Community acquired fulminant Pseudomonas infection of the gastrointestinal tract in previously healthy infants

Ck, Yeung; Kh, Lee

doi:10.1046/j.1440-1754.1998.00290.x

Cited by 22 publications

(23 citation statements)

References 13 publications

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“…Although most patients have extensive necrotising enteritis, short bowel syndrome is rare, with only one reported case 9. Second, ecthyma gangrenosum occurs in more than 50% of the patients with Shanghai fever, as seen in this study 10 11. In contrast, this cutaneous manifestation occurs in only 1.3–2.8% of patients with Pseudomonas bacteraemia,24 many of whom are profoundly neutropenic.…”

Section: Discussionmentioning

confidence: 53%

Shanghai fever: a distinctPseudomonas aeruginosaenteric disease

Chuang

Wang

Chang

et al. 2013

Gut

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BackgroundShanghai fever, a community-acquired enteric illness associated with sepsis caused by Pseudomonas aeruginosa, was first described in 1918. The understanding of Shanghai fever is incomplete.ObjectiveTo delineate the clinical features and to examine the host and microbial factors associated with Shanghai fever.MethodsWe prospectively enrolled 27 consecutive previously healthy children with community-acquired P aeruginosa enteritis and sepsis between July 2003 and June 2012. An immunological investigation, including measurement of serum immunoglobulin levels and lymphocyte subpopulations, was performed. The clonal relationship of bacterial isolates was determined by multilocus sequence typing (MLST) and the virulence of isolates was measured using cellular and animal models.ResultsThe median age of the patients was 7 months; 24 (89%) were aged <1 year. The most common clinical manifestations were fever (100%), diarrhoea (96%) and shock (81%). Leucopenia, thrombocytopenia, high C-reactive protein levels, coagulopathy and hypoalbuminaemia were the key laboratory findings. Necrotising enteritis with or without bowel perforation, ecthyma gangrenosum and seizures were main complications. The death rate was 15%. No common primary immune deficiency was identified. MLST genotypes indicated that isolates from Shanghai fever were non-clonal, but they shared similar phenotypes which were invariably cytotoxic, invasive and adhesive in cellular experiments and caused prolonged gut colonisation and more death than respiratory and laboratory control strains in mice.ConclusionsShanghai fever is a sporadic community-acquired disease of previously healthy infants that manifests as sepsis associated with P aeruginosa enteric disease. Both host and microbial factors play a role in pathogenesis.

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Section: Discussionmentioning

confidence: 53%

Shanghai fever: a distinctPseudomonas aeruginosaenteric disease

Chuang

Wang

Chang

et al. 2013

Gut

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“…While bacteria in the gastrointestinal tract have been regarded as important in immunocompromised patients, such as those undergoing anticancer chemotherapy, it is of direct concern that the pathogen can also infect persons from the community and might cause fatal bacteraemia [2] and community-acquired pneumonia [1]. Other reports showed incidences of community-acquired Pseudomonas infection of the gastrointestinal tract causing diarrhoea in infants [39]. …”

Section: Discussionmentioning

confidence: 99%

Diversity of Antimicrobial Resistance and Virulence Determinants inPseudomonas aeruginosaAssociated with Fresh Vegetables

Allydice-Francis

Brown

2012

International Journal of Microbiology

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With the increased focus on healthy eating and consuming raw vegetables, this study assessed the extent of contamination of fresh vegetables by Pseudomonas aeruginosa in Jamaica and examined the antibiotic susceptibility profiles and the presence of various virulence associated determinants of P. aeruginosa. Analyses indicated that vegetables from retail markets and supermarkets were widely contaminated by P. aeruginosa; produce from markets were more frequently contaminated, but the difference was not significant. Lettuce and carrots were the most frequently contaminated vegetables, while tomatoes were the least. Pigment production (Pyoverdine, pyocyanin, pyomelanin and pyorubin), fluorescein and alginate were common in these isolates. Imipenem, gentamicin and ciprofloxacin were the most inhibitory antimicrobial agents. However, isolates were resistant or showed reduced susceptibility to ampicillin, chloramphenicol, sulphamethoxazole/trimethoprim and aztreonam, and up to 35% of the isolates were resistant to four antimicrobial agents. As many as 30% of the isolates were positive for the fpv1 gene, and 13% had multiple genes. Sixty-four percent of the isolates harboured an exoenzyme gene (exoS, exoT, exoU or exoY), and multiple exo genes were common. We conclude that P. aeruginosa is a major contaminant of fresh vegetables, which might be a source of infection for susceptible persons within the community.

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“…Pseudomonas septicemia in infants was manifested as necrotizing bowel lesions with a history of diarrhea (5). There have been some reports on community-acquired Pseudomonas infection of the gastrointestinal tract causing diarrhea in infants (6,7).…”

Section: Discussionmentioning

confidence: 99%

Pseudomonas aeruginosaas a Potential Cause of Antibiotic-Associated Diarrhea

et al. 2001

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Although Pseudomonas aeruginosa is not generally considered as a cause of antibiotic-associated diarrhea, several cases of diarrhea caused by P. aeruginosa have been reported. We experienced seven cases of nosocomial diarrhea presumably caused by P. aeruginosa, which was the predominant organism isolated from stool cultures. Clostridium difficile toxin was also positive in one patient. No other potential or recognized enteropathogens were identified from stools. All patients had underlying diseases and had been receiving antibiotics before the diarrheal onset. All of the seven P. aeruginosa isolates were resistant to previously given antibiotics. Diarrhea stopped three days after withdrawal of probable offending antibiotics without specific treatment in two patients. The other five patients having continuous diarrhea despite withdrawal of probable offending antibiotics, were successfully treated with antipseudomonal agents. The median duration of diarrhea after the initiation of treatment was 6.3 days. These data suggest that P. aeruginosa can be a potential cause of antibiotic-associated diarrhea. Further investigations are warranted to evaluate the possible etiologic role of P. aeruginosa in antibiotic-associated diarrhea.

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Community acquired fulminant Pseudomonas infection of the gastrointestinal tract in previously healthy infants

Cited by 22 publications

References 13 publications

Shanghai fever: a distinctPseudomonas aeruginosaenteric disease

Shanghai fever: a distinctPseudomonas aeruginosaenteric disease

Diversity of Antimicrobial Resistance and Virulence Determinants inPseudomonas aeruginosaAssociated with Fresh Vegetables

Pseudomonas aeruginosaas a Potential Cause of Antibiotic-Associated Diarrhea

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