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Sagerfors S, Edslev S, Lindblad BE, Lilje B, Stegger M, Söderquist B. In the eye of the ophthalmologist: the corneal microbiome in microbial keratitis. Graefes Arch Clin Exp Ophthalmol 2024; 262:1579-1589. [PMID: 37993692 PMCID: PMC11031470 DOI: 10.1007/s00417-023-06310-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 10/26/2023] [Accepted: 11/02/2023] [Indexed: 11/24/2023] Open
Abstract
PURPOSE To describe the bacterial findings by a targeted sequencing approach from corneal samples of patients with microbial keratitis and factors influencing culture outcome of indirectly inoculated corneal specimen. METHODS Prospective inclusion of patients fulfilling predefined criteria of microbial keratitis. Samples from the corneal lesion were collected and dispensed in liquid transport medium, from which both culture and targeted amplification and sequencing of the V3-V4 region of the 16S rRNA gene were carried out. Additional standard corneal culture from the corneal lesions was also performed. Factors influencing culture outcome of indirectly inoculated corneal samples were identified by a multivariate regression model incorporating quantitative data from sequencing. RESULTS Among the 94 included patients with microbial keratitis, contact lens wear (n = 69; 73%) was the most common risk factor. Contact lens wearers displayed significant differences in the bacterial community composition of the corneal lesion compared to no lens wearers, with higher abundance of Staphylococcus spp., Corynebacterium spp., and Stenotrophomonas maltophilia. Targeted sequencing detected a potential corneal pathogen in the highest proportional abundance among 9 of the 24 (38%) culture-negative patients with microbial keratitis. Age, bacterial density in the sample, and prior antibiotic treatment significantly influenced culture outcome of indirectly inoculated corneal samples. CONCLUSION Targeted sequencing may provide insights on pathogens in both culture negative episodes of microbial keratitis and among subgroups of patients with microbial keratitis as well as factors influencing culture outcome of indirectly inoculated corneal samples.
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Affiliation(s)
- Susanna Sagerfors
- Department of Ophthalmology, Faculty of Medicine and Health, Örebro University, SE 701 82, Örebro, Sweden.
| | - Sofie Edslev
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Birgitta Ejdervik Lindblad
- Department of Ophthalmology, Faculty of Medicine and Health, Örebro University, SE 701 82, Örebro, Sweden
| | - Berit Lilje
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Marc Stegger
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, SE 701 82, Örebro, Sweden
- Antimicrobial Resistance and Infectious Diseases Laboratory, Harry Butler Institute, Murdoch University, Murdoch, Australia
| | - Bo Söderquist
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, SE 701 82, Örebro, Sweden
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Borroni D, Bonzano C, Sánchez-González JM, Rachwani-Anil R, Zamorano-Martín F, Pereza-Nieves J, Traverso CE, García Lorente M, Rodríguez-Calvo-de-Mora M, Esposito A, Godin F, Rocha-de-Lossada C. Shotgun metagenomic sequencing in culture negative microbial keratitis. Eur J Ophthalmol 2023:11206721221149077. [PMID: 36617769 DOI: 10.1177/11206721221149077] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE To evaluate the microbiota of culture negative Corneal Impression Membrane (CIM) microbial keratitis samples with the use of shotgun metagenomics analysis. METHODS DNA of microbial keratitis samples were collected with CIM and extracted using the MasterPure™ Complete DNA and RNA Purification Kit (Epicentre). DNA was fragmented by sonication into fragments of 300 to 400 base pairs (bp) using Bioruptor® (Diagenode, Belgium) and then used as a template for library preparation. DNA libraries were sequenced on Illumina® HiSeq2500. The resulting reads were quality controlled, trimmed and mapped against the human reference genome. The unmapped reads were taxonomically classified using the Kraken software. RESULTS 18 microbial keratitis samples were included in the study. Brevundimonas diminuta was found in 5 samples while 6 samples showed the presence of viral infections. Cutibacterium acnes, Staphylococcus aureus, Moraxella lacunata and Pseudomonas alcaligenes were also identified as the presumed putative cause of the infection in 7 samples. CONCLUSIONS Shotgun sequencing can be used as a diagnostic tool in microbial keratitis samples. This diagnostic method expands the available tests to diagnose eye infections and could be clinically significant in culture negative samples.
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Affiliation(s)
- Davide Borroni
- Department of Ophthalmology, Riga Stradins University, Riga, Latvia
| | - Chiara Bonzano
- DiNOGMI, University of Genoa and IRCCS San Martino Polyclinic Hospital, Genoa, Italy
| | | | | | | | | | - Carlo Enrico Traverso
- DiNOGMI, University of Genoa and IRCCS San Martino Polyclinic Hospital, Genoa, Italy
| | | | | | - Alfonso Esposito
- 18470International Centre for Genetic Engineering and Biotechnology, Trieste, Italy
| | - Fernando Godin
- Department of Ophthalmology, Universidad El Bosque, Bogotá, Colombia
| | - Carlos Rocha-de-Lossada
- Qvision, Opththalmology Department, VITHAS Almería Hospital, Almería, Spain.,Ophthalmology Department, VITHAS Málaga, Málaga, Spain.,Hospital Regional Universitario de Málaga, Plaza del Hospital Civil, Málaga, Spain.,Departamento de Cirugía, Universidad de Sevilla, Área de Oftalmología, Doctor Fedriani, Seville, Spain
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Jeong DE, Cha YW, Koh JW. Brevundimonas Species Keratitis in a Patient without Underlying Disease. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2022. [DOI: 10.3341/jkos.2022.63.1.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: To report a case of keratitis caused by Brevundimonas diminuta/vesicularis.Case summary: A 20-year-old man presented with decreased visual acuity and glare in his right eye from 2 days earlier. At the first visit, slit lamp examination revealed a 1.5 × 1.5 mm2-sized stromal infiltration, an edematous cornea and endothelial deposits in the center of the right eye. Microbiological examinations were performed from corneal scrapings. Treatment was started with topical eye drops (fortified cefazolin, fortified tobramycin) as empirical antibiotics. After several days, the cultures revealed Brevundimonas diminuta/vesicularis. After treatment with empirical antibiotic eye drops, the symptoms and visual acuity improved.Conclusions: We report a case of infectious keratitis caused by Brevundimonas diminuta/vesicularis, which has never previously been reported in the Republic of Korea.
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Abstract
Non-fermenting Gram-negative bacteria are problematic in clinical locations, being one of the most prevalent causes of nosocomial infections. Many of these non-fermenting Gram-negative bacteria are opportunistic pathogens that affect patients that are suffering with underlying medical conditions and diseases. Brevundimonas spp., in particular Brevundimonas diminuta and Brevundimonas vesicularis, are a genus of non-fermenting Gram-negative bacteria considered of minor clinical importance. Forty-nine separate instances of infection relating to Brevundimonas spp were found in the scientific literature along with two pseudo-infections. The majority of these instances were infection with Brevundimonas vesicularis (thirty-five cases – 71%). The major condition associated with Brevundimonas spp infection was bacteraemia with seventeen individual cases/outbreaks (35%). This review identified forty-nine examples of Brevundimonas spp. infections have been discussed in the literature. These findings indicate that infection review programs should consider investigation of possible Brevundimonas spp outbreaks if these bacteria are clinically isolated in more than one patient.
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Affiliation(s)
- Michael P Ryan
- a Industrial Biochemistry Programme, Department of Chemical Sciences , School of Natural Sciences, University of Limerick , Limerick , Ireland
| | - J Tony Pembroke
- b Molecular Biochemistry Laboratory, Department of Chemical Sciences , School of Natural Sciences, University of Limerick , Limerick , Ireland.,c Bernal Institute, University of Limerick , Limerick , Ireland
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Stabler SN, Mack B, McCormack G, Cheng MP. Brevundimonas vesicularis Causing Bilateral Pneumosepsis in an Immunocompetent Adult: A Case Report and Literature Review. Can J Hosp Pharm 2018; 71:208-210. [PMID: 29955194 PMCID: PMC6019083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Sarah N Stabler
- , BSc(Pharm), ACPR, PharmD, is with the Department of Critical Care and the Department of Pharmacy Services, Surrey Memorial Hospital, Surrey, British Columbia
| | - Benjamin Mack
- , MD, FRCPC, is with the Department of Laboratory Medicine and Pathology, Surrey Memorial Hospital, Surrey, British Columbia
| | - Grant McCormack
- , MD, FRCPC, is with the Department of Critical Care, Surrey Memorial Hospital, Surrey, British Columbia
| | - Matthew P Cheng
- , MD, FRCPC, is with the Division of Infectious Diseases and the Department of Medical Microbiology, McGill University Health Centre, Montréal, Quebec
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Karadag N, Karagol BS, Dursun A, Okumus N, Tanir G, Zenciroglu A. A premature neonate with early-onset neonatal sepsis owing to Brevundimonas vesicularis complicated by persistent meningitis and lymphadenopathy. Paediatr Int Child Health 2013; 32:239-41. [PMID: 23164299 DOI: 10.1179/2046905512y.0000000019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Human infection by Brevundimonas vesicularis is very rare, especially in children. A 29-week-old neonate is reported who developed early neonatal sepsis owing to B. vesicularis complicated by persistent meningitis and lymphadenopathy. B. vesicularis may be an emerging pathogen in neonatal infection.
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Affiliation(s)
- Nilgun Karadag
- Divisions of Neonatology, Dr Sami Ulus Maternity, Children's Education and Research Hospital, Ankara, Turkey
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Mixed Acanthamoeba and multidrug-resistant Achromobacter xyloxidans in late-onset keratitis after laser in situ keratomileusis. J Cataract Refract Surg 2012; 38:1853-6. [DOI: 10.1016/j.jcrs.2012.08.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 03/19/2012] [Accepted: 03/20/2012] [Indexed: 11/18/2022]
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Yoo SH, Kim MJ, Roh KH, Kim SH, Park DW, Sohn JW, Yoon YK. Liver abscess caused by Brevundimonas vesicularis in an immunocompetent patient. J Med Microbiol 2012; 61:1476-1479. [PMID: 22767540 DOI: 10.1099/jmm.0.045120-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Invasive infections caused by Brevundimonas vesicularis are very rare in humans. We experienced an unusual case of liver abscess due to B. vesicularis in an immunocompetent young male. The patient was successfully treated by liver abscess drainage and with antimicrobial therapy of ceftriaxone followed by ampicillin/sulbactam. The organism found in the aspiration culture of the abscess material was initially reported, by using a VITEK 2 system, as Sphingomonas paucimobilis. However, later, B. vesicularis was confirmed as the true pathogen through 16S rRNA gene sequencing. To our knowledge, this is the first case of liver abscess caused by B. vesicularis.
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Affiliation(s)
- Seu Hee Yoo
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Min Ja Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyoung Ho Roh
- Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Si Hyun Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Dae Won Park
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jang Wook Sohn
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Young Kyung Yoon
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
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Zhang CC, Hsu HJ, Li CM. Brevundimonas vesicularis bacteremia resistant to trimethoprim-sulfamethoxazole and ceftazidime in a tertiary hospital in southern Taiwan. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2012; 45:448-52. [PMID: 22516745 DOI: 10.1016/j.jmii.2012.01.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2011] [Revised: 06/30/2011] [Accepted: 08/31/2011] [Indexed: 12/01/2022]
Abstract
BACKGROUND Over the past 20 years, Brevundimonas vesicularis has rarely been reported as a pathogen causing human infection. The clinical manifestations of B. vesicularis bacteremia and its susceptibility to antibiotics has not been characterized. METHODS A retrospective study was conducted between 2006 and 2009 in a tertiary-care hospital in southern Taiwan. RESULTS A total of 22 cases of B. vesicularis bacteremia were identified during the study with 86% being community-acquired primary bloodstream infections. Of the 22 patients, 15 (68%) presented with fever, fewer comorbidities, shorter hospital stays, lower mean creatinine levels (1.10 mg/dL vs. 1.74 mg/dL), lower aspartate aminotransferase levels (29.1 IU/L vs. 79.0 IU/L), and lower alanine aminotransferase levels (16.4 IU/L vs. 67.0 IU/L) when compared to afebrile patients. Among the bacterial isolates, 90.9% were susceptible to cefpirome, imipenem and piperacillin/tazobactam while 86.4% were susceptible to gentamicin, amikacin and ciprofloxacin. However, 63.6% of the bacterial isolates were susceptible to ceftazidime, and only 59.1% were susceptible to trimethoprim-sulfamethoxazole (TMP-SMX). The 30-day mortality rate from all causes was 4.5%. CONCLUSION B. vesicularis is able to cause community-acquired and low-mortality primary bloodstream infections. The resistance of B. vesicularis to trimethoprim-sulfamethoxazole and ceftazidime limits the choice of available antibiotics for treatment.
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Affiliation(s)
- Chun-Cheng Zhang
- Division of Infectious Diseases, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
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Abstract
PURPOSE To report the first documented case of keratitis secondary to the gram-negative bacillus Brevundimonas diminuta. METHODS A 66-year-old woman with an ocular history of bilateral soft contact lens wear presented with a large, 6×9-mm, culture-positive Pseudomonas aeruginosa-induced corneal ulcer. After weeks of therapy, she developed secondary keratitis. Repeat cultures grew a rare, gram-negative bacillus, B. diminuta. RESULTS Targeted therapy followed by adjustments based on repeat bacterial cultures with sensitivities resulted in slow resolution of the ulcer. After months of therapy, the cornea recovered leaving only a minimal corneal scar. Visual acuity improved from a low of Hand Motions to a final 20/40. CONCLUSIONS This is the first reported case of ocular infection with B. diminuta. This case demonstrates the need to be aware of potential rare secondary infections in corneas compromised by an initial infection and to adjust pharmacotherapy based on sensitivities and clinical signs.
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Bhatawadekar SM, Sharma J. Brevundimonas vesicularis bacteremia: A rare case report in a female infant. Indian J Med Microbiol 2011; 29:420-2. [DOI: 10.4103/0255-0857.90184] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Yeung SN, Lichtinger A, Kim P, Amiran MD, Slomovic AR. Late-onset Klebsiella oxytoca flap-margin–related corneal ulcer following laser in situ keratomileusis. J Cataract Refract Surg 2011; 37:1551-4. [PMID: 21782101 DOI: 10.1016/j.jcrs.2011.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 04/28/2011] [Accepted: 04/28/2011] [Indexed: 11/26/2022]
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Bibliography. Refractive surgery. Current world literature. Curr Opin Ophthalmol 2011; 22:304-5. [PMID: 21654397 DOI: 10.1097/icu.0b013e3283486839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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