MOESM1 of Frequency, associated factors and outcome of multi-drug-resistant intensive care unit-acquired pneumonia among patients colonized with extended-spectrum β-lactamase-producing Enterobacteriaceae

Additional file 1. . Additional results (Tables S1 to S6)

Formation of <i>in vitro</i> biofilm of <i>A</i>. <i>fumigatus</i>.

<p>(<b>A</b>) Kinetics of biofilm formation visualized in CLSM: 8 h (1), 12 h (2) and 24 h (3) after inoculation. (<b>B</b>) 24 h–old biofilm in SEM: general aspect of Af biofilm (1), hyphae embedded in ECM and presence of conidia (2), ECM with holes (3). ECM = extracellular matrix, C = conidia.</p

Formation of <i>in vitro</i> mixed biofilm of <i>S</i>. <i>maltophilia</i> and <i>A</i>. <i>fumigatus</i>.

<p>(<b>A</b>) Kinetics of mixed biofilm formation visualized in CLSM: 8 h (1), 12 h (2) and 24 h (3) after inoculation. (<b>B</b>) 24 h–old biofilm in SEM: general aspect of mixed biofilm (1), bacteria covering <i>A</i>. <i>fumigatus</i> hyphae and embedded in ECM (2), bacteria between hyphae and embedded in ECM (3). ECM = extracellular matrix.</p

<i>A</i>. <i>fumigatus</i> and mixed biofilms thicknesses.

<p>(<b>A</b>) Means of <i>A</i>. <i>fumigatus</i> and mixed biofilms thicknesses after 24 h of culture (<b>B</b>) CLSM observations of 24 h-old biofilms thicknesses inoculated on Lab-Tek^TM slides. Sm = <i>S</i>. <i>maltophilia</i>, Af = <i>A</i>. <i>fumigatus</i>. For each biofilm, 50 measurements were taken. Results are expressed in mean±SE, * <i>p</i> < 0.0001.</p

Cell wall thickness of <i>A</i>. <i>fumigatus</i> in the single and mixed biofilms.

<p>(<b>A</b>) Observation on 24 h–old single <i>A</i>. <i>fumigatus</i> biofilm (1–2) and mixed biofilm (3–4) by TEM (<b>B</b>) Cell wall thickness of <i>A</i>. <i>fumigatus</i> measured on TEM images of the single and mixed biofilms. H = hyphae, B = bacteria, CW = cell wall, ECM = extracellular matrix, Sm = <i>S</i>. <i>maltophilia</i>, Af = <i>A</i>. <i>fumigatus</i>. For each biofilm, approximately 15 measurements on 27 hyphae were taken. Results are expressed in mean±SE, * <i>p</i> < 0.0001.</p

Formation of <i>in vitro</i> biofilm of <i>S</i>. <i>maltophilia</i> observed by SEM.

<p>(<b>A-B</b>) Single biofilm of <i>S</i>. <i>maltophilia</i> after 24 h of culture. ECM = extracellular matrix.</p

Characteristics of <i>Aspergillus fumigatus</i> in Association with <i>Stenotrophomonas maltophilia</i> in an <i>In Vitro</i> Model of Mixed Biofilm - Fig 5

<p><b>Conidiation and phenotype of <i>A</i>. <i>fumigatus</i> in the mixed biofilm visualized on SEM (A, B) and CLSM (C, D).</b> (<b>A, C</b>) 24 h-old single <i>A</i>. <i>fumigatus</i> biofilm (A’) zoom on the presence of conidial head (<b>B, D</b>) 24 h-old mixed biofilm of <i>A</i>. <i>fumigatus</i> and <i>S</i>. <i>maltophilia</i>. Grey circle represents conidial head of <i>A. fumigatus</i> which is only present in the single biofilm.</p

Growth of <i>S</i>. <i>maltophilia</i> and <i>A</i>. <i>fumigatus</i> in the single and mixed biofilms.

<p>Data are expressed in log of CE or BE/mL as measured by qPCR over 24h and presented in the form of mean±SE. Sm = <i>S</i>. <i>maltophilia</i>, Af = <i>A</i>. <i>fumigatus</i>. The experiment was repeated 3 times, using 3 wells per biofilm. Results are expressed in mean±SE, * p < 0.05 compared with the single biofilms.</p

<i>Bacillus cereus</i>, a serious cause of nosocomial infections: Epidemiologic and genetic survey

<div><p><i>Bacillus cereus</i> is the 2^nd most frequent bacterial agent responsible for food-borne outbreaks in France and the 3^rd in Europe. In addition, local and systemic infections have been reported, mainly describing individual cases or single hospital setting. The real incidence of such infection is unknown and information on genetic and phenotypic characteristics of the incriminated strains is generally scarce. We performed an extensive study of <i>B</i>. <i>cereus</i> strains isolated from patients and hospital environments from nine hospitals during a 5-year study, giving an overview of the consequences, sources and pathogenic patterns of <i>B</i>. <i>cereus</i> clinical infections. We demonstrated the occurrence of several hospital-cross-contaminations. Identical <i>B</i>. <i>cereus</i> strains were recovered from different patients and hospital environments for up to 2 years. We also clearly revealed the occurrence of inter hospital contaminations by the same strain. These cases represent the first documented events of nosocomial epidemy by <i>B</i>. <i>cereus</i> responsible for intra and inter hospitals contaminations. Indeed, contamination of different patients with the same strain of <i>B</i>. <i>cereus</i> was so far never shown. In addition, we propose a scheme for the characterization of <i>B</i>. <i>cereus</i> based on biochemical properties and genetic identification and highlight that main genetic signatures may carry a high pathogenic potential. Moreover, the characterization of antibiotic resistance shows an acquired resistance phenotype for rifampicin. This may provide indication to adjust the antibiotic treatment and care of patients.</p></div

M13-PCR fingerprint patterns of <i>B</i>. <i>cereus</i> strains showing eight possible cross contaminations between patients/patients or patients/environment.

<p>Top panel, lane 1: 1kb DNA ladder. Lane 2: reference strain <i>B</i>. <i>cereus</i> ATCC14579. Lane 2 to 23: <i>B</i>. <i>cereus</i> strains. Bottom: divergence tree between eight samples obtained by hierarchical clustering based on the matrix of pairwise divergences after WGS data.</p