Clinical Characteristics of Bacteremia Caused by Helicobacter cinaedi and Time Required for Blood Cultures To Become Positive

Araoka, Hideki; Baba, Masaru; Kimura, Muneyoshi; Abe, Masahiro; Inagawa, Hiroko; Yoneyama, Akio

doi:10.1128/jcm.00265-14

Cited by 72 publications

(82 citation statements)

References 14 publications

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“…This hypothesis is based on several factors. First, the clinical conditions of cyst infection and H. cinaedi infection are similar in terms of ease of relapse [3]. Second, one of the major risk factors for H. cinaedi infection is chronic kidney disease (CKD) [3,4].…”

Section: Introductionmentioning

confidence: 99%

Bacteremic kidney cyst infection caused by Helicobacter cinaedi

et al. 2015

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Cyst infection is one of the major complications in patients with autosomal dominant polycystic kidney disease (ADPKD). The causative pathogen in kidney cyst infection frequently goes undetected. Although only one case report of kidney cyst infection caused by Helicobacter cinaedi (H. cinaedi) is published in English literature, it may be an important pathogen in kidney cyst infection. Kidney cyst infection and H. cinaedi infection share the common characteristic of tendency to relapse and chronic kidney disease is a major risk factor for H. cinaedi infection. Moreover, a long period is required to detect H. cinaedi in blood cultures, potentially causing false-negative results. After the identification of H. cinaedi, we must carefully select antibiotics and the antibiotic treatment period should be extended to prevent recurrence. Here we present a case of a 58-year-old male with ADPKD who developed bacteremic kidney cyst infection caused by H. cinaedi. He was admitted to our hospital because of fever, lower left back pain, vomiting, and feeling of abdominal enlargement. H. cinaedi was detected from the blood cultures obtained at admission after 4 days of culture. Antibiotics were administered for 8 weeks after confirming negative blood cultures. There was no evidence of kidney cyst infection relapse at 3 months after treatment completion. Nephrologists should regard H. cinaedi as a challenging but important pathogen in kidney cyst infection, particularly when the causative organism is unknown or kidney cyst infection is recurrent.

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Section: Introductionmentioning

confidence: 99%

Bacteremic kidney cyst infection caused by Helicobacter cinaedi

et al. 2015

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“…As patients with NHPH infections have recurrent symptoms, many reports have recommended long-term antimicrobial therapy to prevent recurrent symptoms (4,12,15,16). However, our patient did not experience recurrence over a 5-month period after short-term antimicrobial therapy, although we cannot be sure of its efficacy given the high MIC of CMZ.…”

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confidence: 48%

Sepsis Due to a Novel Urease-Positive Helicobacter Species in a Young Man

Môri¹,

Kagawa²,

Higuchi³

et al. 2015

J Clin Microbiol

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We report the first case of sepsis with enterocolitis that was caused by a novel urease-positive Helicobacter species in a young man. The isolate was characterized via 16S rRNA gene sequencing and their biochemical properties, and the patient was successfully treated with short-term antimicrobial therapy; no recurrence was observed. CASE REPORTA 21-year-old previously healthy man presented to the emergency department with abdominal pain, tenesmus, and fever. His abdominal pain was initially localized to the epigastric region and later localized in the right lower quadrant. He did not have a medical history and was not taking medication. He reported having no homosexual contact or pet exposure. A physical examination at admission revealed that his blood pressure was 113/69 mm Hg, his pulse rate was 92 beats/min, his temperature was 38.5°C, and his oxygen saturation was 98% in ambient air. Upon palpation, the patient had abdominal tenderness in the right lower quadrant; no skin lesions were observed. The laboratory test results revealed leukocytosis (14,200/l; normal range, 3,500 to 8,500/l) and an elevated C-reactive protein level (7.9 mg/dl; normal range, Յ0.4 mg/dl), although his liver and renal functions were normal. Abdominal enhanced computed tomography revealed a wall thickening from the cecum to the ascending colon with swollen mesenteric lymph nodes and a normal appendix. Two sets of blood cultures (four bottles), in addition to urine and stool cultures, were taken at the time of admission. The patient was treated with an intravenous infusion of cefmetazole (CMZ; 1 g every 8 h) on the basis of the suspicion of bacterial enterocolitis, and his symptoms immediately improved. The patient was discharged on day 5. Although the urine and stool cultures did not yield pathogenic bacteria, the two aerobic bottle blood cultures collected on the day of admission were found to be positive for pathogenic bacteria on day 5.For diagnostic testing, the Bactec FX system (Becton, Dickinson and Company [BD], Tokyo, Japan) was used for the blood culture, and a positive bacterial isolate were found in only the two Bactec aerobic bottles after 5 days of incubation. Further testing revealed that the bacteria isolated were thin, slightly curved, Gram-negative rods. We then used the API Campy (SYSMEX bioMérieux, Tokyo, Japan) system to determine that the organism was Helicobacter pylori. However, the colony morphology and biochemical properties of the isolate did not match those of H. pylori. Therefore, samples from the bottles were subcultured in 5% sheep blood agar (Nissui Pharmaceutical Co., Tokyo, Japan) and Skirrow's medium (BD). The plates were then incubated under microaerophilic conditions at 37 and 42°C at high humidity. After 3 days of incubation, moist, glassy, and swarming thin-film colonies were observed on both agar plates and these colonies also consisted of long, thin, and slightly curved to spiral-shaped Gramnegative rods. We then performed biochemical tests by standard methods (1) and found that the isolate prod...

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“…Together, the above findings indicate that H. cinaedi will occasionally grow aerobically in the presence of serum, although other environmental or stochastic factors likely influence this ability. The behavior, in fact, is reminiscent of the isolation of H. cinaedi from aerobic blood culture bottles; the latter is a well-described phenomenon in clinical settings, albeit one that occurs with noteworthy interlaboratory variability (30,34).…”

Section: Resultsmentioning

confidence: 99%

“…Rather, microbial growth in commercial systems is detected under a fixed aerobic or anaerobic atmosphere (33). When explicitly reported, H. cinaedi has been detected overwhelmingly in aerobic blood culture bottles (30,34).…”

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confidence: 99%

“…Moreover, the ability of clinical laboratories to propagate H. cinaedi with typical blood culture platforms implies at least some degree of aerotolerance. Although agar subculture of blood bottles (for colonial isolation/identification of H. cinaedi) requires microaerobic conditions (30,31,32), the initial bottles are neither microaerobic nor H 2 -supplemented. Rather, microbial growth in commercial systems is detected under a fixed aerobic or anaerobic atmosphere (33).…”

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Epithelial Coculture and l -Lactate Promote Growth of Helicobacter cinaedi under H ₂ -Free Aerobic Conditions

Schmitz

Taniguchi

Misawa

et al. 2016

Appl Environ Microbiol

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Helicobacter cinaedi is an emerging opportunistic pathogen associated with infections of diverse anatomic sites. Nevertheless, the species demonstrates fastidious axenic growth; it has been described as requiring a microaerobic atmosphere, along with a strong preference for supplemental H 2 gas. In this context, we examined the hypothesis that in vitro growth of H. cinaedi could be enhanced by coculture with human epithelial cells. When inoculated (in Ham's F12 medium) over Caco-2 monolayers, the type strain (ATCC BAA-847) gained the ability to proliferate under H 2 -free aerobic conditions. Identical results were observed during coculture with several other monolayer types (LS-174T, AGS, and HeLa). Under chemically defined conditions, 40 amino acids and carboxylates were screened for their effect on the organism's atmospheric requirements. Several molecules promoted Helicobacter cinaedi is an emerging pathogen of the class Epsilonproteobacteria. This spiral-shaped Gram-negative rod is associated with opportunistic infections of multiple anatomic sites, including the intestinal tract (1, 2), blood (3, 4), peripheral soft tissue (5, 6), and other body fluids (7-9). This behavior contrasts with related Helicobacter and Campylobacter species, which typically demonstrate a more limited tissue tropism. H. cinaedi was identified ϳ30 years ago in men who have sex with men (1) and HIV patients (10, 11), although infections have since been described in other immunocompromised groups (12, 13), as well as immunocompetent (14-17) and postsurgical patients (18).Despite abundant case reports, the ecology/epidemiology of H. cinaedi remains poorly defined and sparsely studied. Limited molecular evidence suggests that it can be found in the stools of a small percentage of healthy individuals (19). The organism has also been isolated from animal feces (including rodents, dogs, and primates), although its role as a veterinary and/or zoonotic pathogen is uncertain (20,21). An environmental reservoir has not yet been identified. The majority of recent literature on H. cinaedi (for instance, many of the current references) originates from Japan, although it is unclear whether this reflects regional prevalence or an increased awareness among Japanese investigators. Knowledge of H. cinaedi biology and tools for its genetic manipulation are likewise sparse, limited to several studies of targeted deletion mutants. These deletion mutants include strains deficient in cytolethal distending toxin (22) and alkyl hydroperoxide reductase (23), both of which demonstrate attenuated virulence in a murine colitis model.Likely contributing to this paucity of information, H. cinaedi is a challenging organism to manipulate in vitro. Strains are notable for poor, film-like growth on agar plates, a preference for biphasic culture (broth over agar), and decreased viability on subculture (24, 25). Recommended medium conditions for H. cinaedi are not

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Clinical Characteristics of Bacteremia Caused by Helicobacter cinaedi and Time Required for Blood Cultures To Become Positive

Cited by 72 publications

References 14 publications

Bacteremic kidney cyst infection caused by Helicobacter cinaedi

Bacteremic kidney cyst infection caused by Helicobacter cinaedi

Sepsis Due to a Novel Urease-Positive Helicobacter Species in a Young Man

Epithelial Coculture and l -Lactate Promote Growth of Helicobacter cinaedi under H ₂ -Free Aerobic Conditions

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Clinical Characteristics of Bacteremia Caused by Helicobacter cinaedi and Time Required for Blood Cultures To Become Positive

Cited by 72 publications

References 14 publications

Bacteremic kidney cyst infection caused by Helicobacter cinaedi

Bacteremic kidney cyst infection caused by Helicobacter cinaedi

Sepsis Due to a Novel Urease-Positive Helicobacter Species in a Young Man

Epithelial Coculture and l -Lactate Promote Growth of Helicobacter cinaedi under H 2 -Free Aerobic Conditions

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Epithelial Coculture and l -Lactate Promote Growth of Helicobacter cinaedi under H ₂ -Free Aerobic Conditions