case_images: PMC6794824_01
case_images: non-lactose fermenting colonies of Providencia vermicola on CLED (Cystine Lactose Electrolyte Deficient) agar
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case_images: Fig1
case_images: 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.
case_images: Biochemical tests showing the organism belonging to Providencia species
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case_images: Fig2
case_images: 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).
case_images: Modified Hodge Test positive for test organism (Providencia)
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case_images: Fig3
case_images: 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).
case_images: Modified Hodge Test positive for test organism (Providencia)
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case_images: Fig4
case_images: 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).
case_images: 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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case_images: Fig5
case_images: 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.
case_images: 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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case_images: PMC6794824_01_13756_2019_608_Fig6_HTML.jpg
case_images: Fig6
case_images: 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.
case_images: Cepheid Xpert Carba-R Assay showing detection of blaOXA-48 gene sequences
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case_images: Fig7
case_images: 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.
case_images: Cepheid Xpert Carba-R Assay showing detection of blaOXA-48 gene sequences
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case_images: Fig8
case_images: 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.