcomes of Elizabethkingia meningoseptica (Chryseobacterium meningosepticum) bacteremia at a medical center in Taiwan, 1999-2006.

A total of 118 patients with Elizabethkingia meningoseptica bacteremia at a medical center in Taiwan from 1999 to 2006 were studied. Minimum inhibitory concentrations (MICs) of 99 preserved isolates were determined. The incidence (per 100,000 admissions) of E. meningoseptica bacteremia increased from 7.5 in 1996 to 35.6 in 2006 (p = 0.006). Among them, 84% presented with fever, 86% had nosocomial infections, and 60% had acquired the infection in intensive care units (ICUs). The most common underlying diseases were malignancy (36%) and diabetes mellitus (25%). Seventy-eight percent of patients had primary bacteremia, followed by pneumonia (9%), soft tissue infection, and catheter-related bacteremia (6%). Forty-five patients (38%) had polymicrobial bacteremia. Overall, the 14-day mortality was 23.4%. Multivariate analysis revealed E. meningoseptica bacteremia acquired in an ICU (p = 0.048, odds ratio [OR] 4.23) and presence of effective antibiotic treatment after the availability of culture results (p = 0.049, OR 0.31) were independent predictors of 14-day mortality. The 14-day mortality was higher among patients receiving carbapenems (p = 0.046) than fluoroquinolones or other antimicrobial agents. More than 80% of the isolates tested were susceptible to trimethoprim-sulfamethoxzole, moxifloxacin, and levofloxacin. The MIC(50) and MIC(90) of the isolates to tigecycline and doxycycline were both 4 µg/mL and 8 µg/ml, respectively.