First Case of Ewingella americana Meningitis in a Term Newborn: A Rare but Real Pathogen

Meisler, Sarah; Kamity, Ranjith; Noor, Asif; Krilov, Leonard R.; Tiozzo, Caterina

doi:10.3389/fped.2020.00308

Cited by 7 publications

(25 citation statements)

References 15 publications

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“…The same result was obtained for an isolate of E. americana (MIC MEM 4 µg/mL), which was resistant to CAZ (MIC CAZ 32 µg/mL) and CTX (MIC CTX 16 µg/mL) and harboured bla TEM-1 and bla CTX-M1 genes. Interestingly, since E. americana is a rare but true human pathogen, able to cause serious invasive infections such as meningitis [ 62 , 63 ], its carriage by pigs is of concern. Globally, the contemporary presence of bla TEM-1 and bla CTX-M1 , or bla TEM-1 and bla SHV , in members of the Enterobacterales was always associated with resistance to CAZ and CTX, while detection of only bla TEM-1 (100% of the isolates) was not.…”

Section: Discussionmentioning

confidence: 99%

Survey on Carbapenem-Resistant Bacteria in Pigs at Slaughter and Comparison with Human Clinical Isolates in Italy

et al. 2022

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This study is focused on resistance to carbapenems and third-generation cephalosporins in Gram-negative microorganisms isolated from swine, whose transmission to humans via pork consumption cannot be excluded. In addition, the common carriage of carbapenem-resistant (CR) bacteria between humans and pigs was evaluated. Sampling involved 300 faecal samples collected from slaughtered pigs and 300 urine samples collected from 187 hospitalised patients in Parma Province (Italy). In swine, MIC testing confirmed resistance to meropenem for isolates of Pseudomonas aeruginosa and Pseudomonas oryzihabitans and resistance to cefotaxime and ceftazidime for Escherichia coli, Ewingella americana, Enterobacter agglomerans, and Citrobacter freundii. For Acinetobacter lwoffii, Aeromonas hydrofila, Burkolderia cepacia, Corynebacterium indologenes, Flavobacterium odoratum, and Stenotrophomonas maltophilia, no EUCAST MIC breakpoints were available. However, ESBL genes (blaCTXM-1, blaCTX-M-2, blaTEM-1, and blaSHV) and AmpC genes (blaCIT, blaACC, and blaEBC) were found in 38 and 16 isolates, respectively. P. aeruginosa was the only CR species shared by pigs (4/300 pigs; 1.3%) and patients (2/187; 1.1%). P. aeruginosa ST938 carrying blaPAO and blaOXA396 was detected in one pig as well as an 83-year-old patient. Although no direct epidemiological link was demonstrable, SNP calling and cgMLST showed a genetic relationship of the isolates (86 SNPs and 661 allele difference), thus suggesting possible circulation of CR bacteria between swine and humans.

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Section: Discussionmentioning

confidence: 99%

Survey on Carbapenem-Resistant Bacteria in Pigs at Slaughter and Comparison with Human Clinical Isolates in Italy

et al. 2022

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“…Além dos microrganismos encontrados nos demais pontos avaliados, foi possível constatar a presença da Ewingella americana. Apesar da indefinição deste microrganismo como um patógeno real ou um agente infeccioso oportunista, existem relatos recentes da literatura quanto a casos de infecções envolvendo a E. americana (Esposito et al, 2019;Meisler et al, 2020;Hassan et al, 2012).…”

Section: Fonte: Autores (2020)unclassified

Avaliação da resistência microbiana de enterobactérias isoladas a partir de água da praia em São José de Ribamar – MA

Silva

Santos

Oliveira

et al. 2022

RSD

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Este estudo teve por objetivo avaliar a qualidade bacteriológica da água da praia de São José de Ribamar - MA nos períodos seco e chuvoso. A partir destas amostras, foram isoladas e identificadas espécies da família Enterobacteriaceae, as quais foram avaliadas quanto à sua resistência frente à antibióticos comerciais. As amostras de água foram coletadas em três pontos da praia e encaminhadas ao Laboratório de Microbiologia de Alimentos e Água da Universidade Federal do Maranhão para realização das análises microbiológicas. Além de medidas de pH e salinidade, a identificação das enterobactérias foi realizada conforme a metodologia descrita em APHA – Standard Methods for the examination of Water e Wastewater. Estes microrganismos foram submetidos aos antibióticos convencionais utilizando-se o método de difusão em discos (MDD): ampicilina (AMP, 10 μg), gentamicina (GEN, 10 μg), cloranfenicol (CLO, 30 μg) e ácido pipemídico (PIP, 30 μg). Através dos testes bioquímicos, foi possível identificar 11 espécies de enterobactérias, entre as quais houve predominância percentual da Escherichia coli, em ambos os períodos do ano avaliados. Os resultados dos ensaios de MDD mostraram que apenas a espécie Citrobacter koseri se mostrou sensível a todos os antibióticos avaliados. Além disso, também foi possível constar que é todas as bactérias demonstraram perfil antimicrobiano sensível ao Cloranfenicol. Tendo em vista a presença de espécies da família Enterobacteriaceae nas amostras avaliadas, observar-se contaminação significativa na praia de São José de Ribamar.

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“…The bacteria grow on 5% sheep blood agar aerobically and anaerobically as well as on MacConkey agar incubated overnight at 37°C [4]. Most of the E. americana strains are methyl red-positive, Voges-Proskauer-positive, Simmons citrate-positive, lysine decarboxylase-negative, ornithine decarboxylase-negative, and arginine dihydrolase-negative [4]. However, it is known that it can survive in water and grow at 4°C [5].…”

Section: Introductionmentioning

confidence: 99%

“…Ryoo et al stated that a potential source of E. americana infection could be the contamination of the catheter or improper hand hygiene [5]. Other reports state that E. americana can be found in citrate solutions, ice baths, running water, and some vegetables [4]. E. americana is primarily seen in immunocompromised patients, such as patients with diabetes mellitus, end-stage renal disease (ESRD), those who have undergone chemotherapy or bone marrow transplantation, and those who use mercaptopurine and is thus considered an opportunistic pathogen [1].…”

Section: Introductionmentioning

confidence: 99%

“…However, when E. americana infects the healthy population, it is a mild infection and presents as conjunctivitis and/or a respiratory infection with a rapid resolution, and the need for antibiotic treatment is not fully described [6]. A review of the literature demonstrated E. americana-associated bacteremia, pneumonia, peritonitis, conjunctivitis, meningitis [4], osteomyelitis, and septic arthritis, with the most common site of isolation being the blood [1,7]. It is important to mention that Farmer et al reported one case of E. americana isolated from the urine; however, no documentation of a distinct infection was noted [8].…”

Section: Introductionmentioning

confidence: 99%

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The First Known Documented Case of Ewingella Americana Urinary Tract Infection

Hourizadeh¹,

Joy²,

Berger³

et al. 2023

Cureus

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We present a 73-year-old male with a history of end-stage renal disease (ESRD) on dialysis, type 2 diabetes mellitus, coronary artery disease status post stents, prostate carcinoma status post radiation, and prostatectomy, with recurrent bladder neck contracture requiring suprapubic catheter, left urethral stricture with nephrostomy tube placement, penile implant, and recurrent urinary tract infections, who presented to the emergency room complaining of constant bilateral groin pain for one day. Physical exam was significant for suprapubic tenderness and a chronic suprapubic catheter and left-sided nephrostomy tube. An initial examination of the patient's urine revealed turbid, yellow-colored fluid, positive for white blood cells, leukocyte esterase, and bacteria. A urine culture was obtained, which returned positive for E. americana, with >100,000 colony-forming units (CFUs) as well as Enterococcus faecalis (E. faecalis) demonstrating low colony counts. The patient was treated with a seven-day course of meropenem 1 gm twice daily, which improved of his symptoms, and then completed a 10-day course of ertapenem 500 mg daily. The patient received a five-day course of vancomycin 1 gm on dialysis days for additional coverage of E. faecalis, despite low colony counts. This is the first documented case of a urinary tract infection caused by E. americana. The organism is primarily found in immunocompromised individuals, and a debate is still ongoing as to whether it is a true pathogen or exists primarily as an opportunistic infection. We suggest further inquiry and study of this resistant organism are paramount in establishing its role in both immunocompromised as well as immunocompetent individuals. E. americana is a multidrug-resistant organism, which to date has sparse documentation regarding its prevalence and potential for morbidity, especially in compromised individuals. In the era of increasing antibiotic resistance, we suggest that more research is needed to understand the pathogenicity of E. americana.

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First Case of Ewingella americana Meningitis in a Term Newborn: A Rare but Real Pathogen

Cited by 7 publications

References 15 publications

Survey on Carbapenem-Resistant Bacteria in Pigs at Slaughter and Comparison with Human Clinical Isolates in Italy

Survey on Carbapenem-Resistant Bacteria in Pigs at Slaughter and Comparison with Human Clinical Isolates in Italy

Avaliação da resistência microbiana de enterobactérias isoladas a partir de água da praia em São José de Ribamar – MA

The First Known Documented Case of Ewingella Americana Urinary Tract Infection

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