The high level of faecal carriage of MDR E. coli in nursing home residents demonstrates their importance as a reservoir population. Public health measures to combat spread of these organisms should address the needs of this group.

A gram-negative bacillus was isolated from a batch of fruit-flavored bottled water, which had spoiled as a result of bacterial overgrowth (>10 6 CFU/ml). The spoilage organism was extremely difficult to identify phenotypically and was poorly identified as Pasturella sp. (78.7% identification profile) employing the API 20NE identification scheme, which gave the profile 5040000. Molecular identification through PCR amplification of a partial region of the 16S rRNA gene followed by direct automated sequencing of the PCR amplicon allowed identification of the organism. Due to the sequence identity (100%) between the spoilage organism and a reference strain in GenBank, the spoilage isolate was considered to be an Asaia sp., a recently described genus and member of the acetic acid bacteria. This is the first report of Asaia sp. causing spoilage of a foodstuff and highlights the benefits of molecular identification techniques based on 16S rRNA gene sequences in the identification of unusual spoilage organisms.There has been a gradual increase in demand for bottled water in the United States over the past 20 years, which has been exacerbated by public health scares relating mainly to waterborne outbreaks of human cryptosporidiosis caused by Cryptosporidium parvum. Furthermore, a recent study has demonstrated a high consumption (40%) of bottled water by human immunodeficiency virus-positive patients (2). To date, there have been relatively few reports employing the use of molecular identification methods, particularly the use of rRNA identification techniques, to identify contaminating bacterial and fungal agents in bottled water. We report an occurrence of spoilage in fruit-flavored bottled drinking water, which was isolated during production and prior to distribution. Our aim was to employ such molecular techniques to identify the bacterial spoilage organism, as phenotypic methods were unable to identify the organism.Microbiological examination was performed on a batch of fruit-flavored bottled water to determine the causal spoilage organism. The spoiled product was turbid (equivalent to McFarland standard 5) and had a characteristic sour odor, with a pH of 3.5. Quantitative microbiological examination on Plate Count Agar (Oxoid CM; Oxoid Ltd., Basingstoke, England) at 30°C for 48 h demonstrated the presence of a pure culture (Ͼ10 6 CFU/ml) consisting of a single and characteristic morphotype from which a single colony was purified, yielding an unidentified gram-negative rod, with no other bacteria or fungi cultured from the spoiled drink. The isolation of this morphotype from the spoiled fruit drink was repeated on further culture of the fruit drink. The spoilage isolate grew at 22 and 30°C but failed to grow at 37°C. It was catalase positive and oxidase negative, with translucent, pale pink, shiny, smooth colonies which were raised with an entire edge. The colonies were extremely small (approximately 1 to 2 mm in diameter), and the isolate was relatively

Long-term treatment with azithromycin in CF patients may reduce antibiotic susceptibility in commensal VGS, where these organisms may potentially act as a reservoir of macrolide resistance determinants for newly acquired and antibiotic-susceptible pathogens.

No abstract

The role of bacterial pathogens in CF pulmonary disease contributes greatly to the morbidity and mortality in patients with CF. CF patients have recurrent and chronic respiratory tract infections and most of their morbidity and mortality is due to such infections throughout their life [1,2]. These infections are usually dominated by non-fermenting Gram-negative organisms (Burkholderia cenocepacia and Stenotrophomonas maltophilia), including Pseudomonas aeruginosa. P. aeruginosa is the single most important pathogen in this patient population. Recent advances in treatment, which include intensive physiotherapy and aggressive antibiotic treatment, have greatly improved the outlook for patients. However, with the improvement in survival rates in CF patients, a new range of pulmonary issues have arisen. These include the emergence of multi-drug resistant strains of P. aeruginosa [3] and the appearance of organisms with increased virulence such as the Burkholderia cepacia complex (BCC).There are approximately 283 adult CF patients in Northern Ireland (NI) with CF, where they receive regional CF centrebased multidisciplinary care at the Regional Adult Cystic Fibrosis Centre, Belfast City Hospital.At present, the UK CF Registry, which is compiled by the CF Trust [4], includes data on the presence of respiratory pathogens, but does not include any information on antibiotic susceptibility of colonising/infection respiratory pathogens, including P. aeruginosa. A study was therefore undertaken locally to evaluate current levels of antimicrobial susceptibility in adult CF patients who were infected with P. aeruginosa and to compare levels of antibiotic susceptibility, with a comparator non-CF population of invasive P. aeruginosa, isolated from blood culture material.One hundred and twenty seven adult patients (approximately. 61.7% of total adult CF patients in NI) with a confirmed clinical diagnosis of CF were included in the study. There were 72 males and 55 females, with an age range of 19-82 years and 18-61 years, respectively. Of the 127 patients with a documented history of P. aeruginosa infection, P. aeruginosa isolates were selected as part of the routine microbiological workup, which included the selection of isolates which were morphologically different, including those which were mucoid. From these, 99 were nonmucoid, 26 were mucoid and 2 were mixed (mucoid + nonmucoid). Antibiotic susceptibility profiles of the most recent P. aeruginosa isolate were examined and antibiotic susceptibility noted against the following four antibiotic classes [11 agents]: aminoglycosides [