Gordonia sternal wound infection treated with ceftaroline: case report and literature review

Abstract

Introduction. Case reports have emerged with identification of Gordonia bronchialis infections including sternal wound infections and foreign bodies such as central lines and shunts.Case presentation. We present a case that demonstrates the need to consider Gordonia infection as a cause of sternal wound infection and highlights the utility of novel diagnostics to aid in the identification of unusual pathogens that can cause post-operative infections. We report here the first successful use of ceftaroline for treatment of a G. bronchialis sternal wound infection.Conclusion. There are only case reports and in vitro assays to date to guide treatment of this infection, and we now add ceftaroline as a new drug to consider, though adequate surgical debridement is paramount.

Case report of cutaneous nodule caused by Gordonia bronchialis in an immunocompetent patient after receiving acupuncture

“…Because they are closely related to members of the genera Nocardia and Rhodococcus , the Gordonia species have been misidentified as Nocardia or Rhodococcus . Moreover, due to its morphological similarity to diphtheria, Gordonia has often been regarded as a contaminant . Gordonia ‐related infections in both immunocompromised and immunocompetent patients have been increasingly reported because of 16S rRNA gene sequencing to identify Gram‐positive bacilli.…”

“…4 Moreover, due to its morphological similarity to diphtheria, Gordonia has often been regarded as a contaminant. 5 Gordonia-related infections in both immunocompromised and immunocompetent patients have been increasingly reported because of 16S rRNA gene sequencing to identify Gram-positive bacilli. Skin and soft tissue infection has been reported in Gordonia bronchialis, G. terrae, G. araii and G. amicalis.…”

New causative agents of respiratory tract diseases in immunocompromized patients (a review)

“…Также G. bronchialis вызывала бактериемию у пациен та с секвестрированным легким и рецидивирующим абсцессом молочной железы у иммунокомпрометированной пациентки [46]. Кроме того, G. bronchialis была выделена из раны грудины у больных, перенесших опе рацию по шунтированию коронарных артерий [47].…”

Sternal osteomyelitis caused by Gordonia bronchialis in an immunocompetent patient following coronary artery bypass surgery

“…Postoperative surgical site infection (SSI) is an uncommon but severe complication following open cardiac surgery with an incidence varying between 1% and 4% depending on compliance with preventive measures, patient baseline risk factors, pre-, peri-, and post-operative risk factors, and degree of postoperative surveillance [1] , [2] . Factors associated with infection include high-risk preoperative state, obesity, older age, chronic obstructive pulmonary disease, transfusion, prolonged ventilation, postoperative vasopressin support, and bilateral internal thoracic arterial bypass grafting [1] , [2] . Microorganisms associated with sternal wound infections are primarily skin commensals with about 72% identified as gram-positive cocci [3] .…”

“…Rarely, environmental bacteria such as Gordonia spp. have been implicated as etiological agents of surgical site and catheter-associated infections [1] , [2] , [4] , [5] , [6] , [7] , [8] , [9] , [10] . Here, we report a patient who presented with sternal osteomyelitis following infection with this uncommon pathogen and review relevant literature.…”