1
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Benhasna S, Boudemagh A. Alternative protocol leading to rapid identification of Actinomycetes isolated from Algerian desertic soil by MALDI-TOF mass spectrometry. J Microbiol Methods 2024; 223:106984. [PMID: 38955305 DOI: 10.1016/j.mimet.2024.106984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 06/19/2024] [Accepted: 06/29/2024] [Indexed: 07/04/2024]
Abstract
Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) is the first-line method for the rapid identification of most cultured microorganisms. As for Streptomyces strains, MALDI-TOF MS identification is complicated by the characteristic incrustation of colonies in agar and the strong cell wall of Actinomycetes cells requiring the use of alternative protein extraction protocols. In this study, we developed a specific protocol to overcome these difficulties for the MALDI-TOF MS identification of Actinomycetes made on solid medium. This protocol includes incubation of colony removed from agar plate with the beta-agarase enzyme, followed by a mechanical lysis and two washes by phosphate buffer and ethanol. Twenty-four Streptomyces and two Lentzea strains isolated from Algerian desertic soils were first identified by 16S rRNA sequencing as gold standard method, rpoB gene was used as a secondary gene target when 16S rRNA did not allow species identification. In parallel the isolates were identified by using the MALDI-TOF MS protocol as reported. After the expansion of the database with the inclusion of this MSPS, the strains were analyzed again in MALDI Biotyper, and all were identified. This work demonstrates that the rapid identification of Actinomycetes can be obtained without protein extraction step frequently used in MALDI-TOF mass spectrometry with this type of microorganisms.
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Affiliation(s)
- Sarra Benhasna
- Laboratory of Molecular and Cellular Biology, Constantine1-Frères Mentouri University, Chaâbat Erssas Campus, Ain El Bey Road, 25000 Constantine, Algeria; Department of Microbiology, Constantine1-Frères Mentouri University, Ain El Bey Road, 25000 Constantine, Algeria.
| | - Allaoueddine Boudemagh
- Laboratory of Molecular and Cellular Biology, Constantine1-Frères Mentouri University, Chaâbat Erssas Campus, Ain El Bey Road, 25000 Constantine, Algeria
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2
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Könönen E. Polymicrobial infections with specific Actinomyces and related organisms, using the current taxonomy. J Oral Microbiol 2024; 16:2354148. [PMID: 38766462 PMCID: PMC11100438 DOI: 10.1080/20002297.2024.2354148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/05/2024] [Indexed: 05/22/2024] Open
Abstract
Actinomyces organisms reside on mucosal surfaces of the oropharynx and the genitourinary tract. Polymicrobial infections with Actinomyces organisms are increasingly being reported in the literature. Since these infections differ from classical actinomycosis, lacking of specific clinical and imaging findings, slow-growing Actinomyces organisms can be regarded as contaminants or insignificant findings. In addition, only limited knowledge is available about novel Actinomyces species and their clinical relevance. The recent reclassifications have resulted in the transfer of several Actinomyces species to novel genera Bowdeniella, Gleimia, Pauljensenia, Schaalia, or Winkia. The spectrum of diseases associated with specific members of Actinomyces and these related genera varies. In human infections, the most common species are Actinomyces israelii, Schaalia meyeri, and Schaalia odontolytica, which are typical inhabitants of the mouth, and Gleimia europaea, Schaalia turicensis, and Winkia neuii. In this narrative review, the purpose was to gather information on the emerging role of specific organisms within the Actinomyces and related genera in polymicrobial infections. These include Actinomyces graevenitzii in pulmonary infections, S. meyeri in brain abscesses and infections in the lower respiratory tract, S. turicensis in skin-related infections, G. europaea in necrotizing fasciitis and skin abscesses, and W. neuii in infected tissues around prostheses and devices. Increased understanding of the role of Actinomyces and related species in polymicrobial infections could provide improved outcomes for patient care. Key messages Due to the reclassification of the genus, many former Actinomyces species belong to novel genera Bowdeniella, Gleimia, Pauljensenia, Schaalia, or Winkia.Some of the species play emerging roles in specific infection types in humans.Increasing awareness of their clinical relevance as an established or a putative pathogen in polymicrobial infections brings about improved outcomes for patient care.
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Affiliation(s)
- Eija Könönen
- Institute of Dentistry, University of Turku, Turku, Finland
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3
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Del Fabro G, Volpi S, Fumarola B, Migliorati M, Bertelli D, Signorini L, Matteelli A, Meschiari M. Actinomyces spp. Prosthetic Vascular Graft Infection (PVGI): A Multicenter Case-Series and Narrative Review of the Literature. Microorganisms 2023; 11:2931. [PMID: 38138076 PMCID: PMC10745418 DOI: 10.3390/microorganisms11122931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/26/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Actinomycosis represents a challenging and under-reported complication of vascular surgery. Optimal management of Actinomyces spp. prosthetic vascular graft infection (PVGI) is highly uncertain because of the paucity of reports on this disease. METHODS We conducted a retrospective case-series of Actinomyces-PVGI that occurred in the last five years in two major university hospitals in northern Italy. We searched for previously published cases in the scientific literature. RESULTS We report five original cases of Actinomyces spp. prosthetic vascular graft infection following aortic aneurysm repair. Our literature review retrieved eight similar cases. Most patients were immunocompetent males. Most infections were polymicrobial (11/13 cases), with a prevalence of A. odontolyticus involvement (3/13 cases were associated with. Salmonella spp. infection). All cases had a late presentation (≥4 months from graft placement), with 61% associated with an aorto-enteric fistula. All patients received antibiotic therapy, but the duration was highly heterogeneous (from two weeks to life-long antibiotics). The patients without surgical revision experienced septic recurrences (2/13), permanent dysfunction (1/13), or a fatal outcome (2/13), while of the remainder who underwent vascular graft explant, six recovered completely and one developed a periprosthetic abscess. In two cases follow-up was not available. CONCLUSIONS This case-series aims to raise the diagnostic suspicion and to describe the current management of Actinomyces-PVGIs. We highlight a high heterogeneity in antibiotic duration, choice of the antibiotic regimen, and surgical management. Higher reporting rate is advisable to produce better evidence and optimize management of this rare complication of vascular surgery.
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Affiliation(s)
- Giovanni Del Fabro
- Department of Infectious Diseases, Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Sara Volpi
- Clinic of Infectious Diseases, University Hospital of Modena, 41124 Modena, Italy
| | - Benedetta Fumarola
- Department of Infectious Diseases, Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Manuela Migliorati
- Department of Infectious Diseases, Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Davide Bertelli
- Department of Infectious Diseases, Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Liana Signorini
- Department of Infectious Diseases, Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Alberto Matteelli
- Department of Infectious Diseases, Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Marianna Meschiari
- Clinic of Infectious Diseases, University Hospital of Modena, 41124 Modena, Italy
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4
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Ding J, Zhang Y, Feng H, Sun H. Actinomycotic primary canaliculitis: Predisposing factors, clinical characteristics, and treatment outcomes. Eur J Ophthalmol 2023; 33:2194-2200. [PMID: 36927124 DOI: 10.1177/11206721231163612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE Ocular actinomycosis is an uncommon progressive infection. The study aims to investigate the predisposing factors, clinical characteristics and treatment outcomes of culture-proven cases of Actinomycotic primary canaliculitis. METHODS Single-center, retrospective, interventional case series. Culture-proven cases of Actinomyces-associated primary canaliculitis diagnosed and treated between January 2017 and December 2021 at the Beijing Tongren Eye Center, Capital Medical University were identified and reviewed for ocular and systemic risk factors, clinical presentations, microbiological profile, treatment modalities and outcomes. RESULTS Of the 201 patients diagnosed with primary canaliculitis, 22 (10.9%) were caused by Actinomyces. The mean age at onset of 22 patients (21 women and one men) was 54 years. The lower canaliculus was most commonly involved (54.6%). The most frequent symptom was mattering without epiphora (77.3%) and clinical signs were punctal regurgitation of purulent discharge (100%) and expressible concretions (95.5%). Dry eye co-existed in 77.3% of patients, whereas no obvious systemic factors were found. Among 19 cases (86.0%) of identified Actinomyces species, A. odontolyticus (43.5%) was the predominant causative microorganism. There were 50% of patients with polymicrobial infection and the most common additional bacteria isolated were Streptococcus species. Conservative therapy combining repeated canalicular expression and irrigation with susceptible topical antibiotics achieved complete resolution in 86.4% of patients. CONCLUSIONS Dry eye was identified in the vast majority of patients with Actinomycotic canaliculitis. Most cases are odontogenic in origin and the infection occurs in immunocompetent individuals. The conservative method combining canalicular expression and irrigation with topical susceptible antibiotics is recommendable as initial therapy.
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Affiliation(s)
- Jingwen Ding
- Department of Oculoplastic Surgery, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Yang Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Hui Feng
- Department of Oculoplastic Surgery, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Hua Sun
- Department of Oculoplastic Surgery, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
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5
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Kövér Z, Johansen Nordskag V, Bán Á, Gajdács M, Urbán E. The role of Actinomyces spp. and related organisms in cervicofacial infections: Pathomechanism, diagnosis and therapeutic aspects. Anaerobe 2023; 82:102767. [PMID: 37482285 DOI: 10.1016/j.anaerobe.2023.102767] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/26/2023] [Accepted: 07/20/2023] [Indexed: 07/25/2023]
Abstract
Members of the Actinomyces genus and Actinomyces-like organisms (ALOs; namely Actinotignum, Arcanobacterium, Schaalia and Varibaculum) are Gram-positive, non-spore-forming rods that are commensal members of the human oral cavity, gastrointestinal tract, female genital tract and skin microbiota. Cervicofacial actinomycosis or "lumpy jaw syndrome" - the chronic, suppurative granulomatous disease caused by Actinomyces spp. And ALOs - is characterized by an initially slow and unspecific disease-presentation, which often mimics other pathologies, followed by the formation of painful abscesses and severe tissue destruction. Actinomycosis has been described as a rare disease, however, reliable epidemiological data are lacking. In addition, there is increasing awareness regarding the role of Actinomyces spp. in the development of osteoradionecrosis and medication-related osteonecrosis of the jaw. The aim of this narrative review is to succinctly summarize the current advances regarding the microbiological, clinical, diagnostic and therapeutic aspects of cervicofacial actinomycosis, in addition to the roles of Actinomyces species and ALOs as members of the oral microbiota and in dental biofilm, in other dental infections (caries, root canal infection, periapical infection, periodontitis) and osteonecrosis of the jaw, in the context of recent taxonomic changes affecting the genus. Our paper aims to be a blueprint for dentists, other physicians, microbiologists and researchers regarding the multifaceted field of cervicofacial actinomycosis.
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Affiliation(s)
- Zsanett Kövér
- Department of Dentistry, Oral and Maxillofacial Surgery, Medical School, University of Pécs, Tüzér U. 1., 7623, Pécs, Hungary.
| | - Vidar Johansen Nordskag
- Department of Dentistry, Oral and Maxillofacial Surgery, Medical School, University of Pécs, Tüzér U. 1., 7623, Pécs, Hungary.
| | - Ágnes Bán
- Department of Dentistry, Oral and Maxillofacial Surgery, Medical School, University of Pécs, Tüzér U. 1., 7623, Pécs, Hungary.
| | - Márió Gajdács
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, Tisza Lajos krt. 64-66., 6725, Szeged, Hungary.
| | - Edit Urbán
- Department of Medical Microbiology and Immunology, Clinical Center, University of Pécs, Szigeti út 12., 7624, Pécs, Hungary.
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6
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Meena DS, Kumar D, Sharma M, Malik M, Ravindra A, Santhanam N, Bohra GK, Garg MK. The epidemiology, clinical presentation and treatment outcomes in CNS actinomycosis: a systematic review of reported cases. Orphanet J Rare Dis 2023; 18:133. [PMID: 37269006 DOI: 10.1186/s13023-023-02744-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/18/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND CNS actinomycosis is a rare chronic suppurative infection with non-specific clinical features. Diagnosis is difficult due to its similarity to malignancy, nocardiosis and other granulomatous diseases. This systematic review aimed to evaluate the epidemiology, clinical characteristics, diagnostic modalities and treatment outcomes in CNS actinomycosis. METHODS The major electronic databases (PubMed, Google Scholar, and Scopus) were searched for the literature review by using distinct keywords: "CNS" or "intracranial" or "brain abscess" or "meningitis" OR "spinal" OR "epidural abscess" and "actinomycosis." All cases with CNS actinomycosis reported between January 1988 to March 2022 were included. RESULTS A total of 118 cases of CNS disease were included in the final analysis. The mean age of patients was 44 years, and a significant proportion was male (57%). Actinomycosis israelii was the most prevalent species (41.5%), followed by Actinomyces meyeri (22.6%). Disseminated disease was found in 19.5% of cases. Most commonly involved extra-CNS organs are lung (10.2%) and abdomen (5.1%). Brain abscess (55%) followed by leptomeningeal enhancement (22%) were the most common neuroimaging findings. Culture positivity was found in nearly half of the cases (53.4%). The overall case-fatality rate was 11%. Neurological sequelae were present in 22% of the patients. On multivariate analysis, patients who underwent surgery with antimicrobials had better survival (adjusted OR 0.14, 95% CI 0.04-0.28, p value 0.039) compared to those treated with antimicrobials alone. CONCLUSION CNS actinomycosis carries significant morbidity and mortality despite its indolent nature. Early aggressive surgery, along with prolonged antimicrobial treatment is vital to improve outcomes.
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Affiliation(s)
- Durga Shankar Meena
- Department of Internal Medicine (Infectious Diseases), All India Institute of Medical Sciences, Jodhpur, 342005, India
| | - Deepak Kumar
- Department of Internal Medicine (Infectious Diseases), All India Institute of Medical Sciences, Jodhpur, 342005, India.
| | - Mukesh Sharma
- Department of Microbiology, Dr. S.N. Medical College, Jodhpur, India
| | - Manika Malik
- Department of Internal Medicine (Infectious Diseases), All India Institute of Medical Sciences, Jodhpur, 342005, India
| | - Akshatha Ravindra
- Department of Internal Medicine (Infectious Diseases), All India Institute of Medical Sciences, Jodhpur, 342005, India
| | - N Santhanam
- Department of Internal Medicine (Infectious Diseases), All India Institute of Medical Sciences, Jodhpur, 342005, India
| | - Gopal Krishana Bohra
- Department of Internal Medicine (Infectious Diseases), All India Institute of Medical Sciences, Jodhpur, 342005, India
| | - Mahendra Kumar Garg
- Department of Internal Medicine (Infectious Diseases), All India Institute of Medical Sciences, Jodhpur, 342005, India
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7
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Bella Z, Erdelyi E, Szalenko-Tőkés Á, Kiricsi Á, Gaál V, Benedek P, Rovó L, Nagy E. Peritonsillar abscess: an 8-year retrospective, culture based evaluation of 208 cases. J Med Microbiol 2022; 71. [DOI: 10.1099/jmm.0.001576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction. Peritonsillar abscess (PTA) is a common infection which requires surgical intervention and suitable antibiotic therapy.
Hypotheses/Gap Statement. Beside
Streptococcus pyogenes
and
Fusobacterium necrophorum
several other mostly anaerobic bacteria can be cultured from the properly taken pus samples of PTA, the clinical significance of which is still not fully understood.
Aim. This study focused on the culture-based microbiological evaluation of PTA cases, compared to surgical intervention and empirical antibiotic management.
Methodology. A retrospective analysis of PTA cases was performed between 2012 and 2019. Data about the aerobic and anaerobic culture results of the samples taken during different surgical interventions were summarized and the coverage of the empirically selected antibiotics was evaluated. The patient’s history, the development of complications and the recurrence rate were also evaluated.
Results. The microbiological culture results were available for 208 of 320 patients with clinically diagnosed PTA. Incision and drainage (I and D) and immediate tonsillectomy were the leading surgical interventions. Ninety-five
Fusobacterium
species (including 44
Fusobacterium necrophorum
), 52
Actinomyces
species and 47
Streptococcus pyogenes
were obtained from PTA samples alone or together with polymicrobial flora.
S. pyogenes
(33.7 %, n=28) and
F. necrophorum
(22.9 %, n=19) were the dominating pathogens in the 83 monobacterial PTA samples. In >60 % of the patients polymicrobial infection was demonstrated, involving a great variety of anaerobic bacteria. In 22 out of 42 cases where intravenous cefuroxime was empirically started, the therapy should be changed to properly cover the culture-proven anaerobic flora. There were no serious complications, abscess recurrence was detected in two cases (0.96 %).
Conclusion. PTAs are often polymicrobial infections including a great variety of anaerobes. Targeted antibiotic therapy, in conjunction with adequate surgical drainage eliminating the anaerobic milieu, can accelerate the healing process and radically reduce the complication and recurrence rate.
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Affiliation(s)
- Zsolt Bella
- Department of Oto-Rhino-Laryngology and Head-Neck Surgery, Faculty of Medicine, University of Szeged, Hungary
| | - Eszter Erdelyi
- Department of Oto-Rhino-Laryngology and Head-Neck Surgery, Faculty of Medicine, University of Szeged, Hungary
| | - Ágnes Szalenko-Tőkés
- Department of Oto-Rhino-Laryngology and Head-Neck Surgery, Faculty of Medicine, University of Szeged, Hungary
| | - Ágnes Kiricsi
- Department of Oto-Rhino-Laryngology and Head-Neck Surgery, Faculty of Medicine, University of Szeged, Hungary
| | - Veronika Gaál
- Department of Pediatric-ENT, Faculty of Medicine, University of Pécs, Pécs, Hungary
| | | | - László Rovó
- Department of Oto-Rhino-Laryngology and Head-Neck Surgery, Faculty of Medicine, University of Szeged, Hungary
| | - Elisabeth Nagy
- Department of Medical Microbiology, Faculty of Medicine, University of Szeged, Szeged, Hungary
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8
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Hsiao YC, Lee YH, Ho CM, Tseng CH, Wang JH. Clinical Characteristics of Actinomyces viscosus Bacteremia. ACTA ACUST UNITED AC 2021; 57:medicina57101064. [PMID: 34684101 PMCID: PMC8537041 DOI: 10.3390/medicina57101064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/21/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Actinomyces species are part of the normal flora of humans and rarely cause disease. It is an uncommon cause of disease in humans. The clinical features of actinomycosis have been described, and various anatomical sites (such as face, bones and joints, respiratory tract, genitourinary tract, digestive tract, central nervous system, skin, and soft tissue structures) can be affected. It is not easy to identify actinomycosis because it sometimes mimics cancer due to under-recognition. As new diagnostic methods have been applied, Actinomyces can now more easily be identified at the species level. Recent studies have also highlighted differences among Actinomyces species. We report a case of Actinomyces viscosus bacteremia with cutaneous actinomycosis. Materials and Methods: A 66 years old male developed fever for a day with progressive right lower-leg erythematous swelling. Blood culture isolates yielded Actinomyces species, which was identified as Actinomyces viscosus by sequencing of the 16S rRNA gene. In addition, we searched for the term Actinomyces or actinomycosis cross-referenced with bacteremia or "blood culture" or "blood stream" from January 2010 to July 2020. The infectious diseases caused by species of A. viscosus from January 1977 to July 2020 were also reviewed. Results: The patient recovered well after intravenous ampicillin treatment. Poor oral hygiene was confirmed by dental examination. There were no disease relapses during the following period. Most cases of actinomycosis can be treated with penicillin. However, clinical alertness, risk factor evaluation, and identification of Actinomyces species can prevent inappropriate antibiotic or intervention. We also compiled a total of 18 cases of Actinomyces bacteremia after conducting an online database search. Conclusions: In summary, we describe a case of fever and progressive cellulitis. Actinomyces species was isolated from blood culture, which was further identified as Actinomyces viscosus by 16S rRNA sequencing. The cellulitis improved after pathogen-directed antibiotics. Evaluation of risk factors in patients with Actinomyces bacteremia and further identification of the Actinomyces species are recommended for successful treatment.
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Affiliation(s)
- Yi-Chun Hsiao
- Department of Internal Medicine, Division of Infectious Diseases, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (Y.-C.H.); (C.-M.H.); (C.-H.T.)
| | - Yi-Hsuan Lee
- Department of Post-Baccalaureate Veterinary Medicine, Asia University, Taichung 41354, Taiwan;
| | - Chun-Mei Ho
- Department of Internal Medicine, Division of Infectious Diseases, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (Y.-C.H.); (C.-M.H.); (C.-H.T.)
| | - Chien-Hao Tseng
- Department of Internal Medicine, Division of Infectious Diseases, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (Y.-C.H.); (C.-M.H.); (C.-H.T.)
| | - Jui-Hsing Wang
- Department of Internal Medicine, Division of Infectious Disease, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 40705, Taiwan
- Department of Internal Medicine, School of Medicine, Buddhist Tzu Chi Medical Foundation Taichung Tzu Chi Hospital, Taichung 427213, Taiwan
- Correspondence:
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9
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Phichaphop C, Apiwattanakul N, Wanitkun S, Boonsathorn S. Bacterial Endocarditis Caused by Actinomyces oris: First Reported Case and Literature Review. J Investig Med High Impact Case Rep 2021; 8:2324709620910645. [PMID: 32131639 PMCID: PMC7059227 DOI: 10.1177/2324709620910645] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Actinomyces species are gram-positive, facultative anaerobic
bacilli. Infection caused by Actinomyces species is usually
limited to cervicofacial, thoracic, and abdominopelvic regions. Infective
endocarditis due to Actinomyces species is extremely rare with
only 30 reported cases since 1939. We report a case of Actinomyces
oris endocarditis in a 14-year-old boy who had a 2-week history of
dyspnea on exertion without other constitutional signs. Transthoracic
echocardiography was suggestive of perforation of the right coronary cusp of
aortic valve. No organisms were isolated from blood cultures. The patient
underwent surgical valve repair due to deteriorated cardiac function. Valve
tissue culture did not initially identify the organism. However, the terminal
subculture in a thioglycolate broth grew gram-positive bacilli. The
matrix-assisted laser desorption ionization time-of-flight mass spectrometry
(MALDI-TOF MS) was compatible with Actinomyces oris. After 6
weeks of intravenous ampicillin, the patient remained well with improved cardiac
function. We reviewed all reported cases of infective endocarditis caused by
Actinomyces species, commenting on clinical characteristics
and factors associated with unfavorable outcomes in infective endocarditis due
to Actinomyces species. Although infective endocarditis caused
by Actinomyces spp is rare, it could be considered in a case of
culture-negative endocarditis since the clinical features might be
indistinguishable from other bacterial endocarditis. Additionally, MALDI-TOF MS
is a useful diagnostic tool for the identification of
Actinomyces spp to improve the accuracy of diagnosis.
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Affiliation(s)
- Chanita Phichaphop
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Suthep Wanitkun
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sophida Boonsathorn
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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10
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Barberis C, Ledesma M, Álvarez C, Famiglietti A, Almuzara M, Vay C. [Analysis of the diversity of Actinomyces/Actinotignum clinical isolates in a university hospital]. Rev Argent Microbiol 2021; 53:202-209. [PMID: 33402284 DOI: 10.1016/j.ram.2020.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 09/22/2020] [Accepted: 11/03/2020] [Indexed: 11/15/2022] Open
Abstract
Actinomyces and related genera are grampositive bacilli, opportunistic pathogens, which have been mainly involved in endogenous infections. However, due to the complexity in identifying them for most clinical laboratories, there is scant knowledge about their real clinical significance. In this work, 166 isolates of 13 different species of Actinomyces/Actinotignum species recovered from clinical samples of patients treated in a university hospital were studied. The identification was performed by MALDI-TOF MS and molecular identification. MALDI-TOF MS identified 91.57% of the isolates (152/166) at the species level using a score ≥ 1.7 and 3.61% (6/166) of the isolates were identified only at the gender level with a score ≥ 1.5. MALDI-TOF MS did not yield reliable identification results for 4.82% (8/166) of the isolates. Actinomyces/Actinotignum species were isolated from: soft tissue (n: 47), urine samples (n: 35), head / neck abscesses (n: 19), genital abscesses (n: 11), blood samples (n: 10), breast abscesses (n: 8), osteoarticular samples (n: 6), abdominal/ascitic fluids (n: 3), abdominal abscesses (n: 5), sputum/BAL (n: 4), brain abscesses (n: 3), and others (n: 15). The results obtained from the statistical analysis showed a high differential frequency (> 2) for the location/species association: urine/A. schaalii/sanguinis; brain abscesses/A. europaeus; osteoarticular samples/A. urogenitalis; abdominal abscesses/ A. turicensis; respiratory samples/A. naeslundii/viscosus. This information provides a greater understanding of the clinical and epidemiological relevance of these species. The pathogenic role of Actinomyces spp. will be increasingly revealed as these microorganisms could be recognized thanks to prolonged culture and the advances in identification technology facilitated by MALDI-TOF MS.
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Affiliation(s)
- Claudia Barberis
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Hospital de Clínicas «José de San Martín», Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Martín Ledesma
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Hospital de Clínicas «José de San Martín», Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Carla Álvarez
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Hospital de Clínicas «José de San Martín», Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Angela Famiglietti
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Hospital de Clínicas «José de San Martín», Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Marisa Almuzara
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Hospital de Clínicas «José de San Martín», Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Carlos Vay
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Hospital de Clínicas «José de San Martín», Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
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Gajdács M, Urbán E. The Pathogenic Role of Actinomyces spp. and Related Organisms in Genitourinary Infections: Discoveries in the New, Modern Diagnostic Era. Antibiotics (Basel) 2020; 9:E524. [PMID: 32824418 PMCID: PMC7459602 DOI: 10.3390/antibiotics9080524] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/14/2020] [Accepted: 08/15/2020] [Indexed: 12/16/2022] Open
Abstract
Actinomycosis is a chronic, suppurative, granulomatous infectious disease, caused by different species of Actinomyces bacteria. To date, 26 validly published Actinomyces species have been described as part of a normal human microbiota or from human clinical specimens. Due to the rapid spread of new, modern diagnostic procedures, 13 of 26 of these species have been described in this century and the Actinomycetaceae family has undergone several taxonomic revisions, including the introduction of many novel species termed Actinomyces-like organisms (ALOs). There is scarce data available on the role of these novel bacterial species in various infectious processes in human medicine. The aim of this review is to provide a comprehensive overview of Actinomyces and closely related organisms involved in human diseases-with a special focus on newly described species-in particular their role in genitourinary tract infections in females and males.
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Affiliation(s)
- Márió Gajdács
- Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, 6720 Szeged, Hungary;
- Institute of Medical Microbiology, Faculty of Medicine, Semmelweis University, 1089 Budapest, Hungary
| | - Edit Urbán
- Institute of Translational Medicine, Faculty of Medicine, University of Pécs, 7624 Pécs, Hungary
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Diagnosis and Management of Cervicofacial Actinomycosis: Lessons from Two Distinct Clinical Cases. Antibiotics (Basel) 2020; 9:antibiotics9040139. [PMID: 32218154 PMCID: PMC7235781 DOI: 10.3390/antibiotics9040139] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/17/2020] [Accepted: 03/23/2020] [Indexed: 01/20/2023] Open
Abstract
Members of the Actinomyces genus are non-spore-forming, anaerobic, and aerotolerant Gram-positive bacteria that are abundantly found in the oropharynx. They are the causative agents of actinomycosis, a slowly progressing (indolent) infection with non-specific symptoms in its initial phase, and a clinical course of extensive tissue destruction if left untreated. Actinomycoses are considered to be rare; however, reliable epidemiological data on their prevalence is lacking. Herein, we describe two representative and contrasting cases of cervicofacial actinomycosis, where the affected patients had distinctively different backgrounds and medical histories. Identification of the relevant isolates was carried out using matrix-assisted laser desorption/ionization mass spectrometry; antimicrobial susceptibility was performed using E-tests. Cervicofacial actinomycoses are the most frequent form of the disease; isolation and identification of these microorganisms from relevant clinical samples (with or without histological examination) is the gold standard for diagnosis. The therapy of these infections includes surgical debridement and antibiotic therapy, mainly with a penicillin-derivative or clindamycin.
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Azadi D, Motallebirad T, Ghaffari K, Shokri D, Rezaei F. Species Diversity, Molecular Characterization, and Antimicrobial Susceptibility of Opportunistic Actinomycetes Isolated from Immunocompromised and Healthy Patients of Markazi Province of Iran. Infect Drug Resist 2020; 13:1-10. [PMID: 32021315 PMCID: PMC6954848 DOI: 10.2147/idr.s234292] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 12/13/2019] [Indexed: 12/17/2022] Open
Abstract
Background Actinomycetes widely exist in nature and these species cause infections in immunocompromised and healthy patients, although they are frequently found as members of the normal microbiota of humans and animals. These subsequent infections are often misdiagnosed as malignancy and tuberculosis. Due to this issue, the present study aimed to determine the presence and diversity of actinomycetes species causing infections in Iranian patients. Materials and Methods A total of 79 clinical samples collected from five hospitals in Markazi province were analyzed for the existence of actinomycetes using standard protocols for isolation and characterization of the isolates. The conventional tests were used for preliminary identification, the PCR amplification of hsp65 gene, the specific region of the 16S rRNA, and sequence analyses of 16S rRNA were applied for the genus and species identification. MICs of the antimicrobial agent were determined by the broth microdilution method and interpreted according to the NCCLS guidelines. Results A total of 17 (21.51%) actinomycetes isolates were recovered from clinical samples. In other analyzed samples, eight (10.12%) gram-positive, 12 (15.18) gram-negative bacteria, and six (7.6) fungi isolates were recovered. The most prevalent actinomycetes species were M. fortuitum (17.64%), N. Mexicana and S. heliomycini (11.76% each), and 10 species, ie, N. farcinica, M. lehmannii, M. flavescens, Arthrobacter crystalopoetis, N. neocaledoniensis, M. phocaicum, M. abscessus, M. arupense, M. setense, and N. cyriacigeorgica made up the single isolates. Results of DST illustrated that all of the isolates were susceptible to Amikacin, Levofloxacin, Ofloxacin, and Ciprofloxacin, whereas all of them were resistant to Rifampicin and Doxycycline. Conclusion In conclusion, increasing isolation of actinomycetes found in various clinical cases merits special attention by health authorities in developing countries. In health centers, action should be taken to increase awareness of appropriate diagnostic criteria and management guidelines for actinomycetes diseases. Furthermore, an increase in the number as well as the quality of national and regional reference laboratories may facilitate more accurate diagnosis of actinomycetes diseases.
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Affiliation(s)
- Davood Azadi
- Department of Laboratory Sciences, Khomein University of Medical Sciences, Khomein, Iran.,Molecular Medicine Research Center, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Tahereh Motallebirad
- Department of Laboratory Sciences, Khomein University of Medical Sciences, Khomein, Iran
| | - Kazem Ghaffari
- Department of Laboratory Sciences, Khomein University of Medical Sciences, Khomein, Iran
| | - Dariuosh Shokri
- Department of Biology and Microbiology, Shahid Ashrafi Isfahani University, Isfahan, Iran
| | - Fatemeh Rezaei
- Department of Laboratory Sciences, Khomein University of Medical Sciences, Khomein, Iran
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Gajdács M, Urbán E, Terhes G. Microbiological and Clinical Aspects of Cervicofacial Actinomyces Infections: An Overview. Dent J (Basel) 2019; 7:dj7030085. [PMID: 31480587 PMCID: PMC6784480 DOI: 10.3390/dj7030085] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/20/2019] [Accepted: 08/23/2019] [Indexed: 02/07/2023] Open
Abstract
Similarly to other non-spore-forming Gram-positive anaerobes, members of the Actinomyces genus are important saprophytic constituents of the normal microbiota of humans. Actinomyces infections are considered to be rare, with cervicofacial infections (also known as ‘lumpy jaw syndrome’) being the most prevalent type in the clinical practice. Actinomycoses are characterized by a slowly progressing (indolent) infection, with non-specific symptoms, and additionally, the clinical presentation of the signs/symptoms can mimic other pathologies, such as solid tumors, active Mycobacterium tuberculosis infections, nocardiosis, fungal infections, infarctions, and so on. The clinical diagnosis of actinomycosis may be difficult due to its non-specific symptoms and the fastidious, slow-growing nature of the pathogens, requiring an anaerobic atmosphere for primary isolation. Based on 111 references, the aim of this review is to summarize current advances regarding the clinical features, diagnostics, and therapy of cervicofacial Actinomyces infections and act as a paper for dentistry specialists, other physicians, and clinical microbiologists.
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Affiliation(s)
- Márió Gajdács
- Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, 6720 Szeged, Eötvös utca 6., Hungary.
- Institute of Clinical Microbiology, Faculty of Medicine, University of Szeged, 6725 Szeged, Semmelweis utca 6., Hungary.
| | - Edit Urbán
- Department of Public Health, Faculty of Medicine, University of Szeged, 6720 Szeged, Dóm tér 10., Hungary
| | - Gabriella Terhes
- Institute of Clinical Microbiology, Faculty of Medicine, University of Szeged, 6725 Szeged, Semmelweis utca 6., Hungary
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