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Moraxella catarrhalis is gaining significance as a pathogen over few decades because of increased rate of isolation in respiratory specimens and due to emergence of multidrug resistant strains. Therefore, appropriate antimicrobial agents are required for eradication and prevention of spread of the organism.
The study was conducted over 1-year perio...
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Context 2
... our study resistance to ciprofloxacin is 16.8% while others have reported 0-1% resistance. [29,30] Overall, in our study 34.9% M. catarrhalis are multidrug resistant as shown in Table 3, which indeed warrants reporting clinically significant M. catarrhalis. Therefore, we emphasize the ignorance of M. catarrhalis as a pathogen in respiratory tract and advice laboratories and clinicians to recognize report and treat it appropriately with antibiotics based on sensitivity to avoid therapeutic failure and serious consequences. ...
Similar publications
Unlabelled:
Moraxella catarrhalis is a human respiratory pathogen that causes acute otitis media in children and is associated with exacerbations in patients suffering from chronic obstructive pulmonary disease (COPD). The first step in M. catarrhalis colonization is adherence to the mucosa, epithelial cells, and extracellular matrix (ECM). The ob...
Moraxella catarrhalis is one of the three most common causative bacterial pathogens of otitis media, however no effective vaccine against M. catarrhalis has been developed so far. To identify M. catarrhalis vaccine candidate antigens, we used carefully selected sera from children with otitis media and healthy individuals to screen small-fragment ge...
Citations
... Moraxella catarrhalis, previously considered a commensal microorganism, has been commonly implicated as the major etiological agent of otitis media and sinusitis in children, and in exacerbation of chronic obstructive pulmonary disease in adults [1]. Multidrug-resistant clinical isolates of M. catarrhalis have emerged, increasing the demand for the identification of new treatment and prevention strategies against this pathogen, especially in the absence of an efficient vaccine [2,3]. A formaldehyde detoxification system is essential for microorganisms to protect themselves from cytotoxic formaldehyde [4]. ...
Multidrug-resistant clinical isolates of Moraxella catarrhalis have emerged, increasing the demand for the identification of new treatment and prevention strategies. A thorough understanding of how M. catarrhalis can establish an infection and respond to different stressors encountered in the host is crucial for new drug-target identification. Formaldehyde is a highly cytotoxic compound that can be produced endogenously as a by-product of metabolism and exogenously from environmental sources. Pathways responsible for formaldehyde detoxification are thus essential and are found in all domains of life. The current work investigated the role of the system consisting of the S-hydroxymethyl alcohol dehydrogenase (AdhC), a Zn-dependent class III alcohol dehydrogenase, and the S-formyl glutathione hydrolase (FghA) in the formaldehyde detoxification process in M. catarrhalis. Bioinformatics showed that the components of the system are conserved across the species and are highly similar to those of Streptococcus pneumoniae, which share the same biological niche. Isogenic mutants were constructed to study the function of the system in M. catarrhalis. A single fghA knockout mutant did not confer sensitivity to formaldehyde, while the adhC–fghA double mutant is formaldehyde-sensitive. In addition, both mutants were significantly cleared in a murine pulmonary model of infection as compared to the wild type, demonstrating the system’s importance for this pathogen’s virulence. The respective phenotypes were reversed upon the genetic complementation of the mutants. To date, this is the first study investigating the role of the AdhC–FghA system in formaldehyde detoxification and pathogenesis of M. catarrhalis.
... Data from other studies suggest similar trends in these bacteria. In China, 70.5% of isolates were MDR, and majority of these isolates were concurrently resistant to amoxicillin, clindamycin, and azithromycin, 7 while in India, most isolates were simultaneously resistant to penicillin, cotrimoxazole, and gentamicin.39 The high AMR of M. catarrhalis to different classes of antibiotics may indicate that this pathogen may exhibit multiple resistance mechanisms. ...
Background:
Moraxella catarrhalis is one of the bacterial pathogens associated with childhood pneumonia, but its clinical importance is not clearly defined.
Objective:
This study aimed to investigate the microbiologic and virulence characteristics of M. catarrhalis isolates obtained from children with pneumonia in Lusaka, Zambia.
Methods:
This retrospective, cross-sectional study analyzed 91 M. catarrhalis isolates from induced sputum samples of children less than five years of age with pneumonia enrolled in the Pneumonia Etiology Research for Child Health study in Lusaka, Zambia between 2011 and 2014. Bacteria identification and virulence genes detection were performed by PCR and DNA sequencing, while antimicrobial susceptibility testing was determined by the Kirby-Bauer method.
Results:
All the M. catarrhalis isolates were obtained from good-quality sputum samples and were the predominant bacteria. These isolates harbored virulence genes copB (100%), ompE (69.2%), ompCD (71.4%), uspA1 (92.3%), and uspA2 (69.2%) and were all β-lactamase producers. They showed resistance to ampicillin (100%), amoxicillin (100%), trimethoprim-sulfamethoxazole (92.3%), ciprofloxacin (46.2%), chloramphenicol (45.1%), erythromycin (36.3%), tetracycline (25.3%) cefuroxime (11.0%) and amoxicillin-clavulanate (2.2%), with 71.4% displaying multi-drug resistant phenotype but all susceptible to imipenem (100%).
Conclusion:
This study showed that M. catarrhalis isolates were the predominant or only bacterial isolates from the sputum samples analyzed. The findings provide supportive evidence for the pathogenic potential role of this bacterium in pediatric pneumonia. High multidrug resistance was also observed amongst the isolates, which can result in affected patients not responding to standard treatment, leading to prolonged illness, increased healthcare costs, and risk of death. This article is protected by copyright. All rights reserved.
... Gupta et al. from Delhi observed 15.8% of ciprofloxacin and 14.2% tetracycline resistant isolates, which was more or less similar to our findings. 26 Another study from India reported 5% of cefuroxime and 15% of amoxicillin-clavulanate resistant isolates, in comparison to 16.23% and 2.09% resistant isolates of M. catarrhalis that were observed respectively, in our study. 24 Krishna et al. reported 13.72% of cefotaxime resistant isolates, which was 3.14% in our study, a higher use of these drugs in the healthcare settings may justify it. ...
Non-fermenting gram-negative bacteria (NFGNB) frequently exhibit drug resistance. The purpose of this study was to determine the drug resistance pattern among the NFGNB isolates causing respiratory tract infections (RTIs). A retrospective analysis of the antimicrobial susceptibility pattern of non-fermenters causing RTIs over four years (2016- 2019) was done and the change in drug resistance pattern was studied. A total of 653 cases were obtained that included 191 (29.2%) Moraxella catarrhalis, 283 (43.3%) Pseudomonas aeruginosa, and 132 (20.2%) Acinetobacter baumannii, 47 (7.2%) Stenotrophomonas maltophilia isolates. A higher resistance (82.6%) was observed for piperacillin-tazobactam and cefpirome, followed by imipenem (79.5%) and ciprofloxacin (76.5 %) for A. baumannii isolates. A sharp decline in resistance pattern for piperacillin, cefpirome, Imipenem and cefoperazone-sulbactam in 2019 and an increasing resistance to gentamycin and ciprofloxacin were noted. Among P. aeruginosa isolates, 94% aztreonam and 83.4% cefoperazone-sulbactam resistance were detected. There was an increased resistance for cefpirome and piperacillin and a decreased resistance for Imipenem was recorded in 2019. In cases of M. catarrhalis, 22.51% of isolates were resistant to ciprofloxacin, followed by erythromycin (18.32%) and tetracycline (17.80 %). S. maltophilia showed a 100% sensitivity for co-trimoxazole and 2.1% resistance for ciprofloxacin. A constantly changing antibiotic-resistant pattern of non-fermenters compels for a continuous update of drug-resistant trends through a longitudinal surveillance program in different geographical areas.
... Furthermore St. pyogenes showed 86.7% of sensitivity against gentamicin which was higher than those reported by [39] which was 39.6%. In addition, the susceptibility of St. pyogenes against ceftriaxone was 86.7% which consider very high compared to those reported by [34] [34], the increasing prevalence of these resistant strains may be related to the misuse of antibiotics in the treatment of various infections or the transmission of resistance genes using transport factors such as bacteriophage, integrons, transposons and plasmids R. The results of this study were higher than those reported by [40] as well as it was very high to those reported by [41] in the resistance of Moraxella against several antibiotic. For Klebsiella pneumoniea, bacteria exhibited 100% of susceptibility against gentamycin, amikacin and amoxiclav, while it was resistant to azithromycin, tetracycline and ceftriaxone with 100.0%. ...
... The result of this study regarding Klebsiella pneumoniae was slightly consistent to the results obtained by [42], whereas, the results were higher those described by [43], [44]. The antibiotic resistance of this bacteria is associated with the presence of pathogen in respiratory tract, advice laboratories and clinicians, therefore, it is very important to recognize and treat it appropriately with antibiotics based on sensitivity to avoid therapeutic failure and serious consequences [41]. Concerning the URTIs causing by Pseudomonas aeruginosa, the highest sensitivity was recorded against amikacin (100.0%), while the highest resistance was recorded against ceftriaxone (66.7%). ...
This study was carried out to isolate and identify the pathogenic bacteria involving URTI as well as to assess the antibiotic susceptibility of bacteria and its correlation of age, sex and study period among patients' swabs. Bacteriological standard methods were used to isolate and identify the bacteria. Total of 106 upper respiratory tract samples were collected from patients in Teba, Dhamar, Dar Al-Shefa, Salama, and Al Mosali hospitals also from Mayas, Al Afara, and Sary clinics, from November 2019 to March 2020. The results showed that the Streptococcus pyogenes recorded the highest rate of infection (34.9%). Followed by 26.6% of Staphylococcus aureus and Moraxella catarrhalis, then 3.6% of Streptococcus pneumoniae, Klebsiella pneumoniae and Pseudomonas aeruginosa, in addition to 0.9% of Haemophilus influenzae. The Incidence of URTI bacteria during period of study recorded the highest rate in March. The highest percentage of patients with URTI based on the sampling sites was recorded in Dar Al-Shefa and Teba hospitals. In addition, study indicated that the throat infections were highly spreading among males, while the otitis was greatly prevalent among the females. Moreover, the highest percentage of URTI was noted in age group between one to eleven years. Additionally, there is a considerable high resistance to some antimicrobial agents, often used in treatment of URTI, especially ceftriaxone, and azithromycin. The most effective antibacterial agents against all isolated URTI pathogens were gentamicin, amikacin and amoxyclav.
... Moraxella catarrhalis is an important pathogen and a common cause of otitis media, pneumonia, sinusitis, and conjunctivitis in infants, children, and the elderly. In adults, M. catarrhalis leads to the formation of chronic obstructive pulmonary disease (COPD) and pneumonia (1)(2)(3)(4). This bacterium further contributes to the formation of respiratory tract infections with other pathogens such as Streptococcus pneumonia and Haemophilus influenza (5)(6)(7). ...
Background and Objectives: Moraxella catarrhalis is considered as an emerging pathogen and a new nosocomial infection agent. This study was conducted to isolate and identify M. catarrhalis from clinical samples (respiratory tracts) and assess them for antimicrobial susceptibility patterns.
Methods: In total, 280 samples were collected from patients with respiratory tract infection, and 120 samples were obtained from healthy individuals in the control group. The isolates were identified by phenotyping and genotyping methods, and their antibiotic susceptibility was evaluated using disk diffusion methods. The presence of β-lactamase and efflux pump activity were specified via phenotypic methods. Finally, Bro and acrA genes in the isolates were detected by PCR technique.
Results: The frequency of this bacterium was 9.64% (27 out of 280) in patients with respiratory tract infection and 4.16% (5 out of 120) in the control group. Although the isolates were resistant to penicillin, they had various responses against other antibiotics. The results obtained from molecular method showed that 90.6% and 84.3% of the isolates possessed Bro and acrA genes, respectively. There was a significant relationship (P
... Fluoroquinolone resistance in M. catarhalis is still a very rare phenomenon; however, it has been reported by several countries. These include, among others, the USA, 7 Europe, 8 India, 9,10 Taiwan, 11 Thailand, 10 and Japan. 12 To date, the exact mechanism of fluoroquinolone resistance in M. catarrhalis has not been fully clarified, and there exist only a few reports dealing with this subject. ...
Purpose
The purpose of this study was to investigate the molecular mechanisms of fluoroquinolone resistance in Moraxella catarrhalis clinical strains isolated in Lublin, Poland.
Materials and methods
A total of 150 non-duplicate clinical strains of M. catarrhalis were obtained from individuals with signs of upper respiratory tract infection. Bacterial identification was corroborated on the basis of phenotypic and biochemical characteristics as well as with the use of molecular tests. The antimicrobial susceptibility of M. catarrhalis isolates was determined using the disk diffusion method and Etest. Mutations in the gyrase (gyrA and gyrB) and topoisomerase (parC and parE) genes were determined by polymerase chain reaction and sequencing.
Results
It was observed that 16.7% of the studied isolates were drug resistant. Resistance to tetracycline was detected for 12% of the strains. Resistance to nalidixic acid, moxifloxacin, and levofloxacin was exhibited by 2.7% of the strains; 1.3% of the strains were resistant to trimethoprim/sulfamethoxazole and 0.7% to erythromycin. Minimum inhibitory concentration values of the four strains demonstrating fluoroquinolone resistance were: 6–12 mg/L for nalidixic acid, 1–1.5 mg/L for levofloxacin, 1 mg/L for moxifloxacin, and 0.25–0.5 mg/L for ciprofloxacin. The research resulted in the detection of mutations in 4 strains, in gyrase gyrA and gyrB genes. In gyrA gene, there occurred mutation G412C as well as four silent transition mutations. Within gyrB gene, there occurred mutation, substitution A1481G, as well as two identical silent mutations.
Conclusion
Our findings reveal that resistance to fluoroquinolones in M. catarrhalis is connected with amino acid substitutions in gyrA and gyrB genes. To our knowledge, this work is the first description of fluoroquinolone-resistant clinical strains of M. catarrhalis with described mutations in gyrA and gyrB genes isolated in Poland and in Europe.
... These other samples were synovial tissue, blood, swab and urine. 11 Study of virulence factors: Lipase enzyme was found in 38.4% isolates; lecithinase and protease could be found in no isolates. Biofilm formation was shown by 67% isolates. ...
Background:
Moraxella catarrhalis
is a known secondary
pathogen in COPD. Its antibiogram has not been studied much
but is important for empiric chemotherapy. Also, studying its
virulence factors is important.
Objectives:
This study was planned to see antibiogram,
virulence factors and bio
film formation.
Methods:
Over 16 months,
M. catarrhalis
was isolated from
sputum and other samples by inoculating on suitable media
and identified using staining and standard biochemicals.
Virulence factors studied were lecithinase, lipase and protease,
serum resistance assay, and biofilm formation by test tube
method. Antibiogram was done by Disk diffusion method using
11 different antibiotics.
Results:
A total of 60
M. catarrhalis
isolates were recovered;
51 from sputum and 9 from other samples. Mean
age and male
to female ratio of patients with respiratory isolates were 38.4
and 1.8:1 respectively. In 3 cases,
M. catarrhalis
was found to
coexist with
M. tuberculosis
and
S. aureus.
All respiratory
isolates were susceptible to Ceftazidime and Piperacill
in
-
Tazobactum. Resistance to Prulifloxacin and Cotrimoxazole
were considerable, and that against Amoxiclav and
Levofloxacin were low. Four
isolates were Multi
-
drug resistan
... These other samples were synovial tissue, blood, swab and urine. 11 Study of virulence factors: Lipase enzyme was found in 38.4% isolates; lecithinase and protease could be found in no isolates. Biofilm formation was shown by 67% isolates. ...
... Moraxella catarrhalis is an established respiratory pathogen, with multidrug resistance seen very commonly (Gupta N et al, 2011). Staphylococcus aureus is also a proven respiratory pathogen, with most number of cases in Cystic fibrosis, and is also associated with worse lung function in Cystic fibrosis (Goss and Muhlebach, 2011). ...
Moraxella catarrhalis and Small colony variants (SCVs) of S. aureus are both respiratory pathogens, with the latter causing persistent, indolent infections. M. catarrhalis is a Gram negative coccobacillus whereas SCV S. aureus is Gram positive with variable sizes. SCVs can often be missed unless proper identification is done, followed by susceptibility testing, since they can be frequently refractory to many antibiotics. Also, antibiotic susceptibility can be different in M. catarrhalis and SCV S.aureus, which makes empirical treatment more difficult. All these points are interesting areas of research. Moraxella catarrhalis is an established respiratory pathogen, with multidrug resistance seen very commonly(Gupta N et al, 2011). Staphylococcus aureus is also a proven respiratory pathogen, with most number of cases in Cystic fibrosis, and is also associated with worse lung function in Cystic fibrosis(Goss and Muhlebach, 2011). Chronic obstructive pulmonary disease (COPD) is also a risk factor for pneumonia due to M. catarrhalis,which can also infect children, while Diabetic ketoacidosis is also a risk factor for lung infection by Staphylococcus aureus (http://downloads.lww.com, Verduin et al, 2002). M. catarrahalis is also common in nosocomial pneumonia(Verduin et al, 2002). SCV S. aureus can be difficult to diagnose since pigmentation is often absent, hemolysis is absent and coagulase may be delayed (Vaudaux P et al, 2006). Mixed pneumonia can be found with M. catarrhalis in conjunction with Hemophilus influenzae and S. pneumoniae, but it is rare in conjunction with SCV S. aureus(Enright MC et al, 1997). We here discuss such a case. CASE REPORT JA, a 35 year-old male patient, who was non-smoker presented to the Pulmonary Medicine OPD with chief complaints of slowly progressive cough which used to occur more in early morning with mucoid expectoration and respiratory distress since the last 2 months. The patient also had low grade fever without evening rise of temperature. There was no history of hemoptysis. The patient gave history of travel to the middle east 5 months back. Chest X ray (PA view) showed no abnormality. On haematological investigation, his Total leucocyte was 12,400 /mm3 , polymorph 82%, Lymphocyte 14%, Random blood sugar 110 mg%, and blood urea nitrogen within normal limits. Sputum sample was obtained and sent for microbiological evaluation. Gram stain showed copious pus cells, Gram negative coccobacilli mostly in pairs, and gram positive cocci of different sizes arranged in clusters. ZN staining for AFB was negative in two consecutives sample .Culture of the sample was carried out in 5% sheep blood agar and MacConkey agar. After overnight incubation at 37⁰C, 2 types of colonies were found: opaque, small (0.1 mm) low convex colonies that were pink on MacConkey agar, and larger (2 mm), translucent colonies that were non-lactose fermenting on MacConkey agar. The smaller colonies showed Gram positive cocci on Gram's staining, while larger colonies revealed Gram negative coccobacilli arranged in pairs. The larger colonies were also oxidase positive and reduced nitrate to nitrite, but were negative for indole production, citrate utilisation and sugar fermentation on TSI slant. The smaller colonies were non-pigmented and delayed positive for slide coagulase test. Both colonies were non-hemolytic. Smaller colonies turned to larger, wild-type colonies on growing in a Carbon dioxide-rich environment, in a CO 2 incubator (having 5% CO 2). Thus the smaller colonies turned out to be CO 2 auxotrophic SCV Staphylococcus aureus. There was no increase in size on growing in chocolate agar (to check for hemin auxotrophism) or around Vitamin K disks (15 µg Vit. K) on a Mueller Hinton Agar plate. Antibiotic susceptibility of both isolates were done by Kirby Bauer disk diffusion on Mueller Hinton Agar, using the following disks: Cefotaxime (30 µg), Amoxiclav (25 µg), Amikacin (30 µg), Netilmicin (30 µg) only in case of SCV S. aureus, Piperacillin-BHATTACHARYYA ET AL.: PNEUMONIA CAUSED BY Moraxella catarrhalis AND SMALL COLONY... Indian J.Sci.Res. 11 (1): 088-089, 2015 Tazobactum (only in case of M. catarrhalis) and Azithromycin (25 µg) disks (HiMedia labs, India) as per CLSI protocol(Clinical Laboratory Standards Institute 2006). The patient improved on antibiotic therapy and symptoms resolved. DISCUSSION Double pneumonia is very rare in the clinical and lab practice, commonly seen in aspiration pneumonia, and empiric treatment becomes difficult if the microorganisms retrieved have different antibiotic susceptibility pattern(http://www.patient.co.uk.). Infection by SCV S. aureus tends to persist in humans due to unique features like less clinical manifestations and resistance to many antibiotics, especially in Vitamin K auxotrophic SCV S. aureus , due to diminished transmembrane drug transport(Sendi P et al, 2006, Lennergard J et al, 2008). It is also a well-documented fact that Chest roentgenogram may be false negative in cases of pneumonia, in up to 30% cases where CT (Computerised Axial Tomography)scan revealed pneumonia(Maughan B et al, 2014) .Thi si especially true in case of early lung infection and affection of the lingular region(Maughan B et al, 2014). Our case highlights the importance of double bacterial pneumonia and need to follow up these cases and perform full battery of laboratory investigations.
... Other NF-GNB frequently detected in drinking water are Moraxella spp and Alcaligenes (formerly Achromobacter) xylosoxidans, occasionally able to cause infections mainly in elderly and in immune-compromised hosts (conjunctivitis, otitis, sinusitis, upper and lower respiratory-tract infections, meningitis, bacteraemia, endocarditis) [22,23,24]. ...
Introduction and objective:
Many devices have been marketed in order to improve the organoleptic characteristics of tap water resulting from disinfection with chlorine derivates. The aim of the presented study was to assess the degree of contamination by non-fermenting Gram-negative bacteria (NF-GNB) of drinking water dispensed from microfiltration devices at point-of-use.
Methods:
Water samples were collected from 94 point-of-use water devices fitted with a filter (0.5 μm pore size) containing powdered activated carbon. The microbiological contamination of water entering and leaving the microfiltered water dispensers was compared. The NF-GNB loads were correlated to Total Heterotrophic Counts (HPCs) at 37 and 22 °C, residua chlorine, and some structural and functional features of the devices.
Results:
NF-GNB were detected from 23% of supply water samples, 33% of still unchilled water, 33% of still chilled water and 18% of carbonated chilled water. The most frequent isolates were Pseudomonadaceae: Steno.maltophilia 30.2% of isolates, Pseudomonas 20.5%, Delftia acidovorans 13.4%, while the species more largely distributed was Ps. aeruginosa recovered from 13% of samples. The distribution of the various NF-GNB was different in the water entering and in that leaving the devices. Ps.aeruginosa and Steno.maltophilia were the predominant species in water leaving the microfiltration dispensers, probably due to their capacity to colonize the circuits and to prevail over the others. Recovery of NF-GNB was favoured by the reduction in residual chlorine of the supply water, occasional use, the absence of a bacteriostatic element in the filter and inadequate disinfection of the water lines.
Conclusions:
The presence of high concentrations of potentially pathogenic species of NF-GNB (Ps.aeruginosa, Steno. maltophilia, Burkhol.cepacia) in the water dispensed from microfiltration devices represents a risk of waterborne infections for vulnerable individuals. When these devices are used in environments such as hospitals, nursing homes for the elderly, etc., microbiological monitoring for the detection of NF-GNB is advisable.
