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Banerjee RK, Sahu M. Granulicatella adiacens Bacterial Infection After Pancreatectomy Whipple's Procedure. Surg Infect (Larchmt) 2024; 25:624-626. [PMID: 38995876 DOI: 10.1089/sur.2024.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2024] Open
Abstract
Background: Granulicatella adiacens inhabits the oral cavity, urogenital, and gastrointestinal tracts and is a typical commensal of human mucosal surfaces. It rarely causes disease. Identification of these gram-positive cocci can be challenging. Case Report: In a 58-year-old male in an oncology center, we report the first occurrence of bacterial infection caused by G. adiacens. After a precise diagnosis of the infection, the patient received effective treatment. Conclusion: Owing to a lack of sufficient diagnostic tools, G. adiacens may be a more notable pathogen than has been previously identified. Sensitivity testing standards are desperately needed.
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Granulicatella spp., a Causative Agent of Infective Endocarditis in Children. Pathogens 2022; 11:pathogens11121431. [PMID: 36558764 PMCID: PMC9785600 DOI: 10.3390/pathogens11121431] [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: 10/12/2022] [Revised: 11/15/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open
Abstract
Granulicatella spp. are non-motile, non-sporulating, facultatively anaerobic Gram-positive cocci. Throughout the literature, these organisms have been referred to by several names, such as “nutritionally deficient streptococci”, “vitamin-B dependent streptococci” and “pyridoxal-dependent streptococci”, because of their fastidious nutritional requirements, which can often make culture isolation challenging. Known to be a member of the normal microbiota of the human oral cavity and urogenital and intestinal tracts, similar to other streptococci, Granulicatella spp. can cause bacteremia, sepsis and infective endocarditis. Considering the difficulty in growing this organism on culture medium, the fact that it is now included among the bacteria known to be responsible for culture-negative infective endocarditis suggests that its pathogenic role could be highly underestimated. Moreover, being considered such a rare causative agent, it is not a target of standard antibiotic empiric treatment. We present a rare case of G. elegans endocarditis in a young child and review the medical literature on Granulicatella endocarditis in the pediatric population, with the aim of sharing knowledge about this microorganism, which can be challenging for a clinician who is not familiar with it.
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Kanamoto T, Terakubo S, Nakashima H. Antimicrobial Susceptibilities of Oral Isolates of Abiotrophia and Granulicatella According to the Consensus Guidelines for Fastidious Bacteria. MEDICINES (BASEL, SWITZERLAND) 2018; 5:E129. [PMID: 30514000 PMCID: PMC6313718 DOI: 10.3390/medicines5040129] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 11/29/2018] [Accepted: 11/29/2018] [Indexed: 12/30/2022]
Abstract
Background: The genera Abiotrophia and Granulicatella, previously known as nutritionally variant streptococci (NVS), are fastidious bacteria requiring vitamin B₆ analogs for growth. They are members of human normal oral microbiota, and are supposed to be one of the important pathogens for so-called "culture-negative" endocarditis. Methods: The type strains and oral isolates identified, by using both phenotypic profiles and the DNA⁻DNA hybridization method, were examined for susceptibilities to 15 antimicrobial agents including penicillin (benzylpenicillin, ampicillin, amoxicillin, and piperacillin), cephem (cefazolin, ceftazidime, ceftriaxone, and cefaclor), carbapenem (imipenem), aminoglycoside (gentamicin), macrolide (erythromycin), quinolone (ciprofloxacin), tetracycline (minocycline), glycopeptide (vancomycin), and trimethoprim-sulfamethoxazole complex. The minimum inhibitory concentration and susceptibility criterion were determined, according to the consensus guideline from the Clinical and Laboratory Standards Institute. Results: Isolates of Abiotrophia defectiva were susceptible to ampicillin, amoxicillin ceftriaxone, cefaclor, imipenem, ciprofloxacin, and vancomycin. Isolates of Granulicatella adiacens were mostly susceptible to benzylpenicillin, ampicillin, amoxicillin, cefazolin, ceftriaxone, imipenem, minocycline, and vancomycin. The susceptibility profile of Granulicatella elegans was similar to that of G. adiacens, and the susceptibility rate was higher than that of G. adiacens. Conclusions: Although Abiotrophia and Granulicatella strains are hardly distinguishable by their phenotypic characteristics, their susceptibility profiles to the antimicrobial agents were different among the species. Species-related differences in susceptibility of antibiotics should be considered in the clinical treatment for NVS related infections.
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Affiliation(s)
- Taisei Kanamoto
- Laboratory of Microbiology, Showa Pharmaceutical University, Machida, Tokyo 194-8543, Japan.
- Department of Microbiology, St. Marianna University School of Medicine, Kawasaki, Kanagawa 216-8511, Japan.
| | - Shigemi Terakubo
- Department of Microbiology, St. Marianna University School of Medicine, Kawasaki, Kanagawa 216-8511, Japan.
| | - Hideki Nakashima
- Department of Microbiology, St. Marianna University School of Medicine, Kawasaki, Kanagawa 216-8511, Japan.
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Birlutiu V, Birlutiu RM. Endocarditis due to Abiotrophia defectiva, a biofilm-related infection associated with the presence of fixed braces: A case report. Medicine (Baltimore) 2017; 96:e8756. [PMID: 29145328 PMCID: PMC5704873 DOI: 10.1097/md.0000000000008756] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Endocarditis with Abiotrophia defectiva represents 4.3% to 6% of all streptococcal endocarditis. The article presents diagnosis issues and the complexity of the treatment. PATIENT CONCERNS We present the case of a female white patient, aged 26 years, who developed infectious endocarditis caused by A defectiva, in the last trimester of pregnancy, a biofilm-related infection associated with the presence of fixed braces. DIAGNOSES The diagnosis of infectious endocarditis was confirmed by the cardiac ultrasound examination that revealed a voluminous vegetation on the mitral valve, and acute mitral regurgitation caused by chordae tendinae rupture, and also by isolating Abiotrophia defectiva from two positive blood cultures. INTERVENTIONS The decision to undergo surgical intervention was taken, and a mitral valve replacement was performed. Surgical intervention that was associated with board-spectrum antibiotic therapy. OUTCOMES A defectiva, remains a rare cause of infective endocarditis, with a reserved prognosis that is motivated by the extensive valvular lesions and the risk of embolism. LESSONS The use of antibiotics administered in association, in the management of infective endocarditis, is mandatory.
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Affiliation(s)
- Victoria Birlutiu
- Faculty of Medicine, Lucian Blaga University of Sibiu, Sibiu
- Academic Emergency Hospital Sibiu—Infectious Diseases Clinic
| | - Rares Mircea Birlutiu
- Faculty of Medicine, Lucian Blaga University of Sibiu, Sibiu
- Spitalul Clinic de Ortopedie-Traumatologie si TBC osteoarticular “Foisor,” Bucuresti, Romania
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Antimicrobial Susceptibility Patterns among a Large, Nationwide Cohort of Abiotrophia and Granulicatella Clinical Isolates. J Clin Microbiol 2017; 55:1025-1031. [PMID: 28077699 DOI: 10.1128/jcm.02054-16] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 12/30/2016] [Indexed: 01/25/2023] Open
Abstract
Antimicrobial susceptibility patterns from 599 A. defectiva, G. adiacens, and G. elegans clinical isolates were determined by broth microdilution. We observed significant differences in susceptibility across species, particularly to penicillin and ceftriaxone, and across geographical regions. A. defectiva was the least susceptible species overall to penicillin. All isolates were susceptible to vancomycin and >90% were susceptible to levofloxacin.
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Mvelase NR, Marajh K, Hattingh O, Mlisana KP. An unusual case of thoracic empyema caused by Granulicatella elegans (nutritionally variant streptococci) in a patient with pulmonary tuberculosis and human immunodeficiency virus infection. JMM Case Rep 2016; 3:e005058. [PMID: 28348783 PMCID: PMC5343141 DOI: 10.1099/jmmcr.0.005058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 07/01/2016] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Nutritionally variant streptococci (NVS) are an infrequent cause of human infection with Granulicatella elegans being the least encountered species in clinical specimens. The most common infection caused by NVS is infective endocarditis. CASE PRESENTATION We report an unusual case of thoracic empyema due to G. elegans in a patient with pulmonary tuberculosis (TB) and human immunodeficiency virus infection. The patient responded favourably to drainage and penicillin. CONCLUSION This case illustrates that even though TB is responsible for the majority of pleural effusions in this setting, other rare opportunistic bacteria may cause infection in susceptible patients. Therefore, microbiological investigations should be performed in all patients presenting with pleural effusion.
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Affiliation(s)
- Nomonde R. Mvelase
- Department of Medical Microbiology, University of Kwazulu-Natal, 800 Bellair Road, Mayville, Durban, South Africa
- National Health Laboratory Service, 1 Modderfontein Road, Sandringham, Johannesburg, South Africa
| | - Kanitha Marajh
- National Health Laboratory Service, 1 Modderfontein Road, Sandringham, Johannesburg, South Africa
| | - Olga Hattingh
- Respiratory and Meningeal Pathogens Reference Unit, National Institute for Communicable Diseases, a division of the National Health Laboratory Service, 1 Modderfontein Road, Sandringham, Johannesburg, South Africa
| | - Koleka P. Mlisana
- Department of Medical Microbiology, University of Kwazulu-Natal, 800 Bellair Road, Mayville, Durban, South Africa
- National Health Laboratory Service, 1 Modderfontein Road, Sandringham, Johannesburg, South Africa
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Renz N, Chevaux F, Borens O, Trampuz A. Successful treatment of periprosthetic joint infection caused by Granulicatella para-adiacens with prosthesis retention: a case report. BMC Musculoskelet Disord 2016; 17:156. [PMID: 27067804 PMCID: PMC4828776 DOI: 10.1186/s12891-016-1008-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 04/01/2016] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Granulicatella and Abiotrophia spp. are difficult to detect due to their complex nutritional requirements. Infections with these organisms are associated with high treatment failure rates. We report the first implant-associated infection caused by Granulicatella para-adiacens, which was cured with anti-microbial treatment consisting of anti-biofilm-active rifampin and debridement, exchange of mobile parts and retention of the prosthesis. CASE PRESENTATION Patient with a history of left hip arthroplasty presented with acute onset of fever, pain and limited range of motion of the left hip. Arthrocentesis of the affected joint yielded purulent fluid and exchange of mobile parts of the prosthesis, but retention of fixed components was performed. Granulicatella para-adiacens grew from preoperative and intraoperative cultures, including sonication fluid of the removed implant. The transesophageal echocardiography showed a vegetation on the mitral valve; the orthopantogram demonstrated a periapical dental abscess. The patient was treated with intravenous penicillin G and gentamicin for 4 weeks, followed by levofloxacin and rifampin for additional 2 months. At discharge and at follow-up 1, 2 and 5 years later, the patient was noted to have a functional, pain-free, and radiologically stable hip prosthesis and the serum C-reactive protein was normal. CONCLUSIONS Although considered a difficult-to-treat organism, we report a successful treatment of the Granulicatella hip prosthesis infection with prosthesis retention and a prolonged antibiofilm therapy including rifampin. The periapical dental abscess is considered the primary focus of hematogenously infected hip prosthesis, underlining the importance treatment of periodontitis prior to arthroplasty and of proper oral hygiene for prevention of hematogenous infection after arthroplasty.
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Affiliation(s)
- Nora Renz
- Center for Septic Surgery/Infectious Diseases, Charité - University Medicine Berlin, Charitéplatz 1, D-10117, Berlin, Germany.
| | - Fabienne Chevaux
- Department of Medicine, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - Olivier Borens
- Division of Orthopedic Surgery and Traumatology, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - Andrej Trampuz
- Center for Septic Surgery/Infectious Diseases, Charité - University Medicine Berlin, Charitéplatz 1, D-10117, Berlin, Germany
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Antimicrobial Susceptibilities of Abiotrophia defectiva, Granulicatella adiacens, and Granulicatella elegans. Antimicrob Agents Chemother 2015; 60:1411-20. [PMID: 26666926 DOI: 10.1128/aac.02645-15] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 12/07/2015] [Indexed: 01/18/2023] Open
Abstract
Nutritionally variant streptococci (NVS) are fastidious Gram-positive cocci comprised of the species Abiotrophia defectiva, Granulicatella adiacens, and Granulicatella elegans. NVS are an important cause of bacteremia and infective endocarditis (IE) associated with significant morbidity and mortality. Antimicrobial susceptibility testing (AST) was performed for 14 antimicrobials using the broth microdilution MIC method described in the Clinical and Laboratory Standards Institute (CLSI) M45 guideline. A total of 132 clinical NVS blood isolates collected from 2008 to 2014 were tested. Species level identification of NVS isolates was achieved by 16S rRNA gene sequencing and/or matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Ninety isolates were identified as G. adiacens, 37 as A. defectiva, and 5 as G. elegans. All isolates were susceptible to vancomycin (MIC90 = 1 μg/ml), and none displayed high-level resistance to aminoglycosides. G. adiacens was considerably more susceptible to penicillin than A. defectiva (38.9% versus 10.8% of isolates susceptible) but was less susceptible to cephalosporins than was A. defectiva (43.3% versus 100% of isolates susceptible to ceftriaxone). Several isolates were resistant to levofloxacin (6%), erythromycin (51%), and clindamycin (10%). The MIC90 for daptomycin was ≥ 4 μg/ml for G. adiacens and A. defectiva. G. elegans isolates were 100% susceptible to all antimicrobials tested, with the exception of erythromycin, to which only 20% were susceptible. This study provides antimicrobial susceptibility data for a recent collection of NVS and demonstrates important NVS species-related differences with respect to susceptibility to penicillin, cephalosporins, carbapenems, and daptomycin. Species-level identification of NVS organisms when susceptibility testing is not readily available may aid in treatment decisions.
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Yamaguchi T, Soutome S, Oho T. Purification of a novel fibronectin binding protein from 'Granulicatella para-adiacens'. Pathog Dis 2014; 71:480371. [PMID: 30979336 DOI: 10.1111/2049-632x.12116] [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: 06/19/2013] [Revised: 11/17/2013] [Accepted: 11/28/2013] [Indexed: 12/01/2022] Open
Abstract
The interaction of microorganisms with fibronectin plays an important role in infective endocarditis. Characterization of fibronectin binding is not sufficient for nutritionally variant streptococci (NVS), which is an important pathogen associated with this disease. In this study, we identified and purified the novel fibronectin binding protein (FBP) by sonication and column chromatography from a ' Granulicatella para-adiacens' strain isolated from the oral cavity of a healthy donor. The purified molecule was located at the top of the gel in SDS-PAGE analysis, and heat treatment in the presence of sodium dodecyl sulfate resulted in its dissociation into smaller molecules. An anti-purified protein antibody was reacted with the topmost component of the sonic extract only from two ' G. para-adiacens' strains in Western blot analyses. Immunofluorescence staining indicated that the protein of interest was located on the cell surface of ' G. para-adiacens', but not on other NVS species. Bacterial adherence to fibronectin was inhibited by the purified FBP preparation. Optimum conditions for fibronectin binding of purified FBP were shown to be an NaCl concentration higher than 150 mM and a pH of c. 7.0. These results provide additional information for the elucidation of fibronectin binding by NVS.
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Affiliation(s)
- Taihei Yamaguchi
- Department of Preventive Dentistry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Sakiko Soutome
- Division of Preventive Dentistry, Center of Developmental Dentistry, Medical and Dental Hospital, Kagoshima University, Kagoshima, Japan
| | - Takahiko Oho
- Department of Preventive Dentistry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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10
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Phulpin-Weibel A, Gaspar N, Emirian A, Chachaty E, Valteau-Couanet D, Gachot B. Intravascular catheter-related bloodstream infection caused by Abiotrophia defectiva in a neutropenic child. J Med Microbiol 2013; 62:789-791. [PMID: 23378563 DOI: 10.1099/jmm.0.047191-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Bacteraemia and endocarditis are the most frequently reported clinical infections due to Abiotrophia defectiva species. This species has been rarely implicated in infections in neutropenic patients. We report a rare case of long-term venous catheter-related infection caused by A. defectiva that occurred in a febrile child who had neutropenia and Langerhans' cell histiocytosis.
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Affiliation(s)
- A Phulpin-Weibel
- Department of Oncology for Children and Adolescents, Institut Gustave Roussy, Villejuif, France
| | - N Gaspar
- Department of Oncology for Children and Adolescents, Institut Gustave Roussy, Villejuif, France
| | - A Emirian
- Microbiology Laboratory, Institut Gustave Roussy, Villejuif, France
| | - E Chachaty
- Microbiology Laboratory, Institut Gustave Roussy, Villejuif, France
| | - D Valteau-Couanet
- Department of Oncology for Children and Adolescents, Institut Gustave Roussy, Villejuif, France
| | - B Gachot
- Department of Intensive Care and Infectious Diseases, Institut Gustave Roussy, Villejuif, France
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Cargill JS, Scott KS, Gascoyne-Binzi D, Sandoe JAT. Granulicatella infection: diagnosis and management. J Med Microbiol 2012; 61:755-761. [PMID: 22442291 DOI: 10.1099/jmm.0.039693-0] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Granulicatella species, along with the genus Abiotrophia, were originally known as 'nutritionally variant streptococci'. They are a normal component of the oral flora, but have been associated with a variety of invasive infections in man and are most noted as a cause of bacterial endocarditis. It is often advised that Granulicatella endocarditis should be treated in the same way as enterococcal endocarditis. We review here the published data concerning diagnosis and treatment of Granulicatella infection, and include some observations from local cases, including four cases of endocarditis.
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Affiliation(s)
- James S Cargill
- Institute of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK.,Department of Microbiology, Old Medical School, Leeds General Infirmary, Leeds LS1 3EX, UK
| | - Katharine S Scott
- Department of Microbiology, Old Medical School, Leeds General Infirmary, Leeds LS1 3EX, UK
| | - Deborah Gascoyne-Binzi
- Department of Microbiology, Old Medical School, Leeds General Infirmary, Leeds LS1 3EX, UK
| | - Jonathan A T Sandoe
- Department of Microbiology, Old Medical School, Leeds General Infirmary, Leeds LS1 3EX, UK
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Gardenier JC, Hranjec T, Sawyer RG, Bonatti H. Granulicatella adiacens bacteremia in an elderly trauma patient. Surg Infect (Larchmt) 2011; 12:251-3. [PMID: 21524203 DOI: 10.1089/sur.2010.059] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Granulicatella adiacens is a normal commensal of human mucosal surfaces, inhabiting the oral cavity and urogenital and gastrointestinal tracts and only rarely causing disease. These gram-positive cocci can be difficult to identify. CASE REPORT We report a first case of bacteremia caused by Granulicatella adiacens in an elderly female trauma victim. The infection was diagnosed accurately, and the patient was treated successfully. CONCLUSION Granulicatella adiacens may be a more important pathogen than thus far recognized because of a lack of adequate diagnostic resources. Standards for sensitivity testing are needed urgently.
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Affiliation(s)
- Jason C Gardenier
- Department of Surgery, University of Virginia Health System, Charlottesville, Virginia 22908-0709, USA
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Yemisen M, Koksal F, Mete B, Yarimcam F, Okcun B, Kucukoglu S, Samasti M, Kocazeybek B, Ozturk R. Abiotrophia defectiva: A rare cause of infective endocarditis. ACTA ACUST UNITED AC 2009; 38:939-41. [PMID: 17008245 DOI: 10.1080/00365540600606424] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A case of Abiotrophia defectiva-caused infective endocarditis is described. The patient was successfully treated with penicillin combined with gentamicin. Due to the fastidious nature of the agent, there is a need for special media for isolation and moreover, there is a need for a future development of susceptibility assays applicable to the organism.
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Affiliation(s)
- Mucahit Yemisen
- Infectious Diseases and Clinical Microbiology, University of Istanbul, Istanbul, Turkey.
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14
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Abiotrophia defectiva endocarditis and associated hemophagocytic syndrome—a first case report and review of the literature. Int J Infect Dis 2008; 12:478-82. [DOI: 10.1016/j.ijid.2008.01.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2007] [Revised: 12/21/2007] [Accepted: 01/14/2008] [Indexed: 11/19/2022] Open
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Kanamoto T, Sato S, Nakashima H, Inoue M. Proliferation of mitogen-stimulated human peripheral blood mononuclear cells is inhibited by extracellular arginine deiminase of Granulicatella elegans isolated from the human mouth. J Infect Chemother 2007; 13:353-5. [PMID: 17982728 DOI: 10.1007/s10156-007-0546-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2006] [Accepted: 06/20/2007] [Indexed: 11/25/2022]
Abstract
Granulicatella elegans is a member of normal human oral flora and is thought to be a potent pathogen in endocarditis, especially so-called "culture-negative" endocarditis. To elucidate the pathogenicity of this microorganism in inflammatory diseases, the effect of the extracellular products of this bacteria on human peripheral blood mononuclear cells (PBMCs) was examined. Culture supernatants produced by oral isolates of G. elegans strongly inhibited the proliferation of PBMC stimulated by the T-cell mitogens phytohemagglutinin-P, phorbol 12-myristate 13-acetate, concanavalin A, and staphylococcal enterotoxin B. Purification of the active extracellular product revealed that a fraction containing proteins of approximately 47 kDa showing arginine deiminase activity contributed to the inhibition of PBMC proliferation.
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Affiliation(s)
- Taisei Kanamoto
- Department of Preventive Dentistry, Kagoshima University Dental School, Kagoshima, Japan.
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Al-Tawfiq JA, Kiwan G, Murrar H. Granulicatella elegans native valve infective endocarditis: case report and review. Diagn Microbiol Infect Dis 2007; 57:439-41. [PMID: 17188448 DOI: 10.1016/j.diagmicrobio.2006.10.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2006] [Revised: 10/05/2006] [Accepted: 10/05/2006] [Indexed: 10/23/2022]
Abstract
Granulicatella elegans is a fastidious organism that is rarely implicated as a cause of infective endocarditis. Here, we describe a patient with mitral valve prolapse who developed G. elegans endocarditis. The organism was isolated from blood cultures and the patient had mitral valvuloplasty and repair, and completed a course of 6 weeks of intravenous antibiotics with no sequela.
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Affiliation(s)
- Jaffar A Al-Tawfiq
- Internal Medicine Services Division, PO Box 76, Dhahran Health Center, Saudi Aramco Medical Services Organization, Saudi Aramco, Dhahran 31311, Saudi Arabia.
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Lee OO, Lau SCK, Qian PY. Consistent bacterial community structure associated with the surface of the sponge Mycale adhaerens bowerbank. MICROBIAL ECOLOGY 2006; 52:693-707. [PMID: 16909349 DOI: 10.1007/s00248-006-9077-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2006] [Revised: 03/09/2006] [Accepted: 04/23/2006] [Indexed: 05/11/2023]
Abstract
As a crucial step in the identification of possible association between bacteria and sponges, we investigated if a unique bacterial population community was consistently associated with the surface of the sponge Mycale adhaerens, irrespective of environmental conditions. The composition of bacterial communities associated with the surface of sponges at three geographically distinctive sites in Hong Kong waters over four seasons was examined by analyzing terminal restriction fragment length polymorphism of the bacterial 16S rRNA genes. Statistical analysis indicated that bacterial communities on inanimate reference surfaces (polystyrene dishes deployed in the close vicinity of the sponge colonies for 7 days) had a relatively high degree of both site and seasonal specificities (R statistics of pairwise comparisons approximately 1), which might be attributed to the differences in environmental conditions at different sites and seasons. On the contrary, the sponge-surface-associated bacterial communities from different sites and seasons were hardly distinguishable from each other (lowest R = -0.16) but were rather distinctive from the reference bacterial communities (R approximately 1), suggesting a highly stable and distinctive bacteria-sponge association irrespective of the environmental conditions. The occurrence of some unique bacterial types in the sponge-surface-associated communities over space and time suggests that the associations are consistent and specific.
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Affiliation(s)
- On On Lee
- Department of Biology/Coastal Marine Laboratory, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong SAR, China
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18
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Senn L, Entenza JM, Greub G, Jaton K, Wenger A, Bille J, Calandra T, Prod'hom G. Bloodstream and endovascular infections due to Abiotrophia defectiva and Granulicatella species. BMC Infect Dis 2006; 6:9. [PMID: 16426445 PMCID: PMC1360077 DOI: 10.1186/1471-2334-6-9] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2005] [Accepted: 01/20/2006] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Abiotrophia and Granulicatella species, previously referred to as nutritionally variant streptococci (NVS), are significant causative agents of endocarditis and bacteraemia. In this study, we reviewed the clinical manifestations of infections due to A. defectiva and Granulicatella species that occurred at our institution between 1998 and 2004. METHODS The analysis included all strains of NVS that were isolated from blood cultures or vascular graft specimens. All strains were identified by 16S rRNA sequence analysis. Patients' medical charts were reviewed for each case of infection. RESULTS Eleven strains of NVS were isolated during the 6-year period. Identification of the strains by 16S rRNA showed 2 genogroups: Abiotrophia defectiva (3) and Granulicatella adiacens (6) or "para-adiacens" (2). The three A. defectiva strains were isolated from immunocompetent patients with endovascular infections, whereas 7 of 8 Granulicatella spp. strains were isolated from immunosuppressed patients, mainly febrile neutropenic patients. We report the first case of "G. para-adiacens" bacteraemia in the setting of febrile neutropenia. CONCLUSION We propose that Granulicatella spp. be considered as a possible agent of bacteraemia in neutropenic patients.
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Affiliation(s)
- Laurence Senn
- Infectious Diseases Service, University Hospital, Lausanne, Switzerland
| | - José M Entenza
- Infectious Diseases Service, University Hospital, Lausanne, Switzerland
| | - Gilbert Greub
- Institute of Microbiology, University Hospital, Bugnon 46, 1011 Lausanne CHUV, Switzerland
| | - Katia Jaton
- Institute of Microbiology, University Hospital, Bugnon 46, 1011 Lausanne CHUV, Switzerland
| | - Aline Wenger
- Institute of Microbiology, University Hospital, Bugnon 46, 1011 Lausanne CHUV, Switzerland
| | - Jacques Bille
- Institute of Microbiology, University Hospital, Bugnon 46, 1011 Lausanne CHUV, Switzerland
| | - Thierry Calandra
- Infectious Diseases Service, University Hospital, Lausanne, Switzerland
| | - Guy Prod'hom
- Institute of Microbiology, University Hospital, Bugnon 46, 1011 Lausanne CHUV, Switzerland
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Ferris MJ, Masztal A, Aldridge KE, Fortenberry JD, Fidel PL, Martin DH. Association of Atopobium vaginae, a recently described metronidazole resistant anaerobe, with bacterial vaginosis. BMC Infect Dis 2004; 4:5. [PMID: 15018635 PMCID: PMC362875 DOI: 10.1186/1471-2334-4-5] [Citation(s) in RCA: 185] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2003] [Accepted: 02/13/2004] [Indexed: 11/18/2022] Open
Abstract
Background Bacterial vaginosis (BV) is a polymicrobial syndrome characterized by a change in vaginal flora away from predominantly Lactobacillus species. The cause of BV is unknown, but the condition has been implicated in diverse medical outcomes. The bacterium Atopobium vaginae has been recognized only recently. It is not readily identified by commercial diagnostic kits. Its clinical significance is unknown but it has recently been isolated from a tuboovarian abcess. Methods Nucleotide sequencing of PCR amplified 16S rRNA gene segments, that were separated into bands within lanes on polyacrylamide gels by denaturing gradient gel electrophoresis (DGGE), was used to examine bacterial vaginal flora in 46 patients clinically described as having normal (Lactobacillus spp. predominant; Nugent score ≤ 3) and abnormal flora (Nugent score ≥ 4). These women ranged in age from 14 to 48 and 82% were African American. Results The DGGE banding patterns of normal and BV-positive patients were recognizably distinct. Those of normal patients contained 1 to 4 bands that were focused in the centre region of the gel lane, while those of BV positive patients contained bands that were not all focused in the center region of the gel lane. More detailed analysis of patterns revealed that bands identified as Atopobium vaginae were present in a majority (12/22) of BV positive patients, while corresponding bands were rare (2/24) in normal patients. (P < 0.001) Two A. vaginae isolates were cultivated from two patients whose DGGE analyses indicated the presence of this organism. Two A. vaginae 16S rRNA gene sequences were identified among the clinical isolates. The same two sequences were obtained from DGGE bands of the corresponding vaginal flora. The sequences differed by one nucleotide over the short (~300 bp) segment used for DGGE analysis and migrated to slightly different points in denaturing gradient gels. Both isolates were strict anaerobes and highly metronidazole resistant. Conclusion The results suggest that A. vaginae may be an important component of the complex bacterial ecology that constitutes abnormal vaginal flora. This organism could play a role in treatment failure if further studies confirm it is consistently metronidozole resistant.
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Affiliation(s)
- Michael J Ferris
- Dept. of Pediatrics, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA
- Research and Education Bldg., The Research Institute for Children, 200 Henry Clay Ave, New Orleans, LA 70118, USA
- Dept. of Microbiology, Immunology and Parasitology, Louisiana State University Health Sciences Center, 1901 Perdido St., New Orleans, LA 70112, USA
| | - Alicia Masztal
- Research and Education Bldg., The Research Institute for Children, 200 Henry Clay Ave, New Orleans, LA 70118, USA
| | - Kenneth E Aldridge
- Dept. of Infectious Disease, Louisiana State University Health Sciences Center, 1542 Tulane Ave, New Orleans, LA 70112, USA
| | - J Dennis Fortenberry
- Department of Pediatrics, Indiana University School of Medicine, Section of Adolescent Medicine, 575 N West St., Room 070, Indianapolis, IN 46202, USA
| | - Paul L Fidel
- Dept. of Microbiology, Immunology and Parasitology, Louisiana State University Health Sciences Center, 1901 Perdido St., New Orleans, LA 70112, USA
| | - David H Martin
- Dept. of Internal Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA
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Cieślikowski T, Gradecka D, Mielczarek M, Kaca W. Tandem tetramer-based microsatellite fingerprinting for typing of Proteus mirabilis strains. J Clin Microbiol 2003; 41:1673-80. [PMID: 12682159 PMCID: PMC153880 DOI: 10.1128/jcm.41.4.1673-1680.2003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Two microsatellite tandem repeated tetramers, (GACA)(4) and (CAAT)(4), were used for Proteus mirabilis strain differentiation. The microsatellite-based PCR tests were applied for the examination of interstrain diversity for 87 P. mirabilis strains. Forty-six of the investigated strains were clinical isolates (5 were hospital isolates and 39 were outpatient clinic isolates); 42 strains were derived from the Kauffmann-Perch collection of laboratory strains. Fingerprinting done with the tetramers had a high discrimination ability [0.992 and 0.940 for (GACA)(4) and (CAAT)(4), respectively]. The distributions of clinical isolates among well-defined laboratory strains, determined by numerical analysis (unweighted pair-group method with arithmetic averages; Dice similarity coefficient), proved their genetic similarity to reference strains in the Kauffmann-Perch collection. This analysis also indicated that it is possible to estimate some phenotypic properties of P. mirabilis clinical isolates solely on the basis of microsatellite fingerprinting.
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Affiliation(s)
- Tomasz Cieślikowski
- Centre of Microbiology and Virology, Polish Academy of Sciences, Łódź, Poland.
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Abstract
Since the division of the Streptococcus genus into enterococci, lactococci, and streptococci in 1984, many changes in the nomenclature and taxonomy of the Streptococcus genus have taken place. The application of genetic comparisons has improved the proper classification of the different species. The Lancefield system of serogrouping the streptococci by the expression of beta-hemolysis on blood agar plates is still very useful for the identification of streptococci for patient management. The Lancefield grouping system cannot be used in itself for accurate identification of specific beta-hemolytic species, but it can be a useful part of the identification procedure. Except for identification of the "Streptococcus bovis group" of species and Streptococcus suis, Lancefield grouping is of little value in identification of the non-beta-hemolytic streptococci and related genera. In fact, identification of the non-beta-hemolytic species is problematic for conventional as well as commercially available identification procedures. A combination of conventional tests and specific chromogenic tests suggested by several investigators is presented and discussed. Tables are included that suggest tests and procedures to guide investigators attempting to identify all the species.
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Affiliation(s)
- Richard Facklam
- Streptococcus Laboratory, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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22
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Ince A, Tiemer B, Gille J, Boos C, Russlies M. Total knee arthroplasty infection due to Abiotrophia defectiva. J Med Microbiol 2002; 51:899-902. [PMID: 12435072 DOI: 10.1099/0022-1317-51-10-899] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The first documented case of knee alloarthroplasty infection due to Abiotrophia defectiva, formerly known as nutritionally variant streptococci (NVS) and Streptococcus defectivus, is presented. The microbiology of this bacterium is discussed and clinical features of previously reported cases of infections by NVS are reviewed briefly.
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Affiliation(s)
| | - B Tiemer
- Departments of Orthopedics and *Microbiology, Luebeck University Hospital, Ratzeburger Allee 160, 23538 Luebeck, Germany
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Casalta JP, Habib G, La Scola B, Drancourt M, Caus T, Raoult D. Molecular diagnosis of Granulicatella elegans on the cardiac valve of a patient with culture-negative endocarditis. J Clin Microbiol 2002; 40:1845-7. [PMID: 11980974 PMCID: PMC130947 DOI: 10.1128/jcm.40.5.1845-1847.2002] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2001] [Revised: 01/11/2002] [Accepted: 02/05/2002] [Indexed: 12/12/2022] Open
Abstract
We herein report one case of culture-negative infectious endocarditis (IE) where the organism, Granulicatella elegans, was identified by molecular analysis using broad-range PCR primers complementary to the 16S rRNA gene on the removed valve. The results and utility of this method are discussed.
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Affiliation(s)
- J P Casalta
- Unité des Rickettsies, CNRS UMR 6020, IFR 48, Université de la Méditerranée, Faculté de Médecine, 27 boulevard Jean Moulin, 13385 Marseille cedex 05, France
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Christensen JJ, Facklam RR. Granulicatella and Abiotrophia species from human clinical specimens. J Clin Microbiol 2001. [PMID: 11574566 DOI: 10.1128/jcm.39.10.3520-3523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2023] Open
Abstract
One hundred one isolates of nutritionally variant streptococci from 97 patients were phenotypically characterized and compared with the type strains of Granulicatella adiacens (formerly Abiotrophia adiacens) (ATCC 49175(T)) Abiotrophia defectiva (ATCC 49176(T)), and Granulicatella elegans (formerly Abiotrophia elegans) (DSM 11693(T)). Of the isolates, 55 and 43 resembled G. adiacens and A. defectiva, respectively, while 3 strains resembled G. elegans. Phenotypic characteristics useful in differentiating between species within the genera Granulicatella and Abiotrophia (G. adiacens, G. elegans, Granulicatella balaenopterae, and A. defectiva) were production of alpha- and beta-galactosidase; production of beta-glucuronidase; hippurate hydrolysis; arginine dihydrolase activity; and acid production from trehalose, sucrose, pullulan, and tagatose. From the reports submitted with the specimens, the clinical diagnosis was endocarditis in 58% of patients and septicemia or bacteremia in 26% of patients.
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Affiliation(s)
- J J Christensen
- Department of Clinical Microbiology at Statens Serum Institut, Copenhagen, Denmark.
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Christensen JJ, Facklam RR. Granulicatella and Abiotrophia species from human clinical specimens. J Clin Microbiol 2001; 39:3520-3. [PMID: 11574566 PMCID: PMC88382 DOI: 10.1128/jcm.39.10.3520-3523.2001] [Citation(s) in RCA: 111] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2001] [Accepted: 07/27/2001] [Indexed: 11/20/2022] Open
Abstract
One hundred one isolates of nutritionally variant streptococci from 97 patients were phenotypically characterized and compared with the type strains of Granulicatella adiacens (formerly Abiotrophia adiacens) (ATCC 49175(T)) Abiotrophia defectiva (ATCC 49176(T)), and Granulicatella elegans (formerly Abiotrophia elegans) (DSM 11693(T)). Of the isolates, 55 and 43 resembled G. adiacens and A. defectiva, respectively, while 3 strains resembled G. elegans. Phenotypic characteristics useful in differentiating between species within the genera Granulicatella and Abiotrophia (G. adiacens, G. elegans, Granulicatella balaenopterae, and A. defectiva) were production of alpha- and beta-galactosidase; production of beta-glucuronidase; hippurate hydrolysis; arginine dihydrolase activity; and acid production from trehalose, sucrose, pullulan, and tagatose. From the reports submitted with the specimens, the clinical diagnosis was endocarditis in 58% of patients and septicemia or bacteremia in 26% of patients.
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Affiliation(s)
- J J Christensen
- Department of Clinical Microbiology at Statens Serum Institut, Copenhagen, Denmark.
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Kitada K, Okada Y, Kanamoto T, Inoue M. Serological properties of Abiotrophia and Granulicatella species (nutritionally variant streptococci). Microbiol Immunol 2001; 44:981-5. [PMID: 11220686 DOI: 10.1111/j.1348-0421.2000.tb02593.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Serological variations were examined among 12 type or reference strains and 91 oral isolates of vitamin B6-dependent Abiotrophia and Granulicatella spp. Rabbits were immunized with whole cells of 12 selected strains and 10 typing antisera were obtained, which were unreactive with the Lancefield group A to G antigen preparations. The reactivity of the antisera and autoclaved cell surface antigen extracts was tested by double diffusion in agar gel and a capillary precipitin test. These typing antisera categorized all Abiotrophia defectiva strains, all except one Granulicatella elegans strain, three-quarters of the Granulicatella adiacens, and half of the Granulicatella paraadiacens into 8 serotypes and 2 subserotypes. The Granulicatella balaenopterae type strain was unserotypable. All A. defectiva strains were serotype I, some of which were divided into subserotype I-1 and/or I-5. The G. adiacens strains generally belonged to serotype II or III, and the G. paraadiacens strains to serotype IV, V or VI. All G. adiacens or G. paraadiacens serotype II strains were also subserotype I-5. The G. elegans strains were serotype VII or VIII. These Abiotrophia and Granulicatella serotypes were undetectable among 33 strains of the other 11 species including the bacteriolytic enzyme-producing but vitamin B6-independent strains of Streptococcus, Enterococcus, Dolosigranulum and Aerococcus. The proposed serotyping system for Abiotrophia and Granulicatella spp. would be helpful in the identification and classification of these unique coccal isolates in ecological and epidemiological studies.
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Affiliation(s)
- K Kitada
- Department of Preventive Dentistry, Kagoshima University Dental School, Kagoshima, Japan
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Murray CK, Walter EA, Crawford S, McElmeel ML, Jorgensen JH. Abiotrophia bacteremia in a patient with neutropenic fever and antimicrobial susceptibility testing of Abiotrophia isolates. Clin Infect Dis 2001; 32:E140-2. [PMID: 11317266 DOI: 10.1086/320150] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2000] [Revised: 09/05/2000] [Indexed: 11/03/2022] Open
Abstract
We report a case of bacteremia due to Abiotrophia species in a patient with neutropenic fever and cancer who was receiving levofloxacin prophylaxis, followed by empirical therapy with cefepime; the organism was resistant to both antibiotics. We provide susceptibility data on 20 additional bloodstream isolates of Abiotrophia species.
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Affiliation(s)
- C K Murray
- Department of Medicine, Infectious Diseases Service, Brooke Army Medical Center, Fort Sam Houston, TX 78234-6200, USA.
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Michelow IC, McCracken GH, Luckett PM, Krisher K. Abiotrophia spp. brain abscess in a child with Down's syndrome. Pediatr Infect Dis J 2000; 19:760-3. [PMID: 10959750 DOI: 10.1097/00006454-200008000-00020] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- I C Michelow
- Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, USA
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Okada Y, Kitada K, Takagaki M, Ito HO, Inoue M. Endocardiac infectivity and binding to extracellular matrix proteins of oral Abiotrophia species. FEMS IMMUNOLOGY AND MEDICAL MICROBIOLOGY 2000; 27:257-61. [PMID: 10683471 DOI: 10.1111/j.1574-695x.2000.tb01438.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Microorganisms of the genus Abiotrophia, formerly known as nutritionally variant streptococci, are members of the oral flora and often isolated from patients with endocarditis, but pathogenicity of oral Abiotrophia species has not been examined yet. In this study, 17 strains isolated from healthy human oral cavities and 7 reference strains (all derived from patients with endocarditis) of Abiotrophia spp. were tested for their abilities to cause infections in damaged heart tissues in catheterized rats and to adhere to extracellular matrix proteins in vitro. The reference strains of A. defectiva and A. adiacens showed high infectivities in the rats. Four oral isolates of these two species showed similarly high infectivities and three had moderate infectivities. Most of 10 oral strains of A. para-adiacens and A. elegans were found to be generally less infective. The highly infective A. adiacens strains showed markedly high fibronectin-binding capacity, suggesting a possible relationship between the fibronectin-binding capacity and damaged heart tissue infectivity of the Abiotrophia species. A. defectiva strains which were also highly infective had moderate levels of binding to fibronectin and other extracellular matrix proteins. Most of A. para-adiacens and A. elegans strains showed low or negligible binding capacities to any extracellular matrix proteins tested.
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Affiliation(s)
- Y Okada
- Department of Preventive Dentistry, Kagoshima University Dental School, 8-35-1 Sakuragaoka, Kagoshima, Japan
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