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dc.contributor.authorPillonetto, Marcelo-
dc.contributor.authorArend, Lavinia-
dc.contributor.authorGomes, Suzie M. T.-
dc.contributor.authorOliveira, Marluce A. A.-
dc.contributor.authorTimm, Loeci N.-
dc.contributor.authorMartins, Andreza F.-
dc.contributor.authorBarth, Afonso L.-
dc.contributor.authorMazzetti, Alana-
dc.contributor.authorHersemann, Lena-
dc.contributor.authorSmits, Theo H. M.-
dc.contributor.authorMira, Marcelo T.-
dc.contributor.authorRezzonico, Fabio-
dc.description.abstractBackground: 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.de_CH
dc.publisherBioMed Centralde_CH
dc.relation.ispartofBMC infectious diseasesde_CH
dc.subjectAcinetobacter baumanniide_CH
dc.subjectRhizobium radiobacterde_CH
dc.subjectBacterial identificationde_CH
dc.subjectPhytobacter diazotrophicusde_CH
dc.subject.ddc570: Biologiede_CH
dc.subject.ddc616: Innere Medizin und Krankheitende_CH
dc.titleMolecular investigation of isolates from a multistate polymicrobial outbreak associated with contaminated total parenteral nutrition in Brazilde_CH
dc.typeBeitrag in wissenschaftlicher Zeitschriftde_CH
zhaw.departementLife Sciences und Facility Managementde_CH
zhaw.organisationalunitInstitut für Umwelt und Natürliche Ressourcen (IUNR)de_CH
zhaw.publication.reviewPeer review (Publikation)de_CH
zhaw.funding.zhawSepsis-Associated Microorganisms in Brazilian Ambulatories (SAMBA)de_CH
Appears in Collections:Publikationen Life Sciences und Facility Management

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