1
|
Oren I, Temper V, Michael-Gayego A, Motro Y, Volovelsky O, Moran-Gilad J, Gordon O. Helicobacter cinaedi Bacteremia in Children: A Case Report and Literature Review. Pediatr Infect Dis J 2024; 43:e135-e138. [PMID: 38295230 DOI: 10.1097/inf.0000000000004237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
Helicobacter cinaedi is known to cause invasive infections in immunocompromised adults. Here we report the first case of H. cinaedi bacteremia in a child with nephrotic syndrome. The patient presented with a mild transient febrile illness that resolved spontaneously. We discuss the diagnostic challenges associated with this case and the microbiologic approach, including genomic analysis. Furthermore, we review the current case together with all previous pediatric cases (n = 6). Notably, all cases involved neonates or otherwise immunocompromised individuals and were characterized by severe disease with complicated infections (eg, meningitis, cholangitis and arthritis). H. cinaedi bacteremia in children is associated with a wide spectrum of clinical presentations ranging from mild to life-threatening conditions. This bacterium may be difficult to diagnose and require specialized methods.
Collapse
Affiliation(s)
- Itamar Oren
- From the Department of Pediatrics, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Ein Karem, Jerusalem, Israel
| | - Violeta Temper
- Department of Clinical Microbiology and Infectious Diseases, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Ein Karem, Jerusalem, Israel
| | - Ayelet Michael-Gayego
- Department of Clinical Microbiology and Infectious Diseases, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Ein Karem, Jerusalem, Israel
| | - Yair Motro
- Department of Health Systems Management, School of Public Health, Faculty for Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Oded Volovelsky
- Pediatric Nephrology Unit, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Ein Karem, Jerusalem, Israel
| | - Jacob Moran-Gilad
- Department of Clinical Microbiology and Infectious Diseases, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Ein Karem, Jerusalem, Israel
- Department of Health Systems Management, School of Public Health, Faculty for Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Oren Gordon
- Infectious Diseases Unit, Department of Pediatrics, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Ein Karem, Jerusalem, Israel
| |
Collapse
|
2
|
Rotella K, Schiano TD, Fiel MI, Ho HE, Cunningham-Rundles C. Four-Year-History of Recurrent Fever, Skin Lesions, and Liver Abscesses in a Patient with Common Variable Immune Deficiency due to Helicobacter cinaedi Infection. J Clin Immunol 2023; 44:16. [PMID: 38129347 DOI: 10.1007/s10875-023-01611-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/02/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Karina Rotella
- Division of Clinical Immunology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1089, New York, NY, 10029, USA.
| | - Thomas D Schiano
- Division of Liver Diseases and Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maria Isabel Fiel
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hsi-En Ho
- Division of Clinical Immunology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1089, New York, NY, 10029, USA
| | - Charlotte Cunningham-Rundles
- Division of Clinical Immunology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1089, New York, NY, 10029, USA
| |
Collapse
|
3
|
Takenaka K, Sugimoto T, Kawamura K, Fukumoto T, Onuma K, Naito T, Oka M. Recurrent Fever due to Helicobacter cinaedi Infection during R-CHOP Chemotherapy in Diffuse Large B-Cell Lymphoma: Case Report and Literature Review. Case Rep Oncol 2021; 14:1315-1322. [PMID: 34720934 PMCID: PMC8525269 DOI: 10.1159/000518685] [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: 07/07/2021] [Accepted: 07/16/2021] [Indexed: 11/29/2022] Open
Abstract
Fever due to Helicobacter cinaedi bacteremia under chemotherapy has not been widely recognized among clinicians. We experienced a 72-year-old man with diffuse large B-cell lymphoma, who was complicated with H. cinaedi bacteremia-induced fever under R-CHOP chemotherapy. We summarized 6 cases including ours, suggesting that fever without neutropenia developing around day 6 from starting chemotherapy is a possible symptom caused by H. cinaedi bacteremia. We should discriminate fever due to H. cinaedi bacteremia if fever emerged before myelosuppression in the course of chemotherapy.
Collapse
Affiliation(s)
- Kei Takenaka
- Department of Hematology, Kita-Harima Medical Center, Ono City, Japan
| | - Takeshi Sugimoto
- Department of Hematology, Kita-Harima Medical Center, Ono City, Japan
| | - Kohei Kawamura
- Department of Hematology, Kita-Harima Medical Center, Ono City, Japan
| | - Takeshi Fukumoto
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kenichiro Onuma
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Takuya Naito
- Department of Clinical Laboratory, Kita-Harima Medical Center, Ono City, Japan
| | - Masahiro Oka
- Department of Dermatology, Kita-Harima Medical Center, Ono City, Japan
| |
Collapse
|
4
|
Ochoa S, Collado L. Enterohepatic Helicobacter species - clinical importance, host range, and zoonotic potential. Crit Rev Microbiol 2021; 47:728-761. [PMID: 34153195 DOI: 10.1080/1040841x.2021.1924117] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The genus Helicobacter defined just over 30 years ago, is a highly diverse and fast-growing group of bacteria that are able to persistently colonize a wide range of animals. The members of this genus are subdivided into two groups with different ecological niches, associated pathologies, and phylogenetic relationships: the gastric Helicobacter (GH) and the enterohepatic Helicobacter (EHH) species. Although GH have been mostly studied, EHH species have become increasingly important as emerging human pathogens and potential zoonotic agents in the last years. This group of bacteria has been associated with the development of several diseases in humans from acute pathologies like gastroenteritis to chronic pathologies that include inflammatory bowel disease, and liver and gallbladder diseases. However, their reservoirs, as well as their routes of transmission, have not been well established yet. Therefore, this review summarizes the current knowledge of taxonomy, epidemiology, and clinical role of the EHH group.
Collapse
Affiliation(s)
- Sofia Ochoa
- Faculty of Sciences, Institute of Biochemistry and Microbiology, Universidad Austral de Chile, Valdivia, Chile.,ANID - Millennium Science Initiative Program - Millennium Nucleus in the Biology of the Intestinal Microbiota, Santiago, Chile
| | - Luis Collado
- Faculty of Sciences, Institute of Biochemistry and Microbiology, Universidad Austral de Chile, Valdivia, Chile.,ANID - Millennium Science Initiative Program - Millennium Nucleus in the Biology of the Intestinal Microbiota, Santiago, Chile
| |
Collapse
|
5
|
Rasmussen SL, Ørsted I, Tarpgaard IH, Nielsen HL. Helicobacter cinaedi bacteraemia secondary to enterocolitis in an immunocompetent patient. Gut Pathog 2021; 13:26. [PMID: 33888153 PMCID: PMC8063464 DOI: 10.1186/s13099-021-00422-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/12/2021] [Indexed: 01/13/2023] Open
Abstract
Background Helicobacter cinaedi are motile, gram-negative spiral rods with a natural reservoir in the intestinal tract of hamsters and rhesus monkeys. In humans, H. cinaedi has been reported in different human infections like fever, abdominal pain, gastroenteritis, proctitis, diarrhoea, erysipelas, cellulitis, arthritis, and neonatal meningitis typically diagnosed by positive blood cultures. Even though H. cinaedi has been detected from human blood and stool the entry of H. cinaedi into the blood stream was undocumented until quite recently. The use of pulse-field gel electrophoresis (PFGE) demonstrated that stool- and blood-derived H. cinaedi strains were consistent. Case presentation Here, we describe a rare Danish case of H. cinaedi bacteraemia in an immunocompetent 44-year-old male with diarrhoea. We isolated H. cinaedi from a blood culture taken at admission, and from a FecalSwab taken at day six despite ongoing antibiotic therapy. Next, we made a genetic comparison of both isolates by use of Multi-locus sequence typing (MLST)- and Single nucleotide polymorphism (SNP)-analysis. The two isolates were identical with zero SNPs and by use of MLST the isolate was identified as a novel ST20, confirming previous data of the intestinal tract as a route of H. cinaedi bacteraemia. The results of our AST showed a resistance pattern with higher MICs for ciprofloxacin and clarithromycin than for ampicillin, amoxicillin, gentamicin, and imipenem. The patient was cured with targeted therapy with pivampicillin; however, the primary source of transmission was unknown. Conclusions In conclusion, this case of H. cinaedi bacteraemia secondary to enterocolitis in an immunocompetent patient provide clear evidence that one route of infection occurs through translocation from the intestinal tract to the bloodstream. Helicobacter cinaedi from blood and faeces were identical with a novel ST20, resistant to ciprofloxacin and clarithromycin however, the patient was cured with oral pivampicillin.
Collapse
Affiliation(s)
- Sofie Larsen Rasmussen
- Department of Clinical Microbiology, Aalborg University Hospital, Hobrovej 18, 9000, Aalborg, Denmark
| | - Iben Ørsted
- Department of Infectious Diseases, Aalborg University Hospital, Hobrovej 18, 9000, Aalborg, Denmark
| | - Irene Harder Tarpgaard
- Department of Clinical Microbiology, Aalborg University Hospital, Hobrovej 18, 9000, Aalborg, Denmark
| | - Hans Linde Nielsen
- Department of Clinical Microbiology, Aalborg University Hospital, Hobrovej 18, 9000, Aalborg, Denmark. .,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| |
Collapse
|
6
|
Conley KJ, Seimon TA, Popescu IS, Wellehan JFX, Fox JG, Shen Z, Haakonsson J, Seimon A, Brown AT, King V, Burton F, Calle PP. Systemic Helicobacter infection and associated mortalities in endangered Grand Cayman blue iguanas (Cyclura lewisi) and introduced green iguanas (Iguana iguana). PLoS One 2021; 16:e0247010. [PMID: 33606766 PMCID: PMC7894872 DOI: 10.1371/journal.pone.0247010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 01/30/2021] [Indexed: 12/20/2022] Open
Abstract
The Blue Iguana Recovery Programme maintains a captive breeding and head-starting program for endangered Grand Cayman blue iguanas (Cyclura lewisi) on Grand Cayman, Cayman Islands. In May 2015, program staff encountered two lethargic wild Grand Cayman blue iguanas within the Queen Elizabeth II Botanic Park (QEIIBP). Spiral-shaped bacteria were identified on peripheral blood smears from both animals, which molecular diagnostics identified as a novel Helicobacter species (provisionary name Helicobacter sp. GCBI1). Between March 2015 and February 2017, 11 Grand Cayman blue iguanas were identified with the infection. Two of these were found dead and nine were treated; five of the nine treated animals survived the initial infection. Phylogenetic analysis of the 16S rRNA gene suggests Helicobacter sp. GCBI1 is most closely related to Helicobacter spp. in chelonians. We developed a Taqman qPCR assay specific for Helicobacter sp. GCBI1 to screen tissue and/or blood samples from clinical cases, fecal and cloacal samples from clinically healthy Grand Cayman blue iguanas, including previously infected and recovered iguanas, and iguanas housed adjacent to clinical cases. Fecal and/or cloacal swab samples were all negative, suggesting that Grand Cayman blue iguanas do not asymptomatically carry this organism nor shed this pathogen per cloaca post infection. Retrospective analysis of a 2014 mortality event affecting green iguanas (Iguana iguana) from a separate Grand Cayman location identified Helicobacter sp. GCBI1 in two of three cases. The source of infection and mode of transmission are yet to be confirmed. Analysis of rainfall data reveal that all infections occurred during a multi-year dry period, and most occurred shortly after the first rains at the end of seasonal drought. Additionally, further screening has identified Helicobacter sp. GCBI1 from choanal swabs of clinically normal green iguanas in the QEIIBP, suggesting they could be asymptomatic carriers and a potential source of the pathogen.
Collapse
Affiliation(s)
- Kenneth J. Conley
- Wildlife Conservation Society, Zoological Health Program, Bronx, New York, United States of America
| | - Tracie A. Seimon
- Wildlife Conservation Society, Zoological Health Program, Bronx, New York, United States of America
| | | | - James F. X. Wellehan
- Department of Comparative, Diagnostic & Population Medicine, University of Florida, Gainesville, Florida, United States of America
| | - James G. Fox
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Zeli Shen
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Jane Haakonsson
- Department of Environment, Cayman Islands Government, Grand Cayman, Cayman Islands
| | - Anton Seimon
- Center for Environmental Policy, Bard College, Annandale-on-Hudson, New York, United States of America
| | - Ania Tomaszewicz Brown
- Wildlife Conservation Society, Zoological Health Program, Bronx, New York, United States of America
| | - Veronica King
- St. Matthew’s University, School of Veterinary Medicine, Grand Cayman, Cayman Islands
| | - Fred Burton
- Department of Environment, Cayman Islands Government, Grand Cayman, Cayman Islands
| | - Paul P. Calle
- Wildlife Conservation Society, Zoological Health Program, Bronx, New York, United States of America
| |
Collapse
|
7
|
Araoka H, Baba M, Okada C, Kimura M, Sato T, Yatomi Y, Moriya K, Yoneyama A. Risk Factors for Recurrent Helicobacter cinaedi Bacteremia and the Efficacy of Selective Digestive Decontamination With Kanamycin to Prevent Recurrence. Clin Infect Dis 2019; 67:573-578. [PMID: 29462291 DOI: 10.1093/cid/ciy114] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 02/09/2018] [Indexed: 01/01/2023] Open
Abstract
Background Previous studies suggest that Helicobacter cinaedi can cause recurrent bacteremia. In this study, we elucidated the risk factors for recurrent H. cinaedi bacteremia and explored the efficacy of selective digestive decontamination (SDD) as a preventive measure. Methods We retrospectively reviewed the medical records of patients with H. cinaedi bacteremia between March 2009 and December 2016 at 2 Japanese hospitals. Results We identified 168 patients with H. cinaedi bacteremia. Bacteremia recurred in 34 patients. The 100-day cumulative incidence rate of recurrent bacteremia was 18.7%. In univariate analysis of factors associated with recurrent bacteremia, anticancer chemotherapy (hazard ratio [HR], 3.75; 95% confidence interval [CI], 1.86-7.58; P < .001), systemic steroids (HR, 3.79; 95% CI, 1.70-8.45; P = .0011), and hematological malignancy (HR, 3.18; 95% CI, 1.64-6.19; P < .001) were detected. Multivariate analysis indicated that anticancer chemotherapy (HR, 2.47; 95% CI, 1.19-5.12; P = .015) and systemic steroids (HR, 2.40; 95% CI, 1.03-5.61; P = .044) were the independent risk factors. Of the 168 patients, 47 received SDD. According to Gray's test, SDD might have reduced the rate of recurrence but this was not statistically significant (HR, 0.46; 95% CI, 0.18-1.18; P = .11). However, in a proportional hazard modeling analysis, SDD reduced the rate of recurrence (HR, 0.36; 95% CI, 0.13-1.00; P = .050). Conclusions The 100-day cumulative incidence of recurrent H. cinaedi bacteremia was 18.7%. Anticancer chemotherapy and systemic steroids were independent risk factors for recurrent bacteremia. SDD is a potential strategy for reducing the recurrence.
Collapse
Affiliation(s)
- Hideki Araoka
- Department of Infectious Diseases, Toranomon Hospital.,Department of Infection Control and Prevention, Graduate School of Medicine, The University of Tokyo, Japan.,Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, Japan
| | - Masaru Baba
- Department of Infectious Diseases, Toranomon Hospital
| | - Chikako Okada
- Department of Infectious Diseases, Toranomon Hospital
| | | | - Tomoaki Sato
- Department of Infection Control and Prevention, Graduate School of Medicine, The University of Tokyo, Japan
| | - Yutaka Yatomi
- Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, Japan
| | - Kyoji Moriya
- Department of Infection Control and Prevention, Graduate School of Medicine, The University of Tokyo, Japan
| | | |
Collapse
|
8
|
Gotoh Y, Taniguchi T, Yoshimura D, Katsura K, Saeki Y, Hirabara Y, Fukuda M, Takajo I, Tomida J, Kawamura Y, Ogura Y, Itoh T, Misawa N, Okayama A, Hayashi T. Multi-step genomic dissection of a suspected intra-hospital Helicobacter cinaedi outbreak. Microb Genom 2019; 4. [PMID: 30629483 PMCID: PMC6412056 DOI: 10.1099/mgen.0.000236] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Helicobacter cinaedi is an emerging pathogen causing bacteraemia and cellulitis. Nosocomial transmission of this microbe has been described, but detailed molecular-epidemiological analyses have not been performed. Here, we describe the results of a multi-step genome-wide phylogenetic analysis of a suspected intra-hospital outbreak of H. cinaedi that occurred in a hospital in Japan. The outbreak was recognized by the infectious control team (ICT) of the hospital as a sudden increase in H. cinaedi bacteraemia. ICT defined this outbreak case based on 16S rRNA sequence data and epidemiological information, but were unable to determine the source and route of the infections. We therefore re-investigated this case using whole-genome sequencing (WGS). We first performed a species-wide analysis using publicly available genome sequences to understand the level of genomic diversity of this under-studied species. The clusters identified were then separately analysed using the genome sequence of a representative strain in each cluster as a reference. These analyses provided a high-level phylogenetic resolution of each cluster, identified a confident set of outbreak isolates, and discriminated them from other closely related but distinct clones, which were locally circulating and invaded the hospital during the same period. By considering the epidemiological data, possible strain transmission chains were inferred, which highlighted the role of asymptomatic carriers or environmental contamination. The emergence of a subclone with increased resistance to fluoroquinolones in the outbreak was also recognized. Our results demonstrate the impact of the use of a closely related genome as a reference to maximize the power of WGS.
Collapse
Affiliation(s)
- Yasuhiro Gotoh
- 1Department of Bacteriology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.,2Previous address: Division of Microbiology, Department of Infectious Diseases, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Takako Taniguchi
- 3Laboratory of Veterinary Public Health, Department of Veterinary Medical Science, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan
| | - Dai Yoshimura
- 4Graduate School of Bioscience and Biotechnology, Tokyo Institute of Technology, Tokyo, Japan
| | - Keisuke Katsura
- 5Frontier Science Research Center, University of Miyazaki, Miyazaki, Japan
| | - Yuji Saeki
- 6Center for Infection Control, University of Miyazaki Hospital, Miyazaki, Japan
| | - Yasutoshi Hirabara
- 6Center for Infection Control, University of Miyazaki Hospital, Miyazaki, Japan
| | - Mayumi Fukuda
- 6Center for Infection Control, University of Miyazaki Hospital, Miyazaki, Japan
| | - Ichiro Takajo
- 6Center for Infection Control, University of Miyazaki Hospital, Miyazaki, Japan
| | - Junko Tomida
- 7Department of Microbiology, School of Pharmacy, Aichi Gakuin University, Nagoya, Japan
| | - Yoshiaki Kawamura
- 7Department of Microbiology, School of Pharmacy, Aichi Gakuin University, Nagoya, Japan
| | - Yoshitoshi Ogura
- 1Department of Bacteriology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.,2Previous address: Division of Microbiology, Department of Infectious Diseases, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Takehiko Itoh
- 4Graduate School of Bioscience and Biotechnology, Tokyo Institute of Technology, Tokyo, Japan
| | - Naoaki Misawa
- 3Laboratory of Veterinary Public Health, Department of Veterinary Medical Science, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan.,8Faculty of Agriculture, University of Miyazaki Center for Animal Disease Control, University of Miyazaki, Miyazaki, Japan
| | - Akihiko Okayama
- 6Center for Infection Control, University of Miyazaki Hospital, Miyazaki, Japan.,9Department of Rheumatology, Infectious Diseases and Laboratory Medicine, University of Miyazaki, Miyazaki, Japan
| | - Tetsuya Hayashi
- 1Department of Bacteriology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.,2Previous address: Division of Microbiology, Department of Infectious Diseases, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| |
Collapse
|
9
|
First case report of thyroid abscess caused by Helicobacter cinaedi presenting with thyroid storm. BMC Infect Dis 2019; 19:166. [PMID: 30770725 PMCID: PMC6377776 DOI: 10.1186/s12879-019-3808-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 02/12/2019] [Indexed: 12/19/2022] Open
Abstract
Background Helicobacter cinaedi is a microaerobic Gram-negative spiral-shaped bacterium that causes enteritis, cellulitis, and bacteremia in both immunocompromised and immunocompetent patients. While there have been increasing numbers of reported H. cinaedi infections recently, there has been no thyroid abscess case caused by H. cinaedi presenting with thyroid storm. Case presentation A 50-year-old Japanese man presented with a 9-day history of high fever associated with palpitations, dry cough, and chronic diarrhea. The patient had a history of Basedow’s disease that had been treated with thiamazole in the past. During the current episode, the patient was diagnosed with thyroid storm and treated accordingly. The blood culture taken on admission was positive for H. cinaedi. This finding was confirmed by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOFMS). A systemic computed tomography (CT) scan revealed a thyroid abscess as the site of infection and cause of the bacteremia. The 16S rRNA gene sequencing identified the pathogen of thyroid abscess as H. cinaedi. Clinical symptoms and laboratory data normalized on admission day 7 after treatment with both effective antibiotics and antithyroid drugs. Conclusions The case study described a patient with a history of Basedow’s disease that presented with a thyroid abscess caused by H. cinaedi with symptoms similar to those of thyroid storm. While this bacterium has been implicated in other infections, we believe this is the first time the bacteria has been documented to have caused a thyroid abscess. Electronic supplementary material The online version of this article (10.1186/s12879-019-3808-7) contains supplementary material, which is available to authorized users.
Collapse
|
10
|
Fujita S, Hayashi H, Kodama S, Mukai T, Morita Y. Bacteremia Possibly Caused by Helicobacter cinaedi and Associated with Painful Erythema in Rheumatoid Arthritis with Malignant Lymphoma. Intern Med 2018; 57:3663-3666. [PMID: 30146580 PMCID: PMC6355406 DOI: 10.2169/internalmedicine.1196-18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
We herein report the case of a 69-year-old woman with rheumatoid arthritis (RA) and malignant lymphoma who developed Helicobacter cinaedi bacteremia after starting rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy. She had a recurrent fever and painful erythema for 13 months before the diagnosis was made. This delayed diagnosis was attributable to the underlying RA, which typically presents with various cutaneous manifestations and elevated C-reactive protein levels. The erythema on the thighs, abdomen, and left forearm improved following treatment with intravenous aminobenzyl penicillin; she received antibiotics for six weeks. This case emphasizes the importance of recognizing this opportunistic infection in immunocompromised patients.
Collapse
Affiliation(s)
| | | | - Shoko Kodama
- Department of Rheumatology, Kawasaki Medical School, Japan
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Japan
| | | |
Collapse
|
11
|
Kedra J, Zeller V, Heym B, Lehours P, Meyssonnier V, Lariven S, Bruhl-Bénéjat L, Marmor S, Ziza JM. A Case Of Recurrent Helicobacter cinaedi Prosthetic Joint Infection In An HIV-Infected Man. J Bone Jt Infect 2018; 3:230-233. [PMID: 30416949 PMCID: PMC6215987 DOI: 10.7150/jbji.28375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 08/17/2018] [Indexed: 12/12/2022] Open
Abstract
We describe the case of an HIV-infected man who developed twice a Helicobacter cinaedi prosthetic joint infection. In our knowledge, it is the first case to date. Furthermore, it illustrates the fact that this bacterium is difficult to isolate and that recurrences can occur even after apparently successful treatment.
Collapse
Affiliation(s)
- Joanna Kedra
- Service de Médecine Interne et Rhumatologie, Groupe Hospitalier Diaconesses-Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France
| | - Valérie Zeller
- Service de Médecine Interne et Rhumatologie & Centre de Référence des Infections Ostéo-Articulaires Complexes, Groupe Hospitalier Diaconesses-Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France
| | - Beate Heym
- Laboratoire de Biologie Médicale & Centre de Référence des Infections Ostéo-Articulaires Complexes, Groupe Hospitalier Diaconesses-Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France
| | - Philippe Lehours
- Centre National de Référence des Campylobacters et Helicobacters. CHU de Bordeaux-Pellegrin. Place Amélie Raba-Léon. 33076 Bordeaux Cedex
| | - Vanina Meyssonnier
- Service de Médecine Interne et Rhumatologie & Centre de Référence des Infections Ostéo-Articulaires Complexes, Groupe Hospitalier Diaconesses-Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France
| | - Sylvie Lariven
- Service de Maladies Infectieuses, Hôpital Bichat, 46 rue Henri Hussard, 75018 Paris
| | - Lucie Bruhl-Bénéjat
- Centre National de Référence des Campylobacters et Helicobacters. CHU de Bordeaux-Pellegrin. Place Amélie Raba-Léon. 33076 Bordeaux Cedex
| | - Simon Marmor
- Service de Maladies Infectieuses, Hôpital Bichat, 46 rue Henri Hussard, 75018 Paris
| | - Jean-Marc Ziza
- Service de Médecine Interne et Rhumatologie & Centre de Référence des Infections Ostéo-Articulaires Complexes, Groupe Hospitalier Diaconesses-Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France
| |
Collapse
|
12
|
Araoka H, Baba M, Okada C, Kimura M, Sato T, Yatomi Y, Moriya K, Yoneyama A. First evidence of bacterial translocation from the intestinal tract as a route of Helicobacter cinaedi bacteremia. Helicobacter 2018; 23. [PMID: 29218758 DOI: 10.1111/hel.12458] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND The route of Helicobacter cinaedi bacteremia has not yet been clarified. Although bacterial translocation from the intestinal tract into the circulation has been suggested, it has not been demonstrated thus far. The objective of this study was to investigate the port of entry of this bacterium. MATERIAL AND METHODS We conducted a retrospective study on patients with H. cinaedi bacteremia between March 2009 and May 2013. Records of patients in whom H. cinaedi was detected in both blood and stool cultures were extracted. H. cinaedi was identified using gyrB-targeted PCR. Pulse-field gel electrophoresis was used to investigate the consistency of the genotypes. RESULTS Seventy-one patients were diagnosed with H. cinaedi bacteremia during the study period. H. cinaedi was detected in both blood and stool samples of 21 patients. Pulse-field gel electrophoresis was used to investigate the consistency of the genotypes in 18 evaluable strains (from 9 patients). The pulse-field gel electrophoresis patterns of the stool- and blood-derived strains of H. cinaedi were consistent among all 9 patients. Most of the 9 patients analyzed were immunocompromised and being treated with anticancer drugs or steroids, which suggests reduced intestinal immunity. CONCLUSIONS This is the first study to demonstrate that bacterial translocation from the intestinal tract could represent one route of H. cinaedi bacteremia.
Collapse
Affiliation(s)
- Hideki Araoka
- Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan.,Department of Infection Control and Prevention, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masaru Baba
- Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan
| | - Chikako Okada
- Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan
| | - Muneyoshi Kimura
- Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan
| | - Tomoaki Sato
- Department of Infection Control and Prevention, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yutaka Yatomi
- Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kyoji Moriya
- Department of Infection Control and Prevention, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akiko Yoneyama
- Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan
| |
Collapse
|
13
|
Mutations in Genes Encoding Penicillin-Binding Proteins and Efflux Pumps Play a Role in β-Lactam Resistance in Helicobacter cinaedi. Antimicrob Agents Chemother 2018; 62:AAC.02036-17. [PMID: 29203490 DOI: 10.1128/aac.02036-17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 11/21/2017] [Indexed: 01/06/2023] Open
Abstract
β-Lactams are often used to treat Helicobacter cinaedi infections; however, the mechanism underlying β-lactam resistance is unknown. In this study, we investigated β-lactam resistance in an H. cinaedi strain, MRY12-0051 (MICs of amoxicillin [AMX] and ceftriaxone [CRO], 32 and 128 μg/ml; obtained from human feces). Based on a comparative whole-genome analysis of MRY12-0051 and the CRO-susceptible H. cinaedi strain MRY08-1234 (MICs of AMX and CRO, 1 and 4 μg/ml; obtained from human blood), we identified five mutations in genes encoding penicillin-binding proteins (PBPs), including two in pbpA, one in pbp2, and two in ftsI Transformation and penicillin binding assays indicated that CRO resistance was mainly associated with mutations in pbpA; mutations in ftsI also led to increased resistance to AMX. Knocking out cmeB and cmeD, which encode resistance-nodulation-division-type efflux pump components, in H. cinaedi type strain CCUG18818 (AMX MIC, 4 to 8 μg/ml) resulted in 8- and 64-fold decreases, respectively, in the AMX MIC. Hence, MICs of AMX in H. cinaedi become similar to those of Helicobacter pylori isolates in the absence of cmeD In conclusion, the difference in susceptibility to β-lactams between H. pylori and H. cinaedi is explained by differences in efflux pump components. Mutations in pbpA are the primary determinant of high resistance to β-lactams in H. cinaedi.
Collapse
|
14
|
Diagnostic Snapshot: Painful Nodules and Recurrent Fever in a Patient With Acute Lymphoblastic Leukemia. J Adv Pract Oncol 2018; 9:758-762. [PMID: 31249724 PMCID: PMC6570516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
15
|
Yamamoto K, Hayakawa K, Nagashima M, Shimada K, Kutsuna S, Takeshita N, Kato Y, Kanagawa S, Yamada K, Mezaki K, Kirikae T, Ohmagari N. Comparison of the clinical and microbiological characteristics of Campylobacter and Helicobacter bacteremia: the importance of time to blood culture positivity using the BACTEC blood culture systems. BMC Res Notes 2017; 10:634. [PMID: 29183353 PMCID: PMC5704506 DOI: 10.1186/s13104-017-2981-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 11/22/2017] [Indexed: 01/13/2023] Open
Abstract
Objective Campylobacter spp. and Helicobacter spp. are rare but important causes of bacteremia in humans. Distinguishing these bacteria is complicated because of their similar phenotypic profiles. We conducted clinical and microbiological investigations of Campylobacter spp. or Helicobacter spp. bacteremia. Patients diagnosed with bacteremia from 2008 to 2014 were included. The clinical and microbiological characteristics of Campylobacter spp. and Helicobacter spp. bacteremia were compared. The BACTEC system was used in blood cultures. A receiver operating characteristic curve was plotted based on the time to blood culture positivity. Results Sixteen cases of Helicobacter spp. bacteremia (patient age: 61 ± 18 years) and 14 cases of Campylobacter spp. bacteremia (patient age: 49 ± 21 years) were identified. Median time to blood culture positivity was longer for the Helicobacter spp. cases than the Campylobacter spp. cases (91.4 h vs 55.3 h, p < 0.01). A time to blood culture positivity > 75 h predicted Helicobacter spp. bacteremia with a sensitivity of 0.88 and a specificity of 0.93 (area under the receiver operating characteristic curve of 0.90). In conclusion, a time to blood culture positivity was useful in distinguishing Helicobacter spp. bacteremia from Campylobacter spp. bacteremia.
Collapse
Affiliation(s)
- Kei Yamamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Maki Nagashima
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Kayo Shimada
- Department of Infectious Diseases, Research Institute, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Satoshi Kutsuna
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Nozomi Takeshita
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Yasuyuki Kato
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Shuzo Kanagawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Koji Yamada
- Clinical Laboratory, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Kazuhisa Mezaki
- Clinical Laboratory, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Teruo Kirikae
- Department of Infectious Diseases, Research Institute, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| |
Collapse
|
16
|
Matsumoto A, Yeh I, Schwartz B, Rosenblum M, Schmidt TH. Chronic Helicobacter cinaedi cellulitis diagnosed by microbial polymerase chain reaction. JAAD Case Rep 2017; 3:398-400. [PMID: 28884138 PMCID: PMC5581853 DOI: 10.1016/j.jdcr.2017.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Andrew Matsumoto
- Department of Dermatology, University of California, San Francisco, California.,Albany Medical College, Albany, New York
| | - Iwei Yeh
- Department of Pathology, University of California, San Francisco, California
| | - Brian Schwartz
- Department of Infectious Disease, University of California, San Francisco, California
| | - Michael Rosenblum
- Department of Dermatology, University of California, San Francisco, California
| | - Timothy H Schmidt
- Department of Dermatology, University of California, San Francisco, California
| |
Collapse
|
17
|
|
18
|
Fujiya Y, Nagamatsu M, Tomida J, Kawamura Y, Yamamoto K, Mawatari M, Kutsuna S, Takeshita N, Hayakawa K, Kanagawa S, Mezaki K, Hashimoto M, Ishii S, Ohmagari N. Successful treatment of recurrent Helicobacter fennelliae bacteraemia by selective digestive decontamination with kanamycin in a lung cancer patient receiving chemotherapy. JMM Case Rep 2016; 3:e005069. [PMID: 28348791 PMCID: PMC5343149 DOI: 10.1099/jmmcr.0.005069] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 10/11/2016] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Helicobacter fennelliae is an enterohepatic Helicobacter species causing bacteraemia in immunocompromised hosts. Only a few cases of recurrent H. fennelliae bacteraemia have been reported in Japan and there are no guidelines regarding antimicrobial treatment for H. fennelliae infection. CASE PRESENTATION H. fennelliae bacteraemia was observed in a patient receiving platinum-based chemotherapy for lung cancer. To prevent recurrence, the patient received antibiotic therapy with cefepime, amoxicillin and doxycycline for 6 weeks, which is similar to the therapy for Helicobactercinaedi bacteraemia. Bacteraemia recurred despite the long-term antibiotic therapy. We hypothesized that the H. fennelliae bacteraemia originated from endogenous infection in the intestinal tract due to the long-term damage of the enteric mucosa by platinum-based drugs and performed selective digestive decontamination (SDD) with kanamycin. Bacteraemia did not recur after SDD. CONCLUSION Our observations indicate that clinicians should be aware of possible recurrent H. fennelliae bacteraemia, which could be effectively prevented by SDD with kanamycin.
Collapse
Affiliation(s)
- Yoshihiro Fujiya
- Disease Control and Prevention Center, National Center for Global Health and Medicine , Tokyo , Japan
| | - Maki Nagamatsu
- Disease Control and Prevention Center, National Center for Global Health and Medicine , Tokyo , Japan
| | - Junko Tomida
- Department of Microbiology, School of Pharmacy, Aichi Gakuin University , Aichi , Japan
| | - Yoshiaki Kawamura
- Department of Microbiology, School of Pharmacy, Aichi Gakuin University , Aichi , Japan
| | - Kei Yamamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine , Tokyo , Japan
| | - Momoko Mawatari
- Disease Control and Prevention Center, National Center for Global Health and Medicine , Tokyo , Japan
| | - Satoshi Kutsuna
- Disease Control and Prevention Center, National Center for Global Health and Medicine , Tokyo , Japan
| | - Nozomi Takeshita
- Disease Control and Prevention Center, National Center for Global Health and Medicine , Tokyo , Japan
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine , Tokyo , Japan
| | - Shuzo Kanagawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine , Tokyo , Japan
| | - Kazuhisa Mezaki
- Department of Clinical Laboratory, National Center for Global Health and Medicine , Tokyo , Japan
| | - Masao Hashimoto
- Respiratory Medicine, National Center for Global Health and Medicine , Tokyo , Japan
| | - Satoru Ishii
- Respiratory Medicine, National Center for Global Health and Medicine , Tokyo , Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine , Tokyo , Japan
| |
Collapse
|
19
|
Abiko S, Nakamura I, Yamaguchi Y, Ohkusu K, Hirayama Y, Matsumoto T. The First Case Report of Cerebral Cyst Infection Due to Helicobacter cinaedi. Jpn J Infect Dis 2016; 70:210-212. [PMID: 27357987 DOI: 10.7883/yoken.jjid.2016.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We report the first case of cerebral cyst infection by Helicobacter cinaedi, a fastidious spiral-shaped gram-negative rod bacterium. A 70-year-old man visited Tokyo Medical University Hospital with persisting fever since 2 weeks. He underwent surgery and radiotherapy for parapharyngeal space squamous cell carcinoma 10 years ago. The radiotherapy resulted in a cerebral cyst as a side effect, and an Ommaya reservoir was inserted into the cyst. Blood culture and analysis of the brain cyst fluid revealed the presence of spiral-shaped gram-negative rod bacteria, which were identified as H. cinaedi by polymerase chain reaction. Initially, we administered clarithromycin (400 mg per day). After H. cinaedi infection was confirmed, the treatment was changed to meropenem (MEPM 6 g per day). The patient was treated for 43 days in the hospital with intravenous meropenem, and his clinical course was satisfactory. On the 44th day, he was discharged and prescribed oral minocycline (MINO 200 mg per day). After discharge, the patient's H. cinaedi infection did not recur. Our case illustrated the wide clinical spectrum of H. cinaedi as well as the effectiveness of antibiotic therapy comprising MERM and MINO for treating central nervous system infection by this organism.
Collapse
Affiliation(s)
- Soichiro Abiko
- Department of General Medicine and Primary Care, Tokyo Medical University Hospital
| | | | | | | | | | | |
Collapse
|
20
|
Saito S, Tsukahara M, Ohkusu K, Kurai H. Helicobacter fennelliae Bacteremia: Three Case Reports and Literature Review. Medicine (Baltimore) 2016; 95:e3556. [PMID: 27149471 PMCID: PMC4863788 DOI: 10.1097/md.0000000000003556] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Helicobacter fennelliae is a gram-negative, spiral bacillus that appears as thin-spread colonies on sheep blood agar and is similar to Helicobacter cinaedi. H fennelliae is diagnosed by genetic testing, which is not readily available in all laboratories. Therefore, H fennelliae bacteremia has only been reported sporadically, and little is known about its clinical characteristics.We describe 3 cases of H fennelliae bacteremia with gastrointestinal symptoms, including nausea, vomiting, and diarrhea. Isolates could be differentiated from H cinaedi by biochemical reaction testing, including nitrate reduction and alkaline phosphatase hydrolysis.We retrospectively reviewed 24 cases of H fennelliae bacteremia reported in the literature. Most of the patients had immunosuppressive backgrounds, including solid tumors, hematological malignancies, and autoimmune diseases. Although gastrointestinal symptoms were common, cellulitis was not often observed in patients with H fennelliae bacteremia.Clinicians should bear in mind that H fennelliae may be a differential diagnosis in patients with gastrointestinal manifestations and gram-negative, spiral bacilli. In addition, biochemical reactions, such as nitrate reduction and alkaline phosphatase hydrolysis, are useful in differentiating H fennelliae from H cinaedi.
Collapse
Affiliation(s)
- Sho Saito
- From the Division of Infectious Diseases (SS, MT, HK), Shizuoka Cancer Center Hospital, Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, Japan; and Department of Microbiology (KO), Tokyo Medical University, Nishishinjuku, Shinjuku-ku, Tokyo, Japan
| | | | | | | |
Collapse
|
21
|
Toyofuku M, Tomida J, Kawamura Y, Miyata I, Yuza Y, Horikoshi Y. Helicobacter cinaedi bacteremia resulting from antimicrobial resistance acquired during treatment for X-linked agammaglobulinemia. J Infect Chemother 2016; 22:704-6. [PMID: 27040158 DOI: 10.1016/j.jiac.2016.02.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 02/13/2016] [Accepted: 02/15/2016] [Indexed: 11/18/2022]
Abstract
This is the first report of penicillin/cephalosporin-resistant Helicobacter cinaedi arising from prolonged treatment. H. cinaedi, common among immunocompromised patients, caused recurrent bacteremia and cellulitis in a 19-year-old Japanese man with X-linked agammaglobulinemia. The minimal inhibitory concentration of these drugs was raised, which subsequently resulted in clinical failure. Prolonged suboptimal treatment may cause bacterial resistance to β-lactam antibiotics in H. cinaedi. It is possible that this resistance may have contributed to the treatment failure.
Collapse
Affiliation(s)
- Meiwa Toyofuku
- Division of Infectious Diseases, Tokyo Metropolitan Children's Medical Center, Japan; Department of Pediatrics, Children's Center, Yokohama Rosai Hospital, Japan.
| | - Junko Tomida
- Department of Microbiology, School of Pharmacy, Aichi Gakuin University, Japan
| | - Yoshiaki Kawamura
- Department of Microbiology, School of Pharmacy, Aichi Gakuin University, Japan
| | - Ippei Miyata
- Department of Pediatrics, Kawasaki Medical School, Japan
| | - Yuki Yuza
- Division of Hematology/Oncology, Tokyo Metropolitan Children's Medical Center, Japan
| | - Yuho Horikoshi
- Division of Infectious Diseases, Tokyo Metropolitan Children's Medical Center, Japan
| |
Collapse
|
22
|
Uwamino Y, Muranaka K, Hase R, Otsuka Y, Hosokawa N. Clinical Features of Community-Acquired Helicobacter cinaedi Bacteremia. Helicobacter 2016; 21:24-8. [PMID: 25997542 DOI: 10.1111/hel.12236] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
BACKGROUND There are growing numbers of reports concerning the clinical and pathological features of Helicobacter cinaedi (H. cinaedi) bacteremia; however, few reports have discussed the features of this condition in healthy individuals. PATIENTS AND METHODS A retrospective observational study was conducted at a Japanese tertiary care hospital to assess the clinical features of community-acquired H. cinaedi. All patients in whom H. cinaedi was isolated between January 2009 and March 2014 were identified from the hospital database. RESULTS Of the 28 patients included in the study, 12 had community-acquired H. cinaedi bacteremia. The most common clinical feature was cellulitis (n = 17). However, nearly half of the patients with healthcare-associated or nosocomial-associated bacteremia displayed no symptoms with the exception of fever. Most patients were successfully treated with a 14-day regime of third-generation cephalosporins or tetracycline. CONCLUSIONS Our results show that H. cinaedi infections are quite common in immunocompetent community-dwelling individuals.
Collapse
Affiliation(s)
- Yoshifumi Uwamino
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Tokyo, Japan
| | - Kiyoharu Muranaka
- Department of Infectious Diseases, Kameda Medical Center, Kamogawa, Japan
| | - Ryota Hase
- Department of Infectious Diseases, Kameda Medical Center, Kamogawa, Japan
| | - Yoshihito Otsuka
- Department of Laboratory Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Naoto Hosokawa
- Department of Infectious Diseases, Kameda Medical Center, Kamogawa, Japan
| |
Collapse
|
23
|
Imafuku A, Araoka H, Tanaka K, Marui Y, Sawa N, Ubara Y, Takaichi K, Ishii Y, Tomikawa S. Helicobacter cinaedi bacteremia in four renal transplant patients: clinical features and an important suggestion regarding the route of infection. Transpl Infect Dis 2016; 18:132-6. [PMID: 26556588 DOI: 10.1111/tid.12480] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 08/21/2015] [Accepted: 09/23/2015] [Indexed: 01/31/2023]
Abstract
Helicobacter cinaedi can cause bacteremia mainly in immunocompromised patients. We present the clinical characteristics of H. cinaedi bacteremia in 4 renal transplant patients. Interestingly, all cases showed triggers of bacterial translocation: 2 cases developed after colonic perforation caused by diverticulitis, 1 case developed post cholecystectomy, and the remaining patient had chronic diarrhea. Accordingly, bacterial translocation caused by severe gastrointestinal complication could be a cause of H. cinaedi bacteremia.
Collapse
Affiliation(s)
- A Imafuku
- Department of Nephrology Center, Toranomon Hospital, Tokyo, Japan
| | - H Araoka
- Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan
| | - K Tanaka
- Department of Nephrology Center, Toranomon Hospital, Tokyo, Japan
| | - Y Marui
- Department of Nephrology Center, Toranomon Hospital, Tokyo, Japan
| | - N Sawa
- Department of Nephrology Center, Toranomon Hospital, Tokyo, Japan
| | - Y Ubara
- Department of Nephrology Center, Toranomon Hospital, Tokyo, Japan
| | - K Takaichi
- Department of Nephrology Center, Toranomon Hospital, Tokyo, Japan
| | - Y Ishii
- Department of Nephrology Center, Toranomon Hospital, Tokyo, Japan
| | - S Tomikawa
- Department of Nephrology Center, Toranomon Hospital, Tokyo, Japan
| |
Collapse
|
24
|
Maki Y, Furukawa S, Kodama Y, Sumiyoshi K, Kino E, Sameshima H. Preterm labor and neonatal sepsis caused by intrauterine Helicobacter cinaedi infection. J Infect Chemother 2016; 22:414-6. [PMID: 26806147 DOI: 10.1016/j.jiac.2015.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 12/09/2015] [Accepted: 12/17/2015] [Indexed: 01/01/2023]
Abstract
Helicobacter cinaedi is a rare pathogen but known to cause bacteremia, cellulitis and enterocolitis. Recently, cases of involving various organs are increasingly reported such as endocarditis, meningitis, and kidney cyst infection. We report a case of intrauterine H. cinaedi infection leading preterm birth and neonatal sepsis. A 29-year-old pregnant women who was no underlying disease hospitalized due to threatened preterm labor at 22 weeks of gestation. Clinical findings showed uterine tenderness, fever, leukocytosis and elevated C-reactive protein. H. cinaedi was isolated from amniotic fluid obtained by transabdominal amniocentesis. We diagnosed as intrauterine H. cinaedi infection and administered intravenous ampicillin followed by oxytocin to terminate pregnancy. A live 446 g male infant was delivered. The patient was no signs of infection throughout postpartum course and discharged on post-delivery day 5. The neonate was admitted in neonatal intensive care unit and administered ampicillin and amikacin. H. cinaedi was isolated from umbilical cord blood culture. He has no signs of infection on day 5 but died from uncontrollable hyperglycemia and ketoacidosis on 15 days of age. H. cinaedi can cause intrauterine infection during pregnancy and lead preterm labor and neonatal sepsis.
Collapse
Affiliation(s)
- Yohei Maki
- Department of Obstetrics and Gynecology, University of Miyazaki, Japan.
| | - Seishi Furukawa
- Department of Obstetrics and Gynecology, University of Miyazaki, Japan
| | - Yuki Kodama
- Department of Obstetrics and Gynecology, University of Miyazaki, Japan
| | - Kaeko Sumiyoshi
- Department of Obstetrics and Gynecology, University of Miyazaki, Japan
| | - Emi Kino
- Department of Obstetrics and Gynecology, University of Miyazaki, Japan
| | - Hiroshi Sameshima
- Department of Obstetrics and Gynecology, University of Miyazaki, Japan
| |
Collapse
|
25
|
Infected Abdominal Aortic Aneurysm with Helicobacter cinaedi. Case Rep Surg 2016; 2016:1396568. [PMID: 26885430 PMCID: PMC4739218 DOI: 10.1155/2016/1396568] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 11/25/2015] [Accepted: 12/28/2015] [Indexed: 11/17/2022] Open
Abstract
Helicobacter cinaedi is a rare human pathogen which has various clinical manifestations such as cellulitis, bacteremia, arthritis, meningitis, and infectious endocarditis. We report an abdominal aortic aneurysm infected with Helicobacter cinaedi, treated successfully with surgical repair and long-term antimicrobial therapy.
Collapse
|
26
|
Ito K, Yamamoto T, Nishio H, Sawaya A, Murakami M, Kitagawa A, Matsuo Y, Matsuo K, Tanaka S, Mori N. Bacteremic kidney cyst infection caused by Helicobacter cinaedi. CEN Case Rep 2015; 5:121-124. [PMID: 28508961 DOI: 10.1007/s13730-015-0207-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 11/20/2015] [Indexed: 11/30/2022] Open
Abstract
Cyst infection is one of the major complications in patients with autosomal dominant polycystic kidney disease (ADPKD). The causative pathogen in kidney cyst infection frequently goes undetected. Although only one case report of kidney cyst infection caused by Helicobacter cinaedi (H. cinaedi) is published in English literature, it may be an important pathogen in kidney cyst infection. Kidney cyst infection and H. cinaedi infection share the common characteristic of tendency to relapse and chronic kidney disease is a major risk factor for H. cinaedi infection. Moreover, a long period is required to detect H. cinaedi in blood cultures, potentially causing false-negative results. After the identification of H. cinaedi, we must carefully select antibiotics and the antibiotic treatment period should be extended to prevent recurrence. Here we present a case of a 58-year-old male with ADPKD who developed bacteremic kidney cyst infection caused by H. cinaedi. He was admitted to our hospital because of fever, lower left back pain, vomiting, and feeling of abdominal enlargement. H. cinaedi was detected from the blood cultures obtained at admission after 4 days of culture. Antibiotics were administered for 8 weeks after confirming negative blood cultures. There was no evidence of kidney cyst infection relapse at 3 months after treatment completion. Nephrologists should regard H. cinaedi as a challenging but important pathogen in kidney cyst infection, particularly when the causative organism is unknown or kidney cyst infection is recurrent.
Collapse
Affiliation(s)
- Kenta Ito
- Department of Nephrology, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan.
| | - Takumi Yamamoto
- Department of Nephrology, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan
| | - Haruomi Nishio
- Department of Nephrology, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan
| | - Asako Sawaya
- Department of Nephrology, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan
| | - Masaaki Murakami
- Department of Nephrology, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan
| | - Akiko Kitagawa
- Department of Nephrology, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan
| | - Yoko Matsuo
- Department of Nephrology, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan
| | - Ken Matsuo
- Department of Nephrology, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan
| | - Satoshi Tanaka
- Department of Nephrology, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan
| | - Noriko Mori
- Department of Nephrology, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan
| |
Collapse
|
27
|
Kamimura K, Kumaki D, Arita M, Kobayashi Y, Mizuno KI, Kusama F, Kobayashi M, Abe H, Takahashi Y, Ogawa K, Shinagawa Y, Takeuchi M, Sato Y, Kawai H, Yamagiwa S, Terai S. First case of bacteremia caused by Helicobacter cinaedi in a patient with liver cirrhosis: a case report and literature review. Clin J Gastroenterol 2015; 8:306-17. [DOI: 10.1007/s12328-015-0600-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 08/13/2015] [Indexed: 12/17/2022]
|
28
|
Mugu V, Nausheen S, Mostofi N. Helicobacter cinaedi: a challenging case in a rural clinic. JMM Case Rep 2015. [DOI: 10.1099/jmmcr.0.000069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Vamshi Mugu
- University of North Dakota School of Medicine and Health Sciences, 501 N. Columbia Road, Grand Forks, ND, 58202, USA
| | - Sara Nausheen
- Altru Health System, 1000 South Columbia Rd, Grand Forks, ND, 58201, USA
| | - Nima Mostofi
- LifeCare Medical Center, 715 Delmore Drive, Roseau, MN, 56751, USA
| |
Collapse
|
29
|
Morel F, Brossier F, Mbadi A, Mégraud F, Jarlier V, Mellon G, Caumes E. Helicobacter cinaedi bacteraemia in an HIV-infected patient. Med Mal Infect 2015; 45:41-3. [PMID: 25623629 DOI: 10.1016/j.medmal.2014.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 12/29/2014] [Accepted: 12/29/2014] [Indexed: 10/24/2022]
Affiliation(s)
- F Morel
- Laboratoire de bactériologie-hygiène, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | - F Brossier
- Laboratoire de bactériologie-hygiène, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France; PRES Sorbonne universités, université Pierre-et-Marie-Curie (UPMC), université Paris 06, faculté de médecine Pitié-Salpêtrière, 75013 Paris, France
| | - A Mbadi
- Laboratoire de bactériologie-hygiène, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | - F Mégraud
- Centre national de référence des campylobacters et hélicobacters, laboratoire de bactériologie, hôpital Pellegrin, 33076 Bordeaux, France
| | - V Jarlier
- Laboratoire de bactériologie-hygiène, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France; PRES Sorbonne universités, université Pierre-et-Marie-Curie (UPMC), université Paris 06, faculté de médecine Pitié-Salpêtrière, 75013 Paris, France
| | - G Mellon
- Service des maladies infectieuses et tropicales, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France.
| | - E Caumes
- PRES Sorbonne universités, université Pierre-et-Marie-Curie (UPMC), université Paris 06, faculté de médecine Pitié-Salpêtrière, 75013 Paris, France; Service des maladies infectieuses et tropicales, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| |
Collapse
|
30
|
Haruki Y, Hagiya H, Hashimoto T, Miyake T, Murase T, Matsuo A, Sugiyama T, Kondo S. Pyogenic Spondylitis and Diskitis Caused by Helicobacter cinaedi in an Immunocompetent Adult Patient. Intern Med 2015; 54:2415-8. [PMID: 26370872 DOI: 10.2169/internalmedicine.54.4726] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein describe the first reported case of pyogenic spondylitis and diskitis caused by Helicobacter cinaedi. The results of magnetic resonance imaging and the histology of biopsied tissue were suggestive of acute infection at the lumbar spine. The pathogen was obtained by a blood culture examination and identified by 16S rRNA analysis. Eight weeks of antibiotics therapy resulted in a good clinical course. H. cinaedi infections have been increasingly reported in recent years, but the pathogen's epidemiological and pathological characteristics are still unclear. One of the difficulties in understanding the pathogenesis of H. cinaedi has been the challenges in cultivating the pathogen. Novel strategies for the diagnosis of H. cinaedi must be developed.
Collapse
Affiliation(s)
- Yuto Haruki
- Department of Pharmacy, Tsuyama Chuo Hospital, Japan
| | | | | | | | | | | | | | | |
Collapse
|
31
|
Bartels H, Goldenberger D, Reuthebuch O, Vosbeck J, Weisser M, Frei R, Bättig V. First case of infective endocarditis caused by Helicobacter cinaedi. BMC Infect Dis 2014; 14:586. [PMID: 25403102 PMCID: PMC4243372 DOI: 10.1186/s12879-014-0586-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 10/23/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Up to 20% of all infective endocarditis are blood culture-negative and therefore a diagnostic challenge. Here we present the case of an infective endocarditis due to Helicobacter cinaedi finally diagnosed using different molecular methods. This highly fastidious gram-negative spiral rod is increasingly recognized as a human pathogen, above all in immunocompromised patients. So far H. cinaedi has been associated with bacteremia, cellulitis, arthritis and meningitis. CASE PRESENTATION A 71-year-old man presented with fever and progressive dyspnea for weeks. He was immunocompromised by long-term steroid therapy. As one major and two minor Duke's criteria (vegetation, fever and aortic valve stenosis as predisposition) were present, an infective endocarditis was suspected and an empiric therapy with amoxicillin/clavulanic acid and gentamicin was established. The persistent severe aortic regurgitation resulted in a valve replacement. Histological evaluation of the aortic valve showed a polypous-ulcerative endocarditis. Gram stain and culture remained negative. Broad-range bacterial PCR targeting the 16S rRNA gene on the biopsy of the aortic valve identified H. cinaedi as the causative agent. The antibiotic therapy was simplified accordingly to ceftriaxone and gentamicin with a recommended duration of 6 weeks. Ten days after valve replacement the patient was discharged. To complete our molecular finding, we sequenced nearly the complete 16S rRNA gene (accession number KF914917) resulting in 99.9% identity with H. cinaedi reference sequences. Based on this result, 2 species-specific PCR tests amplifying part of the ctd gene were established and applied to the valve specimen. The 2 PCRs confirmed H. cinaedi. In addition, we analyzed stool, urine and saliva from the patient using H. cinaedi PCR. The fecal and urine specimen showed a positive signal, saliva was PCR-negative. CONCLUSION We identified H. cinaedi as causative agent of a culture-negative endocarditis in an immunocompromised patient using broad-range and specific PCR. In addition to 2 cases from Japan presented on international meetings in 2010 and 2013, our case report shows that H. cinaedi should be recognized as additional causative organism of infective endocarditis. The use of molecular diagnostic techniques proved to be a powerful complement for the detection of blood culture-negative infective endocarditis.
Collapse
Affiliation(s)
- Hanni Bartels
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.
| | - Daniel Goldenberger
- Division of Clinical Microbiology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.
| | - Oliver Reuthebuch
- Clinic for Cardiac Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
| | - Juerg Vosbeck
- Institute of Pathology, University Hospital Basel, Schönbeinstrasse 40, 4031, Basel, Switzerland.
| | - Maja Weisser
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.
| | - Reno Frei
- Division of Clinical Microbiology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.
| | - Veronika Bättig
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.
| |
Collapse
|
32
|
Kawakami Y. [Clinical and bacteriological examination in hospital of Helicobacter cinaedi (H. cinaedi)]. ACTA ACUST UNITED AC 2014; 88:417-22. [PMID: 25199374 DOI: 10.11150/kansenshogakuzasshi.88.417] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The spiral Gram-negative bacterium Helicobacter cinaedi (H. cinaedi) is usually isolated from immunocompromized patients, and the number of patients in whom H. cinaedi is isolated from their blood culture is increasing in Japan. To elucidate why the number of cases is increasing, we tried to analyze separate cases of H. cinaedi. H. cinaedi was isolated from the blood culture of 24 cases, and the isolate was from the pleural effusion of 1 cases between September 2009 and March 2010. In our cases, H. cinaedi was frequently isolated after anticancer chemotherapies (44 isolates) and steroid therapies (42 isolates). The patients' clinical symptoms were fever (43 isolates), gastrointestinal symptoms (4 isolates) and skin symptoms (8 isolates). In all cases, the H. cinaedi growth was found only in an aerobic bottle, and it needed a long time (2-7 days) to grow. In 14 cases out of 25 cases, H. cinaedi bacteremia was recurred. We analyzed recurrent cases statistically. The result showed there was a significant difference between the kinds of quinolones (p = 0.0018). H. cinaedi infections have a good prognosis, but the infection tends to recur after anticancer chemotherapies. A report has suggested that the minimal inhibitory concentrations of quinolones increased is case of recurrence, we should pay attention to the use of antibacterial agents. Furthermore, the effective method to eliminate or prevert infection [recurrence] remains unknown. Our results show that H. cinaedi infections may prolong the duration of hospitalization. If H. cinaedi is isolated in a patient, it is necessary to set the culture conditions for H. cinaedi. Furthermore, there is a need for appropiate antibiotic selection and medication for H. cinaedi.
Collapse
|
33
|
Clinical and bacteriological characteristics of Helicobacter cinaedi infection. J Infect Chemother 2014; 20:517-26. [PMID: 25022901 DOI: 10.1016/j.jiac.2014.06.007] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 06/15/2014] [Indexed: 12/27/2022]
Abstract
Helicobacter cinaedi was first isolated from rectal cultures from homosexual men in 1984. In the 1980s to mid 1990s, the microorganism was mainly isolated from samples from homosexual men or immunocompromised patients; however, during the last two decades, H. cinaedi has been isolated from immunocompromised and from immunocompetent individuals worldwide. In Japan, the isolation of this microorganism was first reported in 2003. Since then, many cases have been reported in hospitals across the country. Despite many reports, the etiological properties and pathogenicity of H. cinaedi remain elusive; however, we are increasingly able to recognize some of the features and the clinical relevance of infection. In particular, a long incubation period is essential for detection in an automatic blood culture system and many of the recent isolates are resistant to both macrolides and quinolones. Furthermore, there is an association between infection and severe or chronic illnesses, such as meningitis or arteriosclerosis, in addition to mild diseases such as fever, abdominal pain, gastroenteritis, proctitis, diarrhea, erysipelas, cellulitis, arthritis, and bacteremia. In this review, we introduce the current knowledge and our latest findings relating to H. cinaedi.
Collapse
|
34
|
Promotion of atherosclerosis by Helicobacter cinaedi infection that involves macrophage-driven proinflammatory responses. Sci Rep 2014; 4:4680. [PMID: 24732347 PMCID: PMC3986732 DOI: 10.1038/srep04680] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 03/17/2014] [Indexed: 01/11/2023] Open
Abstract
Helicobacter cinaedi is the most common enterohepatic Helicobacter species that causes bacteremia in humans, but its pathogenicity is unclear. Here, we investigated the possible association of H. cinaedi with atherosclerosis in vivo and in vitro. We found that H. cinaedi infection significantly enhanced atherosclerosis in hyperlipidaemic mice. Aortic root lesions in infected mice showed increased accumulation of neutrophils and F4/80+ foam cells, which was due, at least partly, to bacteria-mediated increased expression of proinflammatory genes. Although infection was asymptomatic, detection of cytolethal distending toxin RNA of H. cinaedi indicated aorta infection. H. cinaedi infection altered expression of cholesterol receptors and transporters in cultured macrophages and caused foam cell formation. Also, infection induced differentiation of THP-1 monocytes. These data provide the first evidence of a pathogenic role of H. cinaedi in atherosclerosis in experimental models, thereby justifying additional investigations of the possible role of enterohepatic Helicobacter spp. in atherosclerosis and cardiovascular disease.
Collapse
|
35
|
Clinical characteristics of bacteremia caused by Helicobacter cinaedi and time required for blood cultures to become positive. J Clin Microbiol 2014; 52:1519-22. [PMID: 24574294 DOI: 10.1128/jcm.00265-14] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to clarify the clinical characteristics of patients with Helicobacter cinaedi bacteremia and the time required for blood cultures to become positive. The medical records of all patients with H. cinaedi bacteremia at Toranomon Hospital and Toranomon Hospital Kajigaya between March 2009 and March 2013 were retrospectively reviewed. Sixty-three patients, 34 men and 29 women with a median age of 67 years (range, 37 to 88 years), were diagnosed with H. cinaedi bacteremia. A total of 51,272 sets of blood cultures were obtained during the study period, of which 5,769 sets of blood cultures were positive for some organism and 126 sets were H. cinaedi positive. The time required for blood cultures to become positive for H. cinaedi was ≤5 days in 69 sets (55%) and >5 days in 57 sets (45%). Most patients had an underlying disease, including chronic kidney disease (21 cases), solid tumor (19 cases), hematological malignancy (13 cases), diabetes mellitus (8 cases), chronic liver disease (6 cases), and postorthopedic surgery (3 cases). Only 1 patient had no apparent underlying disease. The clinical symptoms included cellulitis in 24 cases, colitis in 7 cases, and fever only in 27 cases, including 7 cases of febrile neutropenia. The 30-day mortality rate of H. cinaedi bacteremia was 6.3%. In conclusion, most cases of H. cinaedi bacteremia occurred in immunocompromised patients. We might have overlooked nearly half of the H. cinaedi bacteremia cases if the duration of monitored blood culture samples had been within 5 days. Therefore, when clinicians suspect H. cinaedi bacteremia, the observation period for blood cultures should be extended.
Collapse
|
36
|
Yang I, Nell S, Suerbaum S. Survival in hostile territory: the microbiota of the stomach. FEMS Microbiol Rev 2013; 37:736-61. [DOI: 10.1111/1574-6976.12027] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 05/28/2013] [Accepted: 06/07/2013] [Indexed: 02/06/2023] Open
|
37
|
Morita Y, Tomida J, Kawamura Y. Multidrug Efflux Systems in Helicobacter cinaedi. Antibiotics (Basel) 2012; 1:29-43. [PMID: 27029418 PMCID: PMC4790245 DOI: 10.3390/antibiotics1010029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 11/16/2012] [Accepted: 11/16/2012] [Indexed: 12/30/2022] Open
Abstract
Helicobacter cinaedi causes infections, such as bacteremia, diarrhea and cellulitis in mainly immunocompromised patients. This pathogen is often problematic to analyze, and insufficient information is available, because it grows slowly and poorly in subculture under a microaerobic atmosphere. The first-choice therapy to eradicate H. cinaedi is antimicrobial chemotherapy; however, its use is linked to the development of resistance. Although we need to understand the antimicrobial resistance mechanisms of H. cinaedi, unfortunately, sufficient genetic tools for H. cinaedi have not yet been developed. In July 2012, the complete sequence of H. cinaedi strain PAGU 611, isolated from a case of human bacteremia, was announced. This strain possesses multidrug efflux systems, intrinsic antimicrobial resistance mechanisms and typical mutations in gyrA and the 23S rRNA gene, which are involved in acquired resistance to fluoroquinolones and macrolides, respectively. Here, we compare the organization and properties of the efflux systems of H. cinaedi with the multidrug efflux systems identified in other bacteria.
Collapse
Affiliation(s)
- Yuji Morita
- Department of Microbiology, School of Pharmacy, Aichi Gakuin University/ 1-100 Kusumoto, Chikusa, Nagoya, Aichi 464-8650, Japan.
| | - Junko Tomida
- Department of Microbiology, School of Pharmacy, Aichi Gakuin University/ 1-100 Kusumoto, Chikusa, Nagoya, Aichi 464-8650, Japan.
| | - Yoshiaki Kawamura
- Department of Microbiology, School of Pharmacy, Aichi Gakuin University/ 1-100 Kusumoto, Chikusa, Nagoya, Aichi 464-8650, Japan.
| |
Collapse
|
38
|
Identification of and screening for human Helicobacter cinaedi infections and carriers via nested PCR. J Clin Microbiol 2012; 50:3893-900. [PMID: 23015666 DOI: 10.1128/jcm.01622-12] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Helicobacter cinaedi is the most frequently reported enterohepatic Helicobacter species isolated from humans. Earlier research suggested that certain patients with H. cinaedi infection may remain undiagnosed or incorrectly diagnosed because of difficulties in detecting the bacteria by conventional culture methods. Here, we report a nested PCR assay that rapidly detects the cytolethal distending toxin gene (cdt) of H. cinaedi with high specificity and sensitivity. Specificity of the assay was validated by using different species of Helicobacter and Campylobacter, as well as known H. cinaedi-positive and -negative samples. The sensitivity of detection for the cdt gene in the assay was 10(2) CFU/ml urine or 10(2) CFU/10(5) infected RAW 264.7 cells. In an H. cinaedi-infected mouse model, the cdt gene of H. cinaedi was effectively detected via the assay with urine (6/7), stool (2/3), and blood (2/6) samples. Importantly, it detected H. cinaedi in blood, urine, and stool samples from one patient with a suspected H. cinaedi infection and three patients with known infections. The assay was further used clinically to follow up two H. cinaedi-infected patients after antibiotic treatment. Stool samples from these two patients evaluated by nested PCR after antibiotic therapy showed clearance of bacterial DNA. Finally, analysis of stool specimens from healthy volunteers showed occasional positive reactions (4/30) to H. cinaedi DNA, which suggests intestinal colonization by H. cinaedi in healthy subjects. In conclusion, this nested PCR assay may be useful for the rapid diagnosis, antimicrobial treatment evaluation, and epidemiological study of H. cinaedi infection.
Collapse
|
39
|
Complete genome sequence of Helicobacter cinaedi strain PAGU611, isolated in a case of human bacteremia. J Bacteriol 2012; 194:3744-5. [PMID: 22740670 DOI: 10.1128/jb.00645-12] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
We report the complete genome sequence of Helicobacter cinaedi strain PAGU611, isolated in a case of human bacteremia. The PAGU611 genome comprises a 2,078,348-bp chromosome and a 23,054-bp plasmid. The chromosome contains a unique genomic island, encoding a type VI secretion system and clustered regularly interspaced short palindromic repeat (CRISPR) loci.
Collapse
|
40
|
Alkyl hydroperoxide reductase is required for Helicobacter cinaedi intestinal colonization and survival under oxidative stress in BALB/c and BALB/c interleukin-10-/- mice. Infect Immun 2011; 80:921-8. [PMID: 22184416 DOI: 10.1128/iai.05477-11] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Helicobacter cinaedi, a common human intestinal bacterium, has been implicated in various enteric and systemic diseases in normal and immunocompromised patients. Protection against oxidative stress is a crucial component of bacterium-host interactions. Alkyl hydroperoxide reductase C (AhpC) is an enzyme responsible for detoxification of peroxides and is important in protection from peroxide-induced stress. H. cinaedi possesses a single ahpC, which was investigated with respect to its role in bacterial survival during oxidative stress. The H. cinaedi ahpC mutant had diminished resistance to organic hydroperoxide toxicity but increased hydrogen peroxide resistance compared with the wild-type (WT) strain. The mutant also exhibited an oxygen-sensitive phenotype and was more susceptible to killing by macrophages than the WT strain. In vivo experiments in BALB/c and BALB/c interleukin-10 (IL-10)(-/-) mice revealed that the cecal colonizing ability of the ahpC mutant was significantly reduced. The mutant also had diminished ability to induce bacterium-specific immune responses in vivo, as shown by immunoglobulin (IgG2a and IgG1) serum levels. Collectively, these data suggest that H. cinaedi ahpC not only contributes to protecting the organism against oxidative stress but also alters its pathogenic properties in vivo.
Collapse
|
41
|
Döring G, Unertl K, Heininger A. Validation criteria for nucleic acid amplification techniques for bacterial infections. Clin Chem Lab Med 2008; 46:909-18. [PMID: 18605949 DOI: 10.1515/cclm.2008.152] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Nucleic acid techniques (NATs), such as species-specific and universal polymerase chain reactions (PCRs), are finding ever wider use in the diagnosis of bacterial infection. However, although universal PCR assays, in particular, approach a type of modern Petri dish, they have a number of limitations which restrict their applicability. The sensitivity of universal PCR is lower than that of many species-specific PCRs, and the contamination of samples and PCR reagents with irrelevant DNA from various sources remains a problem. Thus, NATs in general and universal PCR assays in particular require careful validation to be of value for the diagnosis of infection. Validation includes sampling, DNA extraction/isolation, template amplification and visualisation of the results. Furthermore, it implies the establishment of measures of asepsis, the inclusion of positive and negative controls, techniques to optimise the release of DNA from bacterial cells, adequate repetition of the amplification reaction, and routine testing of reagent negative and inhibition controls. Finally, it entails the comparison of results obtained by NATs with those obtained by conventional microbiological methods and matching with clinical evidence of infection. Validation of NATs in clinical diagnosis remains an ongoing challenge. Because of these limitations, NATs can only serve as adjunct tools for the diagnosis of infection in selected cases; they cannot replace conventional culturing techniques.
Collapse
Affiliation(s)
- Gerd Döring
- Institut für Medizinische Mikrobiologie und Hygiene, Universitätsklinikum Tübingen, Eberhard-Karls-Universität Tübingen, Tübingen, Germany.
| | | | | |
Collapse
|