PMC6794824_01
non-lactose fermenting colonies of Providencia vermicola on CLED (Cystine Lactose Electrolyte Deficient) agar
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Fig1
Culture of blood and urine revealed gram negative bacilli with non-lactose fermenting colonies on MacConkey and CLED (Cystine Lactose Electrolyte Deficient) agar (Fig. 1) respectively.
Biochemical tests showing the organism belonging to Providencia species
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Fig2
To confirm that the organism belongs to the tribe Proteeae of family Enterobacteriaceae, phenyl pyruvic acid test was performed which was found to be positive (Fig. 2).
Modified Hodge Test positive for test organism (Providencia)
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Fig3
An increase in zone of inhibition of more than or equal to 5 mm for either antimicrobial agent in combination with CA versus its zone when tested alone were negative, but Modified Hodges test revealed carbapenamase producing bacteria (Figs. 3 and 4).
Modified Hodge Test positive for test organism (Providencia)
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Fig4
An increase in zone of inhibition of more than or equal to 5 mm for either antimicrobial agent in combination with CA versus its zone when tested alone were negative, but Modified Hodges test revealed carbapenamase producing bacteria (Figs. 3 and 4).
Detection of OXA-48 by using antibiotic containing disk which is intrinsically resistant to Providencia instead of Blank Disk3. {E - EDTA-0.1 M 10 mul (292 mug of EDTA), P-Phenyl Boronic Acid- 10 muL (containing 600 mug of PBA)}3
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Fig5
Tsakris et al. which revealed indentation of growth toward both EDTA and EDTA/PBA disc (Figs.5 and 6) indicating production of OXA-48 carbapenamase. The isolates were transported to India, where they were confirmed as Providencia vermicola by VITEK MS, which use matrix-assisted laser desorption/ionization time-of- flight (MALDI-TOF) technology.
Detection of OXA-48 by using antibiotic containing disk which is intrinsically resistant to Providencia instead of Blank Disk3. {E - EDTA-0.1 M 10 mul (292 mug of EDTA), P-Phenyl Boronic Acid- 10 muL (containing 600 mug of PBA)}3
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Fig6
Tsakris et al. which revealed indentation of growth toward both EDTA and EDTA/PBA disc (Figs.5 and 6) indicating production of OXA-48 carbapenamase. The isolates were transported to India, where they were confirmed as Providencia vermicola by VITEK MS, which use matrix-assisted laser desorption/ionization time-of- flight (MALDI-TOF) technology.
Cepheid Xpert Carba-R Assay showing detection of blaOXA-48 gene sequences
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Fig7
Added to that, the resistance pattern of the isolated colonies was processed by Xpert Carba-R (Cepheid) assay, which detect blaOXA-48 gene (Figs. 7 and 8) and OXA48 drug resistance pattern was confirmed.
Cepheid Xpert Carba-R Assay showing detection of blaOXA-48 gene sequences
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Fig8
Added to that, the resistance pattern of the isolated colonies was processed by Xpert Carba-R (Cepheid) assay, which detect blaOXA-48 gene (Figs. 7 and 8) and OXA48 drug resistance pattern was confirmed.