The first case report of infective endocarditis caused by Gemella taiwanensis

Hikone, Mayu; Sakamoto, Naoya; Ota, Masayuki; Washino, Takuya; Kobayashi, Kenichiro; Iwabuchi, Sentaro; Kazama, Haruko; Kounosu, Akiko; Negishi, Kumiko; Ainoda, Yusuke; Iguchi, Shigekazu; Yoshida, Atsushi; Kikuchi, Ken; Ohnishi, Koji

doi:10.1016/j.jiac.2017.02.012

Cited by 15 publications

(19 citation statements)

References 13 publications

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“…tend to be misidentified due to the tendency to easily decolorize in Gram staining, and commercial biochemical tests are still incapable of identifying all of the strains accurately. A molecular method such as 16S rRNA gene sequence analysis is a useful tool for accurate identification [ 1 , 5 – 7 ]. In our case, at first, we misidentified G. bergeri as beta-hemolytic streptococcus spp.…”

Section: Discussionmentioning

confidence: 99%

“…Gemella bergeri is one of nine species (the others include G. haemolysans , G. morbillorum , G. sanguinis , G. asaccharolytica , G. taiwanensis , G. parahaemolysans , G. cuniculi, and G. palanticanis ) belonging to the genus Gemella [ 1 – 3 ]. Because conventional biochemical methods may result in misidentification of Gemella as viridans group streptococci or other related organisms, they are relatively difficult to identify and considered uncommon organisms [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Purpura fulminans with Lemierre’s syndrome caused by Gemella bergeri and Eikenella corrodens: a case report

et al. 2018

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BackgroundGemella bergeri is one of the nine species of the genus Gemella and is relatively difficult to identify. We herein describe the first case of septic shock due to a Gemella bergeri coinfection with Eikenella corrodens.Case presentationA 44-year-old Asian man with a medical history of IgG4-related ophthalmic disease who was prescribed corticosteroids (prednisolone) presented to our hospital with dyspnea. On arrival, he was in shock, and a purpuric eruption was noted on both legs. Contrast enhanced computed tomography showed fluid retention at the right maxillary sinus, left lung ground glass opacity, and bilateral lung irregular opacities without cavitation. Owing to suspected septic shock, fluid resuscitation and a high dose of vasopressors were started. In addition, meropenem, clindamycin, and vancomycin were administered. Repeat computed tomography confirmed left internal jugular and vertebral vein thrombosis. Following this, the patient was diagnosed with Lemierre’s syndrome. Furthermore, he went into shock again on day 6 of hospitalization. Additional soft tissue infections were suspected; therefore, bilateral below the knee amputations were performed for source control. Cultures of the exudates from skin lesions and histopathological samples did not identify any pathogens, and histopathological findings showed arterial thrombosis; therefore it was concluded that the second time shock was associated with purpura fulminans. Following this, his general status improved. He was transferred to another hospital for rehabilitation. The blood culture isolates were identified as Gemella bergeri and Eikenella corrodens. Gemella bergeri was identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry and confirmed by 16S rRNA gene sequencing later. The primary focus of the infection was thought to be in the right maxillary sinus, because the resolution of the fluid retention was confirmed by repeat computed tomography.ConclusionsGemella bergeri can be the causative pathogen of septic shock. If this pathogen cannot be identified manually or through commercial phenotypic methods, 16S rRNA gene sequencing should be considered.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Purpura fulminans with Lemierre’s syndrome caused by Gemella bergeri and Eikenella corrodens: a case report

et al. 2018

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“…Up to this time, most human cases have been found in northeastern Thailand (136). The first case report of infective endocarditis caused by Gemella taiwanensis was published by Hikone et al (137). In contrast to the cases mentioned in the initial description of this organism (173), this patient was not immunocompromised, and it is believed that her native valve endocarditis occurred after extensive treatment for dental caries (137).…”

Section: Acinetobacter Taxon 20mentioning

confidence: 93%

“…The first case report of infective endocarditis caused by Gemella taiwanensis was published by Hikone et al (137). In contrast to the cases mentioned in the initial description of this organism (173), this patient was not immunocompromised, and it is believed that her native valve endocarditis occurred after extensive treatment for dental caries (137). The first reported case of disseminated Nocardia kroppenstedtii was reported by Majeed et al (138).…”

Section: Acinetobacter Taxon 20mentioning

confidence: 97%

An Update on the Novel Genera and Species and Revised Taxonomic Status of Bacterial Organisms Described in 2016 and 2017

Munson

Carroll

2019

J Clin Microbiol

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Recognition and acknowledgment of novel bacterial taxonomy and nomenclature revisions can impact clinical practice, disease epidemiology, and routine clinical microbiology laboratory operations. The Journal of Clinical Microbiology (JCM) herein presents its biannual report summarizing such changes published in the years 2016 and 2017, as published and added by the International Journal of Systematic and Evolutionary Microbiology. Noteworthy discussion centers around descriptions of novel Corynebacteriaceae and an anaerobic mycolic acid-producing bacterium in the suborder Corynebacterineae; revisions within the Propionibacterium, Clostridium, Borrelia, and Enterobacter genera; and a major reorganization of the family Enterobacteriaceae. JCM intends to sustain this series of reports as advancements in molecular genetics, whole-genome sequencing, and studies of the human microbiome continue to produce novel taxa and clearer understandings of bacterial relatedness.

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“…associated with disease or human colonization, but without available genome sequences, were analyzed by at least one of these methods. By doing so, G. parahaemolysans (Hung et al, 2014) and G. taiwanensis (Hikone et al, 2017) were also members of the "Haemolysans group, " whereas Gemella palaticanis (Hoyles et al, 2000) had its own clade.…”

Section: Genome-wide Comparisons Reveal Unnoticed Relationships Betwementioning

confidence: 99%

The Versatility of Opportunistic Infections Caused by Gemella Isolates Is Supported by the Carriage of Virulence Factors From Multiple Origins

López

Martín-Galiano

2020

Front. Microbiol.

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The molecular basis of the pathogenesis of the opportunistic invasive infections caused by isolates of the Gemella genus remains largely unknown. Moreover, inconsistencies in the current species assignation were detected after genome-level comparison of 16 public Gemella isolates. A literature search detected that, between the two most pathogenic species, Gemella morbillorum causes about twice the number of cases compared to Gemella haemolysans. These two species shared their mean diseasessepsis and endocarditis-but differed in causing other syndromes. A number of well-known virulence factors were harbored by all species, such as a manganese transport/adhesin sharing 83% identity from oral endocarditis-causing streptococci. Likewise, all Gemellae carried the genes required for incorporating phosphorylcholine into their cell walls and encoded some choline-binding proteins. In contrast, other proteins were species-specific, which may justify the known epidemiological differences. G. haemolysans, but not G. morbillorum, harbor a gene cluster potentially encoding a polysaccharidic capsule. Species-specific surface determinants also included Rib and MucBP repeats, hemoglobin-binding NEAT domains, peptidases of C5a complement factor and domains that recognize extracellular matrix molecules exposed in damaged heart valves, such as collagen and fibronectin. Surface virulence determinants were associated with several taxonomically dispersed opportunistic genera of the oral microbiota, such as Granulicatella, Parvimonas, and Streptococcus, suggesting the existence of a horizontally transferrable gene reservoir in the oral environment, likely facilitated by close proximity in biofilms and ultimately linked to endocarditis. The identification of the Gemella virulence pool should be implemented in whole genomebased protocols to rationally predict the pathogenic potential in ongoing clinical infections caused by these poorly known bacterial pathogens.

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The first case report of infective endocarditis caused by Gemella taiwanensis

Cited by 15 publications

References 13 publications

Purpura fulminans with Lemierre’s syndrome caused by Gemella bergeri and Eikenella corrodens: a case report

Purpura fulminans with Lemierre’s syndrome caused by Gemella bergeri and Eikenella corrodens: a case report

An Update on the Novel Genera and Species and Revised Taxonomic Status of Bacterial Organisms Described in 2016 and 2017

The Versatility of Opportunistic Infections Caused by Gemella Isolates Is Supported by the Carriage of Virulence Factors From Multiple Origins

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