Publications

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identifying antimicrobial resistance genes with dna microarrays.we developed and tested a glass-based microarray suitable for detecting multiple tetracycline (tet) resistance genes. microarray probes for 17 tet genes, the beta-lactamase bla(tem-1) gene, and a 16s ribosomal dna gene (escherichia coli) were generated from known controls by pcr. the resulting products (ca. 550 bp) were applied as spots onto epoxy-silane-derivatized, teflon-masked slides by using a robotic spotter. dna was extracted from test strains, biotinylated, hybridized overnight to indivi ...200314506043
enhancement of plasmid curing by 9-aminoacridine and two phenothiazines in the presence of proton pump inhibitor 1-(2-benzoxazolyl)-3,3,3-trifluoro-2-propanone.plasmid-containing bacteria often cause serious therapeutic failure during the treatment of infectious diseases. the selection of resistant-mutant strains and the transfer of mobile genetic determinants (such as plasmids and transposons) of resistance promote increased antibiotic resistance. in the last 30 years the antiplasmid effect of acridine dyes, ethidium bromide, sodium dodecyl sulphate and phenothiazines was described. the main aim of this study was to test the mechanism of the antiplasm ...200313678825
resistance to extended-spectrum cephalosporins and mortality in patients with citrobacter freundii bacteremia.this study was performed to characterize the clinical features and to identify the risk factors for resistance to extended-spectrum cephalosporins (escs) and for mortality in patients with citrobacter freundii bacteremia.200314562942
[yearly changes in antibacterial activities of cefozopran against various clinical isolates between 1996 and 2001--ii. gram-negative bacteria].the in vitro antibacterial activities of cefozopran (czop), an agent of cephems, against various clinical isolates obtained between 1996 and 2001 were yearly evaluated and compared with those of other cephems, oxacephems and carbapenems. a total of 3,245 strains in 32 species of gram-negative bacteria were isolated from the clinical materials annually collected from january to december, and consisted of moraxella subgenus branhamella catarrhalis, escherichia coli, citrobacter freundii, citrobact ...200314567255
effects of triclosan-containing rinse on the dynamics and antimicrobial susceptibility of in vitro plaque ecosystems.dental plaque microcosms were established under a feast-famine regimen within constant-depth film fermentors and exposed four times daily postfeeding to a triclosan (tr)-containing rinse (dentifrice) (trd). this was diluted so that the antimicrobial content was 0.6 mg/ml. microcosms were characterized by heterotrophic plate counts and pcr-denaturing gradient gel electrophoresis (dgge) with primers specific for the v2-v3 region of the eubacterial 16s rrna gene (rdna). dominant isolates and pcr am ...200314576113
functional profiling of mercuric reductase (mer a) genes in biofilm communities of a technical scale biocatalyzer.bacterial mercury resistance is based on enzymatic reduction of ionic mercury to elemental mercury and has recently been demonstrated to be applicable for industrial wastewater clean-up. the long-term monitoring of such biocatalyser systems requires a cultivation independent functional community profiling method targeting the key enzyme of the process, the mera gene coding for the mercuric reductase. we report on the development of a profiling method for mera and its application to monitor chang ...200314577839
use of o-antigen gene cluster-specific pcrs for the identification and o-genotyping of yersinia pseudotuberculosis and yersinia pestis.yersinia pestis is a very recently evolved clone of yersinia pseudotuberculosis serotype o:1b. this close relationship causes potential difficulties in dna-based diagnostic methods. analysis of the o-antigen gene clusters in these two organisms identified two regions that were used to specifically identify y. pestis-y. pseudotuberculosis as a group or y. pestis alone. both pcr assays were found to be 100% specific when tested on a large collection of yersinia species and other enterobacteriaceae ...200314605146
application of an rrna probe matrix for rapid identification of bacteria and fungi from routine blood cultures.one of the most important functions of the clinical microbiology laboratory is the identification of the etiology of sepsis. for this study, aliquots from 405 positive blood cultures were tested against a unique array of dna probes directed against rrna subsequences of bacteria and fungi for identification. another 280 samples that were negative after 5 days of incubation were also tested. blood culture bottles were incubated in a bact/alert3d instrument. for the rrna assay, a 0.4-ml aliquot was ...200314605149
escherichia coli o157 exposure in wyoming and seattle: serologic evidence of rural risk. 200314609456
cephamycin resistance in clinical isolates and laboratory-derived strains of escherichia coli, nova scotia, canada. 200314609460
antimicrobial resistance in gram-negative bacilli isolated from infant formulas.a total of 90 samples of infant formula (if) were collected from the lactary of a teaching hospital, during a 4-month period from july to august 1999. the sanitary conditions of the formulas were analyzed, and a physiological characterization of gram-negative bacillus isolates and antimicrobial susceptibility testing were performed. colony counts were considered to be unacceptable for the majority of the if samples and the contamination rates were related to inadequate handling. coliforms (35 de ...200314638421
prevalence and molecular epidemiology of ctx-m extended-spectrum beta-lactamase-producing escherichia coli and klebsiella pneumoniae in russian hospitals.a total of 904 consecutive nosocomial isolates of escherichia coli and klebsiella pneumoniae collected from 28 russian hospitals were screened for production of extended-spectrum beta-lactamases (esbls). the esbl phenotype was detected in 78 (15.8%) e. coli and 248 (60.8%) k. pneumoniae isolates. one hundred fifteen isolates carried the genes for ctx-m-type beta-lactamases, which, as shown by pcr-restriction fragment length polymorphism analysis, were distributed into the two genetic groups of c ...200314638473
genehunter, a transposon tool for identification and isolation of cryptic antibiotic resistance genes.genehunter is a transposon tool designed for the experimental activation and identification of silent antibiotic resistance genes. the method permits the identification of novel resistance genes that lack previously identified homologues. using salmonella enterica serovar typhimurium strain lt2 as a test organism for the in vivo version of the genehunter method, we were able to activate, clone, and identify two cryptic antibiotic resistance genes, the aminoglycoside acetyltransferase aac(6')-iaa ...200314638492
carbapenem-resistant strain of klebsiella oxytoca harboring carbapenem-hydrolyzing beta-lactamase kpc-2.we investigated a klebsiella oxytoca isolate demonstrating resistance to imipenem, meropenem, extended-spectrum cephalosporins, and aztreonam. the mics of both imipenem and meropenem were 32 microg/ml. the beta-lactamase activity against imipenem and meropenem was inhibited in the presence of clavulanic acid. isoelectric focusing studies demonstrated five beta-lactamases with pis of 8.2 (shv-46), 6.7 (kpc-2), 6.5 (unknown), 6.4 (probable oxy-2), and 5.4 (tem-1). the presence of the bla(shv) and ...200314638498
a molecular phylogeny of enteric bacteria and implications for a bacterial species concept.a molecular phylogeny for seven taxa of enteric bacteria (citrobacter freundii, enterobacter cloacae, escherichia coli, hafnia alvei, klebsiella oxytoca, klebsiella pneumoniae, and serratia plymuthica) was made from multiple isolates per taxa taken from a collection of environmental enteric bacteria. sequences from five housekeeping genes (gapa, groel, gyra, ompa, and pgi) and the 16s rrna gene were used to infer individual gene trees and were concatenated to infer a composite molecular phylogen ...200314640415
mutagenesis of suge, a small multidrug resistance protein.the small multidrug resistance protein family has two subclasses. in this study we used a mutation approach to see what is necessary to convert a sug subgroup member into a quaternary ammonium compound (qac) transporter. we chose four key residues (h24, m39, i43, and a44) conserved within sugs but conserved differently within the qac transporters. altogether, seven mutants were generated in citrobacter freundii suge. surprisingly, the mutated suge demonstrated an increased sensitivity to represe ...200314651958
protein identification from two-dimensional gel electrophoresis analysis of klebsiella pneumoniae by combined use of mass spectrometry data and raw genome sequences.separation of proteins by two-dimensional gel electrophoresis (2-de) coupled with identification of proteins through peptide mass fingerprinting (pmf) by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (maldi-tof ms) is the widely used technique for proteomic analysis. this approach relies, however, on the presence of the proteins studied in public-accessible protein databases or the availability of annotated genome sequences of an organism. in this work, we investig ...200314653859
transduction of porcine enteropathogenic escherichia coli with a derivative of a shiga toxin 2-encoding bacteriophage in a porcine ligated ileal loop system.in this study, we have investigated the ability of detoxified shiga toxin (stx)-converting bacteriophages phi3538 (deltastx(2)::cat) (h. schmidt et al., appl. environ. microbiol. 65:3855-3861, 1999) and h-19b::tn10d-bla (d. w. acheson et al., infect. immun. 66:4496-4498, 1998) to lysogenize enteropathogenic escherichia coli (epec) strains in vivo. we were able to transduce the porcine epec strain 1390 (o45) with phi3538 (deltastx(2)::cat) in porcine ligated ileal loops but not the human epec pro ...200314660372
pcr typing of genetic determinants for metallo-beta-lactamases and integrases carried by gram-negative bacteria isolated in japan, with focus on the class 3 integron.from january 2001 to december 2002, 587 strains of gram-negative bacterial isolates demonstrating resistance to ceftazidime and a combination of sulbactam and cefoperazone were subjected to a disk diffusion screening test using sodium mercaptoacetic acid; 431 strains (73.4%) appeared to produce metallo-beta-lactamase (mbl). of these 431 strains, 357 were found by pcr to carry genes for imp-1 type mbl (bla(imp-1)), while only 7 and 67 strains carried the imp-2 gene (bla(imp-2)) and the vim-2 gene ...200314662918
etiologic diagnosis of 204 pericardial effusions.the etiologic evaluation of pericardial effusion is frequently unsuccessful when noninvasive methods are used. to determine the cause of the current episode, all patients with echographically identified pericardial effusion from may 1998 to december 2002 underwent noninvasive diagnostic testing of blood, throat, and stool samples. patients with postpericardiotomy syndrome were excluded. to analyze the value of our tests, we tested randomly selected blood donors as negative controls. among 204 in ...200314663288
peritoneal infection in acute intermittent peritoneal dialysis.a prospective study was done to evaluate the incidence and microbiological trend of peritoneal infection in patients undergoing acute intermittent peritoneal dialysis (pd). complete sterile procedure was ensured and at the completion of the procedure pd fluid was sent for bacteriological culture, sensitivity, and total and differential cell count. during the period september 2000 to february 2001 a total of 100 patients were evaluated. male female ratio was 72:28. mean age was 43.17 +/- 17.2 yea ...200314669856
[comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (2001). i. susceptibility distribution].the bacterial strains isolated from patients diagnosed as having urinary tract infections (utis) in 10 institutions in japan were supplied between the period of september and december 2001. then, the susceptibilities of them to a variety of antimicrobial agents were investigated. the number of them were 496 strains. the breakdown of these strains was gram-positive bacteria as 29.6% and gram-negative bacteria as 70.4%. susceptibilities of these bacteria to antimicrobial agents were as follows; ag ...200314692378
[post-marketing surveillance of antibacterial activities of cefozopran against various clinical isolates--ii. gram-negative bacteria].as a post-marketing surveillance, the in vitro antibacterial activities of cefozopran (czop), an agent of cephems, against various clinical isolates were yearly evaluated and compared with those of other cephems, oxacephems, carbapenems, monobactams, and penicillins. changes in czop susceptibility among bacteria were also evaluated with the bacterial resistance ratio calculated from the breakpoint mic. twenty-five species (4,154 strains) of gram-negative bacteria were isolated from the clinical ...200314692381
[characteristics of bacteria isolated from body surface of german cockroaches caught in hospitals].the objective of the study was to identify bacterial flora from external parts of german cockroaches caught in hospitals. the susceptibility of the bacteria to the most important groups of antimicrobial agents was also examined. 80 strains of bacteria were isolated, among them 34 strains of gram-positive cocci and 31 strains of gram-negative rods. one of isolated strains of citrobacter freundii and two strains of serratia liquefaciens showed esbl mechanism of resistance and extended level of amp ...200315029841
sanitary and bacteriological aspects of sewage treatment.a study into the removal of contamination load and indicator bacteria was carried out in 1992-1996 in the mechanical, biological and chemical waste-water treatment plant wtp in lezany, in the county of reszel, in the province of warmia and mazury in poland. the results of chemical analyses found a high efficiency of removal of carbon compounds, cod (90%) and bod (98%), in the process of purification of household sewage. in addition, a high effectiveness of total nitrogen, on average 71%, and uns ...200315058814
oral bacterial flora of dogs with and without rabies: a preliminary study in thailand.the authors studied the bacterial flora of the dog oral cavity and of bite wounds, aerobic bacteria were isolated from mouth swabs of 16 normal and 5 rabid dogs as well as from infected dog-bite wounds from 18 patients. a total of 20 different microbial species were recovered from mouth swab cultures. the most frequently isolated organisms were klebsiella pneumoniae ssp pneumoniae, escherichia coli, staphylococcus aureus, citrobacter freundii, enterobacter cloacae, acinetobacter calcoaceticus, a ...200314971525
occurrence & detection of ampc beta-lactamases at a referral hospital in karnataka.ampc beta-lactamases confer resistance to a wide variety of beta-lactam drugs except for cefepime, cefpirome and carbapenems. they are known to be responsible for nosocomial outbreaks, therapeutic failures and multidrug resistance. although reported with increasing frequency the true rate of occurrence of these beta-lactamases in enterobacteriaceae is not known. hence the present study was undertaken to determine the occurrence of ampc enzymes among clinical isolates.200314748463
rapid identification of bacteria from positive blood cultures by terminal restriction fragment length polymorphism profile analysis of the 16s rrna gene.bacteremia results in significant morbidity and mortality, especially among patient populations that are immunocompromised. broad-spectrum antibiotics are administered to patients suspected to have bloodstream infections that are awaiting diagnosis that depends on blood culture analysis. significant delays in identification of pathogens can result, primarily due to the dependence on growth-based identification systems. to address these limitations, we took advantage of terminal restriction fragm ...200312904391
integration of a transposon tn1-encoded inhibitor-resistant beta-lactamase gene, bla(tem-67) from proteus mirabilis, into the escherichia coli chromosome.proteus mirabilis nel-1 was isolated from a urine sample of a patient hospitalized in a long-term care facility. strain nel-1 produced a beta-lactamase with a pi of 5.2 conferring resistance to amoxicillin and amoxicillin-clavulanic acid. sequencing of a pcr amplicon by using tem-specific primers revealed a novel bla(tem) gene, bla(tem-67). tem-67 was an irt-1-like tem derivative related to tem-65 (lys39, cys244) with an additional leu21ile amino acid substitution in the leader peptide. the bioc ...200312499163
escherichia coli with a self-transferable, multiresistant plasmid coding for metallo-beta-lactamase vim-1.an escherichia coli strain exhibiting decreased susceptibility to carbapenems was isolated from a hospitalized patient in greece. the strain carried a self-transferable plasmid coding for metallo-beta-lactamase vim-1. bla(vim-1), along with aaca7, dhfri, and aada, was included as a gene cassette in a novel class 1 integron. a citrobacter freundii ampc-derived gene, not associated with the integron, was also located in the same plasmid.200312499222
activities of the glycylcycline tigecycline (gar-936) against 1,924 recent european clinical bacterial isolates.the in vitro activities of tigecycline against 1,924 clinical isolates were examined. the new glycylcycline exhibited excellent activity against all gram-positive cocci (mics at which 90% of the isolates tested were inhibited [mic(90)s], <or=1 microg/ml). in addition, it was also very potent against most members of the enterobacteriaceae, with most mic(90)s being <or=2 microg/ml. among the nonfermenters, acinetobacter spp. and stenotrophomonas maltophilia are included in the in vitro spectrum of ...200312499224
salmonella enterica serovar typhimurium bla(per-1)-carrying plasmid psti1 encodes an extended-spectrum aminoglycoside 6'-n-acetyltransferase of type ib.we have studied the aminoglycoside resistance gene, which confers high levels of resistance to both amikacin and gentamicin, that is carried by plasmid psti1 in the per-1 beta-lactamase-producing strain of salmonella enterica serovar typhimurium previously isolated in turkey. this gene, called aac(6')-ib(11), was found in a class 1 integron and codes for a protein of 188 amino acids, a fusion product between the n-terminal moiety (8 amino acids) of the signal peptide of the beta-lactamase oxa-1 ...200312543680
clinical isolates of enterobacteriaceae producing extended-spectrum beta-lactamases: prevalence of ctx-m-3 at a hospital in china.the prevalence of extended-spectrum beta-lactamase-producing strains was demonstrated in 5 of 44 (11.4%) escherichia coli, 17 of 43 (39.5%) klebsiella pneumoniae, 3 of 50 (6.0%) enterobacter cloacae, and 2 of 25 (8.0%) citrobacter freundii strains at a teaching hospital in china. nineteen of these 27 strains expressed ctx-m-3 beta-lactamase (pi 8.6). a subset of the clinical isolates expressing the ctx-m-3 enzyme, tested by pulsed-field gel electrophoresis, revealed multiple clones. five isolate ...200312543694
levofloxacin and ciprofloxacin in vitro activities against 4,003 clinical bacterial isolates collected in 24 italian laboratories.levofloxacin showed comparable in vitro susceptibility to ciprofloxacin among enterobacteriaceae, pseudomonas aeruginosa, enterococci, and staphylococcus aureus, while greater susceptibility was observed in stenotrophomonas maltophilia and staphylococcus epidermidis, mainly when oxacillin resistant. the susceptibility of streptococcus pneumoniae to levofloxacin reached 99%.200312543701
optimum detection times for bacteria and yeast species with the bactec 9120 aerobic blood culture system: evaluation for a 5-year period in a turkish university hospital.we tracked and documented the time of positivity of blood cultures by using the bactec 9120 (becton dickinson diagnostic instrument systems) blood culture system over a 5-year study period. a 7-day protocol of the incubation period was selected, and a total of 11156 blood cultures were evaluated. the clinically significant microorganisms (32.95%) were isolated in 3676 specimens. gram-positive and -negative bacterial isolation rates were found to be 41.07 and 44.88%, respectively. yeasts were fou ...200312574291
a dynamic structure for the acyl-enzyme species of the antibiotic aztreonam with the citrobacter freundii beta-lactamase revealed by infrared spectroscopy and molecular dynamics simulations.infrared difference spectra show that at least 4 conformations coexist for the ester carbonyl group of the stable acyl-enzyme species formed between the antibiotic aztreonam and the class c beta-lactamase from citrobacter freundii. a novel method for the assignment of the bands that arise from the ester carbonyl group has been employed. this has made use of the finding that the infrared absorption intensity of aliphatic esters is surprisingly constant, so a direct comparison with simple model es ...200312590581
in vitro activity of s-3578, a new broad-spectrum cephalosporin active against methicillin-resistant staphylococci.the in vitro antibacterial activity of s-3578, a new parenteral cephalosporin, against clinical isolates was evaluated. the mics of the drug at which 90% of the isolates were inhibited were 4 micro g/ml for methicillin-resistant staphylococcus aureus (mrsa) and 2 micro g/ml for methicillin-resistant staphylococcus epidermidis, which were fourfold higher than and equal to those of vancomycin, respectively. the anti-mrsa activity of s-3578 was considered to be due to its high affinity for penicill ...200312604523
a real-time pcr assay for the detection of campylobacter jejuni in foods after enrichment culture.a real-time pcr assay was developed for the quantitative detection of campylobacter jejuni in foods after enrichment culture. the specificity of the assay for c. jejuni was demonstrated with a diverse range of campylobacter species, related organisms, and unrelated genera. the assay had a linear range of quantification over six orders of magnitude, and the limit of detection was approximately 12 genome equivalents. the assay was used to detect c. jejuni in both naturally and artificially contami ...200312620820
construction and screening of metagenomic libraries derived from enrichment cultures: generation of a gene bank for genes conferring alcohol oxidoreductase activity on escherichia coli.enrichment of microorganisms with special traits and the construction of metagenomic libraries by direct cloning of environmental dna have great potential for identifying genes and gene products for biotechnological purposes. we have combined these techniques to isolate novel genes conferring oxidation of short-chain (c(2) to c(4)) polyols or reduction of the corresponding carbonyls. in order to favor the growth of microorganisms containing the targeted genes, samples collected from four differe ...200312620823
pcr detection of virulence genes in yersinia enterocolitica and yersinia pseudotuberculosis and investigation of virulence gene distribution.pcr-based assays were developed for the detection of plasmid- and chromosome-borne virulence genes in yersinia enterocolitica and yersinia pseudotuberculosis, to investigate the distribution of these genes in isolates from various sources. the results of pcr genotyping, based on 5 virulence-associated genes of 140 strains of y. enterocolitica, were compared to phenotypic tests, such as biotyping and serotyping, and to virulence plasmid-associated properties such as calcium-dependent growth at 37 ...200312620874
molecular epidemiology of orf513-bearing class 1 integrons in multiresistant clinical isolates from argentinean hospitals.the spread of orf513-bearing class 1 integrons is associated with bla(ctx-m-2) in gram-negative clinical isolates in argentina, with in35 being the most frequently found integron (74%). among 65 isolates without bla(ctx-m-2), only one harbored a novel orf513-bearing class 1 integron with the dfra3b gene. the finding of orf513 not associated with class 1 integrons in two gram-positive strains indicates the widespread occurrence of this putative site-specific recombinase.200314638506
procalcitonin as a marker of bacterial infection in the emergency department: an observational study.procalcitonin (pct) has been proposed as a marker of infection in critically ill patients; its level is related to the severity of infection. we evaluated the value of pct as a marker of bacterial infection for emergency department patients.200314975050
procalcitonin as a marker of bacterial infection in the emergency department: an observational study.procalcitonin (pct) has been proposed as a marker of infection in critically ill patients; its level is related to the severity of infection. we evaluated the value of pct as a marker of bacterial infection for emergency department patients.200314975050
controlled clinical comparison of bact/alert standard aerobic medium with bactec standard aerobic medium for culturing blood.standard aerobic media are widely used for culturing blood with the bact/alert (biomérieux, inc., durham, n.c.) (bm) and bactec 9240 (bd diagnostic systems, sparks, md.) (bd) automated continuously monitoring instrument systems. although similarly composed of soybean-casein digest broths, the formulations of the standard aerobic media available for these instruments differ from each other in supplements and in sodium polyanetholesulfonate concentration. therefore, we compared the standard aerobi ...200312791854
in vitro and bactericidal activities of abt-492, a novel fluoroquinolone, against gram-positive and gram-negative organisms.in vitro activities of abt-492, ciprofloxacin, levofloxacin, trovafloxacin, moxifloxacin, gatifloxacin, and gemifloxacin were compared. abt-492 was more potent against quinolone-susceptible and -resistant gram-positive organisms, had activity similar to that of ciprofloxacin against certain members of the family enterobacteriaceae, and had comparable activity against quinolone-susceptible, nonfermentative, gram-negative organisms. bactericidal activity of abt-492 was also evaluated.200415215148
microarray-based identification of bacteria in clinical samples by solid-phase pcr amplification of 23s ribosomal dna sequences.the rapid identification of the bacteria in clinical samples is important for patient management and antimicrobial therapy. we describe a dna microarray-based pcr approach for the quick detection and identification of bacteria from cervical swab specimens from mares. this on-chip pcr method combines the amplification of a variable region of bacterial 23s ribosomal dna and the simultaneous sequence-specific detection on a solid phase. the solid phase contains bacterial species-specific primers co ...200415004052
in vitro antimicrobial activity of doripenem, a new carbapenem.the doripenem mics at which 90% of the tested strains were inhibited ranged from 0.03 to 1 microg/ml for 10 species of enterobacteriaceae (n = 351), from 0.03 to 0.12 microg/ml for oxacillin-susceptible staphylococci (n = 119), from 4 to 32 microg/ml for oxacillin-resistant staphylococci (n = 64), from < or =0.008 to 0.06 microg/ml for penicillin-susceptible streptococci (n = 132), and from 1 to 4 microg/ml for penicillin-resistant streptococci (n = 51). overall, doripenem demonstrated in vitro ...200415047550
computer-assisted surveillance for detecting clonal outbreaks of nosocomial infection.whole-house surveillance for healthcare-associated infection is no longer the recommended practice because of the large personnel time investment required. we developed a computer-based tracking system using microbiologic data as an aid in detecting potential outbreaks of healthcare-associated infections on a hospital-wide basis. monthly total isolates of 25 clinically significant hospital pathogens were tallied from 1991 to 1998 to form a database for future comparison. two different algorithm ...200415004070
use of positive blood cultures for direct identification and susceptibility testing with the vitek 2 system.in order to further decrease the time lapse between initial inoculation of blood culture media and the reporting of results of identification and antimicrobial susceptibility tests for microorganisms causing bacteremia, we performed a prospective study in which specially processed fluid from positive blood culture bottles from bactec 9240 (becton dickinson, cockeysville, md.) containing aerobic media were directly inoculated into vitek 2 system cards (bio-mérieux, france). organism identificatio ...200415297523
growing group of extended-spectrum beta-lactamases: the ctx-m enzymes. 200414693512
structured representation of the pharmacodynamics section of the summary of product characteristics for antibiotics: application for automated extraction and visualization of their antimicrobial activity spectra.the aim of this study was to construct automatically a knowledge base concerning the pharmacodynamic properties of antibiotics and a visualization tool.200415064283
in vitro activities of moxifloxacin against 900 aerobic and anaerobic surgical isolates from patients with intra-abdominal and diabetic foot infections.the in vitro activities of moxifloxacin, ciprofloxacin, levofloxacin, gatifloxacin, imipenem, piperacillin-tazobactam, clindamycin, and metronidazole against 900 surgical isolates were determined using nccls testing methods. moxifloxacin exhibited good to excellent antimicrobial activity against most aerobic (90.8%) and anaerobic (97.1%) microorganisms, suggesting that it may be effective for the treatment of polymicrobial surgical infections.200414982797
evaluation of the new vitek 2 card for identification of clinically relevant gram-negative rods.the vitek 2 card for gram-negative bacteria (biomérieux,marcy-l'etoile, france) has been redesigned to improve the identification of fermenting and nonfermenting bacilli. forty-seven biochemical tests, including 19 enzymatic tests, are present in the new card and interpreted in a kinetic mode. final identification results are available within 10 h. the database allows the identification of 159 different taxa. six hundred fifty-five gram-negative rods (gnr; 511 fermenters and 144 nonfermenters), ...200415364991
phase and antigenic variation in bacteria.phase and antigenic variation result in a heterogenic phenotype of a clonal bacterial population, in which individual cells either express the phase-variable protein(s) or not, or express one of multiple antigenic forms of the protein, respectively. this form of regulation has been identified mainly, but by no means exclusively, for a wide variety of surface structures in animal pathogens and is implicated as a virulence strategy. this review provides an overview of the many bacterial proteins a ...200415258095
lead precipitation by vibrio harveyi: evidence for novel quorum-sensing interactions.three pleiotropic, quorum sensing-defective vibrio harveyi mutants were observed to precipitate soluble pb2+ as an insoluble compound. the compound was purified and subjected to x-ray diffraction and elemental analyses. these assays identified the precipitated compound as pb9(po4)6, an unusual and complex lead phosphate salt that is produced synthetically at temperatures of ca. 200 degrees c. regulation of the precipitation phenotype was also examined. introduction of a luxo::kan allele into one ...200414766565
improved laboratory enrichment for enterohemorrhagic escherichia coli by exposure to extremely acidic conditions.analysis of food samples for e. coli o157:h7 using the standard u.s. food and drug administration procedure is frequently complicated by overgrowth of nontarget microorganisms. a new procedure was developed for enrichment of enterohemorrhagic e. coli (ehec) which utilizes exposure to ph 2.00 for 2 h. this procedure yielded larger populations of ehec than the standard method by factors ranging from 2.7 to 7.7 and, when age-stressed cultures were used, by factors ranging from 2.7 to 11.5. cultures ...200414766610
escherichia coli dihydroxyacetone kinase controls gene expression by binding to transcription factor dhar.dihydroxyacetone (dha) kinases are a sequence-conserved family of enzymes, which utilize either atp (in animals, plants, bacteria) or the bacterial phosphoenolpyruvate carbohydrate phosphotransferase system (pts) as a source of high-energy phosphate. the pts-dependent kinase of escherichia coli consists of three subunits: dhak contains the dha binding site, dhal contains adp as cofactor for the double displacement of phosphate from dham to dha, and dham provides a phospho-histidine relay between ...200415616579
escherichia coli dihydroxyacetone kinase controls gene expression by binding to transcription factor dhar.dihydroxyacetone (dha) kinases are a sequence-conserved family of enzymes, which utilize either atp (in animals, plants, bacteria) or the bacterial phosphoenolpyruvate carbohydrate phosphotransferase system (pts) as a source of high-energy phosphate. the pts-dependent kinase of escherichia coli consists of three subunits: dhak contains the dha binding site, dhal contains adp as cofactor for the double displacement of phosphate from dham to dha, and dham provides a phospho-histidine relay between ...200415616579
[a new member of cmy type cephalosporinase prevailing in escherichia coli].to study the resistant phenotype and molecular biology character of plasmid mediated high ampc-producing clinical isolates of escherichia coli and to find new ampc genotype.200415631796
invasion of porcine brain microvascular endothelial cells by streptococcus suis serotype 2.streptococcus suis is an important swine pathogen that mainly causes meningitis and occasionally causes other infections, such as endocarditis, arthritis, and pneumonia. the pathogenesis of s. suis infection has not been completely defined. however, in order to cause meningitis, s. suis has to cross the blood-brain barrier (bbb) made up of brain microvascular endothelial cells. the objective of this work was to study the interactions of s. suis serotype 2 with porcine brain microvascular endothe ...200414977949
resistance to cefepime and cefpirome due to a 4-amino-acid deletion in the chromosome-encoded ampc beta-lactamase of a serratia marcescens clinical isolate.a multiresistant serratia marcescens strain, hd, isolated from a patient with a urinary tract infection, was resistant to amino-, carboxy-, and ureidopenicillins, ceftazidime, and cefepime and was susceptible to cefotaxime and ceftriaxone, according to the guidelines of the nccls. no synergy was found between expanded-spectrum cephalosporins and clavulanic acid, according to the double-disk synergy test. the bla(ampc) gene of the strain was amplified by pcr and cloned into escherichia coli dh10b ...200414982755
quantitative detection of listeria monocytogenes and listeria innocua by real-time pcr: assessment of hly, iap, and lin02483 targets and amplifluor technology.we developed and assessed real-time pcr (rti-pcr) assays for the detection and quantification of the food-borne pathogen listeria monocytogenes and the closely related nonpathogenic species l. innocua. the target genes were hly and iap for l. monocytogenes and lin02483 for l. innocua. the assays were 100% specific, as determined with 100 listeria strains and 45 non-listeria strains, and highly sensitive, with detection limits of one target molecule in 11 to 56% of the reactions with purified dna ...200415006755
detection of escherichia coli serogroups o26 and o113 by pcr amplification of the wzx and wzy genes.pcr-based assays for detecting enterohemorrhagic escherichia coli serogroups o26 and o113 were developed by targeting the wzx (o-antigen flippase) and the wzy (o-antigen polymerase) genes found in the o-antigen gene cluster of each organism. the pcr assays were specific for the respective serogroups, as there was no amplification of dna from non-o26 and non-o113 e. coli serogroups or from other bacterial genera tested. using the pcr assays, we were able to detect the organisms in seeded apple ju ...200415006811
analysis of ampc beta-lactamase expression and sequence in biochemically atypical ceftazidime-resistant enterobacteriaceae from paediatric patients.to analyse the variation of ampc beta-lactamase gene sequence and expression in biochemically atypical enterobacteriaceae isolates, and to identify them definitively.200415014062
diagnostic real-time pcr for detection of salmonella in food.a robust 5' nuclease (taqman) real-time pcr was developed and validated in-house for the specific detection of salmonella in food. the assay used specifically designed primers and a probe target within the ttrrsbca locus, which is located near the salmonella pathogenicity island 2 at centisome 30.5. it is required for tetrathionate respiration in salmonella. the assay correctly identified all 110 salmonella strains and 87 non-salmonella strains tested. an internal amplification control, which is ...200415574899
nucleotide sequences, genetic organization, and distribution of peu30 and pel60 from erwinia amylovora.the nucleotide sequences, genetic organization, and distribution of plasmids peu30 (30,314 bp) and pel60 (60,145 bp) from the plant pathogen erwinia amylovora are described. the newly characterized peu30 and pel60 plasmids inhabited strains isolated in the western united states and lebanon, respectively. the gene content of peu30 resembled plasmids found in plant-associated bacteria, while that of pel60 was most similar to incl/m plasmids inhabiting enteric bacteria.200415574957
phenotypic and molecular detection of ctx-m-beta-lactamases produced by escherichia coli and klebsiella spp.organisms producing ctx-m-beta-lactamases are emerging around the world as a source of resistance to oxyiminocephalosporins such as cefotaxime (ctx). however, the laboratory detection of these strains is not well defined. in this study, a molecular detection assay for the identification of ctx-m-beta-lactamase genes was developed and used to investigate the prevalence of these enzymes among clinical isolates of escherichia coli and klebsiella species in the calgary health region during 2000 to 2 ...200415583304
histidine decarboxylase in enterobacteriaceae revisited.with a modification of taylor's decarboxylation broth, histidine decarboxylase was detected in enterobacter aerogenes, morganella morganii, raoultella ornithinolytica, and some strains of citrobacter youngae and raoultella planticola. this method provides a useful confirmatory test for identification of e. aerogenes strains.200415583342
quantification of salmonella by 5'-nuclease real-time polymerase chain reaction targeted to fimc gene.a new 5'-nuclease real-time polymerase chain reaction (pcr) system for the quantification of salmonella enterica was developed, with primers and the probe oriented to a salmonella-specific region of the fimc gene. the pcr system was specific and sensitive, its inclusivity was 100% (determined by the analysis of 53 strains of salmonella belonging to 38 serovars) and its exclusivity was 100% (determined by the analysis of 49 non-salmonella strains). for quantification purposes, calibration lines w ...200415592843
detection of low levels of listeria monocytogenes cells by using a fiber-optic immunosensor.biosensor technology has a great potential to meet the need for sensitive and nearly real-time microbial detection from foods. an antibody-based fiber-optic biosensor to detect low levels of listeria monocytogenes cells following an enrichment step was developed. the principle of the sensor is a sandwich immunoassay where a rabbit polyclonal antibody was first immobilized on polystyrene fiber waveguides through a biotin-streptavidin reaction to capture listeria cells on the fiber. capture of cel ...200415466560
digestion of cellulose and xylan by symbiotic bacteria in the intestine of the indian flying fox (pteropus giganteus).bats (order chiroptera) are a widely distributed group of mammals. pteropus giganteus belongs to the suborder megachiroptera. this bat consumes fruits and leaves as their major food. cellulose and xylan are the major composition of leaves. as they consume leaves in their diet, their digestive tract must contain cellulolytic and xylanolytic bacteria which help in the digestion of cellulose and xylan. the cellulolytic and xylanolytic bacteria were isolated and screened on berg's agar containing ce ...200415471682
evaluation of the microscan esbl plus confirmation panel for detection of extended-spectrum beta-lactamases in clinical isolates of oxyimino-cephalosporin-resistant gram-negative bacteria.we aimed to assess the performance of the microscan esbl plus confirmation panel using a series of 87 oxyimino-cephalosporin-resistant gram-negative bacilli of various species.200415471997
controlled clinical comparison of the bact/alert fn and the standard anaerobic sn blood culture medium.to determine the optimal anaerobic companion bottle to pair with the bact/alert (biomerieux, durham, n.c.) nonvented aerobic fa (fa) medium for recovery of pathogenic microorganisms from adult patients with bacteremia and fungemia, we compared the bact/alert fn (fn) anaerobic bottle with the standard bact/alert sn (sn) anaerobic bottle. each bottle, fa, fn, and sn, was filled with 8 to 12 ml of blood. of 11,498 blood culture sets received in the clinical microbiology laboratories at two universi ...200415472312
phylogeny, clinical associations, and diagnostic utility of the pilin subunit gene (sfpa) of sorbitol-fermenting, enterohemorrhagic escherichia coli o157:h-.the plasmid-borne sfpa gene encodes the pilin subunit in sorbitol-fermenting (sf) enterohemorrhagic escherichia coli (ehec) o157:h-. we investigated the distribution of sfpa among 600 e. coli isolates comprising the complete e. coli standard reference (ecor) and diarrheagenic e. coli (dec) strain collections and clinical isolates associated with enteric disease. sfpa was detected in dec3f sf ehec o157:h- strain 493/89, each of 107 sf ehec o157:h- clinical isolates, and 14 shiga toxin-negative sf ...200415472329
dramatic increase in prevalence of fecal carriage of extended-spectrum beta-lactamase-producing enterobacteriaceae during nonoutbreak situations in spain.the occurrence of extended-spectrum beta-lactamase (esbl)-producing isolates has increased worldwide. fecal carriage of esbl-producing isolates has mainly been detected in nosocomial outbreaks, and few studies have evaluated fecal carriage during nonoutbreak situations and among patients in the community. we have studied the prevalence of esbls in 1,239 fecal samples from 849 patients (64.1% of whom were ambulatory) in 1991 and have compared the prevalence data with those obtained in 2003 for 40 ...200415472339
kpnbi is the prototype of a new family (ie) of bacterial type i restriction-modification system.kpnbi is a restriction-modification (r-m) system recognized in the gm236 strain of klebsiella pneumoniae. here, the kpnbi modification genes were cloned into a plasmid using a modification expression screening method. the modification genes that consist of both hsdm (2631 bp) and hsds (1344 bp) genes were identified on an 8.2 kb ecori chromosomal fragment. these two genes overlap by one base and share the same promoter located upstream of the hsdm gene. using recently developed plasmid r-m tests ...200415475385
phosphoenolpyruvate- and atp-dependent dihydroxyacetone kinases: covalent substrate-binding and kinetic mechanism.dihydroxyacetone (dha) kinases are a sequence-conserved family of enzymes, which utilize two different phosphoryldonors, atp in animals, plants, and some bacteria, and a multiphosphoprotein of the phosphoenolpyruvate carbohydrate phosphotransferase system (pts) in most bacteria. here, we compare the pts-dependent kinase of escherichia coli and the atp-dependent kinase of citrobacter freundii. they display 30% sequence identity. the binding constants of the e. coli kinase for eleven short-chain c ...200415476397
[rapid diagnosis of common pathogenic bacteria infection in newborn infants by 16srdna oligonucleotide array].the rapid identification of pathogenic bacteria is important for earlier effective patient management and antimicrobial therapy, especially for the infant patient, whose immunological system is not fully developed. however conventional microbiogical techniques of bacterial identification, culture and isolation of pathogenic bacteria, identification by biochemistry and serological assay, are time-consuming and require intensive labor. on the basis of special gene sequence, pcr provides simple and ...200415482667
shiga toxin-encoding bacteriophages--genomes in motion.shiga toxins (stx) represent a group of bacterial toxins that are involved in human and animal disease. stx are mainly produced by escherichia coli isolated from human and non-human sources, shigella dysenteriae type 1, and sporadically, by citrobacter freundii, enterobacter cloacae and shigella flexneri. the genes encoding stx are encoded in the genome of heterogeneous lambdoid prophages (stx-converting bacteriophages; stx-phages). they are located in a similar position in the late region of th ...200415493821
[effects of splenectomy on peritonitis produced by a colonic injury: study in rats].study the effects of splenectomy on the intra-abdominal infection by bowel flora, consequent to a colonic injury in wistar rats.200415499477
four variants of the citrobacter freundii ampc-type cephalosporinases, including novel enzymes cmy-14 and cmy-15, in a proteus mirabilis clone widespread in poland.twenty-nine proteus mirabilis isolates from 17 polish hospitals were analyzed. the isolates were resistant to a variety of antimicrobials, and their patterns of resistance to beta-lactams resembled those of the constitutive class c cephalosporinase (ampc) producers. indeed, beta-lactamases with a pi of approximately 9.0 were found in all of the isolates, and they were subsequently identified as four ampc-type cephalosporinases, cmy-4, -12, -14, and -15, of which the two last ones were novel enzy ...200415504832
promoter sequences necessary for high-level expression of the plasmid-associated ampc beta-lactamase gene blamir-1.little is known about mechanisms involved in high-level expression of plasmid-associated ampc genes. the sequence for bla(mir-1) has been elucidated, and the gene is not inducible. although the sequence for the promoter (pra) that drives expression of enterobacter cloacae chromosomal ampc is present upstream of bla(mir-1), high-level expression from bla(mir-1) is directed from a hybrid promoter (prb) located further upstream of pra. the purpose of this study was to determine the influence of eac ...200415504838
community-onset disease caused by citrobacter freundii producing a novel ctx-m beta-lactamase, ctx-m-30, in canada.strains of citrobacter freundii intermediate to cefotaxime but sensitive to ceftazidime were isolated from four different patients in canada. sequencing of pcr products by use of ctx-m-specific primers revealed a new combination of four amino acid substitutions. this new gene was designated bla(ctx-m-30) and was encoded on a 3-kb plasmid. the pi of ctx-m-30 was 8.0.200415504875
antimicrobial effect of water extract of sumac (rhus coriaria l.) on the growth of some food borne bacteria including pathogens.the antimicrobial effect of water extracts of sumac (rhus coriaria l.) at concentrations of 0.1%, 0.5%, 1.0%, 2.5% and 5.0% (w/v), non-neutralized and after neutralization to ph 7.2+/-0.1, was studied on the growth of 12 bacterial strains (six gram positive strains and six gram negative strains), mostly food borne including pathogens. it was found to be effective against all the test organisms with gram positive strains being more sensitive than gram negative strains. significant differences (p< ...200415527919
new quadriplex pcr assay for detection of methicillin and mupirocin resistance and simultaneous discrimination of staphylococcus aureus from coagulase-negative staphylococci.major challenges in diagnostic molecular microbiology are to develop a simple assay to distinguish staphylococcus aureus from the less virulent but clinically important coagulase-negative staphylococci (cons) and to simultaneously determine their antibiotic resistance profiles. multiplex pcr assays have been developed for the detection of methicillin- and mupirocin-resistant s. aureus and cons but not for the simultaneous discrimination of s. aureus from cons. we designed a new set of staphyloco ...200415528678
detection of campylobacter spp. in chicken fecal samples by real-time pcr.a real-time pcr assay for detecting thermophilic campylobacter spp. directly in chicken feces has been developed. dna was isolated from fecal material by using magnetic beads followed by pcr with a prealiquoted pcr mixture, which had been stored at -18 degrees c. campylobacter could be detected in less than 4 h, with a detection limit of 100 to 150 cfu/ml, in a fecal suspension. a bacterial internal control was added before dna extraction to control both dna isolation and the presence of pcr inh ...200415528705
effects of intrapartum penicillin prophylaxis on intestinal bacterial colonization in infants.early-onset group b streptococcal (gbs) infections remain a leading cause of morbidity and mortality in infants. to prevent the vertical transmission of gbs and neonatal gbs infection, guidelines recommend intrapartum penicillin or amoxicillin prophylaxis. this intrapartum antibiotic prophylaxis (iap) is suspected to favor colonization by antibiotic-resistant bacteria. however, the effects of this prophylaxis on the patterns of acquisition of gastrointestinal bacterial flora in infants have neve ...200415528713
metallo-beta-lactamase-producing gram-negative bacilli: laboratory-based surveillance in cooperation with 13 clinical laboratories in the kinki region of japan.a total of 19,753 strains of gram-negative rods collected during two 6-month periods (october 2000 to march 2001 and november 2001 to april 2002) from 13 clinical laboratories in the kinki region of japan were investigated for the production of metallo-beta-lactamases (mbls). mbls were detected in 96 (0.5%) of the 19,753 isolates by the broth microdilution method, the 2-mercaptopropionic acid inhibition test, and pcr and dna sequencing analyses. mbl-positive isolates were detected in 9 of 13 lab ...200415528723
sensitive and specific detection of yersinia pseudotuberculosis by loop-mediated isothermal amplification.we developed a loop-mediated isothermal amplification method able to detect yersinia pseudotuberculosis strains in 30 min by using six primers designed by targeting the inv gene. this method is more sensitive than pcr and might be a useful tool for detecting and identifying y. pseudotuberculosis.200415528740
identification and phylogeny of enterobacter sakazakii relative to enterobacter and citrobacter species.the phylogenetic relationships of enterobacter sakazakii strains were investigated using 16s ribosomal dna (rdna) and hsp60 sequencing. each analysis distributed e. sakazakii strains among four clusters, indicating substantial taxonomic heterogeneity. the e. sakazakii type strain 16s rdna sequence was 97.8% similar to that of citrobacter koseri but 97.0% similar to that of enterobacter cloacae.200415528745
role of lysine-256 in citrobacter freundii tyrosine phenol-lyase in monovalent cation activation.tyrosine phenol-lyase (tpl) from citrobacter freundii is dependent on monovalent cations, k(+) or nh(4)(+), for high activity. we have shown previously that glu-69, which is a ligand to the bound cation, is important in monovalent cation binding and activation [sundararaju, b., chen, h., shillcutt, s., and phillips, r. s. (2000) biochemistry 39, 8546-8555]. lys-256 is located in the monovalent cation binding site of tpl, where it forms a hydrogen bond with a structural water bound to the cation. ...200415533046
diversity and host range of shiga toxin-encoding phage.shiga toxin 2 (stx2) from the foodborne pathogen escherichia coli o157:h7 is encoded on a temperate bacteriophage. toxin-encoding phages from c600::933w and from six clinical e. coli o157:h7 isolates were characterized for pcr polymorphisms, phage morphology, toxin production, and lytic and lysogenic infection profiles on o157 and non-o157 serotype e. coli. the phages were found to be highly variable, and even phages isolated from strains with identical pulsed-field gel electrophoresis profiles ...200415557637
accelerating bacterial identification by infrared spectroscopy by employing microarray deposition of microorganisms.a microarray method for the deposition of bacteria onto an agar slide was developed to accelerate the formation of microcolonies. representative microarrays each consisting of 40 micro-spots of five replicates of eight foodborne bacteria (yersinia enterocolitica, staphylococcus aureus, salmonella typhimurium, listeria monocytogenes, enterobacter cloacae, citrobacter freundii, klebsiella pneumoniae, and escherichia coli) were printed on a brain heart infusion (bhi) agar slide using a contact micr ...200415992277
enzymatic synthesis of poly-n-acetyllactosamines as potential substrates for endo-beta-galactosidase-catalyzed hydrolytic and transglycosylation reactions.enzymatic synthesis of glcnac-terminated poly-n-acetyllactosamine beta-glycosides glcnacbeta1,3(galbeta1,4glcnacbeta1,3)(n)galbeta1,4glcnacbeta-pnp (n=1-4) was demonstrated using a transglycosylation reaction of escherichia freundii endo-beta-galactosidase. the enzyme catalyzed a transglycosylation reaction on glcnacbeta1,3galbeta1,4glcnacbeta-pnp (1), which served both as a donor and an acceptor, and converted 1 into p-nitrophenyl beta-glycosides glcnacbeta1,3(galbeta1,4glcnacbeta1,3)(1)galbeta ...200415716127
[urinary tract infections in children--etiologic agents and susceptibility to antibiotics].urinary tract infections (utis) are common clinical problem in pediatric hospitals. the aim of this study was to compare the incidence of utis during two different time periods (from february 1999 to march 2000, and from april 2000 to september 2001) in pediatric patients treated in ambulatory or hospitalized in new children hospital. the frequency of occurrence of esbl--producing gram-negative rods increased during second period study. the isolated esbl--producing strains were resistant also to ...200415765758
use of the bd phoenix automated microbiology system for direct identification and susceptibility testing of gram-negative rods from positive blood cultures in a three-phase trial.the present study describes the use of the automated bactec 9240 blood culture system, the serum separator tube (sst), and the bd phoenix automated microbiology system in combination for the direct identification and antimicrobial susceptibility testing (ast) of gram-negative rods (gnrs) from positive blood cultures (bcs) without subculture. the study was conducted in three phases: (i) the recovery yield of escherichia coli atcc 25922 was determined with the sst between 0 and 8 h after spiked bc ...200415070990
evaluation of the automated phoenix system for potential routine use in the clinical microbiology laboratory.a comparative study was designed to evaluate the identification (id) and antimicrobial susceptibility testing (ast) performances of the bd phoenix automated microbiology system (becton dickinson diagnostic systems [bd], pont de claix, france). a total of 305 single clinical isolates were collected, and comparisons were made with routine manual methods in use in our microbiology laboratories. the percentages of correct ids were 93.3, 89.4, 91.8, and 85.7% for enterobacteria, nonfermenting gram-ne ...200415071001
development of a multiplex pcr technique for detection and epidemiological typing of salmonella in human clinical samples.we have developed a multiplex pcr assay for salmonella detection and epidemiological typing. six sets of primers were designed to detect the major salmonella serotypes and phage types in spain. an internal amplification control was designed in order to detect pcr inhibition. the different amplification profiles obtained allowed us to detect salmonella bacteria and to distinguish the clinically prevalent salmonella enterica serotypes enteritidis, typhimurium and subspecies i serotype 4,5,12:i:-. ...200415071035
nonpseudomonal ecthyma gangrenosum.ecthyma gangrenosum is a cutaneous infection associated most commonly with pseudomonal sepsis in the patient who is immunocompromised. we describe an 8-month-old girl with acute myelocytic leukemia who developed perineal ecthyma gangrenosum caused by citrobacter freundii, a gram-negative pathogen that has been rarely associated with cutaneous disease. we also review the literature to categorize the range of pseudomonal and nonpseudomonal pathogens associated with ecthyma gangrenosum.200415097944
vertical transmission of citrobacter freundii. 200415102740
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