Chronic lower extremity wound infection due to Kerstersia gyiorum in a patient with Buerger’s disease: a case report

Abstract

Background Kerstersia gyiorum is an extremely rare pathogen of human infection. It can cause chronic infection in patients with underlying conditions. It can easily be misdiagnosed if proper diagnostic methods are not used.Case presentationA 47-year-old male patient with a history of Buerger’s Disease for 28 years presented to our hospital with an infected chronic wound on foot. The wound was debrided, and the specimen was sent to Microbiology laboratory. Gram staining of the specimen showed abundant polymorphonuclear leukocytes and gram-negative bacilli. Four types of colonies were isolated on blood agar. These were identified as Kerstersia gyiorum, Proteus vulgaris, Enterobacter cloacae, Morganella morganii by Maldi Biotyper (Bruker Daltonics, Germany). The identification of K. gyiorum was confirmed by 16S ribosomal RNA gene sequencing. The patient was successfully recovered with antimicrobial therapy, surgical debridement, and skin grafting.ConclusionsThis is the first case of wound infection due to K. gyiorum in a patient with Buerger’s Disease. We made a brief review of K. gyiorum cases up to date. Also, this case is presented to draw attention to the use of new and advanced methods like MALDI-TOF MS and 16S rRNA gene sequencing for identification of rarely isolated species from clinical specimens of patients with chronic infections and with chronic underlying conditions.

Genomic characterization of Kerstersia gyiorum SWMUKG01, an isolate from a patient with respiratory infection in China

“…Clinical reports showed that some of K . gyiorum isolates were resistant to ciprofloxacin [2, 8], colistin [10], cefepime and ceftazidime [7], which suggested potential drug resistance genes or efflux pumps. K .…”

“…gyiorum [2, 3, 5–13]. Among them, seven cases were associated with chronic otitis media [2, 5, 6, 8, 11, 13], three with chronic leg wound [2, 7, 10]. Additionally, K .…”

The First Case of Chronic Otitis Media due to Kerstersia gyiorum in Korea

“…Kerstersia gyiorum is a pathogen that is infrequently reported in humans [ 1 ]. This bacterium, first classified in 2003, is a gram-negative coccobacillus belonging to the family Alcaligenaceae , which is isolated from water, soil, animal, and human specimens [ 2 3 ].…”

“…The species was identified as K. gyiorum by matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) with a MALDI Biotyper using MALDI-Biotyper software (version 2.3, Bruker Daltonics, Bremen, Germany). 16S ribosomal RNA gene sequencing was performed using primers 27F (5′-AGAGTTTGATCCTGGCTCAG-3′) and 1492R (5′-GGTTACCTTGTTACGACTT-3′) as described previously [ 1 ]. We obtained a consensus sequence of 1,394 bp, which was 99.9% identical to K. gyiorum LMG 5906 (GenBank accession number AY131213).…”

“…K. gyiorum has been isolated from patients with various diseases [ 1 ]. A total of 10 cases of patients infected with K. gyiorum have been recorded, five of which were associated with COM; the features of these cases are shown in Table 1 [ 4 5 6 7 ].…”