High cholesterol is one of the important factors inducing cardiovascular and cerebrovascular diseases. Drug therapy is the main method for reducing cholesterol, but has the disadvantages such as high cost and side effects. Studies have shown that intestinal bacteria play important roles in cholesterol metabolism. However, there are few reports on the screening and functional evaluation of cholesterol-lowering intestinal bacteria. In this study, 36 bile-tolerant bacteria were screened from healthy people stool through culturomics using bovine bile acid or artificial mixed bile acids as substrates. Taking Lactobacillus rhamnosus GG (LGG) as a positive control, three bile acid concentration groups (0 g/L, 0.3 g/L, 3 g/L) were set up to evaluate the cholesterol-lowering ability of bile-tolerant bacteria in vitro. Ten bacteria (including Proteus mirabilis, Providencia stuartii, Proteus vulgaris et al) were identified as the dominant cholesterol-lowering bacteria. Six of the above bacteria, Proteus mirabilis, Providencia stuartii, Proteus vulgaris, Proteus penneri, Wohlfahrtiimonas chitiniclastica, Providencia rettger, were evaluated for their ability to reduce triglycerides in vitro and tolerance to artificial gastric juice. Comparing with strain LGG, the six bacteria showed better triglyceride-lowering ability in vitro. With the decrease of pH value of artificial gastric juice and the increase of treatment time, the survival rate of six bacteria decreased. The above screening experiments and functional evaluation provide a basis for further development of potential cholesterol-lowering bacterial products.
Animals ; Cattle ; Cholesterol ; Gammaproteobacteria ; Humans ; Proteus mirabilis ; Providencia

BACKGROUND/AIMS: Providencia species frequently colonize urinary catheters and cause urinary tract infections (UTIs); however, bacteremia is uncommon and not well understood. We investigated the clinical features of Providencia bacteremia and the antibiotic susceptibility of Providencia species. METHODS: We identified cases of Providencia bacteremia from May 2001 to April 2013 at a tertiary care hospital. The medical records of pertinent patients were reviewed. RESULTS: Fourteen cases of Providencia bacteremia occurred; the incidence rate was 0.41 per 10,000 admissions. The median age of the patients was 64.5 years. Eleven cases (78.6%) were nosocomial infections and nine cases (64.3%) were polymicrobial bacteremia. The most common underlying conditions were cerebrovascular/neurologic disease (n = 10) and an indwelling urinary catheter (n = 10, 71.4%). A UTI was the most common source of bacteremia (n = 5, 35.7%). The overall mortality rate was 29% (n = 4); in each case, death occurred within 4 days of the onset of bacteremia. Primary bacteremia was more fatal than other types of bacteremia (mortality rate, 75% [3/4] vs. 10% [1/10], p = 0.041). The underlying disease severity, Acute Physiologic and Chronic Health Evaluation II scores, and Pitt bacteremia scores were significantly higher in nonsurvivors (p = 0.016, p =0.004, and p = 0.002, respectively). Susceptibility to cefepime, imipenem, and piperacillin/tazobactam was noted in 100%, 86%, and 86% of the isolates, respectively. CONCLUSIONS: Providencia bacteremia occurred frequently in elderly patients with cerebrovascular or neurologic disease. Although Providencia bacteremia is uncommon, it can be rapidly fatal and polymicrobial. These characteristics suggest that the selection of appropriate antibiotic therapy could be complicated in Providencia bacteremia.
APACHE ; Adolescent ; Adult ; Aged ; Anti-Bacterial Agents/therapeutic use ; Bacteremia/diagnosis/drug therapy/*microbiology/mortality ; Child ; Cross Infection/diagnosis/drug therapy/*microbiology/mortality ; Cross-Sectional Studies ; Drug Resistance, Bacterial ; Enterobacteriaceae Infections/diagnosis/drug therapy/*microbiology/mortality ; Female ; Hospital Mortality ; Humans ; Incidence ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Predictive Value of Tests ; Providencia/drug effects/*isolation & purification ; Republic of Korea ; Retrospective Studies ; Risk Factors ; *Tertiary Care Centers ; Treatment Outcome ; Young Adult

No abstract available.
Bacteremia/*microbiology ; Cross Infection/*microbiology ; Enterobacteriaceae Infections/*microbiology ; Female ; Humans ; Male ; Providencia/*isolation & purification ; *Tertiary Care Centers

We report a suspicious case of spontaneous bacterial peritonitis (SBP) caused by Providencia rettgeri and Clostridium perfringens in a patient with alcoholic cirrhosis. The patient presented with altered mentality and was taken to the emergency room. He was diagnosed with SBP after abdominal paracentesis and computed tomography and was treated with ceftriaxone and metronidazole. The pathogens were identified under suspicion of polymicrobial infection because of Gram-staining discrepancies between broth from blood culture bottles and colonies on solid media. He died of septic shock despite transfer to the intensive care unit. Although we could not conclude which organism had the leading role in this case of SBP and septicemia, we did verify the importance of Gram staining in a microbiology laboratory in terms of quality assurance.
Ceftriaxone ; Clostridium perfringens* ; Coinfection ; Emergency Service, Hospital ; Humans ; Intensive Care Units ; Liver Cirrhosis, Alcoholic ; Metronidazole ; Paracentesis ; Peritonitis* ; Providencia* ; Sepsis* ; Shock, Septic

A prostatic abscess is a rare, but potentially serious disease. The mainstay of treatment for the prostatic abscess is antibiotic administration and drainage. Here, we experienced a 66-year-old man with a prostatic abscess caused by Providencia rettgeri, which has not been reported as a pathogenic agent of a prostatic abscess. He was cured using antibiotics, without surgical drainage. This case suggests that the appropriate selection of patients for antibiotic therapy may provide an excellent prognosis.
Abscess ; Anti-Bacterial Agents ; Drainage ; Humans ; Prognosis ; Prostate ; Providencia

Providencia rettgeri is a member of Enterobacteriacea that is known to cause urinary tract infection (UTI), septicemia, and wound infections, especially in immunocompromised patients and in those with indwelling urinary catheters. We experienced a case of UTI sepsis by Providencia rettgeri in a patient with spinal cord injury. The patient had only high fever without urinary symptoms or signs after high dose intravenous methylprednisolone. The laboratory results showed leukocytosis (21,900/microL, segmented neutrophils 91.1%) and pyuria. Cefepime was given empirically and it was switched to oral trimethoprim-sulfamethoxazole because P. rettgeri was identified from blood and urine culture which was susceptible to TMP-SMX. The patient was improved clinically but P. rettgeri was not eradicated microbiologically. To the best of our knowledge, this is the first case report on sepsis caused by Providencia rettgeri in Korea.
Cephalosporins ; Fever ; Humans ; Immunocompromised Host ; Korea ; Leukocytosis ; Methylprednisolone ; Neutrophils ; Providencia ; Pyuria ; Sepsis ; Spinal Cord Injuries ; Trimethoprim, Sulfamethoxazole Drug Combination ; Urinary Catheters ; Urinary Tract Infections ; Wound Infection

BACKGROUND: VIM-2 type metallo-beta-lactamase (MBL) producing strains are presently spreading to Pseudomonas spp., Acinetobacter spp. and even to Enterobacteriaceae such as Serratia marcescens, Enterobacter cloacae and Klebsiella pneumoniae in Korea. Recently we determined the phenotype and the genotype of three MBL-producing Providencia rettgeri isolated from urinary specimen of three patients with neurosurgical ward, and analyzed the blaVIM-2 containing integron of a P. rettgeri CBU852. METHODS: EDTA-disk synergy test was used for the screening of MBL, and the PCR for blaIMP-1, blaVIM-1 and blaVIM-2 was performed. The minimal inhibitory concentration of those isolates was determined by broth microdilution method, and the genomic DNA fingerprinting analysis was performed by random amplified polymorphic DNA (RAPD). The sequence of the blaVIM-2 containing integron was determined. RESULTS: Three P. rettgeri with reduced imipenem susceptibility showed the positive EDTA-disk synergy test and blaVIM-2 was detected by PCR. Antimicrobial susceptibility test showed the resistance to all beta-lactams tested, ciprofloxacin and aminoglycoside such as gentamicin, tobramycin and amikacin, indicating multidrug resistance of those isolates. RAPD analysis showed the identical DNA fingerprint of those three isolates. The novel class 1 integron, including aacA4, blaVIM-2, orf "ii" and orf "iii", was detected in a P. rettgeri CBU852. CONCLUSIONS: In this study, the multidrug resistant P. rettgeri CBU852 had blaVIM-2 containing novel class 1 integron. The emergence of blaVIM-2 producing P. rettgeri could compromise the use of carbapenem in treatment of infections caused by MBL producing bacteria. To our knowledge, this is the first report that VIM-2 MBL gene has been detected in P. rettgeri.
Acinetobacter ; Amikacin ; Animals ; Bacteria ; beta-Lactams ; Ciprofloxacin ; DNA ; DNA Fingerprinting ; Drug Resistance, Multiple ; Ecthyma, Contagious ; Enterobacter cloacae ; Enterobacteriaceae ; Genotype ; Gentamicins ; Humans ; Imipenem ; Integrons ; Klebsiella pneumoniae ; Korea ; Mass Screening ; Phenotype ; Polymerase Chain Reaction ; Providencia* ; Pseudomonas ; Serratia marcescens ; Tobramycin

BACKGROUND: At antimicrobial susceptibility testing (AST), clinical isolates may appear susceptible sometimes to the antibiotics that are clinically ineffective or due to technical errors in the testing. So an interpretive reading of AST should be done, but most hospitals do not perform it routinely. Here, we developed and evaluated a computerized expert system to interpret AST of Enterobacteriaceae to beta-lactam antibiotics. METHODS: We made a rule-based expert system according to the natural resistance of the members of Enterobacteriaceae and the common phenotypes of resistance mechanisms for Enterobacteriacae. Antimicrobial suceptibility testings were performed using the disk diffusion method with 12 beta-lactam antibiotics for a total of 1, 016 clinical isolates. Then we compared the raw and expert results of AST. RESULTS: An overall discrepancy rate due to natural resistance was 5.9%; 10.4% for Klebsiella spp. and Citrobacter diversus, 15.0% for Enterobacter spp., 2.6% for Serratia marcescens, 31.6% for Morganella morganii and Providencia stuartti. Accoriding to acquired antimicrobial resistant mechanisms, overall resistant discrepancy was 21.8%; 18.8% for Escherichia coli, Proteus mirabilis, Salmonella and Shigella spp., 25.9% for Citrobacter diversus and Klebsiella spp., 21.6% for Citrobacter freundii and Enterobacter spp., 45.6% for Morganella morganii, 10.0% for Proteus vulgaris, 12.2% for Serratia spp.. CONCLUSIONS: These results indicate that the application of the expert system for interpretation of antimicrobial susceptibility test may provide more reliable data for the treating physician. Additional information should be applied on the software for new resistant mechanisms or some misinterpretive readings.
Anti-Bacterial Agents ; beta-Lactams* ; Citrobacter freundii ; Citrobacter koseri ; Diffusion ; Enterobacter ; Enterobacteriaceae* ; Escherichia coli ; Expert Systems* ; Immunity, Innate ; Klebsiella ; Morganella morganii ; Phenotype ; Proteus mirabilis ; Proteus vulgaris ; Providencia ; Reading ; Salmonella ; Serratia ; Serratia marcescens ; Shigella

BACKGROUND AND OBJECTIVES: It is important to know the current trend of resistance rate and species of pathogens in order to select appropriate antibiotics in the management of chronic suppurative otitis media. The purpose of this study is to investigate the current bacteriology of chronic supprative otitis media. SUBJECTS AND METHOD: A retrospective study was performed on the bacteriologic results of 169 out-patients of chronic otitis media with otorrhea who visited the department of otolaryngology at the Kyung Hee Medical Center from Jan 2000 to Dec 2002. RESULTS: The most common pathogenic organisms were Staphylococcus, Pseudomonas, Proteus and Providencia. The prevalence of MRSA was found to be 61.0 per cent of isolated Staphylococcus aureus. CONCLUSION: We investigated the current bacteriology of chronic suppurative otitis media and could not find remarkable changes in comparison with the results reported recently. Continuous and periodic studies on bacteriology and sensitivity tests should be performed for effective treatment of chronic suppurative otitis media.
Anti-Bacterial Agents ; Bacteriology* ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Otitis Media ; Otitis Media, Suppurative* ; Otolaryngology ; Outpatients ; Prevalence ; Proteus ; Providencia ; Pseudomonas ; Retrospective Studies ; Staphylococcus ; Staphylococcus aureus

Providencia stuartii is occasionally isolated from patients with chronic otitis media, however it has not been reported as a cause of acute otitis media so far. We recently isolated P. stuartii from the pus specimen of right middle ear of a 2-year-old patient with acute otitis media. The patient was admitted because of right-sided otorrhea for 2 weeks. The symptom was not relieved by first-line empirical antibiotics (amoxicillin-clavulanic acid and netilmicin), but it was subsided dramatically with the changed antibiotics (ceftriaxone and amikacin); the isolate was susceptible to these two antibiotics in in vitro susceptibility testing. To our knowledge, this is the first case report of acute otitis media caused by P. stuartii.
Anti-Bacterial Agents ; Child, Preschool ; Ear, Middle ; Humans ; Otitis Media* ; Otitis* ; Providencia* ; Suppuration