Curtobacterium flaccumfaciens Septic Arthritis following Puncture with a Coxspur Hawthorn Thorn

Abstract

Curtobacterium species are recognized plant pathogens. We report the first well-documented case of Curtobacterium human infection, a child with septic arthritis following puncture with a Coxspur Hawthorn plant thorn. The organism isolated from synovial tissue and the plant thorn was identified as Curtobacterium flaccumfaciens by 16S rRNA gene sequence analysis. CASE REPORTA previously healthy 7-year-old boy presented with right knee pain 1 day after being pushed into a thorny bush at school. He had noticed swelling and redness at the site of the puncture and was unable to bear weight on his right leg. His symptoms settled somewhat with analgesia and immobilization, and he was discharged the following day. He returned 2 days later with increasing right knee pain, swelling, and fever. He was discharged the next day without antibiotic therapy.Five days later (10 days after the injury), he presented again with a limp and ongoing fevers of up to 39°C. On examination, there was reduced range of right knee flexion, knee swelling without erythema, and a joint effusion. There was a healing puncture wound on the lateral aspect, and palpation of the surrounding area did not suggest the presence of a foreign body. The peripheral blood leukocyte count was 13.1 ϫ 10 9 cells/liter (77% neutrophils). He underwent an arthroscopic washout and synovial biopsy of the right knee. A 1-cm-long piece of thorn was identified in the synovial tissue and removed. Histological examination was consistent with acute synovitis and septic arthritis.Perioperative intravenous (i.v.) cefazolin was administered for 24 h and then changed to i.v. ticarcillin-clavulanate for 8 days. He remained afebrile from the second day of admission and was discharged to continue oral amoxicillin (80 mg/kg body weight/ day) for a further 4 weeks. The residual knee swelling and stiffness resolved slowly with physical therapies over the weeks after discharge. At the 6-month follow-up, he had made a full recovery, with no limitation of movement in the affected knee.Microbiology. The Gram stain of the synovial fluid and knee tissue revealed numerous polymorphonuclear leukocytes but no bacteria. In aerobic conditions at 35°C, bacterial growth was observed on horse blood agar at 24 h. The organism grew equally well and with identical morphology at both 30°C and 37°C. The colonies were nonhemolytic, smooth, entire, low convex, with a yellow pigment. Colonies were 1 to 1.5 mm in diameter after 48 h incubation. Gram stain showed Gram-positive small, short rods, some in palisade arrangements, with no branching. The isolate was nonmotile, catalase positive, and urease negative and strongly hydrolyzed esculin. The API Coryne version 3.0 identification system (bioMérieux, Marcy l'Etoile, France) gave an identification of Brevibacterium species, with a confidence value of 79% (code 2040005). MICs determined using Etest (bioMérieux, Marcy l'Etoile, France) were 0.125 g/ml for penicillin and 0.25 g/ml for cefotaxime and vancomycin.Because of the inconclusive phenotypic identificat...

Epiphytic Curtobacterium flaccumfaciens strains isolated from symptomless solanaceous vegetables are pathogenic on leguminous but not on solanaceous plants

“…The species C. flaccumfaciens has been isolated from a wide range of animals and plants as an epiphyte or endophyte, as well as from inanimate objects, e.g. synovial tissue of the injured knee of a child with septic arthritis following puncture with a coxspur hawthorn (Crataegus crus-galli) thorn (Francis et al, 2011). Strains isolated from the injured knee and coxspur hawthorn thorn were highly similar to Cff DSM 20129 isolated from common bean (Francis et al, 2011).…”

Bacterial isolates fromPalomena prasina(Hemiptera: Pentatomidae) include potential microbial control agents

“…oxydans JQ861547 *and § marks show that they were isolated from hemolymph of insect and dead insect, respectively. Frodl, 2005), and at least one strain of Curtobacterium species has been shown to be infectious in humans (Francis et al, 2011).…”

Cultivable bacterial microbiota from choanae of free-living birds captured in Slovenia / Kultivabilna bakterijska mikrobiota iz sapišč prosto¬živečih ptic, ujetih v Sloveniji

“…These were Agrobacterium larrymoorei (Bouzar & Jones 2001), Clavibacter michiganensis (Xu et al 2010), Curtobacterium flaccumfaciens (Francis et al 2011), Plantoea agglomerans (Rezzonico et al 2010), Pseudomonas aeruginosa (Yamazaki et al 2012), Pseudomonas flavescens (Fett, Cescutti & Wijey 1996) and Rhodococcus fascians (Crespi et al 1992). Ten (40 %) birds were colonized by one plant pathogen and only one tree sparrow by two (Agrobacterium larrymoorei and Curtobacterium flaccumfaciens).…”

“…Species previously described as being associated with human infections were Acinetobacter calcoaceticus (Nonaka et al 2014), Cellulosimicrobium funkei (Petkar et al 2011), Curtobacterium citreum (Rivera et al 2012), Curtobacterium flaccumfaciens (Francis et al 2011), Exiguobacterium sibiricum (Tena et al 2014), Hafnia alvei (Gunthard & Pennekamp 1996), Microbacterium oleivorans (Kim & Lee 2012), Microbacterium resistens (Panackal 2013), Pantoea agglomerans (Rezzonico et al 2010), Pseudomonas aeruginosa (Yamazaki et al 2012), Serratia grimesii (Kumar et al 2013), Staphylococcus epidermidis (Vuong & Otto 2002) and Staphylococcus gallinarum (Tibra et al 2010). Eight out of 25 (32 %) sampled birds carried one or more human opportunistic bacteria in their choanae.…”