Isolation of Bordetella trematum from the respiratory tract of a patient with lung cancer: a case report

Abstract

We report the case of isolation of Bordetella trematum from the respiratory tract of a patient with lung carcinoma. This gram-negative, opportunistic rod was firstly described in 1996. To date, only several strains of Bordetella trematum have been isolated and reported, mostly from skin and soft tissue infections. The patient was admitted to the ICU of the Pulmonary Department in incipient septic shock with respiratory failure. Intravenous fluid resuscitation and noninvasive ventilation were administered immediately. A broad spectrum antibiotic piperacillin/tazobactam was administered empirically after sampling of material for microbiological examination. The bronchoscopy showed a large cavern of decayed tumour invading into mediastinum. Both sample cultures showed significant quantities of gramnegative non-fermenting bacteria. The isolate was identified using MALDI-TOF MS as Bordetella trematum and the identification was confirmed using 16S ribosomal RNA sequencing. In the last few years, routine bacterial identification using MALDI-TOF MS has enabled correct discrimination of this species. Nevertheless, isolation of Bordetella trematum in clinical samples is still very uncommon, and it is appropriate to confirm the species identification via 16S ribosomal RNA sequencing. To our knowledge, this is the first case of B. trematum isolated from the human respiratory tract since its first description. The clinical significance of Bordetella trematum in the rapid deterioration of the patient's status remains unclear.

Bordetella trematum bacteraemia secondary to an empyema in an immunocompromised host: A case report and review of the literature

“…In addition, Kulka et al . [7] suggested that the recovery of B. trematum in the presence of oropharyngeal flora from the respiratory tract (sputum and bronchoalveolar lavage) was a plausible source of infection in an oncology patient.…”

“…In 2020, Kukla et al . [7] described the recovery of B. trematum from the respiratory tract of an immunocompromised host, and more recently a letter-to-the-editor by Lee et al .…”

“…Bordetella trematum is an aerobic non-lactose fermenting Gram-negative bacillus, first recognized and described in 1996 by Vandamme et al [1], Most published B. trematum cases [2][3][4][5][6] between 2004 to 2019 were based on the recovery of isolates from infected lower limb wounds in the presence of other pathogens, with only a handful of cases recovered from sterile sites. In 2020, Kukla et al [7] described the recovery of B. trematum from the respiratory tract of an immunocompromised host, and more recently a letter-to-the-editor by Lee et al [8] described a case of B. trematum catheter related bloodstream infection. To date, documented clinical cases are relatively scarce, limited to case series and reports.…”

Detection and Characterization of Clinical Bordetella trematum Isolates from Chronic Wounds

“…That we identified genes conferring decreased susceptibility to aminoglycosides, fosfomycin, and fluoroquinolones on the genomes of all three isolates, together with the observation that most if not all isolates described in the literature showed decreased susceptibility to these substances, suggests that such genes are common among B. trematum strains. To our knowledge, we describe the first documented B. trematum isolate phenotypically resistant to trimethoprim/sulfamethoxazole and detected the sul-2 gene on its genome, likely responsible for this resistance encoding forms of dihydropteroate synthase that are not inhibited by the substance, and thus invite to rethink the assumption that B. trematum can safely be considered as susceptible to this substance [ 12 ].…”

“…The most important ones in this regard are Pseudomonas aeruginosa , Acinetobacter baumannii, and Stenotrophomonas maltophilia . A recent literature review reveals the clinical significance of B. trematum to still be a matter of debate as the little information available on this pathogen left authors largely uncertain as to whether therapy was necessary or superfluous in the respective cases [ 2 , 3 , 4 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ]. Previously documented cases have mainly been isolated from ulcers and soft tissue infections, even though occasional cases of bacteremia have been described [ 6 , 7 ].…”