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The anaerobic bacteria
... CLSI, yukarıda sözü edilen artan direnç sorunu nedeniyle antibiyotiklere karşı direnç profili öngörülemeyen ve virülansı yüksek gram-negatif basillerden olan Bacteroides, Prevotella ve Fusobacterium izolatlarında antibiyotik duyarlılık testi yapılmasını önermektedir 8 . Amerika Gıda ve İlaç Dairesi (FDA) onayı almış olan antibiyotik konsantrasyon gradiyent yöntemi, diğer yöntemlere göre nispeten pahalı olmakla birlikte, özellikle az sayıda anaerop bakterilere ait antibiyotik duyarlılıklarının belirlenmesinde önerilen, oldukça pratik ve güvenilir bir yöntemdir 10,14,15 . ...
... çok çeşitli ve ciddi seyirli enfeksiyonlara neden olabilen mikroorganizmalardır9,10 . Standart koşullarda anaerop kültür çalışması yapılan laboratuvarlarda %25-50 arasında değişen oranlarda anaerop bakterilerin izole edildiği bildirilmiştir11,12 . ...
The aim of this study was to identify gram-negative anaerobic bacilli isolated from various clinical specimens that were obtained from patients with suspected anaerobic infections and to determine the antibiotic resistance profiles by using the antibiotic concentration gradient method. The study was performed in Afyon Kocatepe University Ahmet Necdet Sezer Research and Practice Hospital, Medical Microbiology Laboratory between 1 November 2014 and 30 October 2015. Two hundred and seventyeight clinical specimens accepted for anaerobic culture were enrolled in the study. All the samples were cultivated anaerobically by using Schaedler agar with 5% defibrinated sheep blood and Schaedler broth. The isolated anaerobic gram-negative bacilli were identified by using both the conventional methods and automated identification system (VITEK 2, bioMerieux, France). Antibiotic susceptibility tests were performed with antibiotic concentration gradient method (E-test, bioMerieux, France); against penicillin C, clindamycin, cefoxitin, metronidazole, moxifloxacin, imipenem, meropenem, ertapenem and doripenem for each isolate. Of the 28 isolated anaerobic gram-negative bacilli; 14 were identified as Bacteroides fragilis group, 9 were Prevotella spp., and 5 were Fusobacterium spp. The highest resistance rate was found against penicillin (78.5%) and resistance rates against clindamycin and cefoxitin were found as 17.8% and 21.4%, respectively. No resistance was found against metronidazole, moxifloxacin, imipenem, meropenem, ertapenem and doripenem. As a result, isolation and identification of anaerobic bacteria are difficult, time-consuming and more expensive when compared with the cost of aerobic culture. The rate of anaerobic bacteria isolation may be increased by obtaining the appropriate clinical specimen and appropriate transportation of these specimens. We believe that the data obtained from the study in our center may offer benefits for the follow up and treatment of infections caused by anaerobic bacteria and may contribute to the current literature. Because of high resistance rate detected against penicillin, this antibiotic should not be used as a first choice in empirical treatment. Cefoxitin may be used in empirical antimicrobial treatment of anaerobic gram-negatives; but the rate of antibiotic resistance should be detected for more useful and proper treatment. The prior selection of the most effective antibiotic, may contribute to decrease the rate of high resistance. In our study, no resistance was observed against carbapenem group antibiotics and metronidazole; so these antibiotics should be reserved as treatment options in the future for infections caused by resistant gram-negative anaerobic bacteria.
... It did not produce catalase and did not ferment raffinose and trehalose, thereby confirming the identification. [1,2] Antibiogram revealed sensitivity to metronidazole, minocycline, cefatoxime, amoxicillin-clavulanic acid, clarithromycin and chloramphenicol. A subsequent sample obtained two days later also yielded the same organism. ...
... They frequently colonize the oral cavity and cause cervicofacial disease. [1] The most significant pathogen of this group is A. israelii which is associated with the cervicofacial and thoracopulmonary diseases. [2] However, A. odontolyticus, a less commonly recognized pathogen of the Actinomyces group, has been encountered in systemic infections such as peritonitis, brain abscess and thoracopulmonary. ...
Actinomyces odontolyticus has been reported as an opportunistic pathogen causing systemic infections. A case of empyema thoracis due to this organism in a 68-year-old male is reported here. The patient did not have any underlying disease or immunosuppression. The organism was isolated from his oral flora also. Eight cases of thoracopulmonary infections due to A. odontolyticus have been reported from the western countries, but none from India.
... Most frequently, Actinomyces israelii and Actinomyces naeslundii are isolated. However, they represented less than 1% of clinical isolates of anaerobic bacteria identi®ed by the Indiana University Medical Center Anaerobe Laboratory [7]. The majority of actinomycosis infections are diagnosed histopathologically (sulfur granules). ...
... Actinomyces spp. are susceptible to most anti- biotics [7] , but are less susceptible to metronidazole . Generally, the recommendation is to initiate antibiotic treatment with intravenous penicillin G (20 million IU/day) for four weeks, followed by oral penicillin V (2±4 g/day) for two to 12 months. ...
Intra-abdominal and extraperitoneal actinomycosis are rare infections, caused by different Actinomyces species. However, they have been diagnosed more frequently in the last ten years. We report three cases of abdominal actinomycosis and a literature review of the last eight years. All three patients were diagnosed by means of histopathologic examination only. In one case, an intrauterine device (IUD) was associated with the infection. Therapy consisted of surgical resection of the inflammatory, infected tissue, and long-term antibiotic therapy. All patients are free of recurrence. Abdominal actinomycosis should be included in the differential diagnosis of an abdominal pathology of insidious onset, especially when an IUD is in place. Even when infection had spread extensively, combined operative and antibiotic therapy cured most of the cases.
... It exhibits an evasion mechanism against host defenses and survives even when antibiotic therapy is employed. 36,37 Clostridium perfringens is rarely found in the oral cavity 38 ; however, the strain ATCC 13124 showed more uniform results in microbial susceptibility tests for anaerobes and was used in the present study as a control. ...
... Nevertheless, in some tests that use antibiotics there is poor correlation between diffusion-test inhibition zones and dilution-test MIC values. 38 Even at a distance, the formocresol effect is noxious to living tissues and its carcinogenic potential 42 must be recognized and related to the dose used. We tested this drug first for comparison, owing to its high antimicrobial effect, and second because it is sometimes used in Brazil in emergency cases, where the infected root canals could not be totally cleaned right away. ...
The aim of this study was to determine the antimicrobial effect of ethanol extract of propolis (EEP) and intracanal medicaments calcium hydroxide, camphorated paramonochlorophenol, and formocresol by means of the macrodilution method using the reinforced clostridial medium (RCM) and brucella and brain heart infusion media.
The antimicrobial agents were sequentially diluted and tested against anaerobic bacteria Prevotella nigrescens, Fusobacterium nucleatum, Actinomyces israelii, and Clostridium perfringens and against Enterococcus faecalis, with the 5 x 10(5) CFU/mL standardized inocula. The tubes were anaerobically incubated and the minimum inhibitory concentration was detected. Blood agar RCM subcultures were performed to provide minimum bactericidal concentration. The results were analyzed by analysis of variance test.
All drugs were effective against all tested strains, without statistical differences. E. faecalis was the less susceptible strain, and RCM broth promoted faster bacterial growth, but there were no significant differences in these results. Ethanol did not influence the antimicrobial effect of EEP.
... They are responsible for various endogenous bacterial infections in any organ or system of body leading to severe lifethreatening infections if left untreated. [1][2][3] Conditions such as trauma, poor blood supply, vascular stasis leading to tissue necrosis, and lowered oxidation -reduction potential in tissue provide favorable conditions for the anaerobes to multiply. 3 Handling of specimen containing anaerobic organisms is very much challenging due to their susceptibility to environmental oxygen, technical difficulties in cultivation, cost, and most importantly prolonged Bacteriological profile of anaerobes in deep-seated abscess of patients attending a tertiary care hospital turnaround time leading to delayed report to the clinicians. ...
Background: Anaerobes are recognized as important human pathogens causing severe life threatening exogenous and endogenous infection if left untreated. Anaerobes are one of the most neglected pathogens in various clinical samples due to the problem in sample handling, technical difficulties in their cultivation, and identification along with prolonged turnaround time.
Aims and Objectives: The present study was undertaken to identify the different anaerobic organisms associated with deep seated abscess and their association with various risk.
Materials and Methods: Pus and fluid sample collected in sterile syringe or swab stick were immediately put in RCM and taken to the laboratory. Gram staining, ZN stain, and culture--both aerobic and anaerobic were done. Obligate anaerobes were checked for aerotolerance. Subcultures were done for identification of species level by Gram stain, colony morphology, biochemical tests, and final identification that were done by the Vitek 2 system.
Results: Out of the 170 samples, 144 (84.70%) were culture positive and the rest 26 (15.29%) were culture negative; 101 (70.1%) were aerobic, 23 (16%) anaerobes, and 20 (13.9%) mixed aerobic and anaerobic. A total of 51 obligate anaerobes were isolated from various samples. Out of which 32 (62.74 %) anaerobic Gram-positive cocci-Peptostreptococcus anaerobious being the most common and 13 (25.49%) anaerobic Gram-negative bacilli --Bacteroids fragilis being most common and 6 (11.76%) were anaerobic Gram-positive bacilli - Actinomyces meyeri being the most common. Diabetes mellitus was a significant associated factor. Maximum number of anaerobes was isolated from abscess over oral cavity followed by gangrenous foot, scrotal abscess, and diabetic foot.
Conclusion: Anaerobes are an important cause of deep-seated abscess—mostly being polymicrobial in nature. Incision--drainage and proper antibiotic therapy is necessary for their early control and prevention of complications.
... Stained slides were then blot-dried and examined under light microscope at × 100 using an oil immersion lens. All anaerobes were identified based on the guidelines specified by Koneman et al. [11] After identification, data were recorded and sent to the statistician for the frequency distribution of bacteria (%) isolated in placental and plaque samples of both the study groups (Group I and Group II). ...
Background:
Adverse pregnancy outcome is due to deviation from the normal physiological and immunological process. There is conflicting evidence in support of maternal periodontitis as a risk factor for preterm low birth weight (PTLBW). Thus, the aim of the present study is to evaluate the correlation between PTLBW and periodontitis in postpartum mothers based on clinical and microbiological parameters.
Materials and methods:
An observational retrospective study was conducted. A total of 103 women with singleton births were included in the study, which was divided into two groups, i.e., Group I-PTLBW and Group II-normal term normal birth weight (NTNBW). Clinical parameters such as oral hygiene index simplified, gingival bleeding index (BOP %), periodontal probing depth (PPD) and and clinical attachment loss (CAL) were recorded on the next day of postpartum. Two samples from each group, i.e., placental extract and the subgingival plaque were collected and transported to the laboratory in an anaerobic medium for microbiological analysis. The statistical analysis was performed using an unpaired t-test and Wilcoxon Mann-Whitney U-test. The P < 0.001 was considered statistically significant.
Results:
PTLBW group showed significantly higher amounts of periodontal destruction in terms of clinical parameters. The pathogens were also in higher quantities in the PTLBW group compared to the NTNBW group.
Conclusion:
Periodontitis is related to PTLBW in pregnant women of the studied population. Maternal oral hygiene status delivering PTLBW babies are compromised compared to mothers delivering NTNBW babies. Hence, periodontitis during pregnancy phase is an important health concern for the growing fetus.
... Colonies grown were identified by standard microbiological procedure for anaerobic bacteria. 7,8 Antimicrobial susceptibilities of aerobic bacterial isolates were tested by the Kirby Bauer disk diffusion method according to the guidelines of the Clinical and Laboratory Standards Institute. Fungal isolates were processed according to standard mycological procedures. ...
... Actinomyces are a group of gram positive bacilli, predominantly anaerobic in nature. They frequently colonize the oral cavity and cause cervicofacial disease [13] . The most significant pathogen of this group is A. israelii which is usually associated with the cervico-facial and thoraco-pulmonary diseases [14] . ...
... In the present work, the broth macrodilution and agar diffusion methods were used. It was verified that in the agar diffusion test, there was no inhibitory halo formation, corroborating the findings of Koneman et al. (19), who saw the agar diffusion test with restrictions because the correlation between the inhibition zone sizes and the MIC results of macrodilution is not in agreement. ...
The present study evaluated the antimicrobial in vitro effects of the salivary proteins lactoferrin and lysozyme on microorganisms involved in the carious process, obtaining their minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Streptococcus mutans (ATCC 25175) and Lactobacillus casei (ATCC 7469) were submitted to broth macrodilution of lysozyme at 80 mg/mL and lactoferrin at 200 mg/mL. The tubes were read in a spectrophotometer after they had been incubated at 37 °C for 18 h, in a carbon dioxide chamber, in order to read the MIC. A new subculture was carried on agar plates to obtain the MBC. The agar diffusion method was also tested, using BHI agar with 100 µL of the standardized microbial inocula. Filter-paper disks soaked in 10 µL of the solutions lactoferrin (200 µg/mL) and lysozyme (80 µg/mL) were placed on the agar surface. Inhibition halos were not observed on the plates, showing the absence of the antimicrobial effects of these proteins in this method. The bactericidal and bacteriostatic effects of lysozyme on L. casei were 50.3 mg/mL and 43.1 mg/mL respectively. The bactericidal and bacteriostatic effects on S. mutans were 68.5 mg/mL and 58.7 mg/mL. Lactoferrin did not induce any inhibitory effects on any microorganism, even in the concentration of 200 mg/mL. There was not a synergic antimicrobial effect of proteins, when they were tested together, even in the concentration of 42.8 mg/mL of lysozyme and 114 mg/mL of lactoferrin (the highest values evaluated). S. mutans and L. casei were only inhibited by lysozyme, not affected by lactoferrin and by the synergic use of both proteins.
... The agar diffusion test is viable when testing antimicrobials having a similar diffusion gradient to enable the comparison of the medicaments. However, in some tests using antibiotics, there is a poor correlation between diffusion-test inhibition zones and dilution-test MIC values (Koneman et al., 1997). ...
Propolis has been shown to be possibly an appropriate alternative as an intracanal medicament due to
its antibacterial properties. The aim of present study was to compare the activity of calcium hydroxide
and propolis against Lactobacillus, Enterococcus faecalis, Peptostreptococcus and Candida albicans.
This experimental study was conducted to evaluate antimicrobial activity of ethanol extract of propolis
and calcium hydroxide (Ca(OH)2) powder mixed with saline solution. Agar diffusion test and dilution
methods were used to compare the results. There were separate plates to control diffusion of two
substances in agar and antimicrobial activity of solvents. Figures of diameter of inhibition zone and
minimal inhibitor concentration (MIC) and minimal bacterial concentration (MBC) were calculated.
Paired T-test was used to compare the MIC differences. Propolis was more effective against
Lactobacillus, E. faecalis and Peptostreptococcus with 8.6984 mm compared with 7.0833 mm mean
diameter of inhibitory zone for Ca(OH)2. The difference was statistically significant (P<0.001) indicating
that Ca(OH)2 was less effective against experimental microorganisms. The inhibitory zone of the two
drugs demonstrated stronger effect of propolis on contaminating microorganisms. The MIC of propolis
for all studied microorganisms was at least 4 times less than calcium hydroxide. Propolis was more
effective than calcium hydroxide against Lactobacillus, E. faecalis and Peptostreptococcus. In ADT For
C. albicans, larger inhibition zone observed around calcium hydroxide, could be due to low diffusion
potentiality of propolis in agar compared to calcium hydroxide whereas, MIC demonstrated higher
antifungal activity for propolis. Propolis was more effective against C. albicans in spite of its smaller
inhibitory zone.
Introduction
The high prevalence of urinary tract infections (UTIs) and rising resistance to beta-lactam antibiotics, which is a global therapeutic concern, are caused by Escherichia coli (E. coli) extended-spectrum beta-lactamases (ESBLs) producers. It is unclear how E. coli that produces ESBLs spreads throughout Gezira state, Sudan. The study aimed to evaluate the dissemination of class A and class D resistance genes among E. coli and to recognize the antibacterial activity of the locally used cephalosporins and carbapenems.
Methods
One hundred and fifteen isolates of uropathogenic E. coli were collected from patients who attended a tertiary hospital. The isolates were identified using colony morphology, gram staining, and biochemical tests and checked for 16S rRNA using PCR. The multidrug-resistant (MDR) testing was conducted using agar disk diffusion. Finally, the class A and D resistance genes were analyzed by multiplex PCR.
Results
The study enrolled 200 patients with UTIs. E. coli isolates were found in 115 (57.5%) urine specimens examined, and 60 (52.2%) of them produced resistance to most locally used antibiotics. The antibiotic resistance pattern was higher against cefepime (100%), ceftizoxime (90%), cefuroxime (81.7%), and ceftriaxone (81.7%) and had lower activity against meropenem (13.3%). The genotypic characterization of class A cephalosporinases was 85% for blaCTX-M, 70% for blaSHV, and 33.3% for blaTEM, while for class D carbapenemases, it was 10% for both blaOXA-23 and blaOXA-51.
Conclusion
The considerable antibiotic resistance to the cephalosporins and meropenem and the increased predominance of the blaCTX-M and blaSHV genes are serious concerns for the health authorities. Meropenem could still be used as the drug of choice for ESBL-producing E. coli.
We report a case of a rapidly fatal postlaparoscopic cholecystectomy liver infection from the rarely isolated species Clostridium butyricum. Liver examination at autopsy showed cystic spaces, necrosis, and spore-forming Gram-positive rods. 16sRNA gene sequencing of the cystic liver tissue identified the organism as C. butyricum.
1. Case Report
An adult patient underwent a laparoscopic cholecystectomy for symptomatic cholelithiasis. According to the operative report, the gallbladder was constricted and had minimal adhesions, a single gall stone, and a relatively short cystic duct. The gallbladder exhibited scarring and was removed. After multiple attempts, an intraoperative cholangiogram was aborted secondary to problems maintaining a seal and contrast leakage. The patient was discharged home, 6 hours after surgery.
During the first night at home after surgery, the patient was inactive, resting on the sofa, and slept uneventfully. The day after surgery, she spiked a 101°F temperature and called the hospital. The patient reportedly was told to take an over-the-counter fever reducer and call back if the fever did not abate. The patient remained ill throughout the day and was found dead the following day. Past medical history was significant for schizophrenia, glucose intolerance, and obesity, and prescribed medications included divalproex sodium, olanzapine, and hydrocodone. At autopsy, the decedent was 66 inches in length and weighed 257 pounds (BMI 42.8).
Three small surgical incisions (0.5 × 0.1 cm each) were apparent to the right of the midline approximately 2.0 cm from the umbilicus, and a 2.0 × 0.1 cm surgical incision overlying the umbilicus was also noted. All surgical incisions appeared to be clean and healing. The patient had cardiomegaly (560 grams) with slightly thickened mitral valve leaflets and no evidence of atherosclerotic heart disease. The liver weighed 1990 grams, and the surface demonstrated a greasy, yellow parenchyma consistent with hepatic steatosis. The gallbladder bed was normal for the postoperative period.
Upon serial sectioning of the liver, 10.0 × 6.0 × 4.0 cm of small (0.1 cm) cystic spaces were located in the inferior portion of the liver; the consistency of the liver in this area was readily compressible, reminiscent of lung parenchyma (Figure 1(a)). Microscopic examination of the liver parenchyma demonstrated focal areas of necrosis, rare areas of acute inflammatory cells, vacuolated hepatocytes, and tissue air spaces (Figure 1(b); H&E section). On tissue Gram stain, copious amounts of Gram-positive rods with spores were present (Figure 1(c)). Toxicology results indicated the presence of diphenhydramine (too low to quantify) and bupivicaine. A postmortem liver swab sample was submitted for culture and demonstrated a rare diptheroid bacilli, rare Group F beta hemolytic Streptococcus, and rare Gram-positive bacilli, which the microbiology laboratory was unable to identify. Standard biochemical profile testing was used for identification of these organisms. At this time, evidence pointed to sepsis as the cause of death. Bacterial identification by 16s rRNA gene sequencing of a portion of the liver tissue was performed. As previously described, DNA extracted from the paraffin-embedded liver tissue was subjected to PCR amplification and sequencing of the first 500 base pairs of the bacterial 16S rRNA gene to identify the Gram-positive rod seen in the tissue sections [1, 2]. Comparison of the bacterial 16S rRNA gene sequence (GenBank accession number EU239262.1) obtained from the paraffin-embedded liver tissue to the MicroSeq bacterial 500 sequence database library (Applied Biosystems, Foster City, CA) and GenBank NCBI sequence database using the BLASTN algorithm [3] revealed 100.0% sequence similarity (no mismatches) with C. butyricum.
Clostridium sordellii bacteriemia is infrequent and usually comes from infections of gynecological and puerperal etiology, with mortality near 70%. There are few
tools for rapid and timely diagnosis. Thus, treatment experience for this pathogen is very limited in other scenarios, which is probably the cause of high mortality
rates. We describe a patient with a history of expansive abdominal mass, diagnosed with metastasic Gastrointestinal Stromal Tumor (GIST), with Clostridium sordellii bacteremia.
The purpose of this study was to investigate the susceptibility of a series of 33 Prevotella strains isolated from patients with abscesses in the head and neck spaces, presented to one Romanian hospital. The Etest was applied to determine the value of the minimum inhibitory concentrations for: penicillin G, ampicillin, amoxicillin-clavulanate, metronidazole and clindamycin. In addition, the beta-lactamase activity was detected by the chromogenic cephalosporin disc method. The results indicated that 11 isolates were resistant to both penicillin G and ampicillin due to the beta-lactamase production. All the 33 Prevotella strains were susceptible to the other 3 antimicrobial agents tested, except for only one penicillin G - ampicillin resistant isolate of P. buccae (MIC > 32 and MIC = 12 mg/L, respectively), which showed high resistance to clindamycin (MIC > 256 mg/L) too. Our data underline the necessity for antimicrobial testing including monitoring of beta-lactamase production in cases of oro-maxillo-facial mixed anaerobic infections where antimicrobial treatment is required in addition to the surgical drainage. The results of the study indicated that amoxicillin-clavulanate, like metronidazole, was fully active against the tested Prevotella strains. However, local and multicentre surveys on drug resistance among the clinically significant anaerobic isolates should be carried out periodically.
Copyright © 2014 Elsevier Ltd. All rights reserved.
Routine isolation, identification and susceptibility testing of anaerobic bacteria present several difficulties leading to defects in the determination of local susceptibility patterns which will guide empirical treatment protocols. This study was carried out to identify the anaerobic bacteria isolated from various clinical materials obtained from the suspected patients with anaerobic infection and to determine the antibiotic susceptibilities against several antibiotics. One hundred clinical specimens (36 blood, 31 abscess, 12 peritoneal fluid, 7 joint fluid, 7 pleural fluid, 3 biopsies, 3 cerebrospinal fluids and 1 surgical wound) that were examined in our laboratory during March 20-October 30 2007, were included in the study. The specimens were collected and transported under anaerobic conditions and inoculated to conventional aerobic media and to Wilkins Chalgren agar, Schaedler agar and chopped-meat broth for anaerobic isolation. Isolated anaerobic bacteria were identified with API 20A panels (Bio-Merieux, France) via conventional methods and by the help of AN-IDENT Discs (Oxoid, England). Penicillin G, clindamycin, cefoxitin, metronidazole, piperacillin/tazobactam and imipenem susceptibility tests were performed with E- test method. Twenty two anaerobic bacteria were isolated from 14 clinical specimens; 7 of the specimens yielding the growth of more than one type of anaerobic bacteria and 8 specimens yielding both anaerobic and facultative anaerobic bacterial (4 Escherichia coli and 4 Enterococcus spp.) growth. Anaerobic bacteria were isolated in 89 abscess and in 6 peritoneal fluid specimens. The distribution of the anaerobic bacteria identified among these specimens were as follows: Bacteroides fragilis (n = 6), Bacteroides spp. other than B.fragilis (n = 4), Clostridium spp. (n = 2), Fusobacterium necrophorum/nucleatum (n = 1), Prevotella intermedia/disiens (n = 1), Peptococcus niger (n = 2), Peptostreptococcus spp. (n = 5), and Lactobacillus acidophilus/lenseii (n = 1). Beta-lactamase activity was detected only in 2 of the 6 B. fragilis isolates. All of the isolates were susceptible to imipenem and piperacillin/tazobactam. The highest rate of resistance was detected against penicillin G (9/22; 41%). While anaerobic gram-positive cocci (n = 7) were found to be sensitive to all antibiotics, the rate of resistance among anaerobic gram-negative bacilli were 75% (9/12) to penicillin, 33.3% (4/12) to clindamycin, 8.3% (1/12) to metronidazole. Among anaerobic gram-positive bacilli (n = 3), 2 were resistant to metronidazole, one to clindamycin and one to cefoxitin. The results of this first anaerobic antimicrobial susceptibility testing study performed at Konya area in Turkey revealed that penicillin was not appropriate in empirical treatment of anaerobic infections, clindamycin susceptibility should be tested before use, metronidazole and cefoxitin could be used in empirical treatment and imipenem and piperacillin/tazobactam should be saved for the treatment of complicated infections and infections caused by resistant bacteria.
Strain A2 is an anaerobic, variably Gram-stain-positive, non-spore-forming, small and irregularly rod-shaped bacterium from the ruminal fluid of a sheep that has been described informally as a representative of 'Olsenella (basonym Atopobium) oviles'. Three phenotypically similar bacterial strains (lac15, lac16 and lac31(T)) were isolated in concert with Veillonella magna lac18(T) from the mucosal jejunum of a pig. A phylogenetic analysis based on 16S rRNA gene sequences revealed that strains A2, lac15, lac16 and lac31(T) formed a genetically coherent group (100 % interstrain sequence similarity) within the bigeneric Olsenella-Atopobium branch of the family Coriobacteriaceae, class Actinobacteria. This group was most closely related to the type strains of the two recognized Olsenella species, namely Olsenella uli (sequence similarity of 96.85 %) and Olsenella profusa (sequence similarity of 97.20 %). The sequence similarity to the type strain of Atopobium minutum, the type species of the genus Atopobium, was 92.33 %. Unlike those of O. uli and O. profusa, outgrown colonies of strains A2, lac15, lac16 and lac31(T) were opaque and greyish-white with an umbonate elevation on solid culture media. The four novel strains were characterized as being well-adapted and presumably indigenous to the gastrointestinal tract of homoeothermic vertebrates: they were mesophilic, microaerotolerant, neutrophilic and acidotolerant, bile-resistant, mucin-utilizing and markedly peptidolytic lactic acid bacteria. The results of DNA-DNA hybridizations, cellular fatty acid analysis and other differential phenotypic (physiological and biochemical) tests confirmed that strains A2, lac15, lac16 and lac31(T) represent a novel species of the genus Olsenella. On the basis of the genotypic and phenotypic results, we therefore describe Olsenella umbonata sp. nov., with lac31(T) ( = CCUG 58604(T) = DSM 22620(T) = JCM 16156(T)) as the type strain and A2 ( = CCUG 58212 = DSM 22619 = JCM 16157) as an additionally available reference strain. Also, based on our data, we propose emended descriptions of the genus Olsenella and the species Olsenella uli and Olsenella profusa.
A 46-year-old man was admitted with confusion and lower limb weakness that had developed over 2 weeks. A history of chronic productive cough was noted. Significantly, 4 years previously he had been investigated for cough and left apical lung consolidation. No evidence of Mycobacterium tuberculosis was found at the time and this was not investigated further. The only other relevant history was of heavy ethanol intake and self-neglect.
The patient was febrile (38.6°C), confused and unwell. He had evidence of finger clubbing, poor oral hygiene and signs of consolidation in the left lung. Early bilateral papilloedema and a flaccid paralysis in the lower limbs were noted. Admission investigations identified a raised white cell count of …
Propionibacterium acnes (P. acnes) is emerging as a pathogen in postneurosurgical infections. A case of cranial bone flap infection due to P. acnes successfully treated with daptomycin is presented. This case demonstrates the potential of daptomycin as an option in the treatment of P. acnes.
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