Mycoplasma salivarium detected in a microbial community with Candida glabrata in the biofilm of an occluded biliary stent

Abstract

Mycoplasma salivarium, preferentially an inhabitant of the human oral cavity, has rarely been found in other locations associated with disease. We describe here, for what is believed to be the first time, the detection of M. salivarium, together with Candida glabrata, in an occluded biliary stent of an icteric, cholestatic patient. Case reportA 71-year-old man with known alcoholic liver cirrhosis was admitted with painless jaundice, an increase in abdominal circumference, dark urine and acholic faeces of 7 days' duration. Abdominal sonography revealed a cirrhotic liver with enlarged intra-and extra-hepatic bile ducts (common bile duct 12 mm), gall bladder hydrops, and moderate ascites in the abdomen. Ascites yielded the growth of coagulasenegative staphylococci. The patient was treated with ceftriaxone, and due to hyperthyroidism with carbimazole and perchlorate.Gastroscopy and endosonography revealed oesophageal varices grade II, ulcera duodeni and portal-hypertensive gastropathy. Furthermore, endosonography and sonography revealed a possible distal cholangio-carcinoma leading to biliary tract obstruction. A malignant stricture was detected in endoscopic retrograde cholangio-pancreotography (ERCP) and in cytology of a brush sample. Drainage of the biliary tract was performed by endoscopic placement of a plastic stent (60 mm, 10 French diameter) across the stricture.As bilirubin values remained increased, suggesting early stent occlusion, the stent was replaced by ERCP (thus avoiding contaminations) 2 days later. The main channel and the flaps of the stent were occluded with sludge. Within 24 h the patient developed temperatures of 39 u C and became dyspnoeic, respiratory insufficient and acidotic suggestive of early sepsis leading to hypotension and acute renal failure. The patient was transferred to the intensive care unit intubated, and ventilated and continuous venovenous haemofiltration was started.Bile and blood cultures were positive for Candida glabrata. Despite therapy with voriconazole and imipenem the patient died with clinical signs of sepsis 12 days after admission to hospital.In the context of studying bacterial communities in biofilm formation, the patient's stent, removed due to occlusion, was used in analysis by PCR. The biofilm was mechanically scraped off the inner surface of the stent. Total DNA was isolated using an EZ1 Biorobot from Qiagen and amplified in fungal 18-28S rDNA PCR with primers 18S-1508f (59-TCC GTA GGT GAA CCT GCG G-39) and 28S-197r (59-TCC TCC GCT TAT TGA TAT GC-39), and in eubacterial

Effect of Human Serum on Biofilm Formation by Oral Mycoplasma on Nitinol Surfaces

“…A number of research works have demonstrated that a variety of medical devices (including intravenous and arterial lines, urinary catheters, cardiac and biliary stents), can harbor biofilms that infect them, resulting in the need for device replacement [12,16]. The present results show the ability of Mycoplasma to adhere to nitinol surfaces.…”

“…In a recent study, Henrich et al [12] reported the finding of two inhabitants of the oral cavity in a biliary stent of a cholestatic patient: Mycoplasma salivarium, and Candida glabrata.…”

Mycoplasma salivarium as a Dominant Coloniser of Fanconi Anaemia Associated Oral Carcinoma

“…Incidental findings identified M. salivarium as causative agent of disseminated infections, such as a chronic joint infection in a patient with hypogammaglobulinaemia [32]. M. salivarium was found in brain abscesses of two patients [33], in an occluded biliary stent in polymicrobial community with Candida glabrata [34] and as causative agent of a pleural empyema [35].…”

Real-time PCR analysis of fungal organisms and bacterial species at peri-implantitis sites

“…In house TaqMan PCRs for the quantification of Mycoplasma salivarium ( M. salivarium ) [12], Veillonella parvula ( V. parvula ) [13], S. aureus [14], P. gingivalis [15], Parvimonas micra ( P. micra ) [16], and T. forsythia [15] (Table 1) were carried out in a total volume of 25 μl consisting of 1× Eurogentec qPCR MasterMix (Eurogentec, Seraing, Belgium) without ROX (containing buffer, dNTPs (including dUTP), HotGoldStar DNA polymerase, 5 mM MgCl 2 , uracil-N-glycosylase and stabilizers (RT-QP2X-03NR, Eurogentec)), 300 nM each forward and reverse primer, 200 nM labeled probe, and 2.5 μl of template DNA (primer and probes are listed in Tables 1 and 2). Amplicon carrying plasmids were used in concentrations of 10 5 and 10 2 copies/μl as quantification standards.…”