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PubMed2006

Chryseobacterium meningosepticum infection and cardiac tamponade in a long-term hemodialysis patient.

Chryseobacterium meningosepticum is a lactose-nonfermenting gram-negative bacilli ubiquitously found in the natural and hospital environment. Clinical infection caused by C. meningosepticum is very rare among healthy adults. We present the case of a patient with end-stage renal disease who developed purulent pericarditis with C. meningosepticum infection, which rapidly evolved into cardiac tamponade and death. To our knowledge, this is the first case in which C. meningosepticum caused fatal purulent pericarditis in a hemodialysis patient.

Aged↗
PubMed2003

Chryseobacterium indologenes bacteremia in a bone marrow transplant recipient with chronic graft-versus-host disease.

We describe a case of Chryseobacterium indologenes bacteremia in a leukemia patient with chronic graft-versus-host disease (GVHD) 6 months after allogeneic bone marrow transplantation. Blood cultures from a vein and via Hickman catheter grew C. indologenes. The patient was successfully treated with piperacillin/tazobactam and the infection did not recur. Our case indicates that C. indologenes infection can occur in patients with GVHD after allogeneic BMT and might be treated with a single agent, piperacillin/tazobactam without the removal of intravascular catheter.

Adult↗
PubMed2003

A Chryseobacterium meningosepticum outbreak in a neonatal ward.

OBJECTIVE: To report epidemiologic, bacteriologic, and clinical features of a Chryseobacterium meningosepticum outbreak. DESIGN: Outbreak investigation. SETTING: A neonatal intensive care unit (NICU) of a referral teaching hospital. METHODS: During 2 weeks in September 2001, four neonates in the NICU developed sepsis and underwent laboratory investigation. Multiple samples were obtained for cultures from endotracheal tubes, mechanical ventilators and humidifier boxes, infant incubators, parenteral and antiseptic solutions, feeding bottles, sinks, faucets, doors, and healthcare workers. RESULTS: C. meningosepticum was isolated from the blood cultures of four patients. The first isolate was identified 5 days after the death of the index case. Although all isolates were ciprofloxacin susceptible in vitro, the remaining three patients did not respond to ciprofloxacin therapy given for 6 or 7 days. Therapy was switched to vancomycin and rifainpin and all three patients survived, with one having a complication (hydrocephalus). Environmental surveillance revealed C. meningosepticum in the stock lipid solution as the source of the epidemic. The outbreak was controlled after discontinuation of intravenous lipid solution, restriction of further neonatal admissions, and thorough disinfection of the unit and its equipment. CONCLUSION: Early identification of an epidemic and its source is important in avoiding morbidity and mortality. A contaminated lipid stock bottle was the source of this outbreak associated with multiple cases and one death.

Chryseobacterium↗
PubMed2006

Heterogeneity of metallo-beta-lactamases in clinical isolates of Chryseobacterium meningosepticum from Hangzhou, China.

OBJECTIVES: To determine the distribution and heterogeneity of metallo-beta-lactamases (MBLs) responsible for imipenem resistance in Chryseobacterium meningosepticum. METHODS: Clinical C. meningosepticum isolates (n = 170) were collected from hospitals in Hangzhou, China. Production of MBLs was investigated by determination of imipenem MICs, and by using both a three-dimensional test and a 2-mercaptopropionic acid inhibitory test. Genes encoding BlaB and GOB MBLs were amplified by PCR, sequenced and compared with genes in GenBank. RESULTS: More than 95% of the 170 isolates showed high (MIC > 16 mg/L) or intermediate resistance to imipenem, but only 94 isolates (55%) were shown phenotypically to produce MBLs (imipenem MIC range, 8-256 mg/L), with MBL genes detected in 93 of these. Among them, 83 isolates had blaB alleles and 65 isolates had bla(GOB) alleles; 38 isolates possessed one MBL gene and 55 isolates contained two genes. The major blaB alleles encoded BlaB-2, -3 and -11, while the major bla(GOB) alleles encoded GOB-2, -4, -8 and -10. MBLs or their genes were not detected in 76 (45%) isolates, including many that were highly resistant to imipenem. CONCLUSIONS: High levels and rates of imipenem resistance in C. meningosepticum from Hangzhou often result from the presence of heterogeneous BlaB and/or GOB MBLs, although undefined carbapenem resistance mechanisms also exist. Susceptibility testing and screening for MBLs should be conducted in order to inform effective treatment for C. meningosepticum infections.

Anti-Bacterial Agents↗
PubMed2004

Septic arthritis caused by Chryseobacterium meningosepticum in an elbow joint prosthesis.

Chryseobacterium meningosepticum is a Gram-negative bacillus historically associated with meningitis and sepsis in premature neonates. Clinicians should suspect this organism when Gram-negative bacilli are seen on Gram-stain and culture, particularly in immunocompromised patients, and in cases of disrupted host tissue integrity. We report the first case of septic arthritis due to this organism.

Arthritis, Infectious↗
PubMed2006

Description of Wautersiella falsenii gen. nov., sp. nov., to accommodate clinical isolates phenotypically resembling members of the genera Chryseobacterium and Empedobacter.

A total of 26 isolates of non-fermenting, Gram-negative rods, obtained between 1980 and 2004 by various clinical laboratories in Belgium, with phenotypic characteristics resembling those of members of the genera Chryseobacterium and Empedobacter (indole-positive) and a biochemical profile resembling that of CDC group II-h, but urease-positive, were collected at the Université Catholique de Louvain Microbiology Laboratory, Belgium. The 16S rRNA gene sequences were determined for most of the isolates and showed 94-95 % similarity with the type strain of Empedobacter brevis as the closest relative, indicating that these isolates might belong to a separate genus. Furthermore, the 16S rRNA gene sequences of the isolates were similar, but two clusters (genomovars) could be distinguished. The sequence similarities were 99.5-100 % for the 14 isolates of genomovar 1 and 99.4-100 % for the 12 isolates of genomovar 2. The similarity between the two clusters was 98.3-99.5 %. The presence of two clearly different groups was corroborated by using tRNA intergenic length polymorphism analysis, which also enabled differentiation of the novel species from all other species studied thus far using this technique. DNA-DNA hybridization results excluded a close relatedness to Empedobacter brevis. The DNA G+C contents of the reference strains of genomovars 1 and 2 were 33.8+/-0.4 and 34.4+/-0.2 mol%, respectively. The name Wautersiella falsenii gen. nov., sp. nov., is proposed for this group, comprising two closely related genomovars. The type strain of the species and reference strain for genomovar 1 is NF 993(T) (=CCUG 51536(T)=CIP 108861(T)), which was isolated from a surgical wound. The reference strain for genomovar 2 is NF 770 (=CCUG 51537=CIP 108860), which was isolated from blood.

Bacterial Typing Techniques↗
PubMed2005

Chryseobacterium indologenes bacteraemia in a diabetic child.

Chryseobacterium indologenes is a non-fermentative Gram-negative bacillus that is a rare pathogen in humans. Its occurrence in diabetic children has not been previously reported. In this report, a case is described of C. indologenes bacteraemia possibly associated with the use of a peripheral venous catheter. A 2-year-old boy with type I diabetes mellitus was admitted due to a coma caused by cerebral oedema and was successfully treated for his neurological condition but presented on the tenth day after admission with fever of 40 degrees C, agitation, restlessness, lack of appetite, somnolence and fatigue. His pulse rate was 90 min(-1) and his respiratory rate was 20 min(-1). Laboratory studies revealed a white blood cell count of 4900 mm(-3) with 67% neutrophils and 27% lymphocytes. Two separate blood cultures yielded C. indologenes. Treatment with ceftriaxone was started before the culture results were obtained, and was continued after susceptibility test results were obtained. The patient became afebrile after 48 h, and his general condition improved within 36 h. The infection did not recur. This is believed to be the third case of bacteraemia outside of Asia due to C. indologenes and the first in a diabetic child not otherwise immunocompromised. This case indicates that C. indologenes infection can occur in diabetic children without ventilator or central venous catheter and might be treated with a single agent after in vitro susceptibility tests have been performed.

Anti-Bacterial Agents↗
PubMed2006

Community-acquired meningitis and sepsis caused by Chryseobacterium meningosepticum in a patient diagnosed with thalassemia major.

Chryseobacterium meningosepticum is a rare pathogen in cases of bacterial meningitis in adults and adolescents. We report on the case history of a 17-year-old boy with thalassemia major and meningitis and sepsis caused by C. meningosepticum in splenectomized. The patient received vancomycin therapy for 21 days and was discharged in a state of complete recovery.

Adolescent↗
PubMed2004

Clinical and microbiological analysis of bloodstream infections caused by Chryseobacterium meningosepticum in nonneonatal patients.

Chryseobacterium meningosepticum bloodstream infections in 11 nonneonatal patients were reported. More than half of the infections were community acquired. PCR assays indicated that the organisms produced extended-spectrum beta-lactamases as well as metallo-beta-lactamases. Genotyping showed diverse fingerprints among the isolates. Six patients survived without appropriate antibiotic treatment. Host factors are the major determinant of the outcomes of C. meningosepticum infections.

Adult↗
PubMed2006

Fatal case of community-acquired bacteremia and necrotizing fasciitis caused by Chryseobacterium meningosepticum: case report and review of the literature.

A diabetic patient with chronic heart failure developed necrotizing fasciitis and bacteremia caused by Chryseobacterium meningosepticum, which rapidly evolved into death, even with fasciotomy and intensive care. A review of the English literature found 10 cases of soft tissue infection caused by C. meningosepticum, which is rarely acquired in the community.

Bacteremia↗
PubMed2004

An adult case of Chryseobacterium meningosepticum meningitis.

Chryseobacterium meningosepticum is an uncommon pathogen causing adult bacterial meningitis. Herein, we report the case history of one 21-year-old woman with this uncommon central nervous system infection. A diagnosis of adult C. meningosepticum meningitis can only be confirmed by a positive cerebrospinal fluid (CSF) culture. The patient had insulin-dependent diabetes mellitus as the underlying condition associated with this infection. The clinical presentations were fever, headache, consciousness disturbance, and seizure. CSF analysis revealed a purulent inflammatory reaction. After a 21-day course of intravenous cefepime (6 g/day) treatment, this patient was discharged in a state of complete recovery.

Adult↗
PubMed2006

Invasion of murine respiratory tract epithelial cells by Chryseobacterium meningosepticum and identification of genes present specifically in an invasive strain.

Chryseobacterium meningosepticum causes severe infections in infants or adults with underlying illness. The species is highly heterogeneous, genetically composed of subgroups with different pathogenicity. Eight strains of C. meningosepticum, representing four different genomic subgroups, were evaluated for their ability to penetrate Madin-Darby Canine Kidney (MDCK) epithelial cell monolayers and serum resistance. None of the strains showed cytotoxicity or penetration to the MDCK cells. All displayed resistance to the bactericidal activity of various normal human sera. A murine pulmonary infection model was used to compare the pathogenicity between a clinical isolate and an environmental isolate. C. meningosepticum were cleared from the lung of infected mice within 7 days following the intratracheal challenge. Electron microscopy demonstrated the large membrane protrusions, indicative of ruffles, and smaller, less organized membrane structures of the respiratory epithelial cells induced by the clinical isolate. Bacteria were observed to enter the cells as single entities in spacious vacuoles. Suppressive subtraction hybridization identified in the invasive isolate 35 distinct sequences associated with systems of energy production and conversion, transport, and secretion. In most cases, the identities between the references and the amino acid sequences deduced were low, suggesting that the functions of these sequences remain unknown.

Animals↗
PubMed2006

[First documented case of Chryseobacterium meningosepticum meningitis in Central African Republic].

Chryseobacterium meningosepdcum is a rare but well-known causative agent of bacterial meningitis and can be the source of epidemic outbreak in neonatal facilities. It has rarely been documented in Africa. The purpose of this report is to describe the first case of C. meningosepticum meningitis in Central African Republic. The case that remained isolated occurred after dystocic delivery with resuscitation in a neonatal unit. Despite intensive care and appropriate antibiotic treatment, the newborn died on day 19. Identification of this rare cause of meningitis underlines the important role of the bacteriologic laboratory in managing bacterial meningitis in Africa. The strain of C. meningosepticum involved in this case was resistant to the main antibiotics used for first-intention treatment of neonatal bacterial meningitis, i.e., third-generation cefalosporins, chioramphenicol, and aminosides. This case also underlines the importance of familiarizing the medical staff with the dangers of nosocomial meningitis and reinforcing hospital hygiene measures.

Central African Republic↗
PubMed1996

Ribotyping of Chryseobacterium meningosepticum: its use as an epidemiological tool and its correlation with serovars.

Chryseobacterium meningosepticum (basonym, Flavobacterium meningosepticum King 1959) is associated with neonatal meningitis and is isolated from normal and immunocompromised adults. AAF-labelled Escherichia coli 16 + 23S rRNA was used as a probe for ribotype analysis of 92 clinical isolates from tracheal exsudate, blood culture, cerebrospinal fluid, urine and pus. The 92 isolates belonged to the 15 described serovars of C. meningosepticum, and included 21 strains isolated during an outbreak in an intensive care unit, all belonging to serovar G. Three restriction endonucleases, EcoRI, HindIII and PstI, were selected for use in ribotyping after preliminary experiments. Epidemiologically unrelated isolates were discriminated by ribotyping and could be classified into 48 ribotypes according to the hybridization banding patterns obtained after restriction with the three enzymes. Strains which were not discriminated by combined ribotype analysis belonged to the same serovar, and were of identical geographic origin. In one case, analysis with an additional enzyme, PvuII, was necessary for separating strains from two different serovars. However, three strains from different serovars (two isolated from the same place and one elsewhere within eight years) showed the same combined ribotype. Analysis of the rRNA gene patterns revealed 6 different patterns for clinical isolates of the outbreak, suggesting unrelated sources of infection. In three patients, isolation of C. meningosepticum with different combined ribotypes suggested superinfection. Ribotyping enabled differentiation between isolates belonging to the same serovar as well as between isolates of different serovars and provided a useful molecular epidemiological tool for the study of C. meningosepticum. Combined ribotype analysis with several restriction endonucleases increased the discriminating power of the method. However, there was only a partial correlation between serovars and the extent of DNA relatedness.

Adult↗
PubMed2003

Chryseobacterium meningosepticum keratitis.

PURPOSE: To describe a case of a corneal ulcer caused by Chryseobacterium meningosepticum in an eye without significant comorbidities. DESIGN: Interventional case report. METHODS: Retrospective case review. RESULTS: A 48-year-old man presented with a corneal ulcer in his right eye and was treated with ofloxacin and fortified bacitracin ophthalmic solution. Cultures grew C. meningosepticum, and the infection resolved. Two previous case reports in the literature have described ocular infections with this bacterium, both in postoperative patients with significant ocular comorbidities. CONCLUSIONS: This is the first report of ocular infection with C. meningosepticum in an eye with no significant comorbidities.

Bacitracin↗
PubMed2003

Purification and characterization of an epsilon-poly-L-lysine-degrading enzyme from the epsilon-poly-L-lysine-tolerant Chryseobacterium sp. OJ7.

The epsilon-poly-L-lysine-degrading enzyme of the epsilon-poly-L-lysine-tolerant Chryseobacterium sp. OJ7 was purified and characterized. The bacterium excreted the enzyme into the culture filtrate. The purified enzyme has a molecular mass of approximately 38.4 kDa and consists of two identical subunits with a molecular mass of 19.5 kDa. The enzyme catalyzed the endo-type degradation of epsilon-poly-L-lysine. A correlation between the epsilon-poly-L-lysine tolerance of the bacterium and the high epsilon-poly-L-lysine-degrading activity was suggested.

Journal Article↗
PubMed2003

The molecular class C acid phosphatase of Chryseobacterium meningosepticum (OlpA) is a broad-spectrum nucleotidase with preferential activity on 5'-nucleotides.

The olpA gene of Chryseobacterium meningosepticum, encoding a molecular class C phosphatase, was cloned and expressed in Escherichia coli. The gene encodes a 29-kDa polypeptide containing an amino-terminal signal peptide typical of bacterial membrane lipoproteins. Expression in E. coli results in a functional product that mostly partitions in the outer membrane. A secreted soluble OlpA derivative (sOlpA) lacking the N-terminal cysteine residue for lipid anchoring was produced in E. coli and purified by means of two steps of ion exchange chromatography. Analysis of the kinetic parameters of sOlpA with several organic phosphoesters revealed that the enzyme was able to efficiently hydrolyze nucleotide monophosphates, with a strong preference for 5'-nucleotides and for 3'-AMP. The enzyme was also able to hydrolyze sugar phosphates and beta-glycerol phosphate, although with a lower efficiency, whereas it was apparently inactive against nucleotide di- and triphosphates, diesters, and phytate. OlpA, therefore, can be considered a broad-spectrum nucleotidase with preference for 5'-nucleotides. Its functional behaviour exhibits differences from that of the Haemophilus influenzae OMP P4 lipoprotein, revealing functional heterogeneity among phosphatases of molecular class C.

Acid Phosphatase↗