<i>Wohlfahrtiimonas chitiniclastica</i> Bacteremia in Hospitalized Homeless Man with Squamous Cell Carcinoma

Katanami, Yuichi; Kutsuna, Satoshi; Nagashima, Maki; Takaya, Saho; Yamamoto, Kei; Takeshita, Nozomi; Hayakawa, Kayoko; Kato, Yasuyuki; Kanagawa, Shuzo; Ohmagari, Norio

doi:10.3201/eid2409.170080

Cited by 14 publications

(15 citation statements)

References 10 publications

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“…For instance, we observed comparatively low MIC values for trimethoprim/sulfamethoxazole. This is in line with recent case reports, in which W. chitiniclastica were susceptible to trimethoprim/sulfamethoxazole ( Chavez et al, 2017 ; Katanami et al, 2018 ; Connelly et al, 2019 ; Snyder et al, 2020 ; Bueide et al, 2021 ). Interestingly, all isolates revealed in silico hits for the trimethoprim resistant gene dfrI ( Welch et al, 2007 ) (56.63% identity) and the sulfonamide resistance gene sul3 ( Perreten and Boerlin, 2003 ) (39.85% identity), assuming that resistance may be feasible.…”

Section: Discussionsupporting

confidence: 92%

“…Similar results were obtained for the type strain DSM 18708 T ( Supplementary Table 5 ), suggesting a natural aminoglycoside resistance profile. Moreover, other case studies detected analogous MIC results for amikacin and tobramycin ( Kõljalg et al, 2015 ; Chavez et al, 2017 ; Katanami et al, 2018 ), but the interpretation of antibiotic susceptibility was based on the MIC breakpoints for other non- Enterobacteriaceae described in the M100 Performance Standards for Antimicrobial Susceptibility Testing, determined by the Clinical and Laboratory Standards Institute (CLSI) ( Wayne and Clinical and Laboratory Standards Institute (CLSI), 2016 ). Therefore, those isolates were described as susceptible.…”

Section: Discussionmentioning

confidence: 99%

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Identification and Antibiotic Profiling of Wohlfahrtiimonas chitiniclastica, an Underestimated Human Pathogen

et al. 2021

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In the past 12 years, several case reports have clearly demonstrated that Wohlfahrtiimonas chitiniclastica is capable of causing sepsis and bacteremia in humans. However, since most clinicians are not familiar with this species, little is known about its pathogenicity and treatment options while it is as rare but underestimated human pathogen. Therefore, a larger strain collection is required so that methods can be identified that are most suitable to obtain rapid and reliable identification. Moreover, the antimicrobial resistance profile needs to be elucidated in order to explore possible treatment options. Over a period of 6 years, we therefore have collected a total of 14 W. chitiniclastica isolates in routine diagnostics, which now served as the basis for a comprehensive characterization with respect to identification and antibiotic profiling. We compared the accuracy and convenience of several identification techniques in which MALDI-TOF MS and sequencing of the 16S rRNA gene have proven to be suitable for identification of W. chitiniclastica. In addition, whole genome sequencing (WGS)-based digital DNA-DNA hybridization (dDDH) was used as a reference method for strain identification, and surprised with the detection of a novel W. chitiniclastica subspecies. A combination of in silico and in vitro analyses revealed a first insight into the antimicrobial resistance profile and the molecular basis of antimicrobial resistance. Based on our findings, trimethoprim/sulfamethoxazole, levofloxacin, and cephalosporins (e.g., ceftazidime) may be the best antibiotics to use in order to treat infections caused by W. chitiniclastica, while resistance to fosfomycin, amikacin and tobramycin is observed.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Identification and Antibiotic Profiling of Wohlfahrtiimonas chitiniclastica, an Underestimated Human Pathogen

et al. 2021

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“…Previous human cases of W. chitiniclastica have occurred globally including France, Argentina, Estonia, the United Kingdom, Japan, Australia, India, South Africa, Spain, and Malaysia, Hawaii, Germany, and the continental United States [7][8][9][10][11][12][13][14][15][16][17]. Infection is associated with social and medical circumstances that lead to poor sanitation, underlying medical conditions compromising normal host immune function, and chronic open wounds.…”

Section: Discussionmentioning

confidence: 99%

“…Three were primarily treated with a cephalosporin [7,15,17] while two cases including this one had a quinolone in the regimen. There were nine patient reports that had W. chitiniclastica as part of a polymicrobial blood infection and most utilized a beta-lactam antibiotic [5,6,9,[11][12][13][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Maggot Wound Therapy Associated with Wohlfahrtiimonas chitiniclastica Blood Infection

Bueide¹,

Hunt²,

Bande³

et al. 2021

Cureus

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Maggot therapy is the intentional application of live, disinfected fly larvae to wounds for debridement and wound care. Although some studies suggest possible beneficial applications for wound healing, subsequent infection is a potential risk of treatment. We present a case of a 70-year-old male with chronic left temporal wound from squamous cell carcinoma treated with maggot therapy complicated by bacteremia with Wohlfahrtiimonas chitiniclastica (W. chitiniclastica) . This case illustrates the risk for W. chitiniclastica infection associated with maggots used in medical wound therapy of chronic wounds.

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“…Most reports of W. chitiniclastica infections originate from subtropical or tropical regions [ 2 , 11 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ] (see the literature review in Table 2 ). Nevertheless, an infection with bacterium was also reported from northern Europe [ 18 ].…”

Section: Review and Discussionmentioning

confidence: 99%

Human Infections by Wohlfahrtiimonas chitiniclastica: A Mini-Review and the First Report of a Burn Wound Infection after Accidental Myiasis in Central Europe

et al. 2021

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Wohlfahrtiimonas chitiniclastica are bacteria that cause rare infections, typically associated with the infestation of an open wound with fly larvae. Here, we present a unique case report of the first W. chitiniclastica isolation from a burn wound with accidental myiasis in a 63-year-old homeless man and a literature review focused on human infections caused by these bacteria. So far, 23 cases of infection with W. chitiniclastica have been reported; in 52% of these, larvae were found in the wound area. Most of these cases suffered from chronic non-healing wound infections but none of these were burn injuries. The overall fatality rate associated directly with W. chitiniclastica in these cases was 17%. Infections with parasitic larvae occur in moderate climates (especially in people living in poor conditions); therefore, an infection with rare bacteria associated with accidental myiasis, such as W. chitiniclastica, can be expected to become more common there. Thus, in view of the absence of recommendations regarding the treatment of patients with accidental myiasis and, therefore, the risk of infection with W. chitiniclastica or other rare pathogens, we provide a list of recommendations for the treatment of such patients. The importance of meticulous microbial surveillance using molecular biological methods to facilitate the detection of rare pathogens is emphasized.

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Wohlfahrtiimonas chitiniclastica Bacteremia in Hospitalized Homeless Man with Squamous Cell Carcinoma

Cited by 14 publications

References 10 publications

Identification and Antibiotic Profiling of Wohlfahrtiimonas chitiniclastica, an Underestimated Human Pathogen

Identification and Antibiotic Profiling of Wohlfahrtiimonas chitiniclastica, an Underestimated Human Pathogen

Maggot Wound Therapy Associated with Wohlfahrtiimonas chitiniclastica Blood Infection

Human Infections by Wohlfahrtiimonas chitiniclastica: A Mini-Review and the First Report of a Burn Wound Infection after Accidental Myiasis in Central Europe

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