Prospective survey of fecal, urinary tract, and environmental colonization by Providencia stuartii in two geriatric wards

Hawkey, Peter M.; Penner, J L; Potten, M.R.; Stephens, Matthew; Barton, L J; Speller, D. C. E.

doi:10.1128/jcm.16.3.422-426.1982

Cited by 21 publications

(4 citation statements)

References 14 publications

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“…The predilection for Proteeae species to cause urinary tract infections in persons in chronic care facilities has been amply documented (2,7,9,13,14,16,20). Such infections are usually attributed to persistence of Proteeae species in catheterized subjects (20), along with opportunistic crossinfection among persons with urethral catheters (5,7,9). No reservoir has been previously identified in noncatheterized persons.…”

Section: Discussionmentioning

confidence: 99%

“…In newly hospitalized patients, risk factors for a variety of asymptomatic and life-threatening aerobic gram-negative bacillus (AGNB) infections include both recent nursing home residence and prior indwelling urethral catheterization (7,14). In numerous studies among residents of chronic care facilities (7,9,13,16,18,20), Proteeae species (Morganella, Proteus, and Providencia) have been found to be prominent causes of urinary tract infections. On occasion, in a chronic treatment unit urinary tract infections due to Proteeae species have been disproportionately more frequent than infections due to Escherichia coli (13).…”

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confidence: 99%

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Proteeae species bacteriuria accompanying Proteeae species groin skin carriage in geriatric outpatients

Ehrenkranz¹,

Alfonso²,

Eckert³

et al. 1989

J Clin Microbiol

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There have been numerous reports of Proteeae species urinary tract infections among elderly individuals. To explore a possible urinary carrier source of Proteeae species in this population, the frequency of aerobic gram-negative bacillus (AGNB) bacteriuria at the greater than or equal to 10(2)/ml level was determined in 67 ambulatory elderly outpatients classified as to Proteeae group (Morganella, Proteus, Providencia) groin carriage by a set of two skin cultures obtained at least 1 week apart. None had urethral catheters, symptomatic infections, skin ulcers, or recent antibiotic therapy. We found AGNB bacteriuria in 12 of 15 carriers (80%) and in 21 of 52 noncarriers (40%) (P = 0.009). Proteeae species bacteriuria occurred in eight carriers (53.3%) and six noncarriers (11.5%) (P = 0.001). At the 10(2) to 10(4)/ml level, Proteeae species were isolated in urine specimens from seven carriers (46.7%) and four noncarriers (7.7%) (P = 0.001). There was concordance of species of skin and urine Proteeae isolates in six carriers. By contrast, non-Proteeae AGNB bacteriuria at any level was present in four Proteeae species carriers (26%) and 15 noncarriers (28.8%) (P greater than 0.05). There was a 36.7% frequency of Proteeae species bacteriuria in nursing home residents, in contrast to 8.1% among those living in private homes; this parallels the greater frequency of Proteeae species groin carriage among nursing home residents in the study population. Low-level urinary colonization with Proteeae species accompanying Proteeae species groin skin colonization in elderly individuals is a hitherto unrecognized finding. This may account for the greater frequency of Proteeae species urinary infections in this population.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Proteeae species bacteriuria accompanying Proteeae species groin skin carriage in geriatric outpatients

Ehrenkranz¹,

Alfonso²,

Eckert³

et al. 1989

J Clin Microbiol

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“…and the white to grey colonies of the Eniterobacteriaceae; again, no data were provided on suitability for isolating Providencia spp. Primary isolation media incorporating the antibiotic colistin (or polymyxin B) have also been reported (4,8,14). Use of these media is permissible if a particular strain known to be colistin resistant is to be isolated.…”

Section: Discussionmentioning

confidence: 99%

Selective and differential medium for the primary isolation of members of the Proteeae

Hawkey¹,

McCormick²,

Simpson³

1986

J Clin Microbiol

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A new differential and selective medium for the isolation of members of the Proteeae, PIM (Proteeae isolation medium) agar, was developed and evaluated. The medium relies on the ability of all members of the Proteeae (with the exception of a very few Morganella morganii strains) to produce a dark brown pigment in medium containing DL-tryptophan. An additional differential property, tyrosine degradation, was also demonstrated by the medium. Members of the Proteeae appeared as dark brown colonies with a halo of clearing of fine tyrosine crystals when cultured on PIM agar. Occasional strains of Citrobacter sp. and Pseudomonas aeruginosa may degrade tyrosine, but none has the ability to produce dark brown pigmentation on PIM agar. Quantitative recovery studies showed that the addition of 5 mg of clindamycin per liter suppressed gram-positive bacteria without inhibiting any strains of the Proteeae. The addition of 100 mg of colistin per liter made the medium highly selective for strains of the Proteeae, but approximately 10% of the strains were not isolated, thus making this formulation unsuitable for general surveys of the occurrence of members of the Proteeae. PIM agar should aid the investigation of episodes of cross infection caused by members of the Proteeae and the isolation of the new species of the Proteeae recently described.

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“…The reservoirs and mode of spread of P.stuartii were poorly understood, as clusters of cases occurred with colonised urine in catheters as the presumed source of infection, at other times occurrence of overt infection was sporadic with no apparent source 2 . A detailed study of a male CoEW showed that faecal colonisation represented the most significant reservoir 3 . During the course of collecting strains for this study a series of isolates were obtained over a 20 month period from a patient with a long term urinary catheter colonised by a single serotype (O:63) of P.stuartii.…”

Section: Introductionmentioning

confidence: 99%

The 2017 Garrod Lecture: Genes, guts and globalization

Hawkey

2018

Journal of Antimicrobial Chemotherapy

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The widespread use of antibacterial drugs over the last 70 years has brought immense benefits to human health at the price of increasing drug inefficacy. Antibacterial agents have a strong selective effect in both favouring resistant strains and allowing particular species and families of bacteria to prosper, especially in the healthcare setting. Whilst important Gram-positive bacterial pathogens such as Staphylococcus aureus and Streptococcus pneumoniae caused concern over the last 20 years because of the spread of antibiotic-resistant strains, Enterobacteriaceae have become the biggest challenge. They have very efficient mechanisms for genetic exchange, as illustrated by the emergence and rapid spread of CTX-M β-lactamases and the carbapenemases. The unique epidemiology of Enterobacteriaceae, with substantial numbers colonizing the mammalian gut and subsequent release into and spread in the environment, presents a significant threat to human health because of the high levels of exposure for the whole community. The use of antimicrobials in agriculture combined with global movements of people, animals and food, arising from worldwide industrialization, generates a diversity and level of resistance not seen previously. Control will require globally coordinated interventions similar to those needed to ameliorate climate change.

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Prospective survey of fecal, urinary tract, and environmental colonization by Providencia stuartii in two geriatric wards

Cited by 21 publications

References 14 publications

Proteeae species bacteriuria accompanying Proteeae species groin skin carriage in geriatric outpatients

Proteeae species bacteriuria accompanying Proteeae species groin skin carriage in geriatric outpatients

Selective and differential medium for the primary isolation of members of the Proteeae

The 2017 Garrod Lecture: Genes, guts and globalization

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