Ralstonia pickettii bacteremia in a cardiac surgery patient in Belgrade, Serbia

Ralstonia pickettii is an opportunistic bacterium found in the water environment with an increasing incidence as a nosocomial pathogen. The objectives of this study were to describe R. pickettii bacteremia in a cardiac surgery patient and to evaluate its ability to grow in a saline solution and to form biofilm. The patient in this study underwent mitral and aortic valve replacement surgery with two aortocoronary bypasses. She developed signs of respiratory and renal failure, therefore hemodialysis was started. After 25 days in an intensive care unit, the patient had recurrent episodes of fever with signs of bacteremia. R. pickettii was identified from blood cultures by MALDI-TOF MS. Antimicrobial susceptibility testing was performed using disc diffusion and broth microdilution methods in accordance with EUCAST methodology and results were interpreted following clinical breakpoints for Pseudomonas spp. The isolate was susceptible to all tested antimicrobial agents except aminoglycosides and colistin. Survival of R. pickettii was analyzed in saline solution with four different starting concentrations at 25 degrees C and 37 degrees C for six days. Biofilm capacity was tested using the microtiter plate method. R. pickettii showed substantial growth in saline solution, with starting concentration of 2 CFU ml(-1) reaching 107 CFU ml(-1) after six days. There was no significant difference between growth at 25 degrees C and 37 degrees C. This indicates that storage of contaminated solutions at room temperature can enhance the count of R. pickettii. Our strain did not show the capacity to form biofilm. The patient responded well to adequate treatment with ceftazidime, and after 48 days in ICU she was discharged to convalesce

Diagnosis of bacterial vaginosis

Bacterial vaginosis is a common, complex clinical syndrome characterized by alterations in the normal vaginal flora. When symptomatic, it is associated with a malodorous vaginal discharge and on occasion vaginal burning or itching. Under normal conditions, lactobacilli constitute 95% of the bacteria in the vagina. Bacterial vaginosis is associated with severe reduction or absence of the normal H2O2­producing lactobacilli and overgrowth of anaerobic bacteria and Gardnerella vaginalis, Atopobium vaginae, Mycoplasma hominis and Mobiluncus species. Most types of infectious disease are diagnosed by culture, by isolating an antigen or RNA/DNA from the microbe, or by serodiagnosis to determine the presence of antibodies to the microbe. Therefore, demonstration of the presence of an infectious agent is often a necessary criterion for the diagnosis of the disease. This is not the case for bacterial vaginosis, since the ultimate cause of the disease is not yet known. There are a variety of methods for the diagnosis of bacterial vaginosis but no method can at present be regarded as the best. Diagnosing bacterial vaginosis has long been based on the clinical criteria of Amsel, whereby three of four defined criteria must be satisfied. Nugent’s scoring system has been further developed and includes validation of the categories of observable bacteria structures. Up­to­date molecular tests are introduced, and better understanding of vaginal microbiome, a clear definition for bacterial vaginosis, and short­term and long­term fluctuations in vaginal microflora will help to better define molecular tests within the broader clinical context

Mechanisms of Intracellular Chlamydiae Survival

Chlamydiae are Gram-negative, non-motile, obligate intracellular, and spherically shaped bacteria with a diameter of 0.2-1.5 μm. Chlamydiae are present in several different morphological forms: the elementary body, the reticular body, and in the last several years, there has been the observation of a third form known as the persistent or atypical form. The intracellular localization of Chlamydia provides a unique replication cycle that occurs inside a membrane-surrounded vacuole in the host cell cytoplasm and is significantly different from the method of multiplication of other microorganisms. Chlamydiae are capable of manipulating different signalling pathways inside the infected cell, thus avoiding the host immune response. This ensures intracellular multiplication, survival, and long-term persistence of Chlamydiae. There are two basic means of achieving this persistence: inhibition of apoptosis and manipulation of NF-κB (nuclear factor kappa B)-mediated signals in the host

Staphylococcal biofilm on wedding rings worn by laboratory workers

Hands of healthcare workers play essential role in the spreading of antimicrobial-resistant microor-ganisms in and out of the healthcare settings. Less is known about the role of laboratory workers (LWs). The aim of our study was to evaluate the presence of biofilm-forming staphylococci on the surface of jewelry rings of LWs and their antimicrobial susceptibility pattern.A total of 79 LWs from eight different microbiology laboratories that process and analyze specimens from the tertiary care hospitals in Belgrade, Serbia participated in the study. The study was reviewed and approved by the institutional review boards at hospitals. Samples were taken after hand washing. Bacteria on LWs wedding rings were detected with the rolling method, and further analyzed in order to determine the number of colony forming unit (CFU) per ring, species of bacteria and their antimi-crobial susceptibility pattern, methicillin resistance and biofilm-producing capacity in vitro.Staphylococci were recovered from 60.8% of wedding rings. All strains produced biofilm (25% weak, 56.2% moderate and 18.8% large amount), with significant difference between species (P < 0.001). Staphylococcus aureus and Staphylococcus epidermidis formed the largest amount of biofilm and had the largest number of CFU per ring. Staphylococci were most commonly resistant to penicillin (66.7%), tetracycline (50.0%), and erythromycin (45.8%); 41.7% of isolates was multidrug resistant and mecA gene was detected in five strains. All strains were susceptible to linezolid, vancomycin, teicoplanin and tigecycline.Staphylococci colonize LWs wedding rings, form biofilm on it, have multidrug resistant phenotype and/or carry mecA gene, representing a significant reservoir for the spreading of microorganisms and resistance. As far as we know, our study is the first that address this topic in laboratory workers

The effect of lichenocin 50.2 and BGBU1-4 crude extract on biofilm formation of <i>L</i>. <i>Monocytogenes</i>.

<p>The effect of subinhibitory concentrations (1/2–1/256 X MIC) of lichenocin 50.2 (2a) and BGBU1-4 crude extract (2b) on biofilm formation of <i>L</i>. <i>monocytogenes</i>. Results are presented as mean OD ± standard deviation; Category +, weak biofilm producer; Category ++, moderate biofilm producer; Category +++, strong biofilm producer; * p<0.05, ** p<0.01. Control–biofilm density of bacteria cultivated in medium without presence of bacteriocins.</p

Minimal inhibitory concentrations of licheniocin 50.2 and BGBU1-4 crude extract and category of biofilm formation by coagulase negative staphylococci and <i>Listeria monocytogenes</i> clinical isolates.

<p>Minimal inhibitory concentrations of licheniocin 50.2 and BGBU1-4 crude extract and category of biofilm formation by coagulase negative staphylococci and <i>Listeria monocytogenes</i> clinical isolates.</p