Molecular investigation of isolates from a multistate polymicrobial outbreak associated with contaminated total parenteral nutrition in Brazil

Pillonetto, Marcelo; Arend, Lavinia; Gomes, Suzie M. T.; Oliveira, Marluce A. A.; Timm, Loeci N.; Martins, Andreza F.; Barth, Afonso L.; Mazzetti, Alana; Hersemann, Lena; Smits, Theo H. M.; Mira, Marcelo T.; Rezzonico, Fabio

doi:10.21256/zhaw-4685

Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-4685

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	Molecular investigation of isolates from a multistate polymicrobial outbreak associated with contaminated total parenteral nutrition in Brazil
Authors:	Pillonetto, Marcelo Arend, Lavinia Gomes, Suzie M. T. Oliveira, Marluce A. A. Timm, Loeci N. Martins, Andreza F. Barth, Afonso L. Mazzetti, Alana Hersemann, Lena Smits, Theo H. M. Mira, Marcelo T. Rezzonico, Fabio
DOI:	10.21256/zhaw-4685 10.1186/s12879-018-3287-2
Published in:	BMC Infectious Diseases
Volume(Issue):	18
Issue:	397
Page(s):	1
Pages to:	11
Issue Date:	13-Aug-2018
Publisher / Ed. Institution:	BioMed Central
ISSN:	1471-2334
Language:	English
Subjects:	Acinetobacter baumannii; Rhizobium radiobacter; Rep-PCR; Bacterial identification; Phytobacter diazotrophicus; Pantoea; TPN
Subject (DDC):	570: Biology 616: Internal medicine and diseases
Abstract:	Background: Between November 2013 and June 2014, 56 cases of bacteremia (15 deaths) associated with the use of Total Parenteral Nutrition (TPN) and/or calcium gluconate (CG) were reported in four Brazilian states. Methods: We analyzed 73 bacterial isolates from four states: 45 from blood, 25 from TPN and three from CG, originally identified as Acinetobacter baumannii, Rhizobium radiobacter, Pantoea sp. or Enterobacteriaceae using molecular methods. Results: The first two bacterial species were confirmed while the third group of species could not be identified using standard identification protocols. These isolates were subsequently identified by Multi-Locus Sequence Analysis as Phytobacter diazotrophicus, a species related to strains from similar outbreaks in the United States in the 1970’s. Within each species, TPN and blood isolates proved to be clonal, whereas the R. radiobacter isolates retrieved from CG were found to be unrelated. Conclusion: This is the first report of a three-species outbreak caused by TPN contaminated with A. baumannii, R. radiobacter and P. diazotrophicus. The concomitant presence of clonal A. baumannii and P. diazotrophicus isolates in several TPN and blood samples, as well as the case of one patient, where all three different species were isolated simultaneously, suggest that the outbreak may be ascribed to a discrete contamination of TPN. In addition, this study highlights the clinical relevance of P. diazotrophicus, which has been involved in outbreaks in the past, but was often misidentified as P. agglomerans.
URI:	https://digitalcollection.zhaw.ch/handle/11475/9133
Fulltext version:	Published version
License (according to publishing contract):	CC BY 4.0: Attribution 4.0 International
Departement:	Life Sciences and Facility Management
Organisational Unit:	Institute of Natural Resource Sciences (IUNR)
Published as part of the ZHAW project:	Sepsis-Associated Microorganisms in Brazilian Ambulatories (SAMBA)
Appears in collections:	Publikationen Life Sciences und Facility Management

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Pillonetto, M., Arend, L., Gomes, S. M. T., Oliveira, M. A. A., Timm, L. N., Martins, A. F., Barth, A. L., Mazzetti, A., Hersemann, L., Smits, T. H. M., Mira, M. T., & Rezzonico, F. (2018). Molecular investigation of isolates from a multistate polymicrobial outbreak associated with contaminated total parenteral nutrition in Brazil. BMC Infectious Diseases, 18(397), 1–11. https://doi.org/10.21256/zhaw-4685

Pillonetto, M. et al. (2018) ‘Molecular investigation of isolates from a multistate polymicrobial outbreak associated with contaminated total parenteral nutrition in Brazil’, BMC Infectious Diseases, 18(397), pp. 1–11. Available at: https://doi.org/10.21256/zhaw-4685.

M. Pillonetto et al., “Molecular investigation of isolates from a multistate polymicrobial outbreak associated with contaminated total parenteral nutrition in Brazil,” BMC Infectious Diseases, vol. 18, no. 397, pp. 1–11, Aug. 2018, doi: 10.21256/zhaw-4685.

PILLONETTO, Marcelo, Lavinia AREND, Suzie M. T. GOMES, Marluce A. A. OLIVEIRA, Loeci N. TIMM, Andreza F. MARTINS, Afonso L. BARTH, Alana MAZZETTI, Lena HERSEMANN, Theo H. M. SMITS, Marcelo T. MIRA und Fabio REZZONICO, 2018. Molecular investigation of isolates from a multistate polymicrobial outbreak associated with contaminated total parenteral nutrition in Brazil. BMC Infectious Diseases. 13 August 2018. Bd. 18, Nr. 397, S. 1–11. DOI 10.21256/zhaw-4685

Pillonetto, Marcelo, Lavinia Arend, Suzie M. T. Gomes, Marluce A. A. Oliveira, Loeci N. Timm, Andreza F. Martins, Afonso L. Barth, et al. 2018. “Molecular Investigation of Isolates from a Multistate Polymicrobial Outbreak Associated with Contaminated Total Parenteral Nutrition in Brazil.” BMC Infectious Diseases 18 (397): 1–11. https://doi.org/10.21256/zhaw-4685.

Pillonetto, Marcelo, et al. “Molecular Investigation of Isolates from a Multistate Polymicrobial Outbreak Associated with Contaminated Total Parenteral Nutrition in Brazil.” BMC Infectious Diseases, vol. 18, no. 397, Aug. 2018, pp. 1–11, https://doi.org/10.21256/zhaw-4685.