Endocarditis caused by aLeptotrichia buccalis-like bacterium in a patient with a prosthetic aortic valve

Hammann, R.; Iwand, A; Brachmann, Johannes; Keller, Kenneth F.; Werner, Anna

doi:10.1007/bf01967258

Cited by 25 publications

(12 citation statements)

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“…Sequencing 16S rRNA genes PCR-amplified from 416 single-cell MDA reactions, we found 18 candidate commensal and potentially pathogenic species that were selected for 454 shallow sequencing. Initial read mapping and de novo assembly of the low-coverage 454 sequence data confirmed that we had obtained genomic sequences for the pathogen Streptococcus pneumoniae as well as bacterial species highly similar to and those reported to be potentially pathogenic, including Sphingobacterium spiritivorum (Tronel et al 2003;Kampfer et al 2005), Leptotrichia buccalis (Hammann et al 1993;Hot et al 2008), as well as the host-associated oral bacteria, Streptococcus mitis and Veillonella parvula. Of particular note, we found three MDA products with sequences for the oral pathogen Porphyromonas gingivalis, which is a periodontal pathogen involved in periodontal bone loss that has also been linked to progression of atherosclerotic disease (Pussinen et al 2007;Yilmaz 2008).…”

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confidence: 67%

Genome of the pathogen Porphyromonas gingivalis recovered from a biofilm in a hospital sink using a high-throughput single-cell genomics platform

et al. 2013

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Although biofilms have been shown to be reservoirs of pathogens, our knowledge of the microbial diversity in biofilms within critical areas, such as health care facilities, is limited. Available methods for pathogen identification and strain typing have some inherent restrictions. In particular, culturing will yield only a fraction of the species present, PCR of virulence or marker genes is mainly focused on a handful of known species, and shotgun metagenomics is limited in the ability to detect strain variations. In this study, we present a single-cell genome sequencing approach to address these limitations and demonstrate it by specifically targeting bacterial cells within a complex biofilm from a hospital bathroom sink drain. A newly developed, automated platform was used to generate genomic DNA by the multiple displacement amplification (MDA) technique from hundreds of single cells in parallel. MDA reactions were screened and classified by 16S rRNA gene PCR sequence, which revealed a broad range of bacteria covering 25 different genera representing environmental species, human commensals, and opportunistic human pathogens. Here we focus on the recovery of a nearly complete genome representing a novel strain of the periodontal pathogen Porphyromonas gingivalis (P. gingivalis JCVI SC001) using the single-cell assembly tool SPAdes. Single-cell genomics is becoming an accepted method to capture novel genomes, primarily in the marine and soil environments. Here we show for the first time that it also enables comparative genomic analysis of strain variation in a pathogen captured from complex biofilm samples in a healthcare facility.

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confidence: 67%

Genome of the pathogen Porphyromonas gingivalis recovered from a biofilm in a hospital sink using a high-throughput single-cell genomics platform

et al. 2013

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“…Some Leptotrichia species have caused anaerobic bacteremia in immunocompromised patients with cancer or hematological malignancies and in bone marrow transplant recipients (1,23,24,26,28). Leptotrichia buccalis, a part of oral flora, has been implicated in periodontal disease (8,17) but rarely causes serious systemic infections (7,14,21,22). Leptotrichia is known to be part of the periurethral flora of healthy girls (3) and has been isolated from the cervix of a patient with a premature rupture of the membranes (9).…”

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confidence: 99%

Leptotrichia amnionii, an Emerging Pathogen of the Female Urogenital Tract

et al. 2007

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Leptotrichia amnionii, a recently described, very fastidious, gram-negative anaerobic bacterium, is an opportunistic pathogen of the female urogenital tract. We report a case of second-trimester abortion in a patient with chorioamnionitis and L. amnionii bacteremia and a case of renal abscess in a female 5 weeks postpartum. CASE REPORTS Case 1.A 33-year-old, previously healthy female presented in the second trimester of pregnancy with a 2-to 3-day history of vaginal bleeding, lower back pain, fatigue, and fever. On admission, her blood pressure was 95/50, her pulse was 80/min, and her temperature was 39.6°C. Abdominal examination revealed tenderness in the lower right and left quadrants on palpation. There was no guarding or rebound tenderness. There was no vaginal discharge. Ultrasound examination showed a viable normal fetus of approximately 13 weeks gestation. Initial laboratory values showed a normal white blood cell count and differential, a hemoglobin level of 11.1 g/dl, and a C-reactive protein level (CRP) of 88 mg/liter. Urinalysis results were positive for nitrites, ketones, leukocytes, and blood. Urosepsis was suspected. Three sets of blood cultures from peripheral veins (BACTEC Plus aerobic/F and anaerobic/F culture vials) and a urine sample for culture were obtained prior to initiating treatment with intravenous mecillinam (an amidinopenicillin). On the second day of admission, an ultrasound of the urinary tract was reported as normal, urine culture yielded no significant bacterial growth, and the CRP peaked at 178 mg/liter. Gram-negative bacteria were detected in the blood cultures. Chorioamnionitis was suspected. The antibiotic regimen was changed to cefotaxime and metronidazole, after which the patient became afebrile and the CRP fell to 42 mg/liter. The episodes of vaginal bleeding continued, however, and a spontaneous abortion occurred on day 9. Curettage was performed. None of the products were sent for culture, but chorioamnionitis was diagnosed on the basis of the histopathology of the placenta. The patient was discharged from the hospital 2 days later on amoxicillin therapy and made a full recovery. She delivered a healthy baby 1 year later after an uncomplicated pregnancy.Microbiological findings. Two anaerobic and two aerobic BACTEC Plus blood culture vials were flagged as positive after 2 and 3 days, respectively, of incubation. Gram staining showed gram-negative/gram-variable pleomorphic rods and coccobacilli. After 48 to 72 h of incubation of the chocolate agar plates under anaerobic conditions, gray convex colonies of less than 1 mm in size were seen. In comparison, there was less growth on the anaerobic blood agar plates. Under aerobic conditions (37°C, 5% CO 2 ), growth was detected on chocolate agar plates only after 48 to 72 h of incubation. Catalase and indole spot tests were negative. The isolate was sensitive to kanamycin, brilliant green, and oxgall (Diatabs; Rosco). Antimicrobial susceptibility was determined by Etest (AB Biodisk, Solna, Sweden) on Isosensitest chocolate agar ...

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“…After excluding two cases for which insufficient clinical information was provided, we investigated the clinical findings of the remaining 33 cases and our patient [34 cases in total; Table 2 (3,4,(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)]. The patients' ages ranged from three to 84 years (mean: 43.7 years), and there were 17 men and 17 women.…”

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confidence: 99%

Acute Myelogenous Leukemia with <i>Leptotrichia trevisanii</i> Bacteremia

et al. 2013

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A 74-year-old woman visited an otolaryngology clinic with pharyngeal pain, and was diagnosed with a peritonsillar abscess. She received antibiotics and underwent incisional drainage, but displayed high white blood cell and blast cell counts, and was referred to our hospital. Gram-negative rods (Leptotrichia trevisanii) were detected in blood cultures performed on admission. She was diagnosed with bacteremia and acute myelogenous leukemia (FAB classification: M1). After antibiotic therapy, she temporarily recovered from the bacteremia, but subsequently died on day 34. Although Leptotrichia trevisanii bacteremia is extremely rare, clinicians should consider it in cases involving immunocompromised patients with oral lesions.

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Endocarditis caused by aLeptotrichia buccalis-like bacterium in a patient with a prosthetic aortic valve

Cited by 25 publications

References 2 publications

Genome of the pathogen Porphyromonas gingivalis recovered from a biofilm in a hospital sink using a high-throughput single-cell genomics platform

Genome of the pathogen Porphyromonas gingivalis recovered from a biofilm in a hospital sink using a high-throughput single-cell genomics platform

Leptotrichia amnionii, an Emerging Pathogen of the Female Urogenital Tract

Acute Myelogenous Leukemia with <i>Leptotrichia trevisanii</i> Bacteremia

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