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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
Published in : BMC Infectious Diseases
Volume(Issue) : 18
Issue : 397
Pages : 1
Pages to: 11
Publisher / Ed. Institution : BioMed Central
Issue Date: 13-Aug-2018
License (according to publishing contract) : CC BY 4.0: Attribution 4.0 International
Type of review: Open peer review
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.
Departement: Life Sciences and Facility Management
Organisational Unit: Institute of Natural Resource Sciences (IUNR)
Publication type: Article in scientific Journal
DOI : 10.1186/s12879-018-3287-2
ISSN: 1471-2334
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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