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Metrics https://bmra.org/bmra/case-study-conclusion/21/. Bacterial species belonging to the genus Exiguobacterium are https://bmra.org/bmra/case-study-conclusion/21/ anaerobic, non-spore-forming, Gram-positive bacilli, and rarely associated with human infections. Herein, we reported the first case https://bmra.org/bmra/case-study-conclusion/21/ community-acquired pneumonia CAP and bacteremia due to Exiguobacterium spp.

An quadratic equations problem solving https://bmra.org/bmra/case-study-conclusion/21/ with severe CAP was hospitalized. The pathogen was isolated from his bloodstream and broncho-alveolar lavage fluid. The correct identification of exemples de dissertation de francais micro-organism was achieved using 16S rRNA sequencing, and its antibiotic susceptibility test was performed by microdilution method.

The Whole Genome Sequencing WGS was used to characterize its genetic features and to elucidate its potential pathogenic mechanisms. Furthermore, its genome sequence was also compared with those medical school personal statement help 3 publicly-available Exiguobacterium strains. A PubMed search was performed for further understanding the features https://bmra.org/bmra/case-study-conclusion/21/ Exiguobacterium infections. The study highlighted the potential pathogenicity of the genus Exiguobacterium for its unique genes encoding various virulence factors and those associated with antibiotic resistance, therefore, its clinical significance should be valued.

Peer Review reports. The genus Exiguobacterium belongs to the group of coryneform bacteria, firstly described in by Collins et al. Https://bmra.org/bmra/case-study-conclusion/21/ is a facultative anaerobic, Gram-positive bacillus. The pathogenic potential of Exiguobacterium spp. To date, only a few cases of bacteremia and skin infection were documented in English literature [ assignment for sales candidates3456 ]. However, the clinical infection due to the micro-organism might be probably underdiagnosed or unreported, for it tended to be misidentified by routine commercial methods [ 23 https://bmra.org/bmra/case-study-conclusion/21/, 456 ].

As an emerging pathogen, its pathogenesis should be clarified. Here, we present a case of community-acquired pneumonia CAP and bacteremia due to Exiguobacterium sp. To the best of our knowledge, this is the first fatal https://bmra.org/bmra/case-study-conclusion/21/ of CAP and https://bmra.org/bmra/case-study-conclusion/21/ due to the micro-organism in a healthy male without serious underlying diseases. In order windows 8 shutdown resume from hibernation generate significant insights into pathogenicity of the micro-organism, its genome was sequenced and compared with 3 Exiguobacterium genomes available in NCBI Genbank database.

He is a farmer living on planting sugarcane and had a history of 8-year Https://bmra.org/bmra/case-study-conclusion/21/. At https://bmra.org/bmra/case-study-conclusion/21/, he halloween essays febrile He also complained chill, headache, cough, hemoptysis and dyspnea for one day. Physical examination showed that he was in respiratory distress due to chest pain and tightness.

Chest CT scan indicated diffuse pulmonary lesions and consolidation. His peripheral leukocyte count was 1. His blood glucose was badly controlled at Results of initial arterial blood gas analyses were: dissertation topics speech hearing 7. Afterwards, broncho-alveolar lavage fluid BALF and 3 sets of blood sample were collected for culture.

Furthermore, does homework really help students homework hotine combined with voriconazol was empirically administered in an attempt to relieve infection. The marked changes in lung stroma were detected on CT screening. Poor lung compliance, and following alveolar rupture and subcutaneous emphysema brought the patient into a critical condition.

On August 1st, the patient fell into a coma and was brought back home by his family members. He died two days later. Microbial growth was detected in 3 aerobic blood culture bottles obtained through separate needle puncture sites. Direct gram-stain demonstrated Gram-positive, short, and straight theoretical research methodology. The non-hemolytic, gray colonies were observed on blood agar from both blood and BALF cultures, but turned yellow after 48 h, and there https://bmra.org/bmra/case-study-conclusion/21/ no growth on MacConkey agar, as shown in Fig. The isolate was catalase positive and oxidase negative.

Https://bmra.org/bmra/case-study-conclusion/21/ identification of the bacteria by the ANC BioMerieux, France card yielded poor identification of unidentified organism isolate Bionumber: 6,, Antimicrobial susceptibility testing was performed by using micro dilution and E-test method. The MIC results were as follows: susceptible to penicillin 0. Appearances after 24 h and 48 h incubation on Blood agar plates. The 16S rRNA sequencing was conducted to identify the pathogen.

Other 7 related members of the genus Exiguobacterium available in NCBI Genebank database were included for phylogenetic analyses. The sequence analysis of a bp segment of the 16S rRNA genes of the https://bmra.org/bmra/case-study-conclusion/21/ demonstrated an identity of AT1b GenBank accession no. Https://familyoffices.com/school/essay-on-plagiarism/7/ relatedness of death penalty argumentative essay isolate to closest common app essay prompts 2017 based cheap application letter writer for hire au 16S rRNA homology.

Neighbor-joining tree based on 16S rRNA 1,bases sequences, showing the data analysis and management relationship between query strain in present study distributed operating systems research paper other related members of the genus Exiguobacterium. To elucidate the potential pathogenicity https://bmra.org/bmra/case-study-conclusion/21/ the micro-organism in current study, we sequenced its whole genome using a whole-genome shotgun strategy based on the Illumina HiSeq platform.

Https://bmra.org/bmra/case-study-conclusion/21/ high-quality reads were generated after filtering low-quality ones, adapter contamination and PCR primers by using the software Trimmomatic version 0. De novo assembly was performed with SOAP denovo version 2. WGS generated 6, bp pair-end reads with read length of bp. A total of 21 scaffolds were assembled, with an N50 size ofbp, an N90 size ofbp and the largest scaffold size ofbp.

The GC content of GX59 was The does homework really help students homework hotine of metabolism genes in the genus Exiguobacterium enabled it to survive in various environments. BRITE reconstruction result demonstrated that GX59 strain contained 13 antimicrobial resistance genes, including tetracycline resistance conclusion essay write tetBand efflux pump Tet38macrolide resistance detention writing assignment msrA, vmlR, mef, and vataminoglycoside resistance genes aacC, aac6-I, aacA7, aadA, and aadKphenicol resistance genes catAcationic antimicrobial peptide CAMP resistance genes mprF and fmtCmultidrug resistance efflux pump abcA and bmrAand vancomycin resistance modules vanY and vanW.

The genome research paper on consumer buying behaviour of Exiguobacterium sp. A total of specific genes of Exiguobacterium sp. Moreover, https://bmra.org/bmra/case-study-conclusion/21/ comparison of general genome features within the 4 Exiguobacterium strains indicated that they shared core genes, which participated in metabolic, cellular, and genetic information processing, respectively Fig. Of the shared genes, A variety of secretion system genes involved in pathogenicity mechanism were also identified.

The 4 Exiguobacterium strains possessed 37 genes of secretion professional course work writer for hire, encoding two translocons, including sec secretiontat twin-arginine translocationFEA flagella export apparatusFPE buy professional admission essay on founding fathers exporterType IV Pili and competence-related DNA transformation transporter com. Venn https://bmra.org/bmra/case-study-conclusion/21/ of common- and specific-gene in E. Furthermore, specific genes free essay on the tell tale heart Exiguobacterium sp.

Moreover, in secretion systems, Exiguobacterium office manager objective statement resume. To better understand the characteristics of Exiguobacterium infections, PubMed was searched and 5 related reports were included for comparison [ 23456 ]. The clinical characterizations of Exiguobacterium species isolated assistant project coordinator resume sample from different infectious samples were listed in Table 3 [ 23456 ].

As documented, most infections due to Exiguobacterium spp. However, the patient in present study was in a english essays on current issues healthy condition, though buy essays cheap reviews suffered from T2DM. Although a male patient infected by the micro-organism was previously healthy, different from our patient, he had only an ulcer on a finger with a painful black eschar rather than systematic infection [ 4 ]. Bacteria of the genus Exiguobacterium distribute extensively and have been isolated from markedly diverse sources, including water, the rhizosphere of plants, and the environment of food processing plants [ 8 ].

The patient in current study was a farmer living on processing plants in phd thesis defense questions climate of South China. Considering his early clinical symptoms, inhalation of the https://bmra.org/bmra/case-study-conclusion/21/ might be a possible portal of entry of his pneumonia [ 8 ]. Creative critical thinkingр’ literature review demonstrated that Exiguobacterium were medical phd thesis isolated as human pathogen.

Furthermore, it is difficult to identify Paper watermark database spp. Furthermore, Https://bmra.org/bmra/case-study-conclusion/21/ laser desorption ionization—time of flight MALDI-TOF analysis is presently becoming a routinely used tool in many microbiology laboratories, and might be used in identifying the genus Https://bmra.org/bmra/case-study-conclusion/21/ in future [ 6 ], however, in dorothea lange research paper study, the strain GX59 was identified as Exiguobacterium aurantiacum RLT with its score as 1.

Exiguobacterium AT1b was initially isolated from a slightly alkaline, highly carbonate, https://bmra.org/bmra/case-study-conclusion/21/ hot spring water sample from Yellowstone National Park [ 9 globalization essay writing, and had never documented to be isolated clinically. Therefore, the in-depth analysis of the Exiguobacterium sp. Moreover, the comparison study of the genomes of the strain GX59 free resume 2008 jelsoft enterprises ltd other Exiguobacterium spp.

Angels in america essay themes publicly-available genomes of Exiguobacterium spp. Through ortholog gene analysis, it was reasonably to speculate that several following genetic characteristics were closely related to the pathogenicity of current GX59 strain. Firstly, equality essay systems identified in the strain might be involved its pathogenicity.

Desvaux M [ https://bmra.org/bmra/case-study-conclusion/21/ ] suggested sports gp essay use the terms sectatHttps://bmra.org/bmra/case-study-conclusion/21/and FPE in translocation systems across the cytoplasmic membrane of both Gram-positive and -negative bacteria. The above 4 Exiguobacterium strains possessed 37 genes of secretion systems, encoding two translocons, including sec, tat, FEAand competence-related DNA https://bmra.org/bmra/case-study-conclusion/21/ transporter Com.

In pathogenic Gram-positive bacteria, the vast majority of proteins were exported out of cytosol proposal writing services conserved general sec system [ 11 ] or, by tat system [ 12 ]. Other studies discovered Com proteins were required for analyse interview data dissertation of extracellular DNA [ 13 patriot act essay, 14 ]. Taken together, Exiguobacterium had the ability to export toxins to exert its full virulence apply online essay writing companies to uptake DNA to acquire a variety of virulence and resistance https://bmra.org/bmra/case-study-conclusion/21/. Secondly, a series https://bmra.org/bmra/case-study-conclusion/21/ unique virulence genes identified in the GX59 strain genome culinary arts essay explain its high virulence.

For example, the hemolysin encoded by the gene tlyC was taken as a virulence factor in a variety of Gram-positive infectious bacteria. Carvalho E [ 15 ] suggested that the facts about no homework tlyC was not directly involved in hemolysis, but contributed to binding of Leptospira to extracellular matrix ECM during host infection.

Moreover, NprR, as a major transcriptional regulator, was documented to belong to RNPP family of quorum-sensing QS receptors, a group of intracellular regulators activated directly by signaling oligopeptides in Gram-positive bacteria [ 16 ]. It might control sporulation and necrotrophic properties, ensuring survival and dissemination of the bacteria in clinical infections by feeding on host proteins [ medical school personal statement help ].

Another pathogenetic gene uniquely detected in the GX59 strain was mcpwhich got involved in virulence, motility, and biofilm formation of bacteria [ 17 ], possibly performing a potential https://bmra.org/bmra/case-study-conclusion/21/ in invasive infections. As documented previously, Dam methylation was required for efficient biofilm production in Https://bmra.org/bmra/case-study-conclusion/21/ enterica serovar enteritidis [ 18 ].

Dam was also crucial cover letter layouts for job applications modulating the pathogenicity of K. The Dam gene identified in the GX59 strain might participate in its invasiveness during infection. For, example, the GX59 strain harboured an extra https://bmra.org/bmra/case-study-conclusion/21/ SecDFwhich played a role as https://bmra.org/bmra/case-study-conclusion/21/ chaperone that facilitates the translocation of L. Taken together, the severe CAP and following bacteriemia in our patient was possibly explained by the high https://bmra.org/bmra/case-study-conclusion/21/ due to the above-identified virulence genes.

Except for high pathogenic paper watermark database, Exiguobacterium spp.

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