Sternal osteomyelitis by Gordonia Bronchialis in an immunocompetent patient after open heart surgery

Ambesh, Paurush; Kapoor, Aditya; Kazmi, Danish Hasan; Elsheshtawy, Moustafa; Shetty, Vijay; Lin, Yu Shia; Kamholz, Stephan L.

doi:10.4103/aca.aca_125_18

Cited by 12 publications

(16 citation statements)

References 27 publications

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“…The sternal wound infection after open-heart surgery, mentioned above, was one of the most commonly reported local manifestations of the infection caused by Gordonia bronchialis [ 19 , 20 , 21 , 22 ]. The authors described hospital outbreaks and case series, following open-heart surgery, as a result of intraoperative transmission from a health care worker.…”

Section: Discussionmentioning

confidence: 99%

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From NTM (Nontuberculous mycobacterium) to Gordonia bronchialis—A Diagnostic Challenge in the COPD Patient

Franczuk¹,

Klatt²,

Filipczak³

et al. 2022

Diagnostics

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In patients with chronic obstructive pulmonary disease, respiratory infections are of various aetiology, predominantly viral and bacterial. However, due to structural and immunological changes within the respiratory system, such patients are also prone to mycobacterial and other relatively rare infections. We present the 70-year old male patient with chronic obstructive pulmonary disease (COPD) and coexisting bronchial asthma, diagnosed due to cough with purulent sputum expectoration lasting over three months. The first microbiological investigation of the sputum sample revealed the growth of mycobacteria. The identification test based on protein MPT64 production indicated an organism belonging to NTM (nontuberculous mycobacterium). However, further species identification by genetic testing verified the obtained culture as not belonging to the Mycobacterium genus. Based on observed morphology, the new characterisation identified an aerobic actinomycete, possibly a Nocardia spp. The isolated strain was recultured on standard microbiological media. The growth of colonies was observed on Columbia blood agar plates and solid Löewenstein-Jensen medium. The Gram and Zhiel-Nielsen stains revealed the presence of Gram-positive acid-fast bacilli. The extraction protocol and identification were performed in two repetitions; the result was G. bronchialis, with a confidence value of 99% and 95%, respectively. The gene sequencing method was applied to confirm the species affiliation of this isolate. The resulting sequence was checked against the 16S ribosomal RNA sequences database (Bacteria and Archaea). The ten best results indicated the genus Gordonia (99.04–100%) and 100% similarity of the 16S sequenced region was demonstrated for Gordonia bronchialis. The case described indicates that the correct interpretation of microbiological test results requires the use of advanced microbiology diagnosis techniques, including molecular identification of gene sequences. From a clinical point of view, Gordonia bronchialis infection or colonization may present a mild course, with no febrile episodes and no significant patient status deterioration and thus, it may remain undiagnosed more often than expected.

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Section: Discussionmentioning

confidence: 99%

“…The authors indicated the methods that appeared to be essential in establishing the aetiology of infection. In most presented cases, the species identifications required the use of advanced techniques: PCR, 16s rRNA gene sequencing method and MALDI-TOF [ 3 , 21 , 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

From NTM (Nontuberculous mycobacterium) to Gordonia bronchialis—A Diagnostic Challenge in the COPD Patient

Franczuk¹,

Klatt²,

Filipczak³

et al. 2022

Diagnostics

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“…Rhodococcus species are generally considered as opportunity human pathogens, in which R. equi is the most described cause of pheumonia in immunocompromised hosts such as AIDS and transplant recipients [ 1 , 3 ]. Besides, other Rhodococcus human pathogens including R. bronchialis [ 13 , 14 ], R. rhodochrous [ 15 ], R. rubropertinctus [ 16 ], R. aurantiacus [ 17 ], R. rhodnii [ 17 ], R. corynebacterioides [ 18 ], and R. fascians [ 19 ] are also reported.…”

Section: Discussionmentioning

confidence: 99%

A case of peritoneal dialysis-associated peritonitis caused by Rhodococcus kroppenstedtii

et al. 2021

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Background Rhodococcus kroppenstedtii is an aerobic, gram-positive bacterium firstly identified in the environment, which has not been reported in human-related infection. Herein, we reported the first case of peritoneal dialysis (PD)-associated peritonitis caused by R. kroppenstedtii which was identified by whole genome sequencing. Case presentation A 69-year-old man was admitted to hospital with abdominal pain and fever. Over the last 2 years, he had been undergoing continuous ambulatory peritoneal dialysis (CAPD) due to end-stage renal disease. Clinical symptom and sign in combination with laboratory examinations supported the clinical diagnosis of PD-associated peritonitis. Thus, ceftizoxime and teicoplanin were empirically used after PD effluent was collected for bacterial culture. A gram-positive bacterium was found from the PD effluent culture, which could not be identified by either Vitek 2 Compact ANC card or matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The strain was finally confirmed to be R. kroppenstedtii by whole genome sequencing (WGS) through the average nucleotide identity (ANI) analysis. With a continuous treatment with teicoplanin and imipenem for 15 days and intraperitoneal catheter removed, the infection symptom was improved evidenced by a normal body temperature, also with white blood cell count (WBC), procalcitonin (PCT) and C-reactive protein (CRP) dropped to normal levels. Peritoneal dialysis effluent culture showed a negative result. Then, hemodialysis and arteriovenous fistula angioplasty were performed, but the patient developed a progressive blood pressure loss, accompanied by multiple organ disorder, and died on Feb 25, 2020. Conclusions To the best of our knowledge, this is the first time to report a peritoneal dialysis-associated peritonitis caused by R. kroppenstedtii which was identified by average nucleotide identity analysis based on WGS.

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“…Однако, учитывая небольшое ко личество изолятов, данное исследование не может ис пользоваться в качестве окончательного руководства для эмпирического лечения. Тем не менее недавние со общения показали, что микроорганизмы рода Gordonia были выделены из раны грудины, опухолей и из плев рального выпота [49].…”

Section: ■ описание в литературе микроорганизмов -возбудителей инфекционных заболеванийunclassified

“…Возбудитель требует всестороннего морфоло гического и биохимического тестирования или приме нения современных методов идентификации, таких как MALDI-ToF масс-спектрометрия. Нокардии относятся к медленно растущим бактериям, период роста состав ляет минимум 4 дня [49]. Кроме масс-спектрометрии для правильной видовой идентификации возможно использование ПЦР и секвенирования.…”

Section: ■ описание в литературе микроорганизмов -возбудителей инфекционных заболеванийunclassified

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

Исматуллин

Zolotov

Олегович³

et al. 2019

Science and Innovations in Medicine

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The diseases of the respiratory system occupy one of the leading positions in the range of morbidities among the Russian population, both in adults and children. Partly, it is due to an increase of patients with primary and secondary immunodeficiencies, with anatomical anomalies of the respiratory tract, and other diseases of the bronchopulmonary system. Classical pathogens, causing the bacterial respiratory diseases, as a rule, are: Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella pneumoniae, Pseudomonas spp., Staphylococcus spp., as well as other representatives of the Enterobacteriacae family. But each year, the scientific literature presents more and more microorganisms - pathogens of infectious diseases of various localization in humans, the clinical significance of which has long remained poorly understood. These pathogens include representatives of large families of Corynebacteriaceae, Mycobacteriaceae, Nocardiaceae. Clinical physicians need to consider possible disorders in the immune system in patients with respiratory impairment, as well as a wide range of pathogens affecting the respiratory tract. To manage such patients effectively, the close interaction of pulmonologists, bacteriologists, and allergologists-immunologists is important.

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Sternal osteomyelitis by Gordonia Bronchialis in an immunocompetent patient after open heart surgery

Cited by 12 publications

References 27 publications

From NTM (Nontuberculous mycobacterium) to Gordonia bronchialis—A Diagnostic Challenge in the COPD Patient

From NTM (Nontuberculous mycobacterium) to Gordonia bronchialis—A Diagnostic Challenge in the COPD Patient

A case of peritoneal dialysis-associated peritonitis caused by Rhodococcus kroppenstedtii

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

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