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      Bacteriemia por Raoultella planticola de origen gastrointestinal Translated title: Raoultella planticola bacteremia of gastrointestinal origin Translated title: Bacteriemia por Raoultella planticola de origem gastrointestinal

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          Abstract

          RESUMEN La bacteria Raoultella planticola se ha asociado raramente con infección clínica. Entre sus manifestaciones se destacan las infecciones del tubo digestivo y la bacteriemia. La mayoría de los casos son de origen nosocomial secundarios a procedimientos invasivos o se dan en el marco de una afección neoplásica de la vía biliar. Tratada a tiempo, la infección es de curso benigno, pero no se debe desestimar esta bacteria como inocua pues tiene homología estrecha con Klebsiella spp., lo que le confiere el potencial de adquirir mecanismos de resistencia a antibióticos como los genes bla KPC. Presentamos el caso de una paciente con bacteriemia por R. planticola de origen gastrointestinal adquirida en la comunidad y tratada exitosamente en un hospital de referencia en la ciudad de Medellín.

          Translated abstract

          SUMMARY Raoultella planticola, a bacteria found in water and soil, is rarely associated to human disease, mostly bacteremia and gastrointestinal infections. It is usually related with health care procedures or affects patients with malignant biliary disease. If properly treated, this infection is usually benign, but the germ must not be disregarded as an innocent bystander because it has homology with Klebsiella spp., and therefore the potential to acquire antimicrobial resistance mechanisms like bla KPC genes. We report the case of a patient with community-aquired R. planticola bacteremia of gastrointestinal origin.

          Translated abstract

          RESUMO A bactéria Raoultella planticola se há associado raramente com infecção clínica. Entre suas manifesta- ções se destacam as infecções do tubo digestivo e a bacteriemia. A maioria dos casos são de origem nosocomial secundários a procedimentos invasivos ou se dão no marco de uma afecção neoplásica da via biliar. Tratada a tempo, o curso da infecção é benigno, mas não se deve desestimar esta bactéria como inócua pois tem homologia estreita com Klebsiella spp., o que lhe confere o potencial de adquirir mecanismos de resistência a antibióticos como os genes bla KPC. Apresentamos o caso de uma paciente com bacteriemia por R. planticola de origem gastrointestinal adquirida na comunidade e tratada com sucesso num hospital de referência na cidade de Medellín.

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          Phylogenetic analyses of Klebsiella species delineate Klebsiella and Raoultella gen. nov., with description of Raoultella ornithinolytica comb. nov., Raoultella terrigena comb. nov. and Raoultella planticola comb. nov.

          The phylogenetic relationships of the type strains of 9 Klebsiella species and 20 species from 11 genera of the family Enterobacteriaceae were investigated by performing a comparative analysis of the sequences of the 16S rRNA and rpoB genes. The sequence data were phylogenetically analysed by the neighbourjoining and parsimony methods. The phylogenetic inference of the sequence comparison confirmed that the genus Klebsiella is heterogeneous and composed of species which form three clusters that also included members of other genera, including Enterobacter aerogenes, Erwinia clusters I and II and Tatumella. Cluster I contained the type strains of Klebsiella pneumoniae subsp. pneumoniae, Klebsiella pneumoniae subsp. rhinoscleromatis and Klebsiella pneumoniae subsp. ozaenae. Cluster II contained Klebsiella ornithinolytica, Klebsiella planticola, Klebsiella trevisanii and Klebsiella terrigena, organisms characterized by growth at 10 degrees C and utilization of L-sorbose as carbon source. Cluster III contained Klebsiella oxytoca. The data from the sequence analyses along with previously reported biochemical and DNA-DNA hybridization data support the division of the genus Klebsiella into two genera and one genogroup. The name Raoultella is proposed as a genus name for species of cluster II and emended definitions of Klebsiella species are proposed.
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            The Ethical Significance of Antimicrobial Resistance

            In this paper, we provide a state-of-the-art overview of the ethical challenges that arise in the context of antimicrobial resistance (AMR), which includes an introduction to the contributions to the symposium in this issue. We begin by discussing why AMR is a distinct ethical issue, and should not be viewed purely as a technical or medical problem. In the second section, we expand on some of these arguments and argue that AMR presents us with a broad range of ethical problems that must be addressed as part of a successful policy response to emerging drug resistance. In the third section, we discuss how some of these ethical challenges should be addressed, and we argue that this requires contributions from citizens, ethicists, policy makers, practitioners and industry. We conclude with an overview of steps that should be taken in moving forward and addressing the ethical problems of AMR.
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              First descriptions of blaKPC in Raoultella spp. (R. planticola and R. ornithinolytica): report from the SENTRY Antimicrobial Surveillance Program.

              Two strains of Raoultella planticola and one of Raoultella ornithinolytica showing carbapenem resistance were recovered from patients hospitalized in New Jersey and Ohio. All patients had received previous antimicrobial treatment, including carbapenems. These strains harbored bla(KPC-2) and bla(KPC-3). Carbapenemase genes were embedded in isoforms of Tn4401 and were plasmidic and chromosomal in location.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                iat
                Iatreia
                Iatreia
                Universidad de Antioquia (Medellín, Antioquia, Colombia )
                0121-0793
                March 2017
                : 30
                : 1
                : 67-71
                Affiliations
                [2] Medellín Antioquía orgnameUniversidad Pontificia Bolivariana Colombia
                [1] Medellín orgnameHospital Pablo Tobón Uribe Colombia
                Article
                S0121-07932017000100067
                10.17533/udea.iatreia.v30n1a06
                e2b12269-affb-4a66-8145-7846ff5b3ec6

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 19 January 2016
                : 22 January 2016
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 11, Pages: 5
                Product

                SciELO Colombia


                Sepsis,Bacteremia,Drug Resistance, Bacterial,Enterobacteriaceae Infections,Bacteriemia,Farmacorresistência Bacteriana,Infecções por Enterobacteriaceae,Sepse,Farmacorresistencia Bacteriana,Infecciones por Enterobacteriaceae

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