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Moellerella wisconsensis is a Gram-negative, facultative anaerobic bacillus of Entero-bacteriaceae family, and it is an uncommon pathogen in domestic animals. To date, five cases were reported including two dogs, two cattle, and a goat. Streptococcus equisimilis is the second common bacterial agent after the S. equi subsp. zooepidemicus in equine pneumonia cases. The present report describes the isolation of M. wisconses from lungs and spleen of a 10-year-old Arabian horse (May 08, 2022) at post-mortem examination being co-infected with S. equisimilis. Clinical and pathological findings included bilateral nasal discharge, conjunctivitis, sternal recumbency, severe diffuse necrosuppurative rhinitis, multi-focal fibrinopurulent pneumonia and purulent lymphadenitis. Polymerase chain reaction assays showed no viral nucleic acids of equid alphaherpesvirus (EHV) 1, EHV-4, equine arteritis virus and equine papilloma virus. The antibiogram test revealed that the isolate was sensitive to several antibiotics except colistin. Taken together, the present report documents the first isolation of M. wisconsensis from lungs and spleen of a horse; hence, experimental studies are needed to clarify the pathogenity and pathogenesis of M. wisconsensis.

Oral colonization of Acinetobacter baumannii can lead to infections such as pneumonia and sepsis. We aimed to evaluate oral colonization of hospitalized patients in ICUs and to examine risk factors for oral colonization, molecular epidemiology, and incidence of pneumonia and sepsis.  The study began in February 2021. Oral cultures were taken. The microorganisms were identified by a Maldi-tof MS mass spectrometry device. Colistin resistance genes were investigated by polymerase chain reaction. Clonal relationships were determined by pulsed-field gel electrophoresis.  A. baumannii was found in 21 of 96 patients’ oral cultures. Pneumonia and sepsis due to A. baumannii were detected in 14 and 5 patients, respectively. The mean growth time of A. baumannii from oral cultures was 11.8 days, and the meantime for the occurrence of pneumonia after oral growth was 5.2 days. We determined a plasmid mediated mcr-2 colistin resistance gene in a colistin susceptible A. baumannii strain. It is the first report of the plasmid mediated mcr-2 colistin resistance gene in our country. In total, fourteen different A. baumannii genotypes were determined in PFGE. It was determined that the effects of antibiotic use, oral motor dysfunction, mechanical ventilation, intubation, orogastric tube use, and total parenteral nutrition intake on oral colonization were statistically significant. Oral colonization of A. baumannii is a significant concern in ICUs. We believe that it is important to take oral cultures and follow the risk factors and take infection control measures to prevent oral colonization of resistant isolates in ICUs.

Leeches have been used to complement medical therapies for many years, however there is little data on the microorganisms they may harbor as part of their flora. The study aims were to (1) identify the presence of bacteria and (2) the presence of Hepatitis B and C viruses (HBV and HCV) in medicinal leeches using traditional bacteriological assays, Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) and quantitative PCR (qPCR). Samples obtained from the body surface, intestine, and jaws from 10 Hirudo verbana leeches were aseptically cultured using traditional microbiological assays. Bacterial isolates were identified using the MALDI-TOF technique and the presence of HBV and HCV was analyzed using qPCR. The primary bacterium isolated from the sampled leeches were Aeromonas veronii (A. veronii) which was isolated from the jaws, gut and body surface of all leeches. Other bacteria isolated at a lower frequency from various parts were Chryseobacterium gleum, Ochrobactrum anthropi, Moraxella osloensis, Microbacterium oxydans, Kytococcus sedentarius, Rhizobium radiobacter, Staphylococcus hominis, Citrobacter and Bacillus. No anaerobic bacteria or hepatitis viruses were detected. Interestingly, some of the bacterial species identified in this study have been implicated in hospital acquired infections and are of particular risk to immunocompromised patients. The recovery of potential human pathogens from within medicinal leeches is a public health concern and consequently their use should be restricted and avoided in susceptible individuals or a prophylactic treatment should be applied.

Infections due to carbapenemase-producing Klebsiella pneumoniae are associated with high morbidity and mortality. In this study, we report a hospital outbreak due to co-producing OXA-48 and NDM-1 K. pneumoniae clone. The aim of the study is to investigate the clonal relationship of strains, risk factors of outbreak and infection control measures.

Once an outbreak was suspected at the end of December 2017 in our intensive care unit (ICU), carbapenem resistance K. pneumoniae identified in patients’ specimens. An outbreak analysis was begun to determine the risk factors and dissemination of the cases. A case-control study was conducted to determine the risk factors. To control the outbreak; tight contact prevention, good clean-up the medical devices and hospital environment, were done. Staff training programs such as hand hygiene, disinfection, wearing aprons, good cleaning were created. Carbapenem resistance genes determined by PCR. Clonal relationships of strains investigated by PFGE.

We investigate 21 carbapenem-resistant K. pneumonia strains. Nine of them were found co-produced NDM-1 and OXA-48, 11 strains produced OXA-48, and one strain produced NDM-1. Seven strains of co-producing NDM-1 and OXA-48 were found clonally related with PFGE. We could not determine any risk factor except rectal colonization in the case-control study.

The interventions that successfully controlled this outbreak were hand hygiene, tight contact prevention, good clean-up of the hospital environment and medical devices. As a result, we believe that it would be beneficial to take infection control measures to prevent the spread of these strains to the community and hospital settings.

  Pathogens surveillance and antimicrobial resistance are essential for the prompt organization of therapeutic and preventive actions in healthcare settings. We investigated the causative agents of intensive care unit (ICU)-acquired infections and their antimicrobial resistance in a university hospital over a nine-year period. An active, prospective surveillance was conducted in the ICUs of a tertiary care hospital between 2007 and 2015. The changing patterns in the frequency of pathogens and their antimicrobial resistance by the time were statistically evaluated with Mann-Whitney U test. A total of 3044 pathogens were isolated from 4272 healthcare-associated infections attacks in 3437 patients. The most frequently detected organisms were Acinetobacter spp. (n = 1060, 34.8%), Pseudomonas aeruginosa (n = 622, 20.4%), Escherichia coli (n = 340, 11.1%), Klebsiella pneumoniae (n = 331, 10.8%), and Candida spp. (n = 285, 9.3%). Carbapenem resistance among Acinetobacter spp., P. aeruginosa, E. coli, and K. pneumoniae was found as 82%, 30.7%, 2%, and 9.3%, respectively. The prevalence of extended-spectrum beta-lactamase (ESBL) among E. coli and K. pneumoniae was 49.7% and 41.3%, orderly, and methicillin resistance in Staphylococcus aureus was 81.8%. Substantial reductions occurred in the rates of E. coli (16.8% to 8.9%), S. aureus (11% to 3.2%), coagulase-negative staphylococci (7.9% to 0), and Stenotrophomonas maltophilia (4.2% to 0.3%) during the study period by the applied infection control measures while the rate of Acinetobacter spp. (9.7% to 51%) significantly increased. Furthermore, the increases in the carbapenem resistance among Acinetobacter spp. (52.5% to 91.4%), Pseudomonas spp. (25.7% to 51.6%), E. coli (0 to 12.7%), and K. pneumoniae (2.6% to 9%) and the decrease in the prevalence of ESBL-producing E. coli (57% to 27.2%) were statistically significant. Despite the decreases in the frequencies of staphylococci and some Gram-negative bacteria, the current infection control measures have been unable to limit the spread of carbapenem-resistant Gram-negative bacteria in our facility. Additional precautions are required to control such pathogens in the intensive care units