A Case of Septicemia with Pediococcus acidilactici After Long-Term Antibiotic Treatment

Heinz, M.; Wintzingerode, Friedrich von; Moter, Annette; Halle, E.; Lohbrunner, H.; Kaisers, Udo; Neuhaus, P.

doi:10.1007/s100960000409

Cited by 18 publications

(9 citation statements)

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“…Our case represents only the second time that daptomycin was successfully used in therapy and the first time this drug was used to treat a confirmed case of endocarditis (10). Finally, this present case is only the second time that molecular sequencing was performed to verify the species identification (6). Most of the previous cases used a series of biochemical tests to provide a species identification.…”

Section: Case Reportmentioning

confidence: 76%

“…To overcome this, molecular sequencing has been considered (6). Heinz et al sequenced both the full-length 16S rRNA gene and the D-lactate dehydrogenase gene and was able to show a 99% similarity to the P. acidilactici type strain (DSM 20284) in the GenBank database, with the next closest identification to the P. pentosaceus type strain at 72.7% (6). We sequenced the intergenic spacer (IGS) region target within the rRNA gene complex, which also was able to give reliable results using comparison analysis in the GenBank database.…”

Section: Case Reportmentioning

confidence: 99%

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Pediococcus acidilactici Endocarditis Successfully Treated with Daptomycin

et al. 2012

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This report describes the first case of persistent bacteremia with endocarditis caused by Pediococcus acidilactici in a 32-year-old male with a history of short gut syndrome following a small bowel transplant. The results showed the utility of sequencing the intergenic spacer region for species identification and successful treatment using daptomycin. CASE REPORTA 32-year-old male with a history of short gut syndrome following a small bowel transplant 1 year prior with severe rejection requiring explantation 3 weeks after transplant presented with fever (102°F), rigors, and dyspnea of 3 days' duration. His medical history included multiple abdominal surgeries, hepatosteatosis, and diabetes mellitus. He was total parenteral nutrition (TPN) dependent due to short bowel syndrome, with a history of multiple bacterial and fungal line infections. He denied any use of intravenous drugs. The review of systems was positive for dry cough, palpitations, and diffuse myalgias. On the physical examination, the patient was febrile (101.8°F) and his lungs were clear, with no heart murmur, conjunctival hemorrhage, splinter hemorrhages, Janeway lesions, or Osler nodules noted. The laboratory data showed a normal white blood cell count and differential, anemia (hemoglobin of 8.2 g/dl), and mild thrombocytopenia (114,000 cells/microliter). A chest X-ray performed upon admission showed bilateral patchy opacities. He was started on empirical treatment with vancomycin, piperacillin-tazobactam, and micafungin for a suspected line infection. A computer tomography (CT) scan of the chest with intravenous contrast showed multiple bilateral lung nodules suggestive for septic emboli. A transesophageal echocardiogram (TEE) exam showed a subcentimeter vegetation on the mitral valve, as well as a small patent foramen ovale with right to left shunt. He remained febrile during the following 4 days despite broad-spectrum antibiotics. Six sets of blood cultures (standard aerobic and anaerobic media [Bactec System, BD Diagnostics, Franklin Lakes, NJ]) drawn from the central line and peripherally over the next 5 days of hospitalization were Gram stain positive for Gram-positive cocci in clusters after 24 to 27 h of incubation at 37°C. The catheter tip culture following removal (day 5 of hospitalization) also was positive for a nonhemolytic, catalase-negative, Gram-positive coccus in clusters. Subsequent biochemical analysis showed all isolates to be negative for the production of pyrrolidonyl arylamidase (PYR test), positive for the production of leucine aminopeptidase and for the ability to grow in 6.5% NaCl, and resistant to vancomycin for a presumptive identification of the blood culture and catheter tip isolates as a Pediococcus species. At the time of positive blood cultures, micafungin and vancomycin were discontinued and the patient was on only piperacillin-tazobactam. The patient met the Duke criteria for infectious endocarditis. Given the persistent low-grade fever on the appropriate antibiotic therapy, as well as persistent positive blood c...

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Section: Case Reportmentioning

confidence: 76%

Section: Case Reportmentioning

confidence: 99%

Pediococcus acidilactici Endocarditis Successfully Treated with Daptomycin

et al. 2012

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“…2,15 Underlying diseases and conditions associated with Pediococcus infection include chronic lung disease, 14 gastroschisis, 11 congenital jejunoileal atresia, 13 inflammatory bowel disease, 2 diabetes, 2 hematologic malignancies, 12 neutropenic patients, 16 previous abdominal surgeries, 2 presence of central venous access for total parenteral nutrition, 16 and long-term antibiotic use. 10 Some of these reports have described delays in the identification of this pathogen and the persistence of symptoms while receiving vancomycin. 10,12 Pediococcus acidilactici has been the most common isolate recovered 1,11 and has been significantly associated with bacteremia.…”

Section: Discussionmentioning

confidence: 99%

“…10 Some of these reports have described delays in the identification of this pathogen and the persistence of symptoms while receiving vancomycin. 10,12 Pediococcus acidilactici has been the most common isolate recovered 1,11 and has been significantly associated with bacteremia. 4 Pediococcus parvulus has not been previously reported as a cause of infections in humans.…”

Section: Discussionmentioning

confidence: 99%

Use of 16s rRNA Gene Sequencing to Identify a Case ofPediococcus parvulusBacteremia in a Patient with Metastatic Testicular Cancer

Castro¹,

Knezetic²,

Cavalieri³

2010

Lab Med

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93Pediococcus is a gram-positive coccus that is facultatively anaerobic and catalase negative. It has been found in the food and wine industry. 1,2,3 There are 5 Pediococcus species described, 1,4,5 although the exact taxonomy is controversial. 4 Since the first report of infection by Pediococcus in 1987, 6 other cases involving this genus have been described involving either P. acidilactici or P. pentosaceum. 1,4 We present the first known case of Pediococcus parvulus (P. parvulus) infection in a young male with metastatic testicular cancer. Report of CaseA 22-year-old white male with metastatic testicular cancer was admitted to a local medical facility after developing fever, chills, abdominal pain, and dysuria for 3 days. Initial evaluation showed leukocytosis and positive abdominal computerized tomography (CT) scan findings. A retroperitoneal mass was observed with the presence of air, suggesting tumor necrosis and bowel perforation. Blood cultures were obtained prior to empiric antibiotic therapy with cephalothin, levofloxacin, and tobramycin. He was transferred to Creighton University Medical Center for surgical evaluation and further medical management. Past medical history was significant for stage III mature teratoma in the right testicle, with metastatic foci in the liver, lungs, and the retroperitoneal area. The retroperitoneal mass had a diameter of 20 cm and was in contact with the posterior wall of the second portion of the duodenum. He had a right orchiectomy and subsequent chemotherapy with etoposide, cisplatin, and bleomycin. He had his last chemotherapy infusion 10 days prior to the onset of symptoms. Complications derived from testicular cancer included the development of right hydronephrosis requiring ureteral stent placement, gastrointestinal bleeding secondary to retroperitoneal mass erosion into the duodenum, which was medically controlled, and central line-related sepsis with Enterococcus faecium and viridans group streptococci. On evaluation, he was tachycardic (104 beats per minute), and afebrile (temperature: 38.0ºC). He was in mild, generalized distress and had a cachectic appearance. He had facial pallor and diffuse abdominal pain on gentle palpation. The rest of

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“…A 1,002-bp ORF that potentially encodes a 334-amino-acid protein was identified as DLDH. BLAST searches revealed that the nucleotide and deduced amino acid sequences for this ORF have identities of 78 to 90% and 43 to 62%, respectively, to the sequences of published DLDH enzymes from other lactic acid bacteria (LAB) (3,4,10,12,14,15,16,17) (Fig. 2) , and Streptococcus thermophilus LMD-9).…”

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confidence: 89%

Molecular Characterization of Two Lactate Dehydrogenase Genes with a Novel Structural Organization on the Genome of Lactobacillus sp. Strain MONT4

Weekes¹,

Yüksel

2004

Appl Environ Microbiol

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Two lactate dehydrogenase (ldh) genes from Lactobacillus sp. strain MONT4 were cloned by complementation in Escherichia coli DC1368 (ldh pfl) and were sequenced. The sequence analysis revealed a novel genomic organization of the ldh genes. Subcloning of the individual ldh genes and their Northern blot analyses indicated that the genes are monocistronic.Lactobacillus sp. strain MONT4 was isolated from hightemperature-fermenting grape musts (2). It is a unique organism due to its capability of fermenting L-arabinose and ribose exclusively to D(Ϫ)-and L(ϩ)-lactate via a homolactic fermentation pathway (2). Unlike heterolactic fermentations of pentoses that yield equimolar amounts of lactic and acetic acids, homolactic fermentations of pentoses yield only lactic acid and are unknown among lactobacilli. Our long-range goal is to metabolically engineer Lactobacillus sp. strain MONT4 for ethanol production, as it perfectly meets the criteria essential in a commercial biomass-to-ethanol process (25). Metabolic engineering of Lactobacillus sp. strain MONT4 for ethanol production requires the introduction of ethanol production genes into this organism. Moreover, inactivation of the lactate dehydrogenase (ldh) genes is necessary to eliminate coproduct formation.Escherichia coli (pfl ldh) lacks the ability to grow anaerobically on sugars and thus can be used to clone genes from fermentative pathways (1,3,6,7,8,9,10,19,21,24). In order to clone the ldh genes, genomic DNA from Lactobacillus sp. strain MONT4 was partially digested with Sau3AI and was ligated to BamHI-digested pJDC9 (5). E. coli DC1368 transformants were selected on Luria-Bertani medium containing antibiotics (erythromycin, 1 mg per ml; kanamycin, 60 g per ml; chloramphenicol, 60 g per ml) after 48 h of incubation under anaerobic conditions. Four antibiotic-resistant transformants were obtained. One of them, designated E. coli DC1368(pUI100), contained a plasmid with a 5-kb insert (Table 1). When the cell extracts from the transformants were subjected to native polyacrylamide gel electrophoresis and lactate dehydrogenase (LDH) activity staining (11), E. coli DC1368(pUI100) expressed both L(ϩ)-lactate dehydrogenase (LLDH) and D(Ϫ)-lactate dehydrogenase (DLDH) enzymatic activities (Fig. 1).The DNA sequence of the genomic insert from pUI100 was determined (GenBank accession no. AY301012). Eleven open reading frames (ORF) were identified. A 1,002-bp ORF that potentially encodes a 334-amino-acid protein was identified as DLDH. BLAST searches revealed that the nucleotide and deduced amino acid sequences for this ORF have identities of 78 to 90% and 43 to 62%, respectively, to the sequences of published DLDH enzymes from other lactic acid bacteria (LAB) (3,4,10,12,14,15,16,17) (Fig. 2) , and Streptococcus thermophilus LMD-9). At the amino acid level, a 25 to 60% identity and a 45 to 75% similarity within stretches of 244 to 332 amino acids were detected between the deduced amino sequence of the ldhD gene and the translated and annotated genome sequences of 11 LAB stra...

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A Case of Septicemia with Pediococcus acidilactici After Long-Term Antibiotic Treatment

Cited by 18 publications

References 10 publications

Pediococcus acidilactici Endocarditis Successfully Treated with Daptomycin

Pediococcus acidilactici Endocarditis Successfully Treated with Daptomycin

Use of 16s rRNA Gene Sequencing to Identify a Case ofPediococcus parvulusBacteremia in a Patient with Metastatic Testicular Cancer

Molecular Characterization of Two Lactate Dehydrogenase Genes with a Novel Structural Organization on the Genome of Lactobacillus sp. Strain MONT4

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