Actinomyces neuii: review of an unusual infectious agent

Graevenitz, Alexander von

doi:10.1007/s15010-011-0088-6

Cited by 51 publications

(44 citation statements)

References 35 publications

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“…Unlike other Actinomyces species, A. neuii is a nonbranching small rod often misidentified as a Corynebacterium species (4,5). Improved detection of A. neuii via MALDI-TOF MS has led to the recent recognition of this organism as a soft tissue pathogen (5,37). However, few if any urinary tract infections are documented in the literature.…”

Section: Discussionmentioning

confidence: 99%

Clinical Significance of Commensal Gram-Positive Rods Routinely Isolated from Patient Samples

2016

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Commensal bacteria from the skin and mucosal surfaces are routinely isolated from patient samples and considered contaminants. The majority of these isolates are catalase-positive Gram-positive rods from multiple genera routinely classified as diphtheroids. These organisms can be seen upon Gram staining of clinical specimens or can be isolated as the predominant or pure species in culture, raising a priori suspicion of a possible involvement in infection. With the development and adoption of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), suspicious isolates are now routinely identified to the species level. In this study, we performed a retrospective data review (2012 to 2015) and utilized site-specific laboratory criteria and chart reviews to identify species within the diphtheroid classification representative of true infection versus contamination. Our data set included 762 isolates from 13 genera constituting 41 bacterial species. Only 18% represented true infection, and 82% were deemed contaminants. Clinically significant isolates were identified in anaerobic wounds (18%), aerobic wounds (30%), blood (5.5%), urine (22%), cerebrospinal fluid (24%), ophthalmologic cultures (8%), and sterile sites (20%). Organisms deemed clinically significant included multiple Actinomyces species in wounds, Propionibacterium species in joints and cerebrospinal fluid associated with central nervous system hardware, Corynebacterium kroppenstedtii (100%) in breast, and Corynebacterium striatum in multiple sites. Novel findings include clinically significant urinary tract infections by Actinomyces neuii (21%) and Corynebacterium aurimucosum (21%). Taken together, these findings indicate that species-level identification of diphtheroids isolated with a priori suspicion of infection is essential to accurately determine whether an isolate belongs to a species associated with specific types of infection. C linical microbiology specimens frequently grow variable levels of commensal bacteria from the skin and mucosal surfaces in addition to true pathogens (1). The majority of these isolates are aerobic, asporogenic, irregularly shaped, non-partially-acid-fast, catalase-positive, Gram-positive rods from multiple genera with nondistinct colony morphology, routinely classified as diphtheroids (2). The term diphtheroid and coryneform are interchangeable, and for a comprehensive review of bacterial genera classified as coryneform bacteria, see two excellent reviews by Bernard et al. (2,3). In brief, the medically relevant genera whose morphological and biochemical descriptions fit in the diphtheroid classification include Arcanobacterium, Arthrobacter, Brevibacterium, Cellulomonas, Cellulosimicrobium, Corynebacterium (non-diphtheriae), Curtobacterium, Dermabacter, Exiguobacterium, Helcobacillus, Janibacter, Knoellia, Leifsonia, Microbacterium, Pseudoclavibacter, and Trueperella (2-4).Additionally, certain species within other genera share some but not all features of diphtheroids, are part of t...

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Section: Discussionmentioning

confidence: 99%

Clinical Significance of Commensal Gram-Positive Rods Routinely Isolated from Patient Samples

2016

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“…[1,2] The most common Actinomyces is Actinomyces israelii, but several others have been described through the use of biochemical assays. [3] Actinomyces neuii, a species of Actinomyces, was first described in 1994 by Funke et al [4,5] In contrast to other species of Actinomyces, it is a diphtheroidal organism without branching, has both anaerobic and aerobic growth, and has greater than 60 strains. [5] There are limited reports of a classic Actinomyces presentation with gram-positive filaments and sulphur granules.…”

Section: Introductionmentioning

confidence: 99%

“…[3] Actinomyces neuii, a species of Actinomyces, was first described in 1994 by Funke et al [4,5] In contrast to other species of Actinomyces, it is a diphtheroidal organism without branching, has both anaerobic and aerobic growth, and has greater than 60 strains. [5] There are limited reports of a classic Actinomyces presentation with gram-positive filaments and sulphur granules. [5] The diagnosis of A. neuii is based on 16S rRNA sequencing.…”

Section: Introductionmentioning

confidence: 99%

“…[5] There are limited reports of a classic Actinomyces presentation with gram-positive filaments and sulphur granules. [5] The diagnosis of A. neuii is based on 16S rRNA sequencing. A. neuii is known to be endogenous to the human body.…”

Section: Introductionmentioning

confidence: 99%

“…Previous case studies have reported infections and abscesses caused by A. neuii in the skin, eyes, heart, pericardium, bone, and placenta. [5] However, there have been few reports of A. neuii as the causative agent in intra-abdominal infections following pelvic surgery. The case presented here of a dramatic intraabdominal A. neuii infection highlights a new area of pathogenesis for this species.…”

Section: Introductionmentioning

confidence: 99%

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Actinomyces neuii infection following ovarian cystectomy

Lueken

Wilson

Holbrook

et al. 2018

CSS

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Background: Abdominal Actinomyces infections are rare complications of surgery. A case of Actinomyces neuii presenting as a severe postoperative pelvic infection is described. Case: A 30 year-old nulligravid female was transferred from an outside hospital for a postoperative fluid collection, fever, leukocytosis, and abdominal pain following exploratory laparotomy and bilateral ovarian cystectomy. She rapidly decompensated requiring emergent exploratory laparotomy, bilateral salpingooophorectomy, and abdominal washout. Cultures isolated A. neuii. Following a prolonged ICU admission, she was treated with prolonged antibiotics and made a complete recovery. Conclusions: Rare pathogens, such as A. neuii, may cause severe infections following gynecologic surgery. Multidisciplinary care at tertiary care facilities is critical.

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An overview of thoracic actinomycosis: CT features

Han

Lee

et al. 2012

Insights Imaging

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BackgroundThoracic actinomycosis is an uncommon, chronic suppurative bacterial infection caused by actinomyces species, especially Actinomyces israelii.MethodsIt is usually seen in immunocompetent patients with respiratory disorders, poor oral hygiene, alcoholism and chronic debilitating diseases.ResultsWe illustrate the radiological manifestations of thoracic actinomycoses in various involved areas in the thorax.ConclusionThoracic actinomycosis can be radiologically divided into the parenchymal type, the airway type including bronchiectasis, the endobronchial form, and the mediastinum or chest wall involvement type.Teaching PointsImportant risk factors for thoracic actinomycosis are underlying respiratory disorders such as emphysema and chronic bronchitis.Different CT patterns can be distinguished in thoracic actinomycosis: parenchymal, bronchiectatic, endobronchial and extrapulmonary.Typical CT findings in the parenchymal pattern are a central low density within the parenchymal consolidation and adjacent pleural thickening.

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Actinomyces neuii: review of an unusual infectious agent

Cited by 51 publications

References 35 publications

Clinical Significance of Commensal Gram-Positive Rods Routinely Isolated from Patient Samples

Clinical Significance of Commensal Gram-Positive Rods Routinely Isolated from Patient Samples

Actinomyces neuii infection following ovarian cystectomy

An overview of thoracic actinomycosis: CT features

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