Bordetella trematum spp. nov. has been isolated from wounds, ear infections and diabetic ulcers. We report a case of a 7-month-old infant with fever, vomiting and abnormal body movements with bacteremia caused by this novel species. The infant responded to fluoroquinolone and macrolide combination therapy.

Fresh fruits and vegetables contaminated with microbial pathogens can cause outbreaks of food poisoning and other enteric diseases if consumed raw. The objective of the present study was to determine the bacterial contamination and antibiotic resistance in fresh produce sold in Delhi, India. One hundred fifty samples of fruits and vegetables generally consumed raw were collected from retail and wholesale vendors of Delhi-NCR, India. Microbial contamination was studied by culturing 25 g of each sample. Antimicrobial resistance testing was performed for isolated pathogens and resistance phenotypes determined. Overall, 97.3% of fruit and vegetables sampled were contaminated with pathogens. In over 75% of samples, coliforms were detected with Escherichia coli in 17.4%. Majority of vegetables were contaminated with coliforms particularly ginger (100%), cabbage (80%), cucumber (75%), and tomato (75%). Extended spectrum beta-lactamases (ESBL) was detected in eight (5.7%) isolates, carbapenem resistance in four with three metallo-β-lactamases producers. E. coli was isolated at a significantly higher rate from retail shops viz-a-viz wholesale markets (p value = .04).As high level of contamination with potential human pathogens is present in fruits and vegetables sold in wholesale markets and retail shops in Delhi-NCR, the study underlines the need for stricter regulations and implementation of standards. Practical applicationsThe present study highlights the high level of contamination with potential human pathogens including coliforms present in fruits and vegetables sold in wholesale markets, self-service retail shops and road side push carts in Delhi-NCR, India. Presence of extended spectrum beta-lactamases and metallo beta-lactamases producing organisms in fruits and vegetables is a concerning food safety issue. Therefore, the study underlines the need for periodic monitoring of produce at various levels of production and sale are required to achieve satisfactory levels of microbial load.

Introduction: Nocardia otitidiscaviarum is a rare cause of human infections, mostly causing cutaneous and lymphocutaneous infections of mild severity. We report two cases of fatal pulmonary infection caused by Nocardia otitidiscaviarum in elderly patients. Methodology: Case 1: A 70-year old woman presented with fever and cough with expectoration for a month. On physical examination, she had tachypnea and inspiratory crepitations in bilateral basal regions. Case 2: A 74-year old man presented with productive cough with foul smelling expectoration, fever and shortness of breath for one week. On examination, he had tachypnea, bilateral wheezing and inspiratory crepitations. In both cases, sputum was sent to microbiology laboratory. On direct microscopy Gram-positive, finely branching filaments were observed which were acid fast with 1% sulphuric acid. Chalky white opaque wrinkled colonies with musty basement type odour were seen on blood agar. Both patients were treated empirically with trimethoprim-sulfamethoxazole for Nocardia infection after notification of microscopy findings however both expired on Day 2 and Day 5 of admission, respectively. Both isolates were susceptible to amikacin, linezolid, ciprofloxacin and gentamicin. They were resistant to trimethoprim-sulfamethoxazole, ampicillin, amoxicillin-clavulanic acid, erythromycin, and imipenem. Based on biochemical identification and antimicrobial susceptibility pattern, the organism was identified as Nocardia otitidiscaviarum. The identification was confirmed using MALDI-TOF (Vitek MS, Biomerieux, France). Conclusion: Our report highlights the importance of early identification of Nocardia to species level to improve treatment outcomes especially in critically ill patients. Mass spectrometry can become an integral part of diagnostic algorithms for nocardiosis.

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