No abstract available.
Cerebral Ventriculitis* ; Enterobacter aerogenes* ; Enterobacter* ; Pefloxacin*

We report a case of symmei.rical peripheral gangrene in a 22-day-old female associated with dissem-inated intravascular coagulation, which probably occured from septicmia of Enterobacter aerogenes. The skin lesions showed well-defined blackish gangrene surrounded by purpuric patches on the whole fingertips and toes except the loft thumb. Histopathologically, there were epidermal necrosis, diffuse extravasation of RBCs, mild petivascular inflammatory infiltrates and delated and RBC-filled vessels in the dermis. But, there was no definite evidence of vasculitis. In spit,e of aggressive antibictics therapy and other supportive measrres, she died at 39th day after birth.
Dermis ; Disseminated Intravascular Coagulation* ; Enterobacter aerogenes ; Female ; Gangrene* ; Humans ; Necrosis ; Parturition ; Skin ; Thumb ; Toes ; Vasculitis

The symmetrical peripheral gangrene syndrome consists of sudden onset of symmetrical gangrene of the fingers, toes and more raely, the nose, upper lip, ear lobes, or genitalia. There is no evidence of occulusion of large vessels or vasculitis. We experienced a case of symmetrical peripheral gangrene developed in fingers and toes with disseminated intravascular coagulation in 20 day-old permature infant with sepsis by Enterobacter aerogenes. Thereafter, we presented a case with a brief review of the related literatures.
Disseminated Intravascular Coagulation* ; Ear ; Enterobacter aerogenes ; Fingers ; Gangrene* ; Genitalia ; Humans ; Infant ; Lip ; Nose ; Sepsis ; Toes ; Vasculitis

BACKGROUND: Carrying antimicrobial resistance genes is a burden to bacteria. Therefore, in the absence of antimicrobial selective pressure, susceptible bacteria are expected to replace resistant ones. The cost was reported to decrease with time, but the effect of different species of susceptible bacteria on extended-spectrum -lactamase (ESBL)-, AmpC beta-lactamase-, and VIM-2 metallo-beta-lactamase-producing gram-negative bacilli are not known. The aim of this study was to determine the effect in vitro. METHODS: Antimicrobial-susceptible and -resistant strains of Escherichia coli, Enterobacter aerogenes, Klebsiella p neumoniae, and Acinetobacter baumannii were subcultured daily in glucose limited minimal salt medium at 30degrees C and 37degrees C, and the numbers of cells (CFU/mL) were determined by culturing on Mueller-Hinton agar and MacConkey agar plates. RESULTS: Continued incubation without subculture of both individual and mixed cultures at 37degrees C showed higher counts of a ESBL-producing K. p neumoniae than a susceptible E. coli. Daily subcultures of two strains in a tube showed the counts were : ESBL-producing K. pneumoniae >susceptible E. coli; susceptible E. aerogenes >ESBL-producing K. p neumoniae; susceptible E. aerogenes >VIM-2-beta-lactamase-producing Acinetobacter baumannii. The counts were similar for susceptible K. p neumoniae and AmpC beta-lactamasehyperproducing E. aerogenes. Initial low count of a susceptible E. coli and an ESBL-producing K. p neumoniae at 30degrees C gradually increased with continued subculture. CONCLUSION: Growth of not all resistant bacteria are slower and the growth improves with continued subculture. Coexistence of a susceptible bacteria with resistant bacteria in GLMS medium both at 30degrees C and 37degrees C does not reduce the number of resistant bacteria.
Acinetobacter baumannii ; Agar ; Anti-Infective Agents* ; Bacteria ; Enterobacter aerogenes ; Escherichia coli ; Glucose ; Klebsiella ; Pneumonia

Nucleoside phosphorylases (NPases) were found to be induced in Enterobacter aerogenes DGO-04, and cytidine and cytidine 5'-monophosphate (CMP) were the best inducers. Five mmol/L to fifteen mmol/L cytidine or CMP could distinctly increase the activities of purine nucleoside phosphorylase (PNPase), uridine phosphorylase (UPase) and thymidine phosphorylase (TPase) when they were added into medium from 0 to 8 h. In the process of enzymatic synthesis of adenine arabinoside from adenine and uracil arabinoside with wet cells of Enterobacter aerogenes DGO-04 induced by cytidine or CMP, the reaction time could be shortened from 36 to 6 h. After enzymatic reaction the activity of NPase in the cells induced remained higher than that in the cells uninduced.
Cytidine ; pharmacology ; Cytidine Monophosphate ; pharmacology ; Enterobacter aerogenes ; enzymology ; Enzyme Induction ; Pentosyltransferases ; biosynthesis ; Vidarabine ; biosynthesis

BACKGROUND: The emerging mobile colistin resistance gene, mcr-1, is an ongoing worldwide concern and an evaluation of clinical isolates harboring this gene is required in Korea. We investigated mcr-1-possessing Enterobacteriaceae among Enterobacteriaceae strains isolated in Korea, and compared the genetic details of the plasmids with those in Escherichia coli isolates from livestock. METHODS: Among 9,396 Enterobacteriaceae clinical isolates collected between 2010 and 2015, 1,347 (14.3%) strains were resistant to colistin and those were screened for mcr-1 by PCR. Colistin minimum inhibitory concentrations (MICs) were determined by microdilution, and conjugal transfer of the mcr-1-harboring plasmids was assessed by direct mating. Whole genomes of three mcr-1-positive Enterobacteriaceae clinical isolates and 11 livestock-origin mcr-1-positive E. coli isolates were sequenced. RESULTS: Two E. coli and one Enterobacter aerogenes clinical isolates carried carried IncI2 plasmids harboring mcr-1, which conferred colistin resistance (E. coli MIC, 4 mg/L; E. aerogenes MIC, 32 mg/L). The strains possessed the complete conjugal machinery except for E. aerogenes harboring a truncated prepilin peptidase. The E. coli plasmid transferred more efficiently to E. coli than to Klebsiella pneumoniae or Enterobacter cloacae recipients. Among the three bacterial hosts, the colistin MIC was the highest for E. coli owing to the higher mcr-1-plasmid copy number and mcr-1 expression levels. Ten mcr-1-positive chicken-origin E. coli strains also possessed mcr-1-harboring IncI2 plasmids closely related to that in the clinical E. aerogenes isolate, and the remaining one porcine-origin E. coli possessed an mcr-1-harboring IncX4 plasmid. CONCLUSIONS: mcr-1-harboring IncI2 plasmids were identified in clinical Enterobacteriaceae isolates. These plasmids were closely associated with those in chicken-origin E. coli strains in Korea, supporting the concept of mcr-1 dissemination between humans and livestock.
Colistin ; Enterobacter aerogenes ; Enterobacter cloacae ; Enterobacteriaceae* ; Escherichia coli* ; Escherichia* ; Genome ; Humans* ; Klebsiella pneumoniae ; Korea* ; Livestock* ; Microbial Sensitivity Tests ; Plasmids* ; Polymerase Chain Reaction

BACKGROUND: This study was conducted to evaluate the impact of the media type used for direct identification of colonies on the surveillance culture of carbapenem-resistant Enterobacteriaceae (CRE) by matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). METHODS: CRE surveillance culture isolates were subjected to species identification using the MALDI Biotyper (Bruker Daltonics, Germany) for 2 months starting in March 2017. Four types of media were evaluated: blood agar (BA), Mueller Hinton agar (MH), MacConkey agar (Mac), and MacConkey agar containing imipenem of 1 µg/mL (IMP-Mac). CRE-like colonies on IMP-Mac and their subculture colonies on the other media were tested after overnight incubation and extended incubation for one additional day. The percent identification and score value were analyzed for each media types and incubation time when the identification was correct at the genus level. RESULTS: A total of 117 isolates were identified as 84 Klebsiella pneumoniae, 12 Escherichia coli, 9 Enterobacter cloacae, 5 Klebsiella oxytoca, 4 Enterobacter aerogenes, and 2 Raoultella ornithinolytica. The successful identification rates (SIR) for BA and MH were 98.3% and 97.4% (P=0.9), respectively, while those for Mac and IMP-Mac were 82.1% (P < 0.001) and 70.9% (P < 0.001), respectively. After extended incubation, SIRs were decreased to 96.6%, 96.6% (P=1.0), 61.5% (P < 0.001), and 58.1% (P < 0.001) on BA, MH, Mac, and IMP-Mac, respectively. The average score values were significantly lower for Mac (2.017±0.22) and IMP-Mac (1.978±0.24) than for BA (2.213±0.16) (P < 0.001). CONCLUSIONS: The low performance of the MALDI Biotyper applied directly to the colonies grown on Mac or IMP-Mac indicates that subculture on BA or MH is preferable before identification by MALDI-TOF MS.
Agar ; Enterobacter aerogenes ; Enterobacter cloacae ; Enterobacteriaceae* ; Escherichia coli ; Imipenem ; Klebsiella oxytoca ; Klebsiella pneumoniae ; Mass Spectrometry ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization*

PURPOSE: This article analyzes the microorganisms and antibiotics susceptibility in dacryocystitis. METHODS: In this study, patients who were diagnosed with acute and chronic dacryocystitis with nasolacrimal duct obstruction were selected and underwent endoscopic endonasal dacryocystorhinostomy. Cultures were obtained from the lacrimal sac during operation from January 2008 to January 2016, and were used to analyze the microorganisms and antibiotics susceptibility. RESULTS: The 67 patients, 9 were diagnosed with acute dacryocystitis and 58 were diagnosed with chronic dacryocystitis. Among them, 64 cases showed bacterial growth (95.5%). The most frequently detected bacteria was Staphylococcus epidermidis (S. epidermidis) (33.8%), followed by Staphylococcus aureus (S. aureus) (25.4%) and Enterobacter aerogenes (18.3%). S. epidermidis had the most powerful resistance to ciprofloxacin compared to the other bacteria (58.3%, p = 0.02). Except for S. epidermidis and S. aureus, the other bacteria responded to ciprofloxacin and gentamycin. CONCLUSIONS: As a causative microorganism of dacryocystitis, S. epidermidis is becoming more prominent, and it is thought that S. epidermidis may be resistant to quinolones (i.e., broad-spectrum antibiotics). This resistance might be increasing the percentage of present S. epidermidis when viewed as a causal pathogen in dacryocystitis.
Anti-Bacterial Agents* ; Bacteria ; Ciprofloxacin ; Dacryocystitis* ; Dacryocystorhinostomy ; Enterobacter aerogenes ; Gentamicins ; Humans ; Nasolacrimal Duct ; Quinolones ; Staphylococcus aureus ; Staphylococcus epidermidis

BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) are increasingly being reported throughout the world, which is a significant problem for patient treatment and infection control. Carbapenem-resistance in Enterobacteriaceae is mainly due to carbapenem-hydrolyzing β-lactamase, which tends to spread through genetic mobile elements. Therefore, the detection of carbapenemase-producing Enterobacteriaceae (CPE) carriers is particularly important for the prevention and epidemiological monitoring of these infections. In this study, we performed surveillance cultures for CPE in patients admitted to the hospital and evaluated the prevalence of CPE. METHODS: Stool cultures were obtained from a total of 228 patients at our tertiary-care hospital between March and May 2017. Stool specimens were inoculated on ChromID CARBA agar (bioMérieux, France) and incubated for 18-24 hours. Suspicious colonies with pink or bluish-green color were screened for CPE by the modified Hodge test (MHT) and carbapenemase inhibition test (CIT). We performed PCR to detect five carbapenemase genes, bla(KPC), bla(IMP), bla(VIM), bla(NDM), and bla(OXA-48). RESULTS: Among 228 isolates, seven were suspicious for CPE: four Klebsiella pneumoniae, one Escherichia coli, one Enterobacter aerogenes, and one Serratia marcescens. Two K. pneumoniae isolates showed positive reactions in both the modified Hodge test and inhibition test with phenylboronic acid. By PCR, bla(KPC) was identified in these two K. pneumoniae isolates. CONCLUSION: Our results showed a very low prevalence (2/228, 0.9%) of CPE in our tertiary-care hospital based on surveillance culture in a recent three month period.
Agar ; Enterobacter aerogenes ; Enterobacteriaceae* ; Epidemiological Monitoring ; Escherichia coli ; Humans ; Infection Control ; Klebsiella pneumoniae ; Pneumonia ; Polymerase Chain Reaction ; Prevalence ; Serratia marcescens

BACKGROUND: Acne is a common follicular inflammatory dermatosis affecting the pilosebaceous unit. The representative organism isolated from the acne lesion is Propionibacterium acnes, but other aerobic organisms, such as Staphylococcus epidermidis have also been isolated. The exact role of aerobic bacteria in the pathogenesis of acne remains controversial, but several reports have shown that these microorganisms are important in the development of acne lesions and affect acne severity by their involvement in the inflammatory process. OBJECTIVE: The purpose of this study was to investigate the clinical features associated with aerobic microorganisms isolated from inflammatory acne and to identify antibiotic resistance. METHODS: We examined the species of bacteria aerobically and anaerobically isolated from patients with inflammatory acne and determined the relationship between antimicrobial resistance of the isolated aerobic organisms and clinical characteristics in 186 patients. RESULTS: P. acnes was cultured in 40.86% of the patients. Enterobacter aerogenes (4.30%), S. capitis species (6.45%), S. aureus (3.76%), S. hominis (2.15%), Serraita marcescens (1.08%), Klebsiella oxitoca (1.08%), S. lugdunensis (1.08%), S. auricularis (0.54%), S. hyicus (0.54%), S. simulans (0.54%), and S. saprophyticus (0.54%) were also cultured. Among the aerobes isolated from lesions, S. epidermidis was the most common (43.0%) and showed higher resistance to gentamicin (57.5%), ampicilin (45.0%), erythromycin (40.0%), and clindamycin (30.0%) than previous reports. The disease duration in the S. epidermidis group resistant to gentamicin, erythromycin, ampicilin, and clindamycin was longer than that in the susceptible group. CONCLUSION: These results revealed the recent increase in antibiotic resistance of S. epidermidis in patients with acne. Antibiotic resistance of aerobes in patients with acne have a tendency to increase based on disease duration.
Acne Vulgaris ; Bacteria ; Bacteria, Aerobic ; Clindamycin ; Drug Resistance, Microbial ; Enterobacter aerogenes ; Erythromycin ; Gentamicins ; Humans ; Klebsiella ; Propionibacterium acnes ; Skin Diseases ; Staphylococcus epidermidis