1
|
Cenicacelaya Olabarrieta X, Cabello Vallejo M, Morell-Hita JL, Macía-Villa C. Case Report and Literature Review of Parvimonas micra: Difficult-to-Treat Arthritis in Hiding. Healthcare (Basel) 2023; 11:2879. [PMID: 37958023 PMCID: PMC10648561 DOI: 10.3390/healthcare11212879] [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: 09/20/2023] [Revised: 10/27/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
Septic arthritis is a life-threatening rheumatological syndrome that is highly related to a patient's immune status and comorbidities, and although the most common clinical presentation is rapid-onset monoarthritis, it can also appear as subacute or chronic joint swelling. In these cases, differential diagnosis is more challenging, but early diagnosis and treatment is no less urgent to ensure a good global prognosis and the best outcome of the affected joint. Anaerobic microorganisms, such as Parvimonas micra, are an uncommon cause of septic arthritis (less than 5% of cases) but may be the cause of subacute arthritis. Knowledge about Parvimonas micra is important, as it is difficult to culture in the laboratory and generates a synovial fluid with atypical characteristics for septic arthritis so that, if not suspected, its diagnosis can be easily overlooked and underdiagnosed. We present the case of a 76-year-old woman with subacute arthritis of the left knee, describe the difficult diagnosis and treatment of its unexpected cause (Parvimonas micra), and review previously described cases, identifying the possible common comorbidities that may help clinicians easily find and treat this cause of subacute septic arthritis.
Collapse
Affiliation(s)
| | | | - José Luis Morell-Hita
- Department of Rheumatology, Ramón y Cajal University Hospital—IRYCIS, 28034 Madrid, Spain; (X.C.O.); (J.L.M.-H.)
| | - Cristina Macía-Villa
- Department of Rheumatology, Ramón y Cajal University Hospital—IRYCIS, 28034 Madrid, Spain; (X.C.O.); (J.L.M.-H.)
| |
Collapse
|
2
|
Sobol GL, Shin JI, Vives MJ, Dever LL, Harris CB. Micromonas micros: A rare anaerobic cause of late implant failure following spinal surgery. J Spinal Cord Med 2022; 45:311-315. [PMID: 31663835 PMCID: PMC8986200 DOI: 10.1080/10790268.2019.1677984] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Context: Delayed, postoperative, spine infections are rare, most commonly occurring secondary to fastidious, less virulent pathogens. The etiology may involve a distant infectious focus, not related to the index operation. Patients may present months, or even years postoperatively with pain related to mechanical implant failure, often without additional signs of systemic infection.Findings: We present the case of a 59-year-old male who developed rapid disk degeneration and implant failure seven months following instrumented lumbar fusion surgery. The causal organism was found to be Micromonas micros, an anaerobic bacterium typically located in the oral cavity and associated with periodontal disease. The patient was found to have extensive oral caries, which were presumed to have occurred secondary to poor oral hygiene and his use of fentanyl lozenges for chronic back pain. The patient was treated with revision staged spinal surgery and long-term intravenous antibiotics.Conclusion/clinical relevance: This case highlights an unusual etiology of delayed postoperative spinal implant failure and provides evidence for periodontal disease as a source of hematogenous seeding in postoperative spinal infections. The orthopaedist should also be aware of the potential relationship between poor oral hygiene and the use of high sugar content fentanyl lozenges in treating chronic back pain in these patients.
Collapse
Affiliation(s)
- Garret L. Sobol
- Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA,Correspondence to: Garret L. Sobol, Orthopaedic Surgery, Rutgers New Jersey Medical School, 140 Bergen Street, Suite D-1610, Newark, NJ07103, USA; Ph: 614-738-3688.
| | - John I. Shin
- Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Michael J. Vives
- Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Lisa L. Dever
- Department of Medicine, Division of Infectious Diseases, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Colin B. Harris
- Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| |
Collapse
|
3
|
Native joint infections caused by Parvimonas micra. Anaerobe 2021; 71:102412. [PMID: 34217826 DOI: 10.1016/j.anaerobe.2021.102412] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 11/24/2022]
Abstract
Parvimonas micra is an anaerobic, fastidious, gram positive organism commonly found in the oral cavity and gastrointestinal tract. It has been increasingly reported as the cause of septic arthritis of native joints, often times with delayed diagnosis leading to increased morbidity. Risk factors include immunosuppression, inflammation of the joint, and recent dental procedures or infections. It has been a historically difficult organism to culture. However, the development of and increasing use of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) has led to increased identification of P. micra. Common antibiotic susceptibilities, as well as data regarding susceptibilities in specific situations, have been reported, but susceptibility testing is required in all cases. Common treatments include clindamycin, penicillin, and metronidazole for six to ten weeks.
Collapse
|
4
|
Ryan PM, Morrey BF. Parvimonas micra causing native hip joint septic arthritis. Proc (Bayl Univ Med Cent) 2021; 34:486-488. [PMID: 34219932 DOI: 10.1080/08998280.2021.1906827] [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: 10/21/2022] Open
Abstract
Parvimonas micra is a bacterium normal to oral and gastrointestinal flora that has been implicated in cases of discitis, osteomyelitis, and prosthetic joint infections, often involving dental procedures or periodontal disease. It is an extremely rare cause of infection outside of these circumstances. We describe a case of septic arthritis of the native hip joint due to P. micra.
Collapse
Affiliation(s)
- Patrick M Ryan
- Department of Orthopedics, Baylor Scott and White Medical Center - Temple, Temple, Texas
| | - Bernard F Morrey
- Department of Orthopedics, UT Health San Antonio, San Antonio, Texas
| |
Collapse
|
5
|
Ali H, Amir W, Bolick NL. An uncommon case of native joint septic arthritis by Parvimonas micra. Anaerobe 2020; 67:102315. [PMID: 33348083 DOI: 10.1016/j.anaerobe.2020.102315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/06/2020] [Accepted: 12/13/2020] [Indexed: 12/29/2022]
Abstract
Parvimonas micra is an anaerobic, Gram-positive coccus found in the oral cavity and gastrointestinal tract. We report a case of a 77-year-old male with right knee pain after a recent dental procedure and fall. Arthrocentesis was notable for Parvimonas micra which was successfully treated with metronidazole.
Collapse
Affiliation(s)
- Hassam Ali
- Department of Internal Medicine, East Carolina University/Vidant Medical Center, Greenville, NC, USA.
| | - Washma Amir
- Department of Internal Medicine, Dow Medical University, Karachi, Pakistan
| | - Nicole L Bolick
- Department of Internal Medicine, East Carolina University/Vidant Medical Center, Greenville, NC, USA
| |
Collapse
|
6
|
Randall D, Jee Y, Vanood A, Mayo D. Atypical Presentation of Periprosthetic Joint Infection After Total Knee Arthroplasty due to Parvimonas micra. Arthroplast Today 2020; 6:901-905. [PMID: 33204785 PMCID: PMC7649107 DOI: 10.1016/j.artd.2020.09.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/25/2020] [Accepted: 09/30/2020] [Indexed: 11/18/2022] Open
Abstract
There is limited literature reporting the oral pathogen Parvimonas micra as the causative organism of periprosthetic joint infection. Previous reports demonstrate septic arthritis in native or prosthetic joints due to P. micra in elderly or immunocompromised patients associated with tooth abscess and periodontal disease. Our case report is unique because it describes a healthy individual with recurrent gingivitis developing periprosthetic joint infection after total knee arthroplasty as the result of isolated P. micra. Her clinical symptom presented early and manifested as progressive stiffness only. Timely aspiration resulted in early diagnosis, but the patient still underwent 2-stage revision with a more constrained implant. To prevent the risk of infection by oral pathogens such as P. micra, dental history should be thoroughly investigated, and any lingering periodontal infection should be addressed before any arthroplasty operation.
Collapse
Affiliation(s)
- Dustin Randall
- Oakland University William Beaumont School of Medicine, Auburn Hills, MI, USA
| | - Young Jee
- Department of Orthopaedic Surgery, Beaumont Health, Royal Oak, MI, USA
| | - Aimen Vanood
- Oakland University William Beaumont School of Medicine, Auburn Hills, MI, USA
| | - David Mayo
- Department of Orthopaedic Surgery, Beaumont Health, Royal Oak, MI, USA
| |
Collapse
|
7
|
Obiorah S, Zitzmann J, Lane K, Toms S. Right frontal lobe intracranial brain abscess associated with rare cardiac venous developmental anomaly: Implication of cardiac venous anomalies with right-left shunt. INTERDISCIPLINARY NEUROSURGERY 2020. [DOI: 10.1016/j.inat.2020.100730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
8
|
Shimizu J, Yoshimoto M, Takebayashi T, Terashima Y, Yamashita T. A Case Report of Vertebral Osteomyelitis Caused by Peptostreptococcus micros. J Orthop Case Rep 2018; 8:7-9. [PMID: 30584506 PMCID: PMC6298707 DOI: 10.13107/jocr.2250-0685.1084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Introduction: Anaerobic vertebral osteomyelitis has been reported rarely. In this report, we describe an extremely rare case of a patient who suffered from vertebral osteomyelitis caused by Peptostreptococcus micros. Case Report: A 73-year-old man with a history of diabetes mellitus was admitted to our hospital with a 5-month history of severe low back pain. A radiograph of the lumbar spine demonstrated intervertebral disc space narrowing with indistinct end plates at the L3-L4 level. T2-weighted magnetic resonance image showed high signal intensity at L3-L4 intervertebral disc space. We suspected pyogenic spondylitis and performed percutaneous posterolateral endoscopic debridement. The results of intraoperative sample cultures were positive for P. micros, an anaerobic Gram-positive coccus. He was treated by the antibiotic therapy. Low back pain resolved and his white blood cell count and C-reactive protein levels remained normal with the combination therapy. During 2-year follow-up, he reported no low back pain and had no signs of infection recurrence. Conclusion: If a patient who was in immunodepression status develops severe back pain, the clinician should be suspicious of the possibility of spondylitis by P. micros and start antibiotic therapy after undergoing sample collection.
Collapse
Affiliation(s)
- Junya Shimizu
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Mitsunori Yoshimoto
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tsuneo Takebayashi
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yoshinori Terashima
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Toshihiko Yamashita
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| |
Collapse
|
9
|
Multiple Hepatic Abscess from Parvimonas micra: An Emerging Gastrointestinal Microbe. ACG Case Rep J 2018; 5:e70. [PMID: 30280110 PMCID: PMC6160613 DOI: 10.14309/crj.2018.70] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 07/19/2018] [Indexed: 12/18/2022] Open
Abstract
Parvimonas micra is an obligate anaerobic bacterium and a known commensal of the human oral cavity and gastrointestinal tract. It is rarely associated with infections outside the oral cavity. Recently it has been isolated as a causative agent in a variety of systemic infections, but it has never been previously identified to cause a hepatic abscess. We report a 90-year-old woman with multiple hepatic abscesses caused by P. micra.
Collapse
|
10
|
Titanium granules pre-treated with hydrogen peroxide inhibit growth of bacteria associated with post-operative infections in spine surgery. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2018; 27:2463-2468. [DOI: 10.1007/s00586-018-5619-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 04/23/2018] [Accepted: 04/26/2018] [Indexed: 11/25/2022]
|
11
|
Concomitant Parvimonas micra Septic Arthritis and Pseudogout After Total Knee Arthroplasty. J Clin Rheumatol 2018; 25:47-50. [PMID: 29470261 DOI: 10.1097/rhu.0000000000000728] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
12
|
Sultan AA, Cantrell WA, Khlopas A, Cole C, Piuzzi NS, Sodhi N, Brooks P, Mont MA. Acute septic arthritis of the knee: A rare case report of infection with Parvimonas micra after an intra-articular corticosteroid injection for osteoarthritis. Anaerobe 2018; 51:17-20. [PMID: 29305995 DOI: 10.1016/j.anaerobe.2017.12.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 12/28/2017] [Accepted: 12/31/2017] [Indexed: 11/27/2022]
Abstract
Acute bacterial mono-articular septic arthritis affects most commonly the lower extremity joints in adult population and most commonly caused by Staphylococcus aureus. Various risk factors determine susceptibility to infection including host immunity, medical co-morbidity and joint structural abnormality and other organisms may be involved. Parvimonas micra (P. micra) is among the rare organisms that may be associated with atypical septic arthritis and primarily affects the native knee joint. Only 3 case reports in the literature have reported on pyogenic pyogenic joint infection caused by this organism. We hereby present our experience with a case of knee septic arthritis caused by P. micra in a patient with knee osteoarthritis following a recent intra-articular injection with corticosteroids. In susceptible patients, Intra-articular corticosteroid injection and crystal induced arthritis may propose a potential risk of contracting infection with P. micra.
Collapse
Affiliation(s)
- Assem A Sultan
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | | | - Anton Khlopas
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Connor Cole
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Nicolas S Piuzzi
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Nipun Sodhi
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Peter Brooks
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Michael A Mont
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, OH, USA.
| |
Collapse
|
13
|
Roy M, Roy AK, Ahmad S. Septic arthritis of knee joint due to Parvimonas micra. BMJ Case Rep 2017; 2017:bcr-2017-221926. [PMID: 29141929 DOI: 10.1136/bcr-2017-221926] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Parvimonas species are anaerobic, Gram-positive cocci that are a constituent of normal oral and gastrointestinal flora. We present a case of right knee joint septic arthritis due to Parvimonas micra in an immunocompromised patient. A 61-year-old male renal and pancreatic transplant recipient on immunosuppressive therapy was admitted to our hospital due to intense pain, joint swelling and inability to move his right knee over the past 9 months. After synovial fluid was drawn, cultures were positive for P. micra, an anaerobic pathogen that is part of the flora of the oral cavity. We report a rare causative pathogen for septic arthritis in an immunocompromised patient.
Collapse
Affiliation(s)
- Moni Roy
- Internal Medicine, OSF Saint Francis Medical Center, Peoria, Illinois, USA
| | - Ashish Kumar Roy
- Internal Medicine, OSF Saint Francis Medical Center, Peoria, Illinois, USA
| | - Sharjeel Ahmad
- Internal Medicine, Section of Infectious Diseases, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA
| |
Collapse
|
14
|
Dietvorst M, Roerdink R, Leenders ACAP, Kiel MA, Bom LPA. Acute Mono-Arthritis of the Knee: A Case Report of Infection with Parvimonas Micra and Concomitant Pseudogout. J Bone Jt Infect 2016; 1:65-67. [PMID: 28529856 PMCID: PMC5423566 DOI: 10.7150/jbji.16124] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Parvimonas micra is a rare pathogen for septic arthritis and is known for its subacute onset. We report a case of acute arthritis of the knee caused by P. micra and pseudogout. Initially, calcium pyrophosphate crystals were found in the knee, which were successfully treated with a steroid injection. Only anaerobic cultures became positive. A 16S rRNA PCR-analysis was necessary to identify P. micra as causative agent, a method which is never described before in similar cases. The infection was treated with clindamycin for 6 weeks. This is the third case report of a septic arthritis caused by P. micra and the second which also reports concomitant pseudogout.
Collapse
Affiliation(s)
| | - Ramon Roerdink
- Jeroen Bosch general hospital, 's-Hertogenbosch, The Netherlands
| | | | - Menno A Kiel
- Erasmus Medical Centre, Rotterdam, The Netherlands
| | - L Paul A Bom
- Jeroen Bosch general hospital, 's-Hertogenbosch, The Netherlands
| |
Collapse
|
15
|
Baghban A, Gupta S. Parvimonas micra: A rare cause of native joint septic arthritis. Anaerobe 2016; 39:26-7. [PMID: 26911898 DOI: 10.1016/j.anaerobe.2016.02.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 02/13/2016] [Indexed: 11/30/2022]
Abstract
Parvimonas micra is a fastidious, anaerobic, gram positive coccus, which is found in normal human oral and gastrointestinal flora. It has also been known as Peptostreptococcus micros and Micromonas micros with its most recent re-classification in 2006. It has been described in association with hematogenous seeding of prosthetic joints [1,2]. Several cases of discitis and osteomyelitis have been described in association with dental procedures and periodontal disease often with a subacute presentation. However, cases of native joint septic arthritis are limited [3-5]. Per our literature review, there is one case of native knee septic arthritis described in 1999, with a prolonged time to diagnosis and treatment due to difficulty culturing P. micra. The previously reported patient experienced significant joint destruction and morbidity [6]. Advances in culture techniques and new methods of organism identification including MALDI-TOF and 16s rRNA sequencing have lead to increased identification of this organism, which may be a more frequent bone and joint pathogen than previously realized.
Collapse
Affiliation(s)
- Adam Baghban
- Yale University School of Medicine, United States.
| | - Shaili Gupta
- Yale University School of Medicine, United States
| |
Collapse
|
16
|
Shah NB, Tande AJ, Patel R, Berbari EF. Anaerobic prosthetic joint infection. Anaerobe 2015; 36:1-8. [DOI: 10.1016/j.anaerobe.2015.08.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 08/23/2015] [Accepted: 08/24/2015] [Indexed: 12/01/2022]
|
17
|
Murphy EC, Frick IM. Gram-positive anaerobic cocci--commensals and opportunistic pathogens. FEMS Microbiol Rev 2012; 37:520-53. [PMID: 23030831 DOI: 10.1111/1574-6976.12005] [Citation(s) in RCA: 202] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 07/30/2012] [Accepted: 09/24/2012] [Indexed: 12/30/2022] Open
Abstract
Among the Gram-positive anaerobic bacteria associated with clinical infections, the Gram-positive anaerobic cocci (GPAC) are the most prominent and account for approximately 25-30% of all isolated anaerobic bacteria from clinical specimens. Still, routine culture and identification of these slowly growing anaerobes to the species level has been limited in the diagnostic laboratory, mainly due to the requirement of prolonged incubation times and time-consuming phenotypic identification. In addition, GPAC are mostly isolated from polymicrobial infections with known pathogens and therefore their relevance has often been overlooked. However, through improvements in diagnostic and in particular molecular techniques, the isolation and identification of individual genera and species of GPAC associated with specific infections have been enhanced. Furthermore, the taxonomy of GPAC has undergone considerable changes over the years, mainly due to the development of molecular identification methods. Existing species have been renamed and novel species have been added, resulting in changes of the nomenclature. As the abundance and significance of GPAC in clinical infections grow, knowledge of virulence factors and antibiotic resistance patterns of different species becomes more important. The present review describes recent advances of GPAC and what is known of the biology and pathogenic effects of Anaerococcus, Finegoldia, Parvimonas, Peptoniphilus and Peptostreptococcus, the most important GPAC genera isolated from human infections.
Collapse
Affiliation(s)
- Elizabeth Carmel Murphy
- Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden.
| | | |
Collapse
|
18
|
Fenollar F, Roux V, Stein A, Drancourt M, Raoult D. Analysis of 525 samples to determine the usefulness of PCR amplification and sequencing of the 16S rRNA gene for diagnosis of bone and joint infections. J Clin Microbiol 2006; 44:1018-28. [PMID: 16517890 PMCID: PMC1393109 DOI: 10.1128/jcm.44.3.1018-1028.2006] [Citation(s) in RCA: 180] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The 16S rRNA gene PCR in the diagnosis of bone and joint infections has not been systematically tested. Five hundred twenty-five bone and joint samples collected from 525 patients were cultured and submitted to 16S rRNA gene PCR detection of bacteria in parallel. The amplicons with mixed sequences were also cloned. When discordant results were observed, culture and PCR were performed once again. Bacteria were detected in 139 of 525 samples. Culture and 16S rRNA gene PCR yielded identical documentation in 475 samples. Discrepancies were linked to 13 false-positive culture results, 5 false-positive PCR results, 9 false-negative PCR results, 16 false-negative culture results, and 7 mixed infections. Cloning and sequencing of 16S rRNA gene amplicons in 6 of 8 patients with mixed infections identified 2 to 8 bacteria per sample. Rarely described human pathogens such as Alcaligenes faecalis, Comamonas terrigena, and 21 anaerobes were characterized. We also detected, by 16S rRNA gene PCR, four previously identified bacteria never reported in human infection, Alkanindiges illinoisensis, dehydroabietic acid-degrading bacterium DhA-73, unidentified Hailaer soda lake bacterium, and uncultured bacterium clone HuCa4. Seven organisms representing new potential species were also detected. PCR followed by cloning and sequencing may help to identify new pathogens involved in mixed bone infection.
Collapse
Affiliation(s)
- Florence Fenollar
- Unité des Rickettsies, CNRS UMR 6020, IFR 48, Faculté de Médecine, Université de la Méditerranée, 27 Boulevard Jean Moulin, 13385 Marseille cedex 05, France
| | | | | | | | | |
Collapse
|
19
|
Bartz H, Nonnenmacher CB, Bollmann C, Kuhl M, Zimmermann S, Heeg K, Mutters R. Micromonas (Peptostreptococcus) micros: unusual case of prosthetic joint infection associated with dental procedures. Int J Med Microbiol 2005; 294:465-70. [PMID: 15715175 DOI: 10.1016/j.ijmm.2004.10.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Micromonas (Peptostreptococcus) micros is frequently associated with periodontal disease as well as respiratory, gastrointestinal and female genitourinary tract infections, but only rarely has been reported as a pathogenic agent of prosthetic joint infections. Here we describe a case of a 63-year-old woman with prosthetic joint infection of total hip arthroplasty caused by the anaerobic species Micromonas micros, associated with tooth extraction. Samples obtained intraoperatively and from the oral cavity were positive for the presence of M. micros by culture and by real-time PCR. This case report indicates that infections of prosthetic joints can be associated with dental procedures and that sensitive molecular techniques are necessary for their routine diagnostic.
Collapse
Affiliation(s)
- Holger Bartz
- Institute of Medical Microbiology and Hygiene, Pilgrimstein 2, D-35037 Marburg, Germany
| | | | | | | | | | | | | |
Collapse
|