FLASH-BR-03

Sepsis-Associated Microorganisms in Brazilian Ambulatories (SAMBA)

Total parenteral nutrition (TPN) is an important nutritional supplement for seriously ill patients, especially those incapable of oral or enteral nutrition. TPN may become contaminated with bacteria during preparation because its rich formula can act as a favorable growth media [1]. Bacteria of the Erwinia herbicola/Enterobacter agglomerans complex – EEC (family Enterobacteriaceae) have recurrently been related to potentially lethal nosocomial outbreaks especially in pre-term infants and immunocompromised patients [2, 3]. However, due to still the unsettled taxonomy, the routine identification of these bacteria in clinical diagnostic laboratories is still unsatisfactory, with several proven misidentifications as Pantoea species [4]. Within the EEC, Brenner`s Biotype XII [4, 5] forms a distinct, but still undescribed clade, whose representatives have often been isolated as contaminants of intravenous preparations, blood products and transference tubes used for intravenous hydration [6-10]. A number of clinical strains associated to Brenner’s Biotype XII are available in culture collections [4] and from the outbreak described below (the “event”), but have not been thoroughly characterized so far. The aim of this project is to obtain a detailed phenotypic, molecular and taxonomical description of Brenner’s Biotype XII in order to identify sanitary threats connected to these bacteria and the adjoining EEC. A variety of approaches will be employed, from detailed biochemical/metabolic analysis and whole cell MALDI-ToF MS profiling to whole-genome sequencing and comparative genomics. This will pave the way to the understanding of the lifestyle of the bacterial species associated to Brenner’s Biotype XII, their pathogenic potential and the related health risks. Genome data will allow developing specific rapid molecular methods to detect the species from medical compounds and from patient samples in diagnostic laboratories, thus enabling source tracking of future contaminations and expediting the onset of an appropriate therapy for benefit of patients. Molecular characterization, genomics and detection assay development will be performed by the Swiss partner, whereas biochemical typing, assay validation and epidemiological aspects will be implemented by the Brazilian counterpart.

 

Prof. Theo H. M. Smits

Prof. Marcello Pilonetto