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PubMed2006

Molecular basis of resistance displayed by highly ciprofloxacin-resistant Salmonella enterica serovar Typhi in Bangladesh.

Highly ciprofloxacin-resistant (MIC, 512 microg/ml) strains of Salmonella enterica serovar Typhi were isolated from the blood of typhoid patients in Dhaka, Bangladesh. The strains were indistinguishable by their antibiograms, biotypes, and variable-number tandem repeat types and had matching point mutations at positions 83 and 87 of the gyrA gene. The isolation of these strains in an area of high endemicity indicates the need for continuous surveillance of antibiotic resistance of S. enterica serovar Typhi and for the rationalized use of ciprofloxacin.

Anti-Bacterial Agents↗
PubMed1979

Ureolytic Escherichia coli of human origin: serological, epidemiological, and genetic analysis.

Forty-five strains of ureolytic Escherichia coli of human origin, isolated in the United States between 1956 and 1977, were characterized by geographical distribution, site of infection, serotype, resistance to antibiotics, and biochemical reactions. All strains were studied for the ability to generate clones of nonureolytic E. coli (segregants), and a subset of these were selected for plasmid analysis and a variety of bacterial matings. There did not appear to be a common geographical distribution, serotype, antibiogram, or other aberrant biochemical reactions other than the hydrolysis of urea among these strains. The predominance of urinary tract isolates (46.7% total) may reflect a relationship between urea hydrolysis and pathogenesis at this site. Ten of the strains (22.2%) did segregate nonureolytic E. coli colonies, and all possessed at least one common plasmid species with a molecular weight of about 65 X 10(6). Only strain 1138-77 serotype O16:H6 conjugally transfered the ability to hydrolyze urea, ferment sucrose, and resist inhibition by sulfadiazide simultaneously. The resulting, recombination-deficient E. coli K-12 tranconjugant was found to possess a plasmid with a molecular weight of about 80 X 10(6) to 90 X 10(6).

Anti-Bacterial Agents↗
PubMed1980

Differentiation of strains of Escherichia coli: multiple typing approach.

Results from biotyping, resistotyping, hemagglutinin typing, and antibiotic sensitivity testing allowed discrimination of 184 cultures of Escherichia coli and indicated that from each of 20 patients, multiple specimens yielded isolates of a single strain despite the diversity of sites sampled; from each of another 13 patients, strains of different types were isolated. Whereas only 52% of cultures were typed with 24 commerical O antisera, all were characterized by biotyping (27 types) and resistotyping (39 types). Because they identified too few types, hemagglutinin testing (14 types) and antibiogram testing (9 types) were of limited discriminatory value when used alone but aided strain identification when used in conjunction with biotyping and resistotyping. Identification of strains as the same or different is most likely to be achieved by the combined use of several of these systems, each of which may be used in laboratories unable to perform complete serological analysis of strains of E. coli, and we judge that biotyping and resistotyping would provide the most useful information.

Anti-Bacterial Agents↗
PubMed1980

Clinical laboratory evaluation of the Abbott MS-2 automated antimicrobial susceptibility testing system: report of a collaborative study.

The MS-2 system (Abbott Diagnostics, Division of Abbott Laboratories, Dallas, Tex.) was evaluated for its efficacy in determining the susceptibilities of both clinical and selected challenge (nonfastidious, facultative, and aerobic) isolates. The MS-2 results were compared with standard Kirby-Bauer disk diffusion and microdilution results by using fresh clinical isolates. For gram-positive isolates other than enterococci, overall agreement between MS-2 and reference results was 93 to 98%. With enterococci, MS-2 agreement with disk diffusion was 68% but with microdilution was 86% (agreement between disk diffusion and microdilution was 73%). The main discrepancies with enterococci were with cephalothin, penicillin, gentamicin, and kanamycin. With clinical gram-negative isolates, the overall agreement was 91 to 93%, with most discrepancies occurring with Enterobacter spp. and beta-lactam antibiotics (MS-2 versus disk diffusion, 84%; MS-2 versus microdilution, 84%; disk diffusion versus microdilution, 87%) and with Serratia spp. and colistin (false-susceptible results). The agreement of MS-2 results with established reference antibiograms of a special collection of challenge strains was 91 to 97% for the gram-positive cocci and 86 to 98% for the gram-negative strains. (With Enterobacter spp., agreement was 86%, but was greater than 90% for all other organism groups.) Of the 98 finite MS-2 minimum inhibitory concentrations (MICs) that could be directly compared with microdilution MICs, 77 (79%) were within +/- 1 well of the geometric mean microdilution MIC. MS-2 analysis time ranged from 2.8 to 6.5 h (mean, 4.2 h). On the basis of these results, we conclude that the MS-2 can be expected to yield rapid and accurate results with most nonfastidious, facultative, and aerobic pathogens.

Anti-Bacterial Agents↗
PubMed1982

New bacteriophage typing system for Yersinia enterocolitica, Yersinia kristensenii, Yersinia frederiksenii, and Yersinia intermedia: correlation with serotyping, biotyping, and antibiotic susceptibility.

Yersinia enterocolitica is listed as a single species in Bergey's Manual of Determinative Bacteriology, but has recently been split into "true" Y. enterocolitica, Y. kristensenii, Y. intermedia, and Y. frederiksenii. From 48 bacteriophages isolated from raw sewage, 24 were chosen as being the most useful for differentiating strains within the four Yersinia species. The composite set of 24 phages typed 92% of 236 Y. enterocolitica strains, 100% of 16 Y. kristensenii strains, 97% of 29 Y. frederiksenii strains, and 90% of 20 Y. intermedia strains. The most common phage type in any of the groups contained 22% of the strains tested, but most of the phage types contained greater than 5% of the strains. The new typing schema was tested in three outbreaks of Y. enterocolitica, and the results agreed well with serotyping and epidemiological findings. In the same outbreaks, biotyping (API 20E profiles; Analytab Products, Plainview, N.Y.) and antibiograms were less reliable markers and probably should be used only in conjunction with serotyping or phage typing or both. Caution should be used in identifying cultures of Y. frederiksenii and Y. intermedia with the API 20E system, since the tests at 37 degrees C for L-rhamnose and melibiose fermentation are often delayed past 24 h, which is the cut-off point for the final reading in the API system. There were distinct differences in the susceptibilities of Y. enterocolitica and Y. kristensenii to ampicillin, carbenicillin, and cephalothin, which adds further support for classifying the latter as a separate species.

Anti-Bacterial Agents↗
PubMed1982

Species identification and susceptibility to 17 antibiotics of coagulase-negative staphylococci isolated from clinical specimens.

A total of 299 isolates of gram-positive, catalase-positive, coagulase-negative cocci were isolated from a variety of specimens collected from patients at a large university hospital, and 281 (94%) were identified as staphylococci by established methods. Using the scheme of Kloos and Schleifer, we determined the species of the coagulase-negative staphylococci. Staphylococcus epidermidis was the cause of all bacteremias and the most commonly isolated species from bone, joint, and wound infections. Staphylococcus haemolyticus was the second most common isolate from wound infections, and Staphylococcus saprophyticus was the most commonly isolated species from urinary tract infections. Antibiograms to 17 antimicrobial agents were performed by a microdilution technique, and the results revealed that S. epidermidis was resistant to a water spectrum of antimicrobial agents than the other species of staphylococci were.

Adolescent↗
PubMed1975

Unusual Enterobacteriaceae: lactose-positive Salmonella typhimurium which is endemic in São Paulo, Brazil.

Since 1971 a lactose-positive (lac+) Salmonella typhimurium variety Copenhagen has been endemic in the city of Sao Paulo. The strain is a strong lactose fermenter and resembles Escherichia coli on primary plating media and in triple sugar iron agar. Although most isolates of the strain have uniform properties, some have slightly different antigens, antibiograms, phage types, or fermentation patterns. Most isolates have come from stools of infants under 1 year of age and are probably hospital acquired; however, other isolates are probably community acquired. Eighteen other lac+ Salmonella isolated in the United States were also studied. Most of these strains resembled E. coli on primary plates and triple sugar iron agar; thus their identification would pose a problem for most clinical laboratories. A simple procedure for detecting lac+ Salmonella mixed with lac+ E. coli consists of touching 12 colonies in succession with a straight wire and then inoculating a peptone iron agar tube. H2S production is apparent from lac+ Salmonella even if 11 E. coli and one Salmonella colony are picked. If a positive peptone iron agar tube is observed, then individual colonies are tested to rule out other strong H2S producers. The true incidence of lac+ Salmonella is unknown because they are not isolated and identified in most laboratories.

Antigens, Bacterial↗
PubMed1984

Outbreak of Salmonella typhimurium gastroenteritis due to an imported strain resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole in a nursery.

An outbreak caused by a highly resistant strain of Salmonella typhimurium occurred in a nursery at a university medical center. The outbreak strain, which was resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole, was apparently imported from the Far East by a Cambodian refugee. The five patients involved had severe underlying diseases, and bacteremia and meningitis developed in one of these patients. The only reservoir identified was the gastrointestinal tracts of the infected patients, and infection was probably transmitted by the contaminated hands of hospital personnel. The outbreak was rapidly brought under control by isolating cases outside of the nursery and by instituting enteric precautions for infants who remained in the nursery. When compared by disk diffusion susceptibility tests with 353 strains of S. typhimurium tested at the Centers for Disease Control, the imported strain had a unique antibiogram. Bacteriophage typing of the strains revealed that all were untypable; this, in itself, was a good marker, because only 5 to 10% of S. typhimurium isolates in this country have this property. Agarose gel electrophoresis of isolates from the five patients revealed an identical plasmid banding pattern consisting of three large and three small plasmids. Highly resistant strains of S. typhimurium imported from the Far East may spread rapidly when introduced into a hospital nursery. Prompt institution of control measures may limit the outbreak and prevent systemic infections for which there are few effective therapeutic agents.

Ampicillin↗
PubMed1985

Staphylococcus simulans septicemia in a patient with chronic osteomyelitis and pyarthrosis.

Staphylococcus simulans was identified as the etiological agent of osteomyelitis and septic arthritis in an adult male who had sustained a fracture of the fibula and syndesmosis separation which required the installation of orthopedic hardware. Identifying characteristics and antibiograms for this organism, recovered from blood, wound exudate, and deep tissue samples, were determined. Recent evidence has linked slime production (adherence to smooth surfaces) by coagulase-negative staphylococci to infections by these organisms at sites where foreign bodies had been inserted. Tests for adherence showed this S. simulans strain to be a strong slime producer. This is the first reported case of osteomyelitis and septicemia due to S. simulans.

Adult↗
PubMed1985

Antibiotypes of Bacteroides gingivalis assessed by antimicrobial disks and multivariate analysis.

Antibiograms with 20 different antimicrobial disks were studied for antibiotyping of Bacteroides gingivalis isolates. The stability of the antibiotypes was tested by passage in mice. Several B. gingivalis isolates of the same subject were used to investigate the presence of different antibiotypes in one individual, while isolates from different subjects were used to investigate individual differences. The antibiotypes were found to remain stable after animal passage. All tested strains of different origin represented different antibiotypes. The isolates from one subject all belonged to the same antibiotype. Principal component analysis of the data showed that two factors were important in the discrimination of the strains of B. gingivalis. One included beta-lactam antimicrobial agents that affect the cell wall. The other included antimicrobial agents that inhibit synthesis of protein and nucleic acid. Both principal component analysis and discriminant analysis proved to be of great use in the reduction of the amount of data and the visualization of the relations between different antibiotypes of B. gingivalis in a linear map. Among the investigated subjects, different antibiotypes of B. gingivalis were found, indicating that in the mouth of an individual, one antibiotype of B. gingivalis predominates and that different persons harbor different antibiotypes of B. gingivalis.

Analysis of Variance↗
PubMed1987

Aeromonas veronii, a new ornithine decarboxylase-positive species that may cause diarrhea.

In 1983, the vernacular name Enteric Group 77 was coined for a group of strains that had been referred to our laboratory as "possible Vibrio cholerae except for gas production." By DNA-DNA hybridization (hydroxyapatite, 32P), 8 of 10 strains of Enteric Group 77 were very highly related to the labeled strain 1169-83 (74 to 100% at 60 degrees C and 75 to 100% at 75 degrees C; percent divergence, 0.0 to 2.5). Type strains of six other Aeromonas species were 45 to 66% related (60 degrees C) to strain 1169-83, but type strains of 27 Vibrio species were only 2 to 6% related. The name Aeromonas veronii is proposed for the highly related group of nine strains formerly known as Enteric Group 77. The type strain is designated as ATCC 35604 (CDC 1169-83). Strains of A. veronii grew well at 36 degrees C and had positive reactions at this temperature for indole, methyl red, Voges-Proskauer, citrate, lysine and ornithine decarboxylases, DNase, lipase, and motility; the strains had negative reactions for arginine decarboxylase, H2S, urea, and malonate. The following sugars were fermented: D-glucose (acid and gas), cellobiose (seven of nine strains), D-galactose, maltose, D-mannitol, D-mannose, alpha-methyl-D-glucoside (eight of nine strains), salicin, sucrose, and trehalose. The following sugars were not fermented: adonitol, L-arabinose, D-arabitol, dulcitol, erythritol, myo-inositol, lactose, raffinose, L-rhamnose, D-sorbitol, and D-xylose. The positive ornithine decarboxylase reaction differentiates A. veronii from other Aeromonas species. The antibiogram of A. veronii is typical of other Aeromonas strains (resistance to ampicillin and carbenicillin and susceptibility to most other agents). A. veronii strains were isolated from three clinical sources: respiratory secretions of four victims of drowning or near drowning in fresh water (probably not clinically significant); infected wounds of two patients previously exposed to fresh water (unknown clinical significance); and stools from three patients with diarrhea (probably clinically significant).

Adult↗
PubMed1988

Characterization of clinically significant isolates of Staphylococcus epidermidis from patients with endocarditis.

Biotyping, slime production, bacteriophage typing, serotyping, antibiograms, and plasmid profiles were used to characterize 19 Staphylococcus epidermidis strains isolated from 12 patients with prosthetic valve endocarditis and from 7 patients with native valve endocarditis. With the API Staph battery, 12 different biocodes with, at the most, three differences were obtained. Slime production was found for 10 strains (53%). Agglutinogens investigated by agglutination with two specific sera were found for 12 strains (63.1%). Three strains were phage typable (15.2%). Against a panel of nine antimicrobial agents, 15 different profiles were found. Multiply antibiotic-resistant strains were isolated from patients with prosthetic valve endocarditis when disease onset occurred less than 18 months after heart surgery and from patients with native valve endocarditis who received antibiotics immediately prior to their illness. All of the strains were available for plasmid analysis, and all the DNA profiles were distinct. On gels run in Tris-borate buffer, 73.7% of the strains had large plasmids of more than 30 megadaltons. A small plasmid of 2.8 megadaltons was found in multiply resistant strains and in strains resistant only to tetracyclines. None of the isolates appeared to be the same strain, and the bacteriological differences between the strains were confirmed mainly by the antibiotic susceptibility profile and the plasmid pattern analysis. These bacteriological results were in agreement with the clinical data.

Bacteriophage Typing↗
PubMed1988

Aeromonas schubertii, a new mannitol-negative species found in human clinical specimens.

In 1983 the vernacular name Enteric Group 501 was coined for a group of strains that had been referred to our laboratory as "possible Vibrio damsela that does not require NaCl for growth." By DNA-DNA hybridization (hydroxyapatite method, 32P, 60 and 75 degrees C), six strains of Enteric Group 501 were closely related to the labeled strain 2446-81 (70 to 95% at 60 degrees C and 71 to 93% at 75 degrees C; 0 to 1% divergence). Type strains of all Aeromonas species and reference strains of six other Aeromonas DNA hybridization groups were 26 to 42% related (60 degrees C) to strain 2446-81, but type strains of 27 Vibrio and Photobacterium species, including V. damsela, were 0 to 1% (75 degrees C) related. We propose the name Aeromonas schubertii for the highly related group of seven strains formerly known as Enteric Group 501. The type strain is designated as ATCC 43700 (CDC 2446-81). Strains of A. schubertii grew well at 36 degrees C and had positive reactions at this temperature for methyl red, Voges-Proskauer (1% NaCl, Coblentz method), lysine decarboxylase, arginine dihydrolase, motility, lipase, DNase, nitrate reduction to nitrite, oxidase, and growth in nutrient broth with 0 and 1% NaCl. There was no growth in 6% NaCl or on thiosulfate-citrate-bile salts-sucrose agar. The following sugars were fermented: D-glucose, D-galactose, maltose, D-mannose, and trehalose. The following sugars were not fermented: adonitol, L-arabinose, D-arabitol, cellobiose, dulcitol, erythritol, myo-inositol, lactose, D-mannitol, melibiose, alpha-CH3-D-glucoside, raffinose, L-rhamnose, salicin, D-sorbitol, sucrose, and D-xylose. Esculin was not hydrolyzed, and the string test was negative. The mannitol-negative reaction differtiates A. schubertii from other Aeromonas species. The antibiogram of this organism is typical of other Aeromonas strains (resistance to ampicillin and carbenicillin and susceptibility to most other agents). A. schubertii strains have been isolated from abscesses (two strains), wound (one), skin (one), pleural fluid (one), and blood (two). The two blood isolates suggest clinical significance typical of other Aeromonas species , but further information is needed on this group.

Aeromonas↗
PubMed1988

Restriction endonuclease analysis of Staphylococcus epidermidis DNA may be a useful epidemiological marker.

We compared the epidemiological markers of 13 Staphylococcus epidermidis strains isolated from an adult inpatient during a febrile episode and 23 S. epidermidis strains isolated during a presumptive outbreak of nosocomial infection in a neonatal ward. The total DNA restriction endonuclease analysis (REA) was processed along with the following conventional markers: biotyping, serotyping, phage typing, antibiotic susceptibility profiles, and plasmid profiles. The REA method was reproducible, giving stable results both in vitro and in vivo. For the hospitalized adult patient, the conventional markers of the 13 strains were concordant and the restriction profiles were identical. Five restriction groups were demonstrated during the course of the outbreak. Within two of the groups, the identities of all of the markers were used to verify whether all of the isolates belonged to the same cell clone. In a third group, combined analysis of the conventional markers and REA had to be used to demonstrate isolate similarity. On the other hand, in another group, none of the markers were similar; interpretation was not easy. An epidemiological study of S. epidermidis infections in hospitals must take into account all of the epidemiological markers: biotypes, serotypes, phage types, antibiograms, plasmid profiles, and REA.

Bacterial Typing Techniques↗
PubMed1989

Temporal study of staphylococcal species on the skin of human subjects in isolation and clonal analysis of Staphylococcus capitis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis.

The staphylococcal skin floras of an isolated group of subjects were studied for 1 year. A wide variation in isolation patterns was found for different species. Staphylococcus intermedius, previously thought to be of veterinary origin, was found to be part of the resident flora of some subjects, and this may indicate a wider role for it in clinical infection. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) analysis of S. capitis isolates indicated persistent skin colonization at some sites; each region was colonized by only one clone of that species, although an adjacent area could be inhabited by a separate clone. Nine clonal groups were identified by SDS-PAGE; there was a degree of specialization between the groups with regard to the sites which they colonized. The interaction between species at a single site was less well defined. Noncolonizing isolates often exhibited phenotypic similarities that were lower than expected when compared with their presumed source. The results of SDS-PAGE analysis were compared with immunoblotting, antibiograms, and biotyping, and SDS-PAGE analysis was found to be a useful and practical tool for epidemiological work.

Adult↗
PubMed1989

Clonal groups of Salmonella typhimurium in New York State.

The epidemiology of 278 strains of Salmonella typhimurium isolated from 1973 to 1981 from animals in New York State was studied by using four "fingerprinting" techniques, bacteriophage type (B.R. Callow, J. Hyg. 57:346-359, 1959), biotype (J. P. Duguid, E. S. Anderson, G. A. Alfredsson, R. Barker, and D. C. Old, J. Med. Microbiol. 8:149-166, 1975), plasmid profile, and antibiogram. Phage type with biotype was the most useful marker for distinguishing clonal groups of S. typhimurium. Four clones of S. typhimurium predominated, i.e., phage type/biotypes U275/26, 49/26, 10/3, and 2/3. U275/26 and 49/26 were commonly found until 1976, but clones 10/3 and 2/3 were predominant after 1976. Comparison of results with data from Canada suggested a dissemination of strains of S. typhimurium between Canada and New York. Cattle were a common source of phage type 49, as has been observed in other countries.

Animals↗
PubMed1989

Use of an rRNA probe and restriction endonuclease analysis to fingerprint Pasteurella multocida isolated from turkeys and wildlife.

Twenty-five isolates of the bacterium Pasteurella multocida were characterized (fingerprinted) phenotypically and genotypically in order to compare the abilities of various techniques to differentiate strains for epidemiologic studies of fowl cholera. Isolates were obtained over a 16-month period from turkeys dying from fowl cholera (six outbreak flocks) and from wildlife captured on premises with a history of the disease. The characteristics compared included (i) serotype, (ii) subspecies, (iii) antibiogram, (iv) presence of plasmid DNA, (v) restriction endonuclease analysis patterns of whole-cell DNA, and (vi) ribotype. Ribotyping, a method of highlighting DNA restriction site heterogeneity by using an rRNA probe, worked well for differentiating the strains of P. multocida when the majority of the other techniques could not. Ribotyping results correlated directly with and confirmed results obtained from restriction endonuclease analysis. Ribotyping demonstrated the presence of up to three strains of P. multocida in one outbreak flock, recurrence of a single strain in five of the flocks over an 11-month period, and the presence of common strains in turkeys and wildlife on the premises.

Animals↗
PubMed1989

Three cases of neonatal meningitis caused by Enterobacter sakazakii in powdered milk.

Three cases of neonatal infection caused by Enterobacter sakazakii are reported from the Department of Neonatal Intensive Care, the National University Hospital, Reykjavík, Iceland. These infections occurred during a 9-month period in 1986 and 1987. Two of the neonates, who were normal at birth, survived but were left with brain damage. The third, who had Down's syndrome and severe cardiac malformations, died. The same organism was also grown from groin and anal swabs from a healthy neonate. E. sakazakii was not isolated from any environmental sources in the neonatal wards or in the milk kitchen, but it was grown from several lots of the powdered-milk formula used in the hospital. The four E. sakazakii strains isolated from the neonates were indistinguishable from 22 strains grown from the formula. Their biotypes, plasmid DNA profiles, and antibiograms were identical.

Animals↗