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[Chromobacteriosis in Ilhéus, Bahia: epidemiologic, clinical and laboratorial investigation].

In April/2004, a group of people traveled to a farm in a town in the south of Bahia and afterwards, three teenagers from the same family developed symptoms of severe septicemia and two died. The Health Department carried out an epidemiologic, clinical, laboratory and environmental investigation that resulted in the identification of Chromobacterium violaceum, in biological material from one of them, water and soil. This is the first report of the disease in Bahia State.

Adolescent↗

An acute pleuropneumonia in a pig caused by Chromobacterium violaceum.

A 2.5-month-old, 30 kg Duroc pig died 10 days after showing clinical signs of dyspnoea and diarrhoea. Acute necrotizing and fibrinous pleuropneumonia with locally extensive lesions was found. Chromobacterium violaceum was isolated from pneumonic lung tissues and intratracheal inoculation of a pure culture into two SPF pigs reproduced lesions similar to those found in the natural infection.

Acute Disease↗

Ecthyma gangrenosum and septic shock syndrome secondary to Chromobacterium violaceum.

Chromobacterium violaceum is a gram-negative bacterium of soil and water in tropical and subtropical environments. Typically, it is considered a bacterium of low virulence although, uncommonly, it causes human infection, particularly in persons with defects in host defenses. Infection generally follows exposure of broken skin to contaminated water and soil, and is often characterized by pustules, lymphadenitis, fever, and vomiting, as well as rapid dissemination and a high mortality rate. Unfortunately, because C violaceum is ubiquitous, it is often dismissed as a contaminant when cultured. Because rapid diagnosis (by taking appropriate specimens) and treatment are vital to a good prognosis, it is imperative that physicians be aware of this organism. In addition, patients with chromobacterial infections should have an immunologic workup because infections in immunocompetent individuals are rare. Here we report an aggressive yet nonfatal case of C violaceum septicemia in an adolescent male, diagnosed through a punch biopsy of a skin lesion, and resulting in a new diagnosis of chronic granulomatous disease.

Adolescent↗

First case report from Argentina of fatal septicemia caused by Chromobacterium violaceum.

A case of Chromobacterium violaceum fatal septicemia is reported. The microorganism was isolated from six blood cultures and two suppurated skin lesions. It is the first such case described in Argentina, and it reinforces the need for prolonged treatment and careful clinical evaluation to ensure complete remission of human infections caused by this bacterium.

Adult↗

Chromobacteriosis in a Chinese red panda (Ailurus fulgens styani).

An adult Chinese red panda (Ailurus fulgens styani) transported by airplane from Florida to a North Dakota zoo died 1 week after arrival. Grossly, an interscapular abscess, subcutaneous inflammation, lymphadenitis, and pulmonary abscesses were observed. Microscopic findings included necrotizing inflammation in liver, lung, lymph node, and spleen. Chromobacterium violaceum was cultured from the interscapular abscess, liver, lung, and spleen and was injected into Swiss Webster mice. These mice died 18 hours postinoculation, and C. violaceum was cultured from liver, lung, and spleen. Chromobacterium violaceum is a sporadically reported but highly virulent pathogenic bacterium of both animals and humans typically found as a soil and water inhabitant of tropical and subtropical regions.

Animals↗

Less frequently reported gram-negative fermentative rods.

The clinical significance and distinguishing characteristics of less frequently reported gram-negative fermentative rods (Pasteurella, Yersinia, Vibrio, Aeromonas and Plesiomonas, Enterobacter agglomerans, and Chromobacterium) are described. Increased awareness of these organisms, a knowledge of possible sites in which they cause infection, and identification criteria which will separate them from similar bacteria will prepare the clinical microbiologist for the isolation and identification of these "unusual" organisms.

Aeromonas↗

Chromobacterium violaceum bacteremia: a case report.

Chromobacterium violaceum is confined in tropical and subtropical regions, which can cause life-threatening disease. It is the only Chromobacterium species that is pathogenic to humans. Because of its rarity, clinicians often do not appreciate its importance when it is isolated. We report a fulminate fatal case of C. violaceum bacteremia in a 20-year-old male Taiwanese. The clinical manifestations were fever and abdominal pain, followed by shock and pulmonary septic embolism. Emergent laparotomy identified acute appendicitis with rupture. Flomoxef sodium was administered immediately. However, his condition deteriorated rapidly and he died within 48 h after the onset of illness. Two sets of blood culture yielded C. violaceum. Physicians should be aware of the occurrence of this infection in summer season.

Adult↗

Adsorption and selection of rhizobia with ion-exchange papers.

Ion exchange papers were used to study the adsorption of 32P-labelled rhizobia on defined surfaces. Two strains of Rhizobium japonicum and one each of R. leguminosarum and R. lupini were compared with Escherichia coli and Bacillus subtilis. The ratio of adsorption to strong and to weak acid papers/strong and weak basic papers was consistantly higher for all rhizobial strains compared to the other bacteria. The process of desorption by increasing the ion-concentration causes about 35% desorption between 0.02 and 0.1 M MgCl2, however, an increase to 1 M does not desorb more labelled Rhizobium japonicum or E. coli cells. The ratio of adsorbed cpm to colony formers, desorbed by 0.1 M NaCl was similar with Rhizobium japonicum for all six ion exchange papers. For E. coli this ratio varied widely for the different papers. The selection of Rhizobium against a more closely related bacterium by this adsorption/desorption procedure was demonstrated with mixed cultures of Rhizobium japonicum and Chromobacterium violaceum giving a more than 80 fold enrichment of the former. Rhizobium japonicum cells, ad/desorbed from all ion exchange papers kept their infectivity and formed nodules on Glycine max with an activity of 20-40 nM C2H4-hr(-1)-mg nodule(-1). A desorption of Rhizobium japonicum from soybean roots also occurred by increasing the ion concentration. 2-3 times as many cells were removed in this way compared to washing with water.

Adsorption↗

N-butanoyl-L-homoserine lactone (BHL) deficient Pseudomonas aeruginosa isolates from an intensive care unit.

Acylated homoserine lactones (AHLs) are self-generated diffusible signal molecules that mediate population density dependent gene expression (quorum sensing) in a variety of Gram-negative bacteria, and several virulence genes of human pathogens are known to be controlled by AHLs. In this study, strains of Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli and Klebsiella pneumoniae, isolated from intensive care patients, were screened for AHL production by using AHL responsive indicator strains of Chromobacterium violaceum CV026 and Agrobacterium tumefaciens NT1. Positive reactions were recorded for all 50 isolates of P. aeruginosa and 10 isolates of Acinetobacter baumannii with Agrobacterium tumefaciens NT1. Surprisingly, most P. aeruginosa isolates gave negative results with C. violaceum CV026 in contrast to previous reports. This suggests that the new isolates of P. aeruginosa either failed to make short chain AHLs or the level of the signal molecule is very low.

4-Butyrolactone↗

Proteus and coliform meningoencephalitis in neonates.

The characteristic necropsy and histological appearances are described of nine cases of Proteus meningoencephalitis in neonates. One case which was not due to Proteus has been included because of the close similarity of the gross appearances of the brain. Umbilical sepsis in half the cases indicated that this is a common portal of entry of these organisms. That epidemiological factors may be of importance in the aetiology was suggested by the distribution of cases.

Brain↗

Important unusual infections in Australia: a critical care perspective.

OBJECTIVE: To review a number of the important unusual infections in Australia that can lead to critical illness. DATA SOURCES: Articles, reports and published reviews on Japanese encephalitis, murine typhus, Australian spotted fever, Australian bat lyssavirus, leptospirosis, Capnocytophaga canimorsus, Chromobacterium violaceum, Edwardsiella tarda and Vibriosis. Emphasis was placed on articles, reports and published reviews published between 1990-2001. SUMMARY OF REVIEW: Japanese encephalitis has recently emerged in Australia, with reported outbreaks in the Torres Strait and north Queensland. Murine typhus needs to be included in the differential diagnosis of a patient with fever, headache and rash, especially if there has been possible exposure to rats and/or their droppings. If the symptoms follow exposure to ticks, or following a known tick bite, then Australian spotted fever needs to be considered. Australian bat lyssavirus can cause a fatal rabies-like disease in humans exposed to infection by bites or scratches from bats. Leptospirosis should be suspected in any patient with an appropriate history of exposure (especially occupational) and a history of myalgia, arthralgia, fever, malaise and/or chest X-ray shadowing. Capnocytophaga should be specifically sought in any patient with fever and/or septicaemia following a dog bite, especially if immunocompromised. Along with melioidosis, Chromobacteriosis should be considered in the differential diagnosis of a rapidly progressing septic illness with skin lesions and/or multiple visceral abscesses in a patient exposed to soil or muddy water. Edwardsiella ought to be considered as the causative agent of a soft tissue infection, septic arthritis or septicaemia in a recreational fisher or swimmer, especially if following a marine puncture wound. If the exposure is related to salty or brackish water, then Vibriosis needs to be considered. Vibriosis should also be suspected in a patient with septicaemia and a history of recent ingestion of raw or under-cooked seafood, especially oysters. CONCLUSIONS: Critical care physicians need to remain alert to unusual infectious agents as many can lead to significant morbidity and are associated with a high mortality rate.

Journal Article↗

Production of acylated homoserine lactones by different serotypes of Vibrio anguillarum both in culture and during infection of rainbow trout.

Onehundred and forty-eight out of onehundred and fifty strains of Vibrio anguillarum isolated from vibriosis in Danish marine aquaculture produced bacterial communication signals, acylated homoserine lactones, eliciting a response in the Agrobacterium tumefaciens (pZLR4) monitoring system. One strain, a serotype O4, induced a strong response in the Chromobacterium violaceum (CV026) monitoring system. Profiles of AHLs determined by TLC separation revealed the presence of at least four AHLs and a compound similar to N-3-oxo-decanoyl homoserine lactone (3-oxo-C10-HSL) was present in all strains. The production rate of the presumed 3-oxo-C10-HSL followed the growth rate of V. anguillarum whereas the production rate of a small AHL (Rf value of 0.74) increased faster than the growth rate of V. anguillarum indicating autoinduction. AHLs were produced by all serotypes (O1 to O10) and by non-typable strains. During infection with V. anguillarum, AHLs could be extracted from liver, kidney and muscle of rainbow trout and AHLs were detected both in vitro and in vivo when cell numbers reached 10(7) per ml or gram. Preliminary investigations of interactions between AHLs and the fish immune system were carried out determining oxidative burst of fish macrophages exposed to 3-oxo-C10-HSL. No activation or suppression of the superoxide anion production in the head kidney macrophages was seen when treated with the AHL compound in concentrations of 1 nM-10 microM. Our data show that AHLs are produced by almost all V. anguillarum strains and that no clear pattern relating AHL production to disease or virulence appear.

4-Butyrolactone↗

Fatal septicaemia caused by Chromobacterium violaceum.

We report a case of Chromobacterium violaceum septicaemia in a 10-year old boy admitted to hospital in September 2001, two weeks after he suffered a crush injury of the left foot. In spite of surgical debridement and antibiotics his condition worsened and he developed multiple liver and lung abscesses. He died one week after admission and a blood culture grew Chromobacterium violaceum.

Bacteremia↗

Drug resistance in Chromobacterium violaceum.

Chromobacterium violaceum is a free-living bacterium commonly found in aquatic habitats of tropical and subtropical regions of the world. This bacterium is able to produce a large variety of products of biotechnological and pharmacological use. Although C. violaceum is considered to be non-pathogenic, some cases of severe infections in humans and other animals have been reported. Genomic data on the type strain ATCC 12472(T) has provided a comprehensive basis for detailed studies of pathogenicity, virulence and drug resistance genes. A large number of open reading frames associated with various mechanisms of drug resistance were found, comprising a remarkable feature of this organism. Amongst these, beta-lactam (penicillin and cephalosporin) and multidrug resistance genes (drug efflux pumps) were the most numerous. In addition, genes associated with bacitracin, bicyclomycin, chloramphenicol, kasugamycin, and methylenomycin were also found. It is postulated that these genes contribute to the ability of C. violaceum to compete with other bacteria in the environment, and also may help to explain the common drug resistance phenotypes observed in infections caused by this bacterium.

Anti-Bacterial Agents↗