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Escherichia Coli Case Study

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The specimen was processed similarly to case-1. Escherichia coli was grown in aerobic culture, and Bifidobacterium sp. was cultured in anaerobic culture. The identification of Bifidobacterium sp. was done by both MALDI-TOF Vitek MS and Vitek-2. Escherichia coli was found to be Extended spectrum beta-lactamase (ESBL) positive and sensitive to Piperacillin+Tazobactam, Cefoperazone+Sulbactam, Imipenem, Meropenem, Amikacin, Gentamicin, Tobramycin, Chloramphenicol, and Cotrimoxazole. Bifidobacterium sp. was found to be sensitive to Penicillin, Ceftriaxone, Imipenem, Meropenem, Amoxycillin+clavulanic acid, Piperacillin+Tazobactam and Clindamycin and resistant to Metronidazole. The patient showed a good response to Meropenem and recovered completely. …show more content…

has been studied on disease association with altered gut microbiota. The various species of Bifidobacterium which have been used as probiotics are B. bifidum, B. breve, B.lactis, B. longum, B. infantis and B. adolescentis [3]. It is important to note that all the species of Bifidobacteriumare not beneficial. Also, the species which have been used as probiotics have also been reported to cause infections especially in neonates and immunocompromised individuals (See Table 1). The case reports of Bifidobacterium sp. as significant pathogens are enlisted in Table …show more content…

is associated with good oral health. On the other hand, it has also been found to be a predominant microbe in dental caries, and Bifidobacterium dentium is strongly linked to dental caries.Bifidobacterium sp have also been reported in cases of meningitis [10]. Nevertheless, the reports of Bifidobacterium sp. association as a significant human pathogenic agent are less. Bifidobacterium sp. can cause significant infections, and the presentation of the case can mimic tubercular infection also like one of our patients was on antitubercular therapy based on the clinical features and radiological findings. The scarcity of the clinical cases can be because of their fastidious nature, a special requirement of anaerobic atmosphere and thus difficult isolation. The isolation of Bifidobacterium sp. can be improved by the direct microscopic examination i.e. Gram stain of the clinical specimen, appropriate anaerobic techniques and rapid and accurate identification system. In the present reports, Bifidobacterium species were isolated in combination with Escherichia coli. If Gram stain examination would not have been done, it could be overlooked. So, Gram stain examination gave us the initial clue of such type of bacteria. The anaerobic atmosphere was generated by more stringent Anoxomat technique and the identification was made by MALDI-TOF Vitek MS system. Moreover, the identification by the Vitek-2 system also corroborated with MALDI-TOF system.

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