Variability of pMGA/vlhA sequences among Mycoplasma gallisepticum field strains isolated from laying hens and their deformed eggs.
Mycoplasmosis attributed to Mycoplasma gallisepticum poses a significant challenge to poultry farming leading to substantial economic losses and persistent infections within flocks. This bacterium harbors various surface proteins that are crucial for the adhesion transporter activity and evasion of the host immune response facilitating its pathogenicity. One such key surface lipoprotein referred to as pMGA or vlhA hemagglutinin plays a pivotal role in adhesion processes. In this study the clonal regions pMGA1.2 and pMGA1.3 as reported by Markham (M83178.1) were investigated to elucidate differences or similarities in the whole DNA sequences of Myc. gallisepticum field strains. The aim was to analyze sequence diversity within this region. Six internal primers were designed to amplify the target sequence and isolates were obtained from both eggs and chickens sourced from laying hen flocks. Identification revealed 17 strains of Myc. gallisepticum and four strains of Myc. synoviae which were confirmed through the mgc2 and 16S rRNA genes respectively. Positive and negative controls were established using the MGS6 and MSWUV1853 strains. Amplification results indicated a higher frequency of amplification proximal to the C-terminal region with segments 4 (33.3%) and 6 (27.8%) being the most prevalent. Notably none of the field strains exhibited the same amplification pattern as MGS6 and none of the strains characterized as Myc. synoviae amplified any primer set.
Upon translation the amino acid sequences from segments 4 and 6 were found to be compatible with conserved sequences within the Myco_haema protein domains of the genus Mycoplasma specifically corresponding to Q7NAP3_MYCGA VlhA.3.04. The observed homology suggests a potential genetic transfer while the variability identified in the pMGA or vlhA gene region of the field strains may have significant implications for protection against Myc. gallisepticum infection in chickens.
Exceptional association of two species of bacteria causing acute appendicitis: Haemophilus influenzae and Enterobacter cloacae
Appendicitis typically caused by appendiceal lumen obstruction is a prevalent abdominal surgical emergency worldwide. While most cases involve Enterobacterales Haemophilus influenzae primarily known for upper respiratory infections is infrequently associated with gastrointestinal infections. This article presents an exceptional case of acute appendicitis caused by both Haemophilus influenza and Enterobacter cloacae in a 15-year-old child highlighting the significance of recognizing uncommon pathogens in appendicitis and emphasizing the necessity for thorough microbiological investigations to refine diagnostic approaches.
Exploration and characterization of a newly isolated bacterium, Enterobacter quasihormaechei strain BDIFST24001, capable of producing rhamnolipids biosurfactant for oil remediation
Biosurfactants are naturally occurring compounds synthesized by microorganisms that increasingly attract attention due to both their living area and application in various industries. In this study we explore and characterize a novel bacterium Enterobacter quasihormaechei strain BDIFST24001 isolated for its ability to produce rhamnolipids biosurfactants with the aim of facilitating oil remediation processes. The isolation of this bacterium was carried out using Luria-Bertani broth (LB) media from environmental samples collected from oil-contaminated sites in Dhaka city. Screening tests including the oil spreading method and drop collapse assay were conducted to identify potential biosurfactant-producing strains leading to the selection of E. quasihormaechei strain BDIFST24001 based on its favorable performance. Subsequent molecular identification revealed a high similarity of the strain's 16S rRNA gene to E. quasihormaechei which was corroborated through phylogenetic analysis. Further analysis of the biosurfactant produced by this strain indicated its rhamnolipids nature as confirmed by FT-IR spectroscopy. The rhamnolipids exhibited promising surface-active properties including a significant reduction in surface tension and emulsification activity as evidenced by surface tension measurements and emulsification index assays. Optimization studies revealed that the optimal conditions for rhamnolipids production by E. quasihormaechei strain BDIFST24001 were a temperature of 37°C pH 10.0 and salinity of 4%. The rhamnolipids produced by this strain demonstrated effective oil remediation capabilities as observed through controlled experiments using petrol oil. The rhamnolipids effectively reduced the surface tension of the oil-water interface facilitating the dispersion and emulsification of the oil phase in water. Overall our findings highlight the potential of E. quasihormaechei strain BDIFST24001 as a promising candidate for biosurfactant-mediated oil spill cleanup and environmental remediation efforts.
Human Metapneumovirus (hMPV): An associated etiology of Severe Acute Respiratory Infection in Children of Eastern Uttar Pradesh, India.
Acute respiratory infections (ARIs) are a serious public health concern across the world causing considerable morbidity and mortality. Every year around 13 million children under the age of five die. Approximately 95% of them are from developing nations and ARIs are responsible for one-third of all deaths. Human Metapneumovirus (hMPV) is one of the causative agents associated with respiratory tract infections. There is lack of information about hMPV from the eastern region of Uttar Pradesh. In our centre Indian Council of Medical Research- Regional Medical Research Centre Gorakhpur (ICMR‐RMRC Gorakhpur) at Gorakhpur Uttar Pradesh India; we tested for respiratory pathogens in under-five patients presenting with ARI and severe acute respiratory illness (SARI) through semi nested PCR. A total of 100 nasal and throat specimens were collected from the OPD and IPD of Department of Paediatrics BRD Medical College Gorakhpur during from February 2022 to April 2022. Out of 100 enrolled pediatric patients 4 (4%) were found to be positive. Among the patients who tested positive for hMPV 25% (1/4) patient unfortunately died. The phylogenetic analysis of hMPV showed the close resemblance with the clade of Singapore and USA hMPV isolates. Our work underlines the importance of hMPV as the cause of acute respiratory infections in children and the need for routine testing for this virus in laboratories. Further comprehensive information regarding the incidence of hMPV in this area is needed.
Genome sequencing and analysis of Salmonella enterica subsp. enterica serotype Enteritidis PT4 578
Salmonella enterica serotype Enteritidis is a generalist serotype that adapts to different hosts and transmission niches. It has significant epidemiological relevance and is among the most prevalent serotypes distributed in several countries. Salmonella Enteritidis causes self-limited gastroenteritis in humans which can progress to systemic infection in immunocompromised individuals. Poultry products are considered significant reservoirs of many Salmonella serotypes and Salmonella Enteritidis infections are often related to the consumption of chicken meat and eggs. This study reports the whole-genome sequence of Salmonella Enteritidis PT4 strain 578. A total of 165 genes (3.66%) of the 4506 coding sequences (CDS) predicted in its genome are virulence factors associated with cell invasion intestinal colonization and intracellular survival. The genome harbors twelve Salmonella pathogenicity islands (SPIs) with the SPI-1 and SPI-2 genes encoding type III secretion systems (T3SS) showing high conservation. Six prophage-related sequences were found with regions of intact prophages corresponding to Salmon_118970_sal3 and Gifsy-2. The genome also contains two CRISPR systems. Comparative genome analysis with three other serotypes of Salmonella demonstrates that most unshared genes are related to metabolism membrane and hypothetical proteins. Finally the phenotypic characterization evidenced differences among Salmonella Enteritidis PT4 578 and the other three serotypes regarding the expression of the red dry and rough (rdar) morphotype and biofilm formation. Overall the genomic characterization and phenotypic properties expand knowledge of the mechanisms of pathogenicity in Salmonella Enteritidis PT4 578.
Brief Report: Nasal colonization with Staphylococcus aureus and Methicillin resistant Staphylococcus aureus among community-dwelling older adults with comorbidities seeking follow-up medical care in Central Sri Lanka.
Older adults are more severely affected by infections caused by drug-resistant bacteria including Methicillin-Resistant Staphylococcus aureus (MRSA). We aimed to identify the MRSA colonization rates and associated factors among older adults aged more than 65-years-old. Among the 309 recruited 152 (49.2%) were males. Self-collected nasal swabs were used to isolate Staphylococcus aureus and MRSA with routine microbiological methods. Staphylococcus aureus was isolated from 36 (11.7%) participants while 11 (3.6%) were colonized with MRSA. We identified a significant association between the male sex and MRSA colonization (p=0.028 Chi-square test). However this needs careful interpretation given the smaller number of outcome events. Other factors studied had no statistically significant association with MRSA colonization.
Title of Manuscript: Prevalence of SARS- CoV-2 virus in saliva, stool, and urine samples of COVID-19 patients in Bihar, India
Introduction: The coronavirus illness caused by SARS- CoV-2 can cause multiple organ involvement with varying degrees of severity. Besides inhalation as a route for transmission feco-oral has also been proposed. Its transmission to sewage systems is a growing public health issue.
Objective: To detect SARS-CoV-2 RNA in non-respiratory samples (saliva urine and stool) collected from COVID-19 cases in Bihar.
Materials and methods: This Cross-Sectional observational study was conducted from January 2021 to March 2022 on human non-respiratory samples. A total of 345 samples including saliva (116) stool (97) and urine (132) were collected from 143 covid-19 cases. Samples were analyzed for SARS-CoV-2 by multiplex RT-PCR targeted against E ORF 1ab and RdRp gene.
Results: In this study out of 143 cases a total of 107(74.8%) were positive for SARS-CoV-2 RNA in at least one of the non-respiratory samples.
Conclusion: There is a high prevalence of SARS-CoV-2 virus in non-respiratory samples.
HIV combined with skin infection of Nocardia brasiliensis: A rare case report
Introduction. The HIV virus can attack and gradually damage the human immune system causing the host to be unprotected when infected. Nocardia is a type of opportunistic pathogenic bacteria that can easily cause infections in patients with chronic wasting diseases immune dysfunction and the use of immunosuppressants. Nocardia can invade various tissues and parts of the body causing corresponding clinical symptoms. There are few reports of HIV patients being infected with Brazilian Nocardia.
Case presentation. This article reports a case of an HIV patient with concurrent infection with Brazilian Nocardia. A patient with HIV developed a lump on the surface of their left skin without any obvious cause. Due to improper disinfection and treatment methods the condition worsened and they subsequently sought medical attention at our hospital. A series of laboratory related tests are conducted clinically based on the patient's medical history symptoms and signs. Based on the test results a reasonable treatment plan was adopted clinically ultimately achieving satisfactory treatment outcomes for patients.
Conclusion. HIV patients are prone to various types of infections even rare bacteria as their immune function decreases. With the popularity of new identification methods such as mass spectrometry laboratories should pay attention to traditional staining methods and use microscopes to detect pathogens.
Genome sequence of the plant-growth-promoting bacterium Bacillus velezensis EU07
Many Gram-positive spore-forming rhizobacteria of the genus Bacillus show potential as biocontrol biopesticides that promise improved sustainability and ecological safety in agriculture. Here we present a draft-quality genome sequence for Bacillus velezensis EU07 which shows growth-promotion in tomato plants and biocontrol against Fusarium head blight. We found that the genome of EU07 is almost identical to that of the commercially used strain QST713 but identified 46 single-nucleotide differences that distinguish these strains from each other. The availability of this genome sequence will facilitate future efforts to unravel the genetic and molecular basis for its beneficial properties.
Development of Recombinant Proteins for Vaccine Candidates Against Serotype O and A of Foot and Mouth Disease Virus in Bangladesh
Frequent vaccine failure leading to recurrent outbreaks of Foot-and-Mouth Disease (FMD) in livestock populations necessitates the development of a customizable vaccine platform comprising potential antigenic determinants of circulating lineages of FMD viruses. Artificially designed chimeric peptide-based recombinant vaccines are novel approaches to combat the phylogenetically diverse FMD Virus (FMDV) strains. Among seven recognized serotypes only serotypes O and A are dominantly circulating in Bangladesh and neighboring countries of Asia where transboundary transmission recurrent outbreaks and emergence of novel lineages of FMDV are highly prevalent. The objective of this study was to develop multi-epitope recombinant peptides procuring immunogenicity against circulating diverse genotypes of FMDV serotypes O and A. Two chimeric peptides named B1 (41.0 kDa) and B3 (39.3 kDa) have been designed to incorporate potential B-cell and T-cell epitopes selected from multiple FMDV strains including previously reported and newly emerged sub-lineages. After expression characterization and immunization of guineapigs with considerable antigen load of B1 and B3 followed by the serological assays revealed the significant protective immunogenicity developed from the higher (100 µg) doses of both antigens against most of the currently prevalent serotype O and A strains of FMDV. The efficient expression antigenic stability and multivalent immunogenic potency of the chimeric peptides strongly indicate their credibility as novel vaccine candidates for existing serotypes O and A of FMDV in Bangladesh and surrounding territories.
Deciphering the interaction surface between the West Nile virus NS3 and NS5 proteins
West Nile virus (WNV) is the most prevalent mosquito-borne disease and the leading cause of viral encephalitis in the continental United States. It belongs to the Flavivirus family which includes other important human pathogens such as dengue virus (DENV) Japanese encephalitis virus (JEV) and Zika viruses (ZIKV). Despite several decades of research no specific antiviral drugs are available to treat Flavivirus infections. The present study characterizes the interaction between the WNV NS3 and NS5 proteins for the purpose of identifying hotspots in the protein-protein interaction which could be targeted for the development of antiviral therapeutics. We previously developed an interaction model in silico based on data available in the literature. Here potential interacting residues on NS3 and NS5 were mutated in a WNV replicon and seven mutations in the NS3 protein were found to drastically reduce viral replication. In addition to being well conserved among mosquito-borne Flaviviruses these residues are located on the protein’s surface in two clusters which might be interesting new targets for future drug development.
An Evaluation of ChatGPT and Bard (Gemini) in the Context of Biological Knowledge Retrieval
ChatGPT and Bard (now called Gemini) two conversational AI models developed by OpenAI and Google AI respectively have garnered considerable attention for their ability to engage in natural language conversations and perform various language-related tasks. While the versatility of these chatbots in generating text and simulating human-like conversations is undeniable we wanted to evaluate their effectiveness in retrieving biological knowledge for curation and research purposes. To do so we asked each chatbot a series of questions and scored their answers based on their quality. Out of a maximal score of 24 ChatGPT scored 5 and Bard scored 13. The encountered issues included missing information incorrect answers and instances where responses combine accurate and inaccurate details. Notably both tools tend to fabricate references to scientific papers undermining their usability.
In light of these findings we recommend that biologists continue to rely on traditional sources while periodically assessing the reliability of ChatGPT and Bard. As ChatGPT aptly suggested for specific and up-to-date scientific information established scientific journals databases and subject-matter experts remain the preferred avenues for trustworthy data.
Detection and significance of anti-Mycobacterium tuberculosis specific IgG antibody response for the diagnosis of pulmonary tuberculosis using enzyme-linked immunosorbent assay
Objective: Evaluation of an ELISA test for detection of IgG antibody response using in-house prepared Mycobacterium tuberculosis H37Rv soluble extract (MTSE) as antigen for rapid diagnosis of pulmonary tuberculosis and its clinical usefulness.
Methods: In this study a total of 758 pulmonary tuberculosis (TB) patients (652 AFB-positive and 106 AFB-negative) 276 healthy controls and 43 pulmonary infectious disease controls other than TB were recruited. IgG antibody level against MTB soluble extract was measured in sera samples of all study groups using an ELISA test. The level of IgG antibody responses was compared among groups by the Kruskal-Wallis test. The pairwise comparison was made by the Mann-Whitney test A positive score was represented by optical density above the cut–off value which was calculated from OD values of healthy controls by adding 2SD to the mean OD value. The evaluation of diagnostic value was considered based on sensitivity and specificity.
Results: Significantly higher levels of IgG antibody response were observed in PTB patients compared to healthy control and non-TB other pulmonary infectious disease control groups (p value<0.0001). The percent positivity for the IgG antibody response was higher in AFB-positive 574/652 (88.04%) and 79/106 (74.53%) AFB-negative PTB patients as compared to healthy control 9/276 (3.26%) and non-TB other pulmonary infectious disease control 3/43 (6.97%). The sensitivity of the test in PTB patients (AFB-positive and AFB-negative) was 86.15% (95% CI; 83.48-88.53) and the specificity was 96.74% (95% CI; 93.90-98.50).
Conclusion: This developed immunological test could be an efficient test in detecting IgG antibody response in PTB patients. Further this test could be useful for diagnosing AFB-negative presumptive TB cases.
Xanthomonas citri pv. eucalyptorum 4866-2_S43 strain (formerly X. axonopodis pv. eucalyptorum): Causal agent of bacterial leaf blight on eucalypt recovered in Argentina
We report here a draft genome assembly of strain 4866-2_S43 isolated from a eucalyptus lesion in Argentina and what until recently was caused by Xanthomonas axonopodis pv. eucalyptorum (Xae). The genome size is 5188607 bp with a G+C content of 64.66%. Comparative analysis reveals that the closest relative of strain 4866-2_S43 is Xae LPF 602 isolated in Brazil. Comparison of the whole genome sequences revealed an average nucleotide identity (ANI) of 99.96%. between the two strains. ANIs were determined between the whole genome sequence of strain 4866-2_S43 and the genomes of all currently validated Xanthomonas spp. These results revealed that strain 4866-2_S43 had greater than 95% with X. citri pv. citri and X. citri pv. phaseoli and less than 95% with X. euvesicatoria pv. alfalfae X. perforans and X. euvesicatoria pathovars euvesicatoria and eucalyptii.
PATHOGENECITY AND ENZYME SCREENING OF SOME SELECTED NON-DERMATOPHYTIC MOLDS
A total of 10 non-dermatophytic molds isolated from both symptomatic and asymptomatic cattle skin which includes Penicillum citrinum Aspergillus welwitschiae Aspergillus aculeatus Curvularia kusanol Cladosporium teniussmum Pestalotiopsis microspora Fusarium oxysporum Fusarium linchenicola Absidia sp. and Aspergillus fumigatuswere subjected to a pathogenicity test using albino mice. These isolates were also screened for five enzymes using standard plate method. Result from pathogenicity test showed that Absidia sp C. tenuissimum and Aspergillus welwitschiae were able to elicit discoloration lesion production and alopecia on the albino mice skin respectively which are evidences of clinical symptoms associated of cutaneous mycoses. The enzyme screening results revealed the highest zone of activity for keratinase (65mm) amylase (86mm) protease (60mm) lipase (60mm) and cellulase (86mm) which were observed on P. microspora A. welwitschiae C. tenuissimum A. welwitschiae and A. welwitschiae respectively. Pathogenicity test from this study shows that some of these molds may be virulent and that can be attributed to their ability to possess some virulent factors which includes secretion of hydrolytic enzymes.
Inducible clindamycin resistance among clinical Gram-positive cocci in a tertiary hospital in Niger Republic
Background. Macrolide-induced resistance to clindamycin is a well-described mechanism leading to treatment failure. Herein we determined the frequency and associated factors of inducible clindamycin resistance in Gram-positive cocci in a tertiary care hospital.
Methods. A cross-sectional descriptive study was carried out between January and December 2022. D tests were performed as recommended by EUCAST 2021 guidelines on 100 non-duplicate clinical isolates of Gram-positive cocci to determine the prevalence of methicillin resistance and inducible clindamycin resistance among the collected isolates.
Results. Of the 100 Gram-positive cocci isolates 56 (56.0 %) 17 (17.0 %) and 27 (27.0 %) were respectively coagulase-negative staphylococci Staphylococcus aureus and Streptococcus spp. Among Streptococcus spp. Group D Streptococci (15.0%) were the most isolated. Methicillin-resistant Staphylococcus aureus (MRSA) represented 9 (53.0 %) of S.aureus isolates. Constitutive (cMLSb) and inducible clindamycin resistance (iMLSb) phenotypes were detected in 36 (36.0%) and 14 (140%) of the isolates respectively. S. aureus exhibited 38.4% of cMLSb and 13.7% of iMLSb. The result of multivariate analysis showed that age groups gender type of samples provenance and bacteria were not significantly associated with Gram-positive cocci iMLSb phenotype.
Conclusion. The study reported for the first time a high prevalence of inducible resistance of Gram-positive cocci strains to clindamycin in Niger Republic. This suggests the urgent need for the implementation of regular screening of these isolates and the wise use of clindamycin in clinical practice.
Erysipelothrix spp. and other Erysipelotrichales detected by 16S rRNA microbial community profiling in samples from healthy conventionally reared chickens and their environment
Outbreaks of erysipelas a disease caused by infection with Erysipelothrix rhusiopathiae (ER) is a re-emerging problem in cage-free laying hen flocks. The source of ER infection in hens is usually unknown and serological evidence has indicated the presence of ER or other antigenically related bacteria also in healthy flocks. The aim of the present study was to evaluate sample collection culture methods and DNA-based methodology to detect ER and other Erysipelotrichales in samples from healthy chickens and their environment.
We used samples from a research facility with conventionally reared chickens with no history of erysipelas outbreaks where hens with high titers of IgY recognising ER previously have been observed. Microbial DNA was extracted from samples either directly or after pre-culture in nonselective or ER-selective medium. Real-time PCR was used for detection of Erysipelothrix spp. and high-throughput amplicon sequencing of 16S rRNA sequencing was used for detection of Erysipelotrichales. A pilot serological analysis of some Erysipelotrichales members with IgY from unvaccinated and ER vaccinated high biosecurity-chickens as well as conventionally reared chickens was also performed.
All samples were negative for ER E. tonsillarum and E. piscisicarius by PCR analysis. However 16S rRNA community profiling indicated the presence of several Erysipelotrichales genera in both environmental samples and chicken intestinal samples including Erysipelothrix spp. that were detected in environmental samples. Sequences from Erysipelothrix spp. were most frequently detected in samples pre-cultured in ER-selective medium. On species level the presence of E. anatis and/or E. aquatica was indicated. Serological results indicated that IgY raised to ER showed some cross-reactivity with E. anatis. Hence environmental samples pre-cultured in selective medium and analysis by 16S rRNA sequencing proved a useful method for detection of Erysipelotrichales including Erysipelothrix spp. in chicken flocks. The observation of such bacteria in environmental samples offers a possible explanation for the observation of high antibody titres to ER in flocks without a history of clinical erysipelas.
Galleria mellonella as a superficial model for Malassezia globosa and its treatment
Introduction. Malassezia globosa is a yeast species that belongs to the mycobiota of humans and animals associated with dermatological disorders such as dandruff. This is a chronic scalp skin disorder characterized by flaking and itching. Treatments include commercial shampoo with different formulations that contain antifungal activities like Zinc pyrithione or Piroctone Olamine. The effectiveness of these formulations have been evaluated for decades for dandruff symptom relief of volunteers. To date non-mammalian in-vivo methods exist to test formulations of these actives.
Aim. To evaluate in vivo in Galleria mellonella larva two commercial antifungal shampoos (Shampoo with 1% ZPT & 1.6% Zinc Carbonate and shampoo with 0.5% PO) against this species.
Methodology. G. mellonella larvae were inoculated with M. globosa on abraded cuticular surface. Then integument cell viability histological changes and fungal burden were evaluated.
Results. Larvae inoculated with M. globosa showed higher lesion melanization and tissue damage. In addition M. globosa population showed to increase over time. Concerning the shampoo’s effectiveness both formulations significantly reduced M. globosa burden and tissue damage.
Conclusion. G. mellonella larvae were allowed to evaluate M. globosa superficial infection and antifungal effectiveness. Shampoos with ZPT and PO showed a positive effect on inoculated larvae.
Retrospective analysis of Acinetobacter baumannii bacteraemia risk factors, complications, and mortality in a tertiary university hospital in Saudi Arabia
Introduction. Acinetobacter baumannii is a nosocomial pathogen of which many isolates are multidrug resistant. A. baumannii is a major cause of healthcare-acquired infections in patients who are critically ill and A. baumannii bacteraemia (ABB) is associated with high mortality. Several factors are known to play a role in A. baumannii transmission and the emergence of resistance.
Aim. This study aimed to retrospectively analyse ABB cases in Saudi Arabia where little is known about the prevalence risk factors clinical disease treatment outcomes and mortality associated with this infection.
Methods. A retrospective chart review was performed from January 1 2015 until December 31 2022 to identify all patients 14 years and above with ABB. Demographic and clinical data as well as results from laboratory analyses were collected from patients’ electronic charts. Statistical analyses were performed on the data to identify factors associated with 90-day mortality.
Results. In total 112 ABB cases were identified with a mean age of 58.0 years of which 66.1% were males. Of these cases 71 (63.4%) died. The factors that were found to be associated with 90-day mortality were the Charlson comorbidity score Pitt bacteraemia score quick Sequential Organ Failure Assessment (qSOFA) score (p < 0.001 for each) hospital ward (p < 0.02) short duration of antibiotic treatment (p < 0.01) and higher age (p < 0.05). The most common source of infection was Central Line-associated Bloodstream Infection in 52.7%. Also associated with mortality were inappropriate antimicrobial therapy (p < 0.02) and empirical use of colistin (p < 0.05). In many patients ABB was caused by carbapenem-resistant A. baumannii (CRAB) (69.6%) and 74.4% of those patients died.
Conclusion. CRAB is a growing threat in hospitals in Saudi Arabia especially in the critical care setting and carries a very high risk of mortality. Future studies should focus on novel ways of preventing CRAB infections and on the assessment of promising new antimicrobials such as cefiderocol or sulbactam-durlobactam and other treatment options such as bacteriophages.
Fatal Clostridium septicum gas gangrene complicating ECMO : case report and review of literature
Clostridium septicum gas gangrene is a severe and deadly infection caused by an anaerobic spore-forming Gram-positive bacillus. As previously described two entities are observed: traumatic and spontaneous (or non-traumatic) forms. In this report we aim to describe the case of a fulminant and ultimately fatal C. septicum myonecrosis occurring in a patient who was first admitted for refractory cardiac arrest and placed on veino-arterial extracorporeal membrane oxygenation (ECMO). Building upon prior studies that have documented cases of spontaneous gas gangrene caused by C. septicum we provide an updated compilation focusing on microbiological characteristics of C. septicum along with the diagnostic and therapeutic challenges associated with spontaneous gas gangrene. Additionally the specific clinical situation of our case illustrates the seriousness of this infectious complication that combined both spontaneous and traumatic gas gangrene risk factors. We thus discuss the antibiotic coverage prior to the initiation of ECMO procedure.