Catheter-related bacteremia caused by Comamonas testosteroni in a hemodialysis patient

Abstract

Comamonas testosteroni has rarely been implicated as a human pathogen. In general, the outcome of C. testosteroni infections is favorable. We report a case of fatal bacteremia caused by C. testosteroni in a 64-year-old woman on hemodialysis.

The 20th Comamonas Testosteroni Bacteremia Case in the Literature from Turkey: Mortal and Polymicrobial A Case Report and Literature Review

“…The patients of Swain [12] , Barbaro [9] , and Nseir [13] died, despite polyantibiotic therapy, which were the same as our case. We suggest that mortality was associated with underlying malignancy and a polymicrobial condition.…”

“…treatments were initiated. During the treatments, the patient had subfebril fever, increased infection Atkinson [4] 31/F Blood None No Kanamycin tetracycline Cured Smith [7] 89/M Blood Environmental exposure No levofloxacin Cured Le Moal [14] 75/F Blood CVC breast cancer No Ceftazidime gentamicin Cured Cooper [15] 49/M Blood Infective endocarditis No Cefepime, gentamicin Cured then ampicillin Abraham [16] 54/F Blood Esophageal cancer No Cefepime then ciprofloxacin Cured with metastases to lung Chemotherapy, CVC Orsini [8] 80/F Blood Morbidly obese, Staphylococcus aureus Ceftriaxone then nafcillin Cured diabetes mellitus then cefazolin doripenem Barbaro [9] 4/M Blood None reported None reported None reported Cured Barbaro [9] 28/M Blood None reported None reported None reported Cured Barbaro [9] Newborn/F Blood Prematurity a-Hemolytic Streptococcus Ampicillin amikacin Died Gül [6] 22/M Blood Perforated appendicitis None reported cefazolin Cured Nseir [13] 64/F Blood diabetes mellitus, No Vancomycin rocephin Died end-stage kidney disease then ciprofloxacin gentamycin Tsui [10] 54/M Blood Cellulite No Oxacillin then ciprofloxacin Cured Tsui [10] 73/M Blood Hepatocellular carcinoma Acinetobacter baumannii Cefmetazon gentamicin Cured then levofloxacin Farshad [17] 10/M Blood Medulloblastoma No Ciprofloxacin amikacin Cured Farshad [17] 19/F Blood Osteosarcoma No Vancomycin imipenem Cured ciprofloxacin Swain [12] 50/F Blood Chronic renal disease, No Piperacillin-tazobactam then Died gluteal abscess cefoperazone-sulbactam Opota [11] 33/M Blood Chronic hepatitis C, Streptococcus parasanguis, Cefepime vancomycinthen Not chronic alcoholism, Ralstonia pickettii moxifloxacin reported drugaddiction Katırcıoğlu [18] 83/M Blood Old age, SVD No Piperacillin-tazobactam, Cured amikacin Pekintürk [19] parameters, and increased radiological consolidation; C. testosteroni was detected in the first blood cultures during admission. According to an antibiogram, C. testosteroni was resistant to piperacillin-tazobactam, imipenem, meropenem, and gentamycin and susceptible to colistin, levofloxacin, tigecycline, and cefepime.…”

Comamonas testosteroni-associated peritonitis in a pediatric peritoneal dialysis patient

“…C. testosteroni peritonitis in children promptly responsive to antibiotic treatment. Outcome was fatal in three cases, including a 64yearold woman on hemodialysis with a central venous catheterrelated bacteremia [12] . To our knowledge, the present case is the second report of a C. testosteroniassociated peritonitis in a PD patient, but is the first description in pediatric age.…”

“…These results supported the molecular biological basis of the potential pathogenicity of this bacterium. Along with its own virulence factors, pathogenicity of C. testosteroni seems to be emphasized in patients with some degree of immunosuppression such as malignancy, prematurity, primary or secondary immunodeficiency induced by chronic liver disease and endstage renal disease [1,12] . Moreover, bacterial translocation from the gastrointestinal tract seems to play an important role in the pathogenesis of infections [13] .…”

Unusual Pathogen<i> Comamonas testosterone </i>Sepsis<i> </i>Following Gastroenteritis<i> </i>in a 12 Months Old Child: Case Report and Literature Review

“…[1] Formerly known as Pseudomonas testosteroni. It is found in soil, plants, water saprophytes, and also may be found in humidifier reservoir water, even isolated from dromedary rumen fluid [2] It has became clinically important after 1987, when reports began accumulating on human infections such as cellulitis [4], peritonitis especially with a perforated appendix [5], bloodstream infection [6,7], infective endocarditis [8], purulent meningitis, [9] postoperative endophthalmitis [10] and hemodialysis catheter-related bacteremia [11]. However, cases of bloodstream infections caused by Comamonas testosteroni have been infrequently reported [12] and this is the first case reported in Oman in a 12 months old child.…”