Burkholderia pickettii spondylitis

Abstract

Study design: Case report describing Burkholderia pickettii spondylitis in a healthy adult. Objectives: To describe this very rare form of spondylitis and to discuss some of the difficulties in the diagnosis of B. pickettii spondylitis. Setting: Department of Orthopaedic Surgery, Nayoro City General Hospital, Japan. Methods: A 48-year-old woman presented with a complaint of severe back pain radiating from the right side of her chest. Plain radiographs of the spine showed osteolytic destruction of the right side of the T10 vertebral body at T10 level, with an involvement of the pedicle. Magnetic resonance image of the spine showed a low signal intensity from the T10 vertebral body on a Tlweighted image and an increased signal intensity on T2-weighted sequence image. These lesions were enhanced when a contrast medium was used. The patient underwent open biopsy and specimens were collected through the right pedicle. Results: Diagnosis was established on the basis of direct identification of the microorganism. Histological findings were consistent with examination of B. pickettii spondylitis. Chemotherapy (intravenous cefepime and per os minocycline) resulted in complete cure. Conclusion: B. pickettii is widely distributed in aqueous sources in nature and has not previously been considered to be an aggressive pathogen towards humans. This case report will help to improve our understanding of the ecology and virulent pathogenicity of this organism. A biopsy is an essential and reliable method for the early etiologic diagnosis, which will lead to prevent the development of more severe complications such as spinal cord compression.Spinal Cord (2005) 43, 499-502.

Oxacillinases and antimicrobial susceptibility of Ralstonia pickettii from pharmaceutical water systems in Croatia

“…It is difficult to remove it from a water plant due to the protecting effect of its biofilm (Donlan and Costerton 2002). Sterile solutions contaminated with R. pickettii are most likely responsible for the uptake and spread of this bacterium in hospital settings (McNeil et al 1985;Lai et al 2016b) where it colonizes patients (McNeil et al 1985;Tejera et al 2016), causes different infections, such as bacteremia (Woo et al 2002;Nasir et al 2019), bloodstream infections (Vitaliti et al 2008;Strateva et al 2012), endophthalmitis (Choudhury et al 2015), endocarditis (Orme et al 2015), osteomyelitis (Wertheim and Markovitz 1992), spondylitis (Sudo et al 2005), infections in burned patients (Lin et al 2018) and other. Antibiotic resistance can present a challenge for clinicians due to multiple intrinsic and acquired resistance traits (Zellweger et al 2004).…”

Extreme Antimicrobial Peptide and Polymyxin B Resistance in the Genus Burkholderia

“…Resistance mechanisms have been characterized in various Gram-negative bacteria, including Escherichia coli , Salmonella enterica , and Pseudomonas aeruginosa . Many resistance mechanisms in Gram-negative bacteria involve alterations of the lipopolysaccharide (LPS) molecule of the outer membrane, which reduce the access of antimicrobial peptides and polymyxins to the inner membrane (Vaara et al, 1981; Gunn et al, 1998; Guo et al, 1998; Tamayo et al, 2005). Many Gram-positive bacteria display analogous alterations to their lipoteichoic and wall teichoic acids resulting in reduced access of these compounds to their cytoplasmic membranes (Peschel et al, 1999; Kovács et al, 2006; Giaouris et al, 2008).…”

An immunocompetent patient presenting with severe septic arthritis due to Ralstonia pickettii identified by molecular-based assays: a case report

“…Indeed, reports on bacteremia and septicemia caused by Ralstonia pickettii have already been described [7,8]. Occasionally, Ralstonia pickettii has been identified as the causative agent in infectious endocarditis [9], meningitis [10], seminal infection [11], osteomyelitis or spondylodiskitis [12] and septic arthritis [13]. Immunocompromised patients and those with cystic fibrosis are also at increased risk of acquiring infection with Ralstonia pickettii [14,15].…”