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Infective Endocarditis by Moraxella Species: A Systematic Review. J Clin Med 2022; 11:jcm11071854. [PMID: 35407461 PMCID: PMC8999714 DOI: 10.3390/jcm11071854] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 03/17/2022] [Accepted: 03/24/2022] [Indexed: 12/03/2022] Open
Abstract
Moraxella catarrhalis is the most clinically relevant species among Moraxella spp. For decades, it was considered to be part of the normal human flora in the upper respiratory tract. However, since the late 1970s, considerable evidence has proposed that M. catarrhalis is an important pathogen in the human respiratory tract. Even though Infective Endocarditis (IE) is rarely caused by Moraxella spp., these infections can be problematic due to the lack of experience in their management. The aim of this study was to systematically review all published cases of IE by Moraxella spp. A systematic review of PubMed, Scopus and Cochrane library (through 8 December 2021) for studies providing epidemiological, clinical, microbiological data as well as treatment data and outcomes of IE by Moraxella spp. was performed. A total of 27 studies, containing data for 31 patients, were included. A prosthetic valve was present in 25.8%. Mitral valve was the most commonly infected site. Fever, sepsis and embolic phenomena were the most common clinical presentations. Cephalosporins, aminoglycosides, aminopenicillins and penicillin were the most commonly used antimicrobials. Overall mortality was 12.9%.
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Bicoll PS, Goyal A, Blatt NB, Freij BJ. Eculizumab-Associated Moraxella lacunata Bacteremia and Systemic Inflammatory Response Syndrome in a Toddler with Atypical Hemolytic Uremic Syndrome. CLINICAL MEDICINE INSIGHTS-PEDIATRICS 2021; 15:1179556521992367. [PMID: 33613039 PMCID: PMC7876576 DOI: 10.1177/1179556521992367] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/04/2021] [Indexed: 11/16/2022]
Abstract
Moraxella lacunata, a low-virulence Gram-negative coccobacillus, is classically associated with conjunctivitis and upper respiratory tract infections; systemic infections such as sepsis have rarely been reported, especially in children. We describe a 28-month-old girl with atypical hemolytic uremic syndrome and stage II chronic kidney disease on long-term eculizumab therapy who presented with systemic inflammatory response syndrome and was found to have Moraxella lacunata bloodstream infection. Eculizumab, a humanized monoclonal anti-C5 antibody, has been associated with susceptibility to infections with encapsulated bacteria, especially Neisseria meningitidis. This is the first report of an invasive bacterial infection with Moraxella lacunata in a pediatric eculizumab recipient.
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Affiliation(s)
- Paige S Bicoll
- Beaumont Children's Hospital, Royal Oak, Michigan and Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Ashima Goyal
- Beaumont Children's Hospital, Royal Oak, Michigan and Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Neal B Blatt
- Beaumont Children's Hospital, Royal Oak, Michigan and Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Bishara J Freij
- Beaumont Children's Hospital, Royal Oak, Michigan and Oakland University William Beaumont School of Medicine, Rochester, MI, USA
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Sawada N, Morohashi T, Mutoh T, Kuwana T, Yamaguchi J, Kinoshita K, Morioka I, Hao H. Moraxella lacunata infection accompanied by acute glomerulonephritis. Open Med (Wars) 2020; 15:962-967. [PMID: 33313415 PMCID: PMC7706123 DOI: 10.1515/med-2020-0234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 08/21/2020] [Accepted: 09/03/2020] [Indexed: 11/30/2022] Open
Abstract
Moraxella lacunata (M. lacunata) is a Gram-negative bacterium, which rarely causes serious infection. This is a rare case report of acute glomerulonephritis diagnosed by pathological findings in a child accompanied by M. lacunata infection. The patient showed hematuria, proteinuria and hyperkalemia requiring emergency hemodialysis. After hospitalization, M. lacunata bacteremia became apparent. Pathological findings showed an increase in glomerulus inflammatory cells and glomerular C3 deposition was observed in the renal tissue biopsy. Final diagnosis was endocapillary proliferative glomerulonephritis. Clinical reports of M. lacunata infection requiring emergency hemodialysis in children are rare. Previous reports have suggested that lowered immune competency with chronic kidney disease may be a risk factor associated with serious invasive cases of M. lacunata infection. However, detailed clinical laboratory data and pathological findings have not been identified in previous case reports. Our case directly indicated complement activity and acute glomerulonephritis with M. lacunata infection. Although there are various causes for acute glomerulonephritis, infection-related glomerulonephritis (IRGN) is an important concept. M. lacunata infection might have a potential risk for IRGN with dysregulation of complement activity leading to serious and invasive clinical conditions than previously considered.
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Affiliation(s)
- Nami Sawada
- Department of Acute Medicine, Division of Emergency and Critical Care Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Tamaki Morohashi
- Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Oyaguchi Kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Tomokazu Mutoh
- Department of Acute Medicine, Division of Emergency and Critical Care Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan.,Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Oyaguchi Kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Tsukasa Kuwana
- Department of Acute Medicine, Division of Emergency and Critical Care Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Junko Yamaguchi
- Department of Acute Medicine, Division of Emergency and Critical Care Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Kosaku Kinoshita
- Department of Acute Medicine, Division of Emergency and Critical Care Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Ichiro Morioka
- Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Oyaguchi Kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Hiroyuki Hao
- Department of Pathology, Division of Human Pathology, Nihon University School of Medicine, 30-1 Oyaguchi Kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan
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Nakayama A, Yamanaka K, Hayashi H, Ohkusu K. Moraxella lacunata infection associated with septicemia, endocarditis, and bilateral septic arthritis in a patient undergoing hemodialysis: a case report and review of the literature. J Infect Chemother 2013; 20:61-4. [PMID: 24462428 DOI: 10.1016/j.jiac.2013.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 06/09/2013] [Accepted: 06/19/2013] [Indexed: 02/07/2023]
Abstract
We report the first case of both endocarditis and bilateral septic arthritis in a patient caused by Moraxella lacunata and successful management of the infection with antimicrobial therapy. The route of entry leading to bacteremia may have been the oral cavity given the poor oral hygiene of the patient as evidenced by bleeding gums. We hypothesize that the bacteremia led to septic arthritis and mitral valve infective endocarditis. In this case report, we also review the literature on M. lacunata infections and conclude that this organism should be considered in bilateral septic arthritis in a patient with underlying heart abnormalities and/or with renal failure.
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Affiliation(s)
- Asami Nakayama
- Department of Joint Research Laboratory of Clinical Medicine, Fujita Health University, School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan; Division of Clinical Laboratory, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194, Japan
| | - Katsuo Yamanaka
- Department of General Internal Medicine, Fujita Health University School of Medicine, Japan
| | - Hiroki Hayashi
- Department of Nephrology, Fujita Health University School of Medicine, Japan
| | - Kiyofumi Ohkusu
- Department of Microbiology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan.
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Dasari S, Shetty R, Devasia T. A rare case of Moraxella lacunata producing combined native mitral and aortic valve endocarditis. Australas Med J 2011; 4:386-8. [PMID: 23393524 DOI: 10.4066/amj.2011.718] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We describe a case of infective endocarditis due to Moraxella lacunata involving the native mitral and aortic valves, complicated by cerebral emboli and resultant hemiparesis. The patient was treated with ceftriaxone and gentamicin and improved. This appears to be the first case reported in the medical literature of native multivalvular endocarditis produced by this rare organism.
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Affiliation(s)
- S Dasari
- Department of Medicine, Kasturba Medical College, Manipal
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Kutlesa M, Lepur D, Klinar I, Rudez I, Vincelj J, Bukovski S, Barsić B. Moraxella lacunata: A rare cause of infective endocarditis. ACTA ACUST UNITED AC 2009; 39:917-9. [PMID: 17852895 DOI: 10.1080/00365540701403002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We describe the first case of Moraxella lacunata definite native valve endocarditis in a patient with previously normal mitral valves. The disease was complicated with embolizations of the brain and spleen. After 6 weeks of antimicrobial treatment, valvular replacement was performed. The clinical course and diagnostic findings suggest that Moraxella lacunata possesses high aggressiveness leading to progressive valvular destruction and embolizations.
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Affiliation(s)
- Marko Kutlesa
- Department of Neuroinfections and Intensive Care Medicine, University Hospital for Infectious Diseases 'Dr. Fran Mihaljevic', Mirogojska 8, 10000 Zagreb, Croatia.
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Nagano N, Nagano Y, Cordevant C, Shibata N, Arakawa Y. Nosocomial transmission of CTX-M-2 beta-lactamase-producing Acinetobacter baumannii in a neurosurgery ward. J Clin Microbiol 2004; 42:3978-84. [PMID: 15364979 PMCID: PMC516360 DOI: 10.1128/jcm.42.9.3978-3984.2004] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Three strains of cefotaxime (CTX)-resistant Acinetobacter baumannii, FM0209680, FM0300106, and FM0301433, were isolated from transtracheal aspirate cultures of three patients with probable nosocomial infections in a neurosurgery ward in Japan. The CTX MICs for these isolates were greater than 128 microg/ml but were drastically reduced in the presence of 4 microg of clavulanic acid per ml. These strains were also resistant to ceftriaxone, cefpodoxime, and aztreonam but were susceptible to ceftazidime and imipenem. The profile of resistance to various broad-spectrum beta-lactams was transferred by conjugation. Strain FM0209680 was not eradicated from case patient 1 by administration of imipenem, ceftazidime, and levofloxacin, even after a 6-month hospitalization period. Strains FM0300106 and FM0301433 were isolated from case patients 2 and 3 during the sixth week following admission, respectively, and then each patient was colonized for 3 weeks. Eradication of FM0300106 was successfully obtained from case patient 2 by imipenem treatment, while administration of imipenem was continued to prevent pneumonia. Prophylactic antimicrobial therapy was discontinued in case patient 3 because of the lack of pneumonic symptoms, and FM0301433 disappeared after the discontinuation of antimicrobial chemotherapy. All three strains carried the bla(CTX-M-2) gene, and the appearance of colonies in the growth-inhibitory zones around disks of CTX and aztreonam in double-disk synergy tests suggested inducible beta-lactamase production in these A. baumannii strains. The ribotyping investigation suggested that all these strains belong to the same clonal lineage. The plasmids harbored by A. baumannii had the same restriction profile as those harbored by Proteus mirabilis strains previously isolated in a urology ward of the Funabashi Medical Center.
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Affiliation(s)
- Noriyuki Nagano
- Medical Microbiology Laboratory, Funabashi Medical Center, 1-21-1 Kanasugi, Funabashi, Chiba 273-8588, Japan.
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