Lactic acid bacteria from kefir grains: Potential probiotics with antagonistic activity against multidrug resistant Gram-negative bacteria

Aims@#This study aimed to isolate and identify lactobacilli strains that have antagonistic activity against multidrug resistant (MDR) isolates of Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa and evaluate their probiotic properties.@*Methodology and results@#Twenty-one Lactobacillus isolates were collected, and their antimicrobial activity was assessed by agar well diffusion, broth microdilution and time-kill test. The probiotic potential of the isolates was evaluated as well. The bacterial culture and cell free supernatant (CFS) of all isolates exhibited antibacterial activity against all MDR isolates. Out of 21 isolates, 4 isolates (A31, B35, S20 and S25) displayed the highest antimicrobial activity and further evaluated. The minimum inhibitory percentages of CFS from selected isolates against pathogens ranged from 10 to 30% and the bactericidal percentages ranged from 20 to 50%. The inhibitory activity of CFS was not changed after heating but abrogated as the pH neutralized. The growth kinetic of the MDR pathogens was significantly reduced in the presence of the CFS of all isolates. The isolates had a less than 1-log reduction in their viability in acid tolerance test and could grow in the presence of 0.3% bile salts. Strains S20, S25 and B35 exhibited high coaggregation with E. coli (51.7-73.3%), P. aeruginosa (53.7-69.3%) and K. pneumoniae (49.7-65.3%). Molecular identification revealed that the isolates were Lactobacillus rhamnosus (B35) and Lactobacillus paracasei (S20, S25, A31). @*Conclusion, significance and impact of study@#The results suggest that these lactobacilli isolates may have potential applications for controlling and preventing colonization of infections caused by MDR pathogens.

Evaluation of the antimicrobial activity of Cinnamomum zeylanicum essential oil and trans-Cinnamaldehyde against resistant Mycobacterium tuberculosis / Avaliação da atividade antimicrobiana do óleo essencial do cinnamomum zeylanicum essential oil e do trans-cinamaldeído contra mycobacterium tuberculosis resistente

The essential oil (EO) extracted from the bark of Cinnamomum zeylanicum (Czey; also known as cinnamon), mostly derives its properties from its major compound trans-cinnamaldehyde (TCin). The present study evaluated the antimycobacterial activity of the essential oil from Czey (CzeyEO) and TCin against sensitive and resistant clinical isolates of Mycobacterium tuberculosis, as well as the combinatorial effects of CzeyEO and TCin with the anti-tuberculosis (TB) drugs rifampicin (RIF) and isoniazid (INH). The resazurin microtiter assay method was used to determine the minimum inhibitory concentration (MIC) of the components tested on the clinical isolates of M. tuberculosis. The effects of the CzeyEO/RIF, CzeyEO/INH, TCin/RIF, and TCin/INH combinations on the M. tuberculosis H37Rv reference strain were evaluated using the checkerboard method to determine the fractional inhibitory concentration index (FICI). CzeyEO and TCin inhibited all bacterial clinical isolates. In the interactive experiment, CzeyEO and TCin were found to be highly effective in reducing the resistance of resistant M. tuberculosis to RIF and INH. All four tested combinations demonstrated synergistic and additive effects, with no antagonistic effects. The synergistic combinations of CzeyEO/RIF and CzeyEO/INH exhibited FICI values of 0.375 and 0.5, respectively, while the TCin/RIF and TCin/INH combinations exhibited FICI values of 0.31 and 0.5, respectively. These results indicate that CzeyEO and TCin are potential candidates for the treatment of drug-resistant tuberculosis in combination therapy with INH and RIF.

O óleo essencial (EO) extraído da casca do Cinnamomum zeylanicum (CzeyEO), conhecido como canela, tem como seu principal composto o trans-cinamaldeído (TCin). O presente estudo avaliou a atividade antimicobacteriana de CzeyEO e do TCin contra isolados clínicos sensíveis e resistentes de Mycobacterium tuberculosis, bem como os efeitos das associações de CzeyEO e do TCin com os fármacos anti-TB, rifampicina (RIF) e isoniazida (INH). A técnica de ensaio de microtitulação da resazurina foi utilizada para determinar a concentração inibitória mínima (CIM) dos componentes testados nos isolados clínicos de M. tuberculosis. Os efeitos das associações CzeyEO/RIF, CzeyEO/INH, TCin/RIF e TCin/INH contra a cepa de referência H37Rv de M. tuberculosis foram avaliados pelo método Checkerboard, determinando o índice de concentração inibitória fracionária (ICIF). Todos os isolados clínicos bacterianos foram inibidos por CzeyEO e TCin. As interações de CzeyEO e TCin foram altamente eficazes na redução da resistência do M. tuberculosisresistente a RIF e INH. Todas as quatro combinações testadas resultaram em efeitos sinérgicos e aditivos, sem efeito antagônico. Ambas as associações de sinergismo de CzeyEO/RIF e CzeyEO/INH mostraram valores de ICIF de 0,375 e 0,5, enquanto as associações de TCin/RIF e TCin/INH apresentaram valores de ICIF de 0,31 e 0,5. CzeyEO e TCin são potenciais candidatos em terapia combinada com INH e RIF para o tratamento da tuberculose resistente.

Are postoperative prophylactic antibiotics in closed reduction of nasal bone fracture valuable?: prospective study of 30 cases

BACKGROUND: Prophylactic antibiotic administration after surgery for a nasal bone fracture is performed due to concerns about infection-related complications, such as, toxic shock syndrome. To evaluate the validity and efficacy of antibiotic use, we compared the results obtained and the bacterial profiles of nasal packing materials in patients that underwent closed reduction for a nasal bone fracture with or without prophylactic antibiotic administration. METHODS: Thirty consecutive patients with a nasal bone fracture, but without an open wound, that underwent closed reduction during March to August 2017 were included in the present study. Fifteen of these 30 patients were randomly assigned to a control group, members of were administered postoperative intravenous antibiotics once at the day of surgery and then oral antibiotics for 4 days. The other 15 patients were assigned to an experimental group and not administered any antibiotic postoperatively. Antibiotic ointment was not applied to nasal packing in either group. Nasal packing was removed on postoperative day 4 in all cases. Removed nasal gauze packings were culture tested and strains identified in the two groups were compared. RESULTS: Bacterial strain types cultured from packings were similar in the experimental and control groups and no patient showed signs of clinically significant infection. CONCLUSION: The findings of this study suggest postoperative prophylactic antibiotic use is not clinically required after closed reduction of a nasal bone fracture. Furthermore, the non-use of postoperative antibiotics is biologically beneficial, as it reduces the occurrence of resistant strains and medical costs, and is more convenient for patients.

Antimicrobial activity of essential oils from Lippia alba, Lippia sidoides, Cymbopogon citrates, Plectranthus amboinicus, and Cinnamomum zeylanicum against Mycobacterium tuberculosis / Atividade antimicrobiana de leos essenciais de Lippia alba, Lippia sidoides, Cymbopogon citrates, Plectranthus amboinicus, e Cinnamomum zeylanicum em Mycobacterium tuberculosis

ABSTRACT: The rise in cases of antibiotic-resistant Mycobacterium tuberculosis has become a major obstacle to the effective control of tuberculosis (TB) worldwide. Essential oils (EO) are complex mixtures that may contain between 20 and 60 components, with two or three major compounds at relatively high concentrations (20-70%) that are responsible for their pharmacological properties. The objective of this study was to assess the antimicrobial activity of the EOs, bushy lippia (Lippia alba), rosemary pepper (Lippia sidoides), lemon grass (Cymbopogon citratus), Mexican mint or Indian borage (Plectranthus amboinicus), and true cinnamon (Cinnamomum zeylanicum), against Mycobacterium tuberculosis H37Rv. Chemical characterization of the EOs was performed by gas chromatography coupled to mass spectrometry. The minimum inhibitory concentration (MIC) was determined by the microdilution-based resazurin microtiter assay. Four EOs were able to inhibit the growth of M. tuberculosis, with MICs of 286.5±130.2μg/mL (C. zeylanicum), 299.5±117.2μg/mL (L. sidoides), 351.6±39.06μg/mL (P. amboinicus), and 1,250μg/mL (C. citratus). Only the EO of L. alba showed no antimycobacterial activity at the tested concentrations, with an MIC greater than 1,250µg/mL. Results of this study suggested that C. zeylanicum, L. sidoides, and P. amboinicus could be important sources of bactericidal compounds against M. tuberculosis and require further investigation. The activity against M. tuberculosis of these three EOs has not been reported previously. The results show the high potential of the tested antimycobacterial EOs, making them a promising alternative for TB treatment. This data also confirms the importance of bioprospecting studies for active substances with antimycobacterial activity, which are still scarce.

RESUMO: O aumento no número de casos de Mycobacterium tuberculosis resistentes tem se tornado um grande obstáculo no controle efetivo da tuberculose (TB) mundialmente. Os óleos essenciais (OE), que são misturas complexas que podem conter entre 20 a 60 componentes, apresentam dois ou três compostos principais, em concentrações relativamente elevadas, 20 a 70%, que são responsáveis pelas suas propriedades farmacológicas. O objetivo deste estudo foi avaliar a atividade antimicobacteriana dos seguintes óleos essenciais (OEs) em Mycobacterium tuberculosis H37Rv: erva-cidreira (Lippia alba), alecrim-pimenta (Lippia sidoides), capim-limão (Cymbopogon citratus), orégano (Plectranthus amboinicus) e canela (Cinnamomum zeylanicum). A caracterização química dos OEs foi realizada por cromatografia gasosa acoplada a espectrometria de massa. A Concentração Inibitória Mínima (CIM) foi determinada pela técnica de microdiluição da resazurina. Quatro OEs foram capazes de inibir o crescimento de M. tuberculosis, com CIM de 286,5±130,2μg/mL (C. zeylanicum), 299,5±117,2μg/mL (L. sidoides), 351,6±39,06μg/mL (P. amboinicus) e 1250μg/mL (C. citratus). Somente o OE de L. alba não mostrou atividade antimicobacteriana nas conscentrações testadas, considerando CIM maiores que 1250µg/mL. Os resultados deste estudo sugerem que L. sidoides, C. zeylanicum e P. amboinicus podem ser fontes importantes de compostos bactericidas contra M. tuberculosis e prováveis candidatos a serem investigados. A atividade contra M. tuberculosis desses três OEs não foi relatada em estudos anteriores. Os resultados mostram o elevado potencial antimicobacteriano dos OEs analisados, fazendo deles uma alternativa promissora para o tratamento da TB. Os resultados obtidos demonstraram a importância de pesquisas para bioprospecção de substâncias ativas com ação antimicobacteriana, que ainda são escassas.

A Simple, Reproducible, Inexpensive, Yet Old-Fashioned Method for Determining Phagocytic and Bactericidal Activities of Macrophages

Macrophages (Mphi) play a pivotal role in the protection system by recognizing and eliminating invading pathogenic bacteria. Phagocytosis and the killing of invading bacteria are major effector functions of Mphi. Although the phagocytic and bactericidal activities of Mphi have been analyzed via several methods using a light microscope, a fluorescence microscope, or a fluorescence-activated cell sorter, expensive materials and equipment are usually required, and the methods are rather complicated. Moreover, it is impossible to determine both the phagocytic and bactericidal activities of Mphi simultaneously using these methods. In this review, we describe a simple, reproducible, inexpensive, yet old-fashioned method (antibiotic protection assay) for determining the phagocytic and bactericidal activities of Mphi.

Change in Antimicrobial Susceptibility of Skin-Colonizing Staphylococcus aureus in Korean Patients with Atopic Dermatitis during Ten-Year Period

BACKGROUND: A small subset of adolescents atopic dermatitis (AD) tends to persist. This also leads to get more antibiotics exposure with advancing years. Antibiotic resistance has been regarded as a serious problem during Staphylococcus aureus treatment, especially methicillin-resistant S. aureus (MRSA). OBJECTIVE: It was investigated the S. aureus colonization frequency in the skin lesions and anterior nares of adolescent AD patients and evaluated the changes in S. aureus antimicrobial susceptibility for years. METHODS: Patients who visited our clinic from September 2003 to August 2005 were classified into group A, and patients who visited from August 2010 to March 2012 were classified into group B. To investigate the differences with regard to patients' age and disease duration, the patients were subdivided into groups according to age. Lesional and nasal specimens were examined. RESULTS: Among the 295 AD patients, the total S. aureus colonization rate in skin lesions was 66.9% (95/142) for group A and 78.4% (120/153) for group B. No significant changes in the systemic antimicrobial susceptibilities of S. aureus strains isolated from adolescent AD patients were observed during about 10-year period. The increased trend of MRSA isolation in recent adolescent AD outpatients suggest that the community including school could be the source of S. aureus antibiotic resistance and higher fusidic acid resistance rates provides evidence of imprudent topical use. CONCLUSION: Relatively high MRSA isolation and fusidic acid resistance rates in recent AD patients suggest that the community harbors antibiotic-resistant S. aureus.

Pharmacokinetics characterization and toxicology of PNIPAAm-PEO nanoparticles loaded norvancomycin in rabbit eyes / 中华实验眼科杂志

Background The penetration of bacterial agents into the vitreous cavity is difficult because of the existence of blood-retina barrier.So conventional drug therapy is not enough effective on endophthalmitis.Drug delivery systems can decrease drug dose and reduce the drug toxicity.To construct nano controlled-release system of anti-bacterial agents is very important for the treatment of intraocular infectious diseases.Objective This study was to investigate the toxicology and intraocular pharmacoklnetics of intravitreal PNIPAAm-PEO loaded norvancomycin nanoparticles (NV-PNIPAAm-PEO) in normal rabbit eyes.Methods NV-PNIPAAm-PEO was constructed with the drug-loading rate about 22％,and then the drug gelatin solution (20 g/L) was prepared using normal saline solution.Forty-one New Zealand albino rabbits were randomized divided into experimental group and control group.20 g/L drug gelatin solution 0.1 ml was monocularly injected into the vitreous cavity in the experimental group,and the equal volume of sterilized normal saline solution was used in the control group.In 1 day,2,3,7,14,21 and 28 days after injection,ocular anterior and posterior segments were examined by slit lamp microscope and Bsonography,and electroretinogram (ERG) was recorded and the histopathological examination was performed to evaluate the biotoxicity of the drug.Norvancomycin contents in the cornea homogenate,aqueous humor,vitreous,retinochoroid homogenate were detected by high performance liquid chromatography (HPLC) system.Results The anterior and posterior segments were normal by the slit lamp microscope and B-sonography 1-28 days after injection of NV-PNIPAAm-PEO.In 7,14,21 and 28 days after injection,there were no statistically significant difference in the a-wave latency and amplitude of max-ERG between the two groups,as well as the b-wave amplitude(P＞0.05).The histopathological examination showed that the retinal structure was normal in both groups.HPLC assay showed that the norvancomycin level was gradually declined in different eye tissues from 1 day through 28 days after injection.Norvancomycin was undetectable in the cornea during the observing duration.The maximal norvancomycin content in the blood plasma was (0.34 ± 0.11) mg/L in the second day,and norvancomycin content ranged (0.08 ± 0.04)-(2.16±0.07) mg/L in the aqueous humor,(0.11 ±0.22)-(2.54 ±0.38) μg/g in the chorioretina,respectively.The drug concentration was (5.65 ± 1.14)-(406.69 ± 21.05) mg/L in the vitreous,which was higher than the minimal inhibitory concentration (MIC) to the most gram-positive bacteria.Conclusions The intravitreal injection of 22％ NV-PNIPAAm-PEO maintains the therapeutic drug concentration till 21 days in vitreous without the toxic effect on eye tissues,suggesting a great treating potential for intraocular infecting diseases.

Evaluación de sensibilidad antibiótica en urocultivos de pacientes en primer nivel de atención en salud de Pereira / Using an antibiotic sensitivity assay on urine cultures from patients attending general practice healthcare institutions in Pereira

Objetivos: Las Infecciones de vías urinarias son una causa de consulta muy frecuente en primer nivel de atención en salud. Describir los gérmenes más frecuentemente aislados y los patrones de resistencia a los antibióticos en urocultivos y antibiogramas de pacientes de primer nivel de atención de Pereira. Materiales y Métodos: Estudio descriptivo observacional de corte transversal, en una población de 131 608 afiliados al Sistema General de Seguridad Social en Salud entre el 1 de enero de 2010 y 7 de abril de 2011 evaluando las bacterias aisladas en urocultivos procesados con más de 100 000 Unidades Formadoras de Colonias y resultados de sensibilidad y resistencia de antibiogramas. La resistencia se evaluó bajo parametros de Clinical and Laboratory Standards Institute mediante método manual de difusión de disco Kirby-Bauer con sensidiscos Beckton Dickinson Diagnostics. Resultados: Se realizaron 5 226 urocultivos, de los cuales 1 058 mostraron crecimiento de uropatógenos. Un total de 792 (74,9 %) cultivos reportó el crecimiento de más de 105 UFC, Los microorganismos más frecuentemente aislados fueronEscherichia coli(67,2 %),Klebsiella sp(19,2 %) yEnterococcus sp(7,8 %).Escherichia colimostró sensibilidad alta para amoxicilina/clavulanato (100 %), nitrofurantoina (94,8 %), ceftriaxona (86,3 %), ciprofloxacina (71,0 %) y resistencia elevada para ampicilina (54,7 %), amoxicilina (50,0 %), trimetoprimsulfametoxazole (43,8 %) y cefalotina (42,8 %). Conclusiones: Nitrofurantoina puede ser la mejor opción terapéutica en primera línea de manejo en infecciones de vías urinarias bajas y ciprofloxacina para pielonefritis debido a su efectividad y poca resistencia en primer nivel de atención en Pereira.

Objectives: Describing the bacteria most frequently isolated from and antibiotic resistance patterns in urine cultures taken from patients attending general practice healthcare institutions in Pereira as urinary tract infections are a frequent cause for primary healthcare attention. Materials and Methods: A descriptive cross-sectional observational study of 131,608 members of the health social security system was carried out between January 1st 2010 and April 7th 2011;the bacteria isolated from urine cultures having more than 105 colony-forming units (CFU) were assessed, as were the sensitivity and antibacterial agents’ resistance results. Resistance was evaluated in line with Clinical and Laboratory Standards Institute (CLSI) parameters by means of the Kirby-Bauer disk diffusion manual method with Beckton Dickinson diagnostic disks. Results: 5,226 urine cultures were analysed, 1,058 of which showed uropathogengrowth. Bacterial growth was reported in 792 cultures (74.9 %), having more than 105 CFU. The most frequently isolated microorganisms were Escherichia coli (67.2 %), Klebsiella sp (19.2 %) and Enterococcus sp (7.8 %).Escherichia colishowed high sensitivity to amoxicillin / clavulanate (100 %), nitrofurantoin (94.8 %), ceftriaxone (86.3 %), ciprofloxacin (71.0 %) and high resistance to ampicillin (54.7 %), amoxicillin (50.0 %), trimethoprim-sulfamethoxazole (43.8 %) and cephalothin (42.8 %). Conclusions: Nitrofurantoin may be the best therapeutic option in first-line management of lower urinary tract infection and ciprofloxacin for pyelonephritis due to its effectiveness and low resistance as seen in primary healthcare practice in Pereira.

The emergence of multidrug-resistant Acinetobacter baumannii in Colombia: a time-series analysis, 2001-2007 / Surgimiento de Acinetobacter baumannii multirresistente en Colombia: un análisis de series de tiempo 2001-2007

Objective This study was aimed at analyzing the phenotypical behavior of Acinetobacter baumannii resistance to antibiotics currently available in Colombia for its treatment. Methods An ecological time-series study was conducted based on information regarding A. baumannii resistance to available antibiotics gathered through a Colombian surveillance system involving 33 reference hospitals. Descriptive analysis and modeling forecasting were also carried out. Results The sample included 5.415 A. baumannii isolates collected from 33 hospitals throughout Colombia. This microorganism was the eighth most frequently isolated pathogen in hospital settings, having 3.8 % isolation frequency in intensive care units (ICUs).The study recorded the presence of multidrug-resistant A. baumannii strains since 2001, as well as a dramatic increase in A. baumannii strains having decreased susceptibility to the antibiotics currently available on the market (30 % to 70 %). Conclusion A. baumannii has shown a clear transition to a multidrug resistance profile in Colombia during recent years which includes resistance to important second-line antibiotics, such as carbapenems.(AU)

Objetivo Analizar la conducta fenotípica de resistencia del Acinetobacter baumannii a los antibióticos disponibles para su tratamiento en Colombia. Métodos Se llevó a cabo un estudio ecológico de series de tiempo basado en la información de resistencia del A. baumannii a los antibióticos, a partir del sistema de vigilancia colombiana de 33 hospitales de referencia. Se realizaron análisis descriptivos y un modelo de pronóstico. Resultados Se incluyeron 5 415 aislamientos de A. baumannii recolectados en 33 hospitales a través del país. Este microorganismo fue el octavo patógeno más aislado en el escenario hospitalario, con una frecuencia de aislamiento de 3,9 % en unidades de cuidado intensivo (UCIs). Se registra la presencia de cepas de A. baumannii multirresistentes desde el año 2001, así como un dramático incremento de cepas de A. baumannii con menor susceptibilidad a los antibióticos disponibles en el mercado, con una variación del 30 al 70 %. Conclusión En los últimos años, en Colombia, el A. baumannii ha mostrado una clara transición hacia un perfil multirresistente que incluye la resistencia a antibióticos de segunda línea como los carbapenems.(AU)

Caracterización de la compra de antibióticos en droguerías de Bogotá: una mirada desde los usuarios / Characterising the purchase of antibiotics in drugstores in Bogotá: a users' perspective

Objetivo: Caracterizar el proceso de compra de antibióticos con fórmula médica u odontológica o sin esta en la población participante de dieciocho localidades de Bogotá. Método: Diseño transversal aplicado durante el segundo semestre del 2009 mediante 534encuestas a las personas que compraron antibióticos a la salida de droguerías ubicadas en dieciocho localidades de Bogotá. Se indagó sobre variables sociodemográficas, conocimientos y actitudes de los participantes sobre los antibióticos y exploración de las prácticasrelacionadas con el uso de estos medicamentos, características de la compra de antibióticos y autoprescripción. Resultados: El 43,1%de los participantes compraron el antibiótico en las droguerías sin fórmula médica u odontológica y no asistieron a consulta médica.El porcentaje de autoprescripción con antibióticos fue del 13%. Un 30,2% de los antibióticos fue prescrito por un familiar (15,2%), el farmaceuta (11,4 %), un vecino (3%) y un curandero o hierbatero (0,6%). Conclusiones: En el conglomerado de las dieciocho localidadesde Bogotá existe una elevada proporción de personas no facultadas para hacerlo que recomienda antibióticos a la población. Debe enfatizarse que más del 40% de las ventas de antibióticos en las droguerías en las que se hizo la evaluación se hicieron sin la respectivay necesaria fórmula médica. La población participante tiene conocimientos, actitudes y prácticas que afectan el uso adecuado de los antibióticos y no contribuyen a la contención de la resistencia bacteriana en el Distrito Capital.

Objective: Characterising how antibiotics are bought with a doctor’s and/or dentist’s prescription in the participating population from Bogotá’s eighteen local districts. Methods: 534 people buying antibiotics when leaving drugstores in eighteen of Bogotá’s districts were surveyed during the second half of 2009, using a cross-sectional design. The participants’ socio-demographic variables, knowledge and attitudes towards antibiotics were investigated and practice related to using such medicaments, characteristics regarding buying antibiotics and self-medication was also explored. Results: 43.1% of the participants had bought antibiotics in drugstores without a doctor or dentist’s prescription and had not consulted a doctor or dentist; 13% of them were self-medicating themselves withantibiotics. 30.2% of the antibiotics had been prescribed by a family member (15.2%), a pharmacist (11.4%), a neighbour (3%) or an alternative medicine healer or herbalist (0.6%). Conclusions: A high percentage of people who had not been authorised to do sowere recommending antibiotics to the population living in the conglomerate of Bogotá’s eighteen districts. It should be emphasised.

A Case of Acute Phlegmonous Gastritis Causing Gastroparesis and Cured with Medical Treatment Alone / 대한소화기학회지

Acute phlegmonous gastritis is an uncommon disease, often fatal condition characterized by suppurative bacterial infection of the gastric wall. It has a high mortality rate mainly because the diagnosis is usually made late. Until recently, gastrectomy in combination with antibiotics was recommended. We had experienced a case of 66-year-old man presented with epigastric pain, nausea, vomiting, and hematemesis, followed by aspiration pneumonia. At upper gastrointestinal endoscopy, the gastric lumen was narrow, and the mucosa was severely inflamed, which was erythematous, swelled, and showed necrotic areas covered with purulent exudate. Klebsiella oxytoca and Acinetobacter lwoffii were isolated in the gastric tissue culture. Contrast-enhanced computerized tomography scan of abdomen demonstrated diffuse gastric wall thickening and an intramural abscess in the gastric antral wall. Although delayed gastric emptying by gastroparesis prolonged the in-hospital period, the only medical treatment with antibiotics alone successfully cured the patient without gastrectomy.