Human Erysipelothrix rhusiopathiae infection via bath water – case report and genome announcement

Abstract

Erysipelothrix rhusiopathiae is a facultative anaerobic, environmentally stable, Gram-positive rod that causes swine and avian erysipelas as a zoonotic pathogen. In humans, the main manifestations described are circumscribed erysipeloid, generalized erysipeloid, and endocarditis. Here, we report a 46-year-old female patient who presented to the physician because of redness and marked functio laesa of the hand, in terms of a pain-related restricted range of motion, and was treated surgically. E. rhusopathiae was detected in tissue biopsy. The source of infection was considered to be a pond in which both swine and, later, her dog bathed. The genome of the isolate was completely sequenced and especially the presumptive virulence associated factors as well as the presumptive antimicrobial resistance genes, in particular a predicted homologue to the multiple sugar metabolism regulator (MsmR), several predicted two-component signal transduction systems, three predicted hemolysins, two predicted neuraminidases, three predicted hyaluronate lyases, the surface protective antigen SpaA, a subset of predicted enzymes that potentially confer resistance to reactive oxygen species (ROS), several predicted phospholipases that could play a role in the escape from phagolysosomes into host cell cytoplasm as well as a predicted vancomycin resistance locus (vex23-vncRS) and three predicted MATE efflux transporters were investigated in more detail.

Bloodstream Infection Caused by Erysipelothrix rhusiopathiae in an Immunocompetent Patient

“…However, 59.7% of the cases reported a history of contact with animals [12]. Although animal contact is the main transmission route [20,21], this bacterium can persist for several months in many environmental sources such as soil and water, as well as in decaying animals [22,23]. In our case, the origin of the pathogen was not identified, but our patient did not report any animal contact and lived in non-optimal hygienic conditions.…”

“…High values of MIC were measured for vancomycin and metronidazole. According to the literature, E. rhusiopathiae is intrinsically resistant to vancomycin, a broad-spectrum drug frequently used for the treatment of infections caused by Gram-positive bacteria [23]. Metronidazole was used in this case as an empiric therapy, with piperacillin/tazobactam and clindamycin, until the antimicrobial susceptibility profile was available.…”

Integrative and Conjugative Elements and Prophage DNA as Carriers of Resistance Genes in Erysipelothrix rhusiopathiae Strains from Domestic Geese in Poland

“…Erysipelothrix rhusiopathiae is a Gram-positive non-motile narrow rod-shaped bacterium with high growth requirements. It belongs to the genus Erysipelothrix, family Erysipelotrichaceae, order Erysipelotrichales, class Erysipelotrichia, phylum Bacillota (Firmicutes) [1,2]. While pigs are considered the main reservoir of E. rhusiopathiae, this bacterium can also cause infections in other vertebrates, including ruminants, rodents, birds, fish, cetaceans, and humans [3,4].…”