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Li J, Xiong A, Wang J, Wu X, Bai L, Zhang L, He X, Li G. Deciphering the microbial landscape of lower respiratory tract infections: insights from metagenomics and machine learning. Front Cell Infect Microbiol 2024; 14:1385562. [PMID: 38846353 PMCID: PMC11153674 DOI: 10.3389/fcimb.2024.1385562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/29/2024] [Indexed: 06/09/2024] Open
Abstract
Background Lower respiratory tract infections represent prevalent ailments. Nonetheless, current comprehension of the microbial ecosystems within the lower respiratory tract remains incomplete and necessitates further comprehensive assessment. Leveraging the advancements in metagenomic next-generation sequencing (mNGS) technology alongside the emergence of machine learning, it is now viable to compare the attributes of lower respiratory tract microbial communities among patients across diverse age groups, diseases, and infection types. Method We collected bronchoalveolar lavage fluid samples from 138 patients diagnosed with lower respiratory tract infections and conducted mNGS to characterize the lung microbiota. Employing various machine learning algorithms, we investigated the correlation of key bacteria in patients with concurrent bronchiectasis and developed a predictive model for hospitalization duration based on these identified key bacteria. Result We observed variations in microbial communities across different age groups, diseases, and infection types. In the elderly group, Pseudomonas aeruginosa exhibited the highest relative abundance, followed by Corynebacterium striatum and Acinetobacter baumannii. Methylobacterium and Prevotella emerged as the dominant genera at the genus level in the younger group, while Mycobacterium tuberculosis and Haemophilus influenzae were prevalent species. Within the bronchiectasis group, dominant bacteria included Pseudomonas aeruginosa, Haemophilus influenzae, and Klebsiella pneumoniae. Significant differences in the presence of Pseudomonas phage JBD93 were noted between the bronchiectasis group and the control group. In the group with concomitant fungal infections, the most abundant genera were Acinetobacter and Pseudomonas, with Acinetobacter baumannii and Pseudomonas aeruginosa as the predominant species. Notable differences were observed in the presence of Human gammaherpesvirus 4, Human betaherpesvirus 5, Candida albicans, Aspergillus oryzae, and Aspergillus fumigatus between the group with concomitant fungal infections and the bacterial group. Machine learning algorithms were utilized to select bacteria and clinical indicators associated with hospitalization duration, confirming the excellent performance of bacteria in predicting hospitalization time. Conclusion Our study provided a comprehensive description of the microbial characteristics among patients with lower respiratory tract infections, offering insights from various perspectives. Additionally, we investigated the advanced predictive capability of microbial community features in determining the hospitalization duration of these patients.
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Affiliation(s)
- Jiahuan Li
- Clinical Medicine Department, North Sichuan Medical College, Nanchong, China
- Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, the Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
| | - Anying Xiong
- Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, the Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, Chengdu third people’s hospital branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu, China
| | - Junyi Wang
- Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, the Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, Chengdu third people’s hospital branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu, China
| | - Xue Wu
- Clinical Medicine Department, North Sichuan Medical College, Nanchong, China
| | - Lingling Bai
- Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, the Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
| | - Lei Zhang
- Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, the Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, Chengdu third people’s hospital branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu, China
| | - Xiang He
- Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, the Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, Chengdu third people’s hospital branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu, China
- National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Guoping Li
- Clinical Medicine Department, North Sichuan Medical College, Nanchong, China
- Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, the Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
- Department of Pulmonary and Critical Care Medicine, Chengdu third people’s hospital branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu, China
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Thatrimontrichai A, Surachat K, Singkhamanan K, Thongsuksai P. Long Duration of Oral Care Using Mother's Own Milk Influences Oral Microbiota and Clinical Outcomes in Very-low-birthweight Infants: Randomized Controlled Trial. Pediatr Infect Dis J 2023; 42:804-810. [PMID: 37343216 DOI: 10.1097/inf.0000000000004002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
BACKGROUND Several studies have focused on the clinical outcomes of oral care using colostrum for a limited time (2-5 days) in very-low-birthweight (VLBW) infants. However, the effect of long-term mother's own milk (MOM) on the clinical outcomes and oral microbiota of VLBW infants remains unknown. METHODS In this randomized controlled trial, VLBW neonates were randomly assigned to oral care by MOM or sterile water (SW) groups until they started oral feeding. The primary outcome was oral microbiota composition including alpha and beta diversity, relative abundance, and linear discriminant analysis effect size (LEfSe). The secondary outcomes were various morbidities and mortality. RESULTS The baseline characteristics of the two groups did not differ (63 neonates, MOM group, n = 30, oral care 22 days; SW group, n = 33, oral care 27 days). There was no significant difference in alpha and beta diversities between the groups before and after the intervention. The MOM group had a significantly lower rate of clinical sepsis than the SW group (47% vs. 76%, risk ratio = 0.62, 95% CI: 0.40-0.97). The relative abundance of Bifidobacterium bifidum and Faecalibacterium were maintained after MOM care, especially in neonates without clinical sepsis, but decreased after SW care. LEfSe showed that neonates in the MOM and SW groups with clinical sepsis had the highest abundance of Pseudomonas and Gammaproteobacteria, respectively, compared with neonates without sepsis. CONCLUSIONS A longer duration of oral care using MOM in VLBW infants sustains healthy bacteria and decreases the risk of clinical sepsis.
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Affiliation(s)
- Anucha Thatrimontrichai
- From the Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Komwit Surachat
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
- Molecular Evolution and Computational Biology Research Unit, Prince of Songkla University, Songkhla, Thailand
| | - Kamonnut Singkhamanan
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Paramee Thongsuksai
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
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Miernikiewicz P, Barylski J, Wilczak A, Dragoš A, Rybicka I, Bałdysz S, Szymczak A, Dogsa I, Rokush K, Harhala MA, Ciekot J, Ferenc S, Gnus J, Witkiewicz W, Dąbrowska K. New Phage-Derived Antibacterial Enzyme PolaR Targeting Rothia spp. Cells 2023; 12:1997. [PMID: 37566076 PMCID: PMC10417112 DOI: 10.3390/cells12151997] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/12/2023] Open
Abstract
Rothia is an opportunistic pathogen, particularly life-threatening for the immunocompromised. It is associated with pneumonia, endocarditis, peritonitis and many other serious infections, including septicemia. Of note, Rothia mucilaginousa produces metabolites that support and increase overgrowth of Pseudomonas aeruginosa, one of the ESKAPE bacteria. Endolysins are considered as antibacterial enzymes derived from bacteriophages that selectively and efficiently kill susceptible bacteria without harming human cells or the normal microbiome. Here, we applied a computational analysis of metagenomic sequencing data of the gastric mucosa phageome extracted from human patients' stomach biopsies. A selected candidate anti-Rothia sequence was produced in an expression system, purified and confirmed as a Rothia mucilaginosa- and Rothia dentocariosa-specific endolysin PolaR, able to destroy bacterial cells even when aggregated, as in a biofilm. PolaR had no cytotoxic or antiproliferative effects on mammalian cells. PolaR is the first described endolysin selectively targeting Rothia species, with a high potential to combat infections caused by Rothia mucilaginosa and Rothia dentocariosa, and possibly other bacterial groups. PolaR is the first antibacterial enzyme selected from the gastric mucosa phageome, which underlines the biological complexity and probably underestimated biological role of the phageome in the human gastric mucosa.
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Affiliation(s)
- Paulina Miernikiewicz
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland; (A.W.); (I.R.); (A.S.); (K.R.); (M.A.H.); (J.C.); (K.D.)
| | - Jakub Barylski
- Department of Molecular Virology, Faculty of Biology, Adam Mickiewicz University, 61-712 Poznań, Poland; (J.B.); (S.B.)
| | - Aleksandra Wilczak
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland; (A.W.); (I.R.); (A.S.); (K.R.); (M.A.H.); (J.C.); (K.D.)
| | - Anna Dragoš
- Department of Microbiology, Biotechnical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia; (A.D.); (I.D.)
| | - Izabela Rybicka
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland; (A.W.); (I.R.); (A.S.); (K.R.); (M.A.H.); (J.C.); (K.D.)
| | - Sophia Bałdysz
- Department of Molecular Virology, Faculty of Biology, Adam Mickiewicz University, 61-712 Poznań, Poland; (J.B.); (S.B.)
| | - Aleksander Szymczak
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland; (A.W.); (I.R.); (A.S.); (K.R.); (M.A.H.); (J.C.); (K.D.)
| | - Iztok Dogsa
- Department of Microbiology, Biotechnical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia; (A.D.); (I.D.)
| | - Kostiantyn Rokush
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland; (A.W.); (I.R.); (A.S.); (K.R.); (M.A.H.); (J.C.); (K.D.)
| | - Marek Adam Harhala
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland; (A.W.); (I.R.); (A.S.); (K.R.); (M.A.H.); (J.C.); (K.D.)
| | - Jarosław Ciekot
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland; (A.W.); (I.R.); (A.S.); (K.R.); (M.A.H.); (J.C.); (K.D.)
| | - Stanisław Ferenc
- Research and Development Center, Regional Specialist Hospital in Wrocław, 51-124 Wrocław, Poland; (S.F.); (J.G.); (W.W.)
| | - Jan Gnus
- Research and Development Center, Regional Specialist Hospital in Wrocław, 51-124 Wrocław, Poland; (S.F.); (J.G.); (W.W.)
- Faculty of Health Sciences, Wrocław Medical University, 50-367 Wrocław, Poland
| | - Wojciech Witkiewicz
- Research and Development Center, Regional Specialist Hospital in Wrocław, 51-124 Wrocław, Poland; (S.F.); (J.G.); (W.W.)
| | - Krystyna Dąbrowska
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland; (A.W.); (I.R.); (A.S.); (K.R.); (M.A.H.); (J.C.); (K.D.)
- Research and Development Center, Regional Specialist Hospital in Wrocław, 51-124 Wrocław, Poland; (S.F.); (J.G.); (W.W.)
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Robertson RD, Panigrahi A, Cheema R. Rothia mucilaginosa bacteremia, meningitis leading to diffuse cerebritis in an adolescent patient undergoing acute myeloid leukemia chemotherapy causing significant morbidity. SAGE Open Med Case Rep 2021; 9:2050313X211063745. [PMID: 34900260 PMCID: PMC8664311 DOI: 10.1177/2050313x211063745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 11/12/2021] [Indexed: 11/21/2022] Open
Abstract
Infections with Rothia mucilaginosa are rare. We present an unusual case of Rothia mucilaginosa in an immunocompromised host, which is usually considered a low virulence pathogen. The objective of this report is to highlight spectrum of clinical presentations in an immunocompromised individual and discuss various antimicrobial treatment options in the light of lack of definitive treatment guidelines for this organism.
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Affiliation(s)
| | - Arun Panigrahi
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, UC Davis Children's Hospital, Sacramento, CA, USA
| | - Ritu Cheema
- Division of Pediatric Infectious Disease, Department of Pediatrics, UC Davis Children's Hospital, Sacramento, CA, USA
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5
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Rothia mucilaginosa Meningitis in a Child with Myelodysplastic Syndromes. Case Rep Pediatr 2021; 2021:9946868. [PMID: 34567819 PMCID: PMC8457974 DOI: 10.1155/2021/9946868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 08/22/2021] [Accepted: 09/07/2021] [Indexed: 11/18/2022] Open
Abstract
Rothia mucilaginosa is a Gram-positive coccus and an opportunistic pathogen in immunocompromised hosts. The microorganism has been implicated in serious infections, including bacteremia meningitis or endocarditis. However, there is a dearth of investigations on meningitis, especially in children. As this infection is rare and only a few cases have been recorded, evidence-based guidelines for adequate infection treatment are lacking. We herein report the case of a 12-year-old boy with myelodysplastic syndromes (MDS) presenting with a change in mental status who was diagnosed as having febrile neutropenia and bacterial meningitis caused by R. mucilaginosa at 23 days after unrelated cord blood transplant. In our case, the minimum inhibitory concentrations (MICs) of meropenem and vancomycin (VCM) were both ≤1 μg/mL, whereas the MIC of daptomycin (DAP) was 4 μg/mL. The patient was treated with intravenous antimicrobial therapy due to meropenem for 43 days because he had febrile neutropenia. During follow-up, the patient had no neurological complications. We retrospectively reviewed the antimicrobial susceptibility of all R. mucilaginosa isolates (n = 5) from blood or cerebrospinal fluid cultures at our hospital. The MIC of VCM was <0.5 μg/mL for all strains, whereas the MIC of DAP was ≥2 μg/mL for all strains. The MIC of MEPM was >1 μg/mL for one strain. We recommend choosing VCM as the primary treatment for invasive R. mucilaginosa infections until antimicrobial susceptibility results are known, especially in immunocompromised children.
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Li L, Deng X, Zou Y, Lv X, Guo Y. Characterization of the nasopharynx microbiota in patients with nasopharyngeal carcinoma vs. healthy controls. Braz J Microbiol 2021; 52:1873-1880. [PMID: 34491569 DOI: 10.1007/s42770-021-00594-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 08/08/2021] [Indexed: 01/05/2023] Open
Abstract
PURPOSE Nasopharyngeal carcinoma (NPC), an epithelial-originated malignant tumor, has a special geographic distribution. However, the etiology of NPC has not been examined in detail. Increasing pieces of evidence indicate that the microbiome may contribute to head and neck squamous cell carcinoma. Until now, there is limited information on the role of the microbiome in NPC, so we assessed variations in the nasopharynx microbiota of patients with NPC relative to the bacterial in health controls. METHODS Nasopharynx lavage fluid (NLF) samples were collected from 11 NPC patients and 5 volunteer controls. 16S rRNA sequencing and comparative analyses of NLF bacterial microbiome between NPC patients and controls were performed. RESULTS NLF microbial alpha-diversity by the Shannon index and Simpson index decreased significantly in the NPC patients when compared with the controls. Beta-diversity by principal component analysis exhibited separated patterns of the NPC patients and healthy controls. Thirty-one genera differed significantly between the NPC patient group and healthy control group. The abundance of 17 bacteria was correlated with primary tumor size and invaded lymph node size. Functional gene prediction analysis showed that 9 gene function pathways were significantly different between the two groups. CONCLUSION Our results demonstrated that the nasopharynx microbiota in NPC patients was different from that of the healthy controls, suggesting that the nasopharynx microenvironment might be related to NPC.
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Affiliation(s)
- Longjie Li
- Department of Radiation Oncology, the First Affiliated Hospital of Dalian Medical University, Dalian, 116021, Liaoning, China
| | - Xiaoqin Deng
- Department of Radiation Oncology, the First Affiliated Hospital of Dalian Medical University, Dalian, 116021, Liaoning, China
| | - Yang Zou
- Department of Radiation Oncology, the First Affiliated Hospital of Dalian Medical University, Dalian, 116021, Liaoning, China
| | - XiuPeng Lv
- Department of Radiation Oncology, the First Affiliated Hospital of Dalian Medical University, Dalian, 116021, Liaoning, China
| | - Yanjie Guo
- Department of Microecology, School of Basic Medical Science, Dalian Medical University, No. 9, West Segment of South Lvshun Road, Lvshunkou District, Dalian, 116044, China.
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Fatahi-Bafghi M. Characterization of the Rothia spp. and their role in human clinical infections. INFECTION GENETICS AND EVOLUTION 2021; 93:104877. [PMID: 33905886 DOI: 10.1016/j.meegid.2021.104877] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 01/01/2021] [Accepted: 04/19/2021] [Indexed: 11/25/2022]
Abstract
The genus Rothia are emerging as opportunistic pathogens associated with various infections in immunocompromised and immunocompetent individuals. This review describes the taxonomy, cell wall structure, pathogenesis, phenotypic and molecular characteristics, clinical diseases, treatment and, as well as, the related genera that may be misidentified by Rothia species.
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Affiliation(s)
- Mehdi Fatahi-Bafghi
- Department of Microbiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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8
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Franconieri F, Join-Lambert O, Creveuil C, Auzou M, Labombarda F, Aouba A, Verdon R, de La Blanchardière A. Rothia spp. infective endocarditis: A systematic literature review. Infect Dis Now 2020; 51:228-235. [PMID: 33164836 DOI: 10.1016/j.medmal.2020.10.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 10/16/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To describe the epidemiological, clinical, microbiological, and therapeutic features and outcomes of Rothia infective endocarditis (RIE) and extracardiac infections (ECRI). METHODS We performed a systematic literature review of published cases of RIE and ECRI. RESULTS After inclusion of a personal case report, 51 cases of RIE and 215 cases of ECRI were reported. Compared with ECRI patients, RIE patients were significantly more often males (80% versus 59%), intravenous drug users (IVDU) (20% versus 3%), immunocompetent (76% versus 31%), and infected with R. dentocariosa (55% versus 13%) but lacked significant differences with regard to median age (45 years [6-79]), rate of orodental abnormalities (33%), and six-month mortality (14%). Following microbiological documentation, RIE was most often treated with a beta-lactam antibiotic alone (39%) for a median duration of six weeks and required surgery in 39% of cases. CONCLUSION RIE is rare and likely secondary to a dental portal of entry or cutaneous inoculation in IVDU. Its prognosis seems to be favorable.
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Affiliation(s)
- F Franconieri
- Department of Infectious and Tropical Diseases, Normandie Univ, UNICAEN, CHU de Caen Normandie, 14000 Caen, France
| | - O Join-Lambert
- Laboratory of Microbiology, Normandie Univ, UNICAEN, CHU de Caen Normandie, 14000 Caen, France; Research Group on Microbial Adaptation, Normandie Univ, UNICAEN, EA2656, GRAM 2.0, 14000 Caen, France
| | - C Creveuil
- Biostatistics and Clinical Research Unit, Normandie Univ, UNICAEN, CHU de Caen Normandie, 14000 Caen, France
| | - M Auzou
- Laboratory of Microbiology, Normandie Univ, UNICAEN, CHU de Caen Normandie, 14000 Caen, France
| | - F Labombarda
- Department of Cardiology, Normandie Univ, UNICAEN, CHU de Caen Normandie, 14000 Caen, France
| | - A Aouba
- Department of Internal Medicine, Normandie Univ, UNICAEN, CHU de Caen Normandie, 14000 Caen, France
| | - R Verdon
- Department of Infectious and Tropical Diseases, Normandie Univ, UNICAEN, CHU de Caen Normandie, 14000 Caen, France; Research Group on Microbial Adaptation, Normandie Univ, UNICAEN, EA2656, GRAM 2.0, 14000 Caen, France
| | - A de La Blanchardière
- Department of Infectious and Tropical Diseases, Normandie Univ, UNICAEN, CHU de Caen Normandie, 14000 Caen, France.
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9
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Getzenberg RB, Hijano DR, Hakim H, Dallas RH, Ferrolino JA, Brazelton de Cardenas J, Garner CD, Tang L, Su Y, Wolf J, Hayden RT, Maron G. Rothia mucilaginosa Infections in Pediatric Cancer Patients. J Pediatric Infect Dis Soc 2020; 10:341-344. [PMID: 32448911 PMCID: PMC8240734 DOI: 10.1093/jpids/piaa047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 04/21/2020] [Indexed: 11/13/2022]
Abstract
We performed a retrospective study to determine the epidemiology of Rothia mucilaginosa infections among pediatric cancer patients. Over 20 years, 37 cases were identified; 27% developed complications, but there was no infection-related mortality. All cases were successfully treated with vancomycin.
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Affiliation(s)
| | - Diego R Hijano
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Hana Hakim
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Ronald H Dallas
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Jose A Ferrolino
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | | | - Cherilyn D Garner
- Department of Pathology, St Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Li Tang
- Department of Biostatistics, St Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Yin Su
- Department of Biostatistics, St Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Joshua Wolf
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Randall T Hayden
- Department of Pathology, St Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Gabriela Maron
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee, USA,Corresponding author: Gabriela Maron, MD, MS, Department of Infectious Diseases, St Jude Children Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105. E-mail:
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10
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Reichardt E, Geraci J, Sachse S, Rödel J, Pfister W, Löffler B, Wagner Y, Eigenthaler M, Wolf M. Qualitative and quantitative changes in the oral bacterial flora occur shortly after implementation of fixed orthodontic appliances. Am J Orthod Dentofacial Orthop 2019; 156:735-744. [DOI: 10.1016/j.ajodo.2018.12.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 12/01/2018] [Accepted: 12/01/2018] [Indexed: 10/25/2022]
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11
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Poyer F, Friesenbichler W, Hutter C, Pichler H, Dworzak M, Peters C, Mann G, Indra A, Attarbaschi A. Rothia mucilaginosa bacteremia: A 10-year experience of a pediatric tertiary care cancer center. Pediatr Blood Cancer 2019; 66:e27691. [PMID: 30825249 DOI: 10.1002/pbc.27691] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 02/18/2019] [Accepted: 02/20/2019] [Indexed: 11/10/2022]
Abstract
Rothia mucilaginosa is part of the oral and upper respiratory tract flora. Usually, this gram-positive coccus is not pathogenic; however, in the setting of immunosuppressed hosts, it can cause life-threatening infections as an opportunistic pathogen. Among a cohort of 1511 hematologic-oncologic patients at a pediatric tertiary care cancer center, we identified five cancer patients (0.35%) within a period of 10 years having a proven Rothia mucilaginosa bacteremia (1 culture positive: n = 3/5; > 1 culture positive: n = 2/5). With prompt and adequate antibiotic treatment, infection resolved rapidly before recovery of neutrophils and without any sequelae, suggesting that Rothia mucilaginosa bacteremia without organ involvement is not exceptionally problematic in pediatric cancer patients.
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Affiliation(s)
- Fiona Poyer
- Pediatric Hematology and Oncology, St. Anna Children's Hospital, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Waltraud Friesenbichler
- Pediatric Hematology and Oncology, St. Anna Children's Hospital, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Caroline Hutter
- Pediatric Hematology and Oncology, St. Anna Children's Hospital, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.,Children's Cancer Research Institute (CCRI), Vienna, Austria
| | - Herbert Pichler
- Pediatric Hematology and Oncology, St. Anna Children's Hospital, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Michael Dworzak
- Pediatric Hematology and Oncology, St. Anna Children's Hospital, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.,Children's Cancer Research Institute (CCRI), Vienna, Austria
| | - Christina Peters
- Pediatric Hematology and Oncology, St. Anna Children's Hospital, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Georg Mann
- Pediatric Hematology and Oncology, St. Anna Children's Hospital, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Alexander Indra
- Institute for Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Andishe Attarbaschi
- Pediatric Hematology and Oncology, St. Anna Children's Hospital, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
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Clauwaert M, Druwé P, Depuydt P. Meningitis in a patient with neutropenia due to Rothia mucilaginosa: a case report. J Med Case Rep 2019; 13:84. [PMID: 30857551 PMCID: PMC6413452 DOI: 10.1186/s13256-018-1947-x] [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] [Received: 08/04/2018] [Accepted: 12/10/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rothia mucilaginosa is a Gram-positive bacterium occurring as a commensal in the oral cavity and upper respiratory tract. Although rarely pathogenic in an immunocompetent host, it can cause severe opportunistic infections in immunocompromised individuals. CASE PRESENTATION A 67-year-old white woman had a routine blood analysis before undergoing knee surgery. The results showed leukopenia for which bone marrow examination was performed, showing an underlying acute myeloid leukemia. During the neutropenic phase after a second induction with cytarabine/idarubicin, she developed fever, headaches, and photophobia. Cultures of cerebrospinal fluid were positive for Rothia mucilaginosa. Despite full therapy with antibiotics, neurosurgical interventions, and intensive care support, our patient died due to refractory intracranial hypertension and transtentorial herniation. CONCLUSIONS Meningitis due to Rothia mucilaginosa is a rare but potentially lethal infection in patients with neutropenia, and evidence-based guidelines for the treatment of this disease are lacking. We suggest an empirical therapy with amoxicillin/rifampicin until adjustments can be made based on an antibiogram. Intrathecal or intraventricular administration of antibiotics can be considered if neurosurgical access is already obtained because of disease-associated complications.
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Affiliation(s)
- Maxim Clauwaert
- Intensive Care Unit, Universitair Ziekenhuis Gent, C. Heymanslaan 10, 9000, Ghent, Belgium.
| | - Patrick Druwé
- Intensive Care Unit, Universitair Ziekenhuis Gent, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Pieter Depuydt
- Intensive Care Unit, Universitair Ziekenhuis Gent, C. Heymanslaan 10, 9000, Ghent, Belgium
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13
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Bertrand K, Jean-Pierre H, Laurens C. Pyélonéphrite à Rothia mucilaginosa six mois après transplantation rénale. Med Mal Infect 2016; 46:399-401. [DOI: 10.1016/j.medmal.2016.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 05/08/2016] [Accepted: 05/11/2016] [Indexed: 11/27/2022]
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Wang JY, Brossard J, Cellot S, Dix D, Feusner J, Johnston DL, Lewis V, Mitchell D, Portwine C, Price V, Sung L, Ethier MC, Gillmeister B. Invasive Rothia infections in children with acute myeloid leukemia: A report from the Canadian infections in AML research group. Pediatr Hematol Oncol 2016; 33:277-281. [PMID: 27315594 DOI: 10.1080/08880018.2016.1187231] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Rothia spp. (previously termed Stomatococcus) are normal flora that can cause invasive infections in immunocompromised hosts. The objective of this study was to describe infection characteristics and outcomes of Rothia spp. infections in a large cohort of children with newly diagnosed acute myeloid leukemia (AML). This retrospective chart review is a subanalysis of a larger study in which the aim was to identify factors associated with infection in pediatric patients with AML. Only sterile site infections occurring during chemotherapy were included. Among 578 children with AML, 17 (2.9%) children with at least 1 Rothia spp. infection were identified. All children were neutropenic at the time of infection. Eight (47%) had antecedent colitis or mucositis. Of the 17 infections, 16 were bacteremia and 1 was meningitis. Sepsis occurred in 4 patients, and 1 patient died due to infection. Rothia spp. infections are rare in pediatric AML but can cause significant morbidity and mortality. Future studies should describe trends in incidence and resistance patterns over time.
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Affiliation(s)
- Jane Y Wang
- a Child Health Evaluative Sciences , The Hospital for Sick Children , Toronto , Ontario , Canada.,b Faculty of Medicine , University of Toronto , St. George Campus , Ontario , Canada
| | - Josée Brossard
- c Service d'Hémato-Oncologie, Centre Hospitalier Universitaire de Sherbrooke, Hematology/Oncology , Centre Hospitalier Universitaire de Sherbrooke , Quebec , Canada
| | - Sonia Cellot
- d St. George Campus, Hematology/Oncology , Hospital Sainte-Justine , Montreal , Quebec , Canada
| | - David Dix
- e Division of Pediatric Hematology/Oncology , BC Children's Hospital , Vancouver , British Columbia , Canada
| | - Jim Feusner
- f Division of Hematology/Oncology , Children's Hospital & Research Center Oakland , Oakland , California , USA
| | - Donna L Johnston
- g Division of Hematology/Oncology , Children's Hospital of Eastern Ontario , Ottawa , Ontario , Canada
| | - Victor Lewis
- h Hematology/Oncology/Transplant Program , Alberta Children's Hospital , Calgary , Alberta , Canada
| | - David Mitchell
- i Division of Hematology/Oncology , Montreal Children's Hospital , Quebec , Canada
| | - Carol Portwine
- j Division of Haematology/Oncology , Chedoke-McMaster Hospitals , Hamilton , Ontario , Canada
| | - Victoria Price
- k Department of Pediatrics , IWK Health Centre , Halifax , Nova Scotia , Canada
| | - Lillian Sung
- a Child Health Evaluative Sciences , The Hospital for Sick Children , Toronto , Ontario , Canada.,l Division of Haematology/Oncology , The Hospital for Sick Children , Toronto , Ontario , Canada
| | - Marie-Chantal Ethier
- a Child Health Evaluative Sciences , The Hospital for Sick Children , Toronto , Ontario , Canada
| | - Biljana Gillmeister
- a Child Health Evaluative Sciences , The Hospital for Sick Children , Toronto , Ontario , Canada
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15
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Vasconcelos RM, Sanfilippo N, Paster BJ, Kerr AR, Li Y, Ramalho L, Queiroz EL, Smith B, Sonis ST, Corby PM. Host-Microbiome Cross-talk in Oral Mucositis. J Dent Res 2016; 95:725-33. [PMID: 27053118 DOI: 10.1177/0022034516641890] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Oral mucositis (OM) is among the most common, painful, and debilitating toxicities of cancer regimen-related treatment, resulting in the formation of ulcers, which are susceptible to increased colonization of microorganisms. Novel discoveries in OM have focused on understanding the host-microbial interactions, because current pathways have shown that major virulence factors from microorganisms have the potential to contribute to the development of OM and may even prolong the existence of already established ulcerations, affecting tissue healing. Additional comprehensive and disciplined clinical investigation is needed to carefully characterize the relationship between the clinical trajectory of OM, the local levels of inflammatory changes (both clinical and molecular), and the ebb and flow of the oral microbiota. Answering such questions will increase our knowledge of the mechanisms engaged by the oral immune system in response to mucositis, facilitating their translation into novel therapeutic approaches. In doing so, directed clinical strategies can be developed that specifically target those times and tissues that are most susceptible to intervention.
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Affiliation(s)
- R M Vasconcelos
- School of Medicine, New York University, New York, NY, USA College of Dentistry, New York University, New York, NY, USA Faculdade de Odontologia, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - N Sanfilippo
- School of Medicine, New York University, New York, NY, USA New York University Perlmutter Cancer Center, New York, NY, USA
| | - B J Paster
- The Forsyth Institute, Cambridge, MA, USA Department of Oral Medicine, Infection & Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - A R Kerr
- College of Dentistry, New York University, New York, NY, USA
| | - Y Li
- College of Dentistry, New York University, New York, NY, USA
| | - L Ramalho
- Faculdade de Odontologia, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - E L Queiroz
- College of Dentistry, New York University, New York, NY, USA
| | - B Smith
- School of Medicine, New York University, New York, NY, USA New York University Perlmutter Cancer Center, New York, NY, USA
| | - S T Sonis
- Biomodels, LLC, Watertown, MA, USA Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA, USA
| | - P M Corby
- School of Medicine, New York University, New York, NY, USA College of Dentistry, New York University, New York, NY, USA
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16
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Abidi MZ, Ledeboer N, Banerjee A, Hari P. Morbidity and mortality attributable to Rothia bacteremia in neutropenic and nonneutropenic patients. Diagn Microbiol Infect Dis 2016; 85:116-20. [PMID: 26906191 DOI: 10.1016/j.diagmicrobio.2016.01.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 01/06/2016] [Accepted: 01/09/2016] [Indexed: 11/25/2022]
Abstract
Rothia spp. are increasingly being recognized as emerging opportunistic pathogens associated with serious infections in immune-compromised hosts. Risk factors include neutropenia, hematologic malignancies, prosthetic devices, and intravascular catheters. We describe 29 patients at our institute from 2006 to 2014 with positive blood cultures for Rothia spp. Neutropenia was observed in 21/29 (72%) patients at the time of bacteremia, and 16/29 (61%) had leukemia. Neutropenic patients were less likely than nonneutropenic patients to have polymicrobial infection (24% versus 63%; P= 0.083) and were also more likely to have multiple positive blood cultures (76% versus 0%; P= 0.0003), indicating true infection. Sources of bacteremia included intravascular catheters, mucositis, and presumed gut translocation. A significant association was seen with steroid use (81% versus 13%; P= 0.0014) and fluoroquinolone use (86% versus 13%; P≤ 0.0001) preceding bacteremia in neutropenic patients. There was no difference between the 2 groups for admission to intensive care unit or mortality. One death was reported possibly due to Rothia infection.
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Affiliation(s)
- M Z Abidi
- Division of Infectious Disease, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - N Ledeboer
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - A Banerjee
- Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - P Hari
- Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
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Abstract
"Children are not little adults," and while this is a well-worn aphorism, it is especially true in the context of infection, where the same organism may evoke a different immune response in the pediatric central nervous system (CNS) and clinical presentation may be clouded by the lack of a good history or paucity of clinical information. The chronology and natural history of different organisms/infections will be laid out together with the preferred use of different imaging modalities. This chapter will use illustrative examples of some of the more common infections and their complications, in addition to several more rare conditions as well as mimics of childhood CNS infection. Challenges in the imaging of children, including strategies to minimize the use of radiation, are discussed. Some of the more recently voiced concerns regarding the use of anesthetic agents in children are also addressed, along with the contrast agents that are typically required for imaging. With a global increase in worldwide travel the anticipation is that pediatricians will increasingly see unusual organisms presenting with CNS infection while dealing with the ever-present risk of drug resistance with inappropriately treated common or garden infections.
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Affiliation(s)
- Jill V Hunter
- Department of Pediatric Radiology, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA.
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19
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Gevers D, Kugathasan S, Denson LA, Vázquez-Baeza Y, Van Treuren W, Ren B, Schwager E, Knights D, Song SJ, Yassour M, Morgan XC, Kostic AD, Luo C, González A, McDonald D, Haberman Y, Walters T, Baker S, Rosh J, Stephens M, Heyman M, Markowitz J, Baldassano R, Griffiths A, Sylvester F, Mack D, Kim S, Crandall W, Hyams J, Huttenhower C, Knight R, Xavier RJ. The treatment-naive microbiome in new-onset Crohn's disease. Cell Host Microbe 2014; 15:382-392. [PMID: 24629344 DOI: 10.1016/j.chom.2014.02.005] [Citation(s) in RCA: 2144] [Impact Index Per Article: 214.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 01/31/2014] [Accepted: 02/12/2014] [Indexed: 02/07/2023]
Abstract
Inflammatory bowel diseases (IBDs), including Crohn's disease (CD), are genetically linked to host pathways that implicate an underlying role for aberrant immune responses to intestinal microbiota. However, patterns of gut microbiome dysbiosis in IBD patients are inconsistent among published studies. Using samples from multiple gastrointestinal locations collected prior to treatment in new-onset cases, we studied the microbiome in the largest pediatric CD cohort to date. An axis defined by an increased abundance in bacteria which include Enterobacteriaceae, Pasteurellacaea, Veillonellaceae, and Fusobacteriaceae, and decreased abundance in Erysipelotrichales, Bacteroidales, and Clostridiales, correlates strongly with disease status. Microbiome comparison between CD patients with and without antibiotic exposure indicates that antibiotic use amplifies the microbial dysbiosis associated with CD. Comparing the microbial signatures between the ileum, the rectum, and fecal samples indicates that at this early stage of disease, assessing the rectal mucosal-associated microbiome offers unique potential for convenient and early diagnosis of CD.
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Affiliation(s)
- Dirk Gevers
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Subra Kugathasan
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Emory University, Atlanta, GA 30322, USA
| | - Lee A Denson
- Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Yoshiki Vázquez-Baeza
- Department of Computer Science, University of Colorado, Boulder, Colorado 80309, USA
| | - Will Van Treuren
- BioFrontiers Institute, University of Colorado, Boulder, Colorado 80309, USA
| | - Boyu Ren
- Department of Biostatistics, Harvard School of Public Health, Boston, MA 02115, USA
| | - Emma Schwager
- Department of Biostatistics, Harvard School of Public Health, Boston, MA 02115, USA
| | - Dan Knights
- Department of Computer Science and Engineering, University of Minnesota, Minneapolis, MN 55108, USA.,BioTechnology Institute, University of Minnesota, St. Paul, MN 55108, USA
| | - Se Jin Song
- BioFrontiers Institute, University of Colorado, Boulder, Colorado 80309, USA
| | - Moran Yassour
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Xochitl C Morgan
- Department of Biostatistics, Harvard School of Public Health, Boston, MA 02115, USA
| | | | - Chengwei Luo
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Antonio González
- BioFrontiers Institute, University of Colorado, Boulder, Colorado 80309, USA
| | - Daniel McDonald
- BioFrontiers Institute, University of Colorado, Boulder, Colorado 80309, USA
| | - Yael Haberman
- Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Thomas Walters
- Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1X8, Canada
| | - Susan Baker
- Children's Hospital of Buffalo, Buffalo, NY 14222, USA
| | - Joel Rosh
- Goryeb Children's Hospital, Morristown, NJ 07960, USA
| | | | - Melvin Heyman
- University of California, San Francisco, CA 94143, USA
| | - James Markowitz
- North Shore Long Island Jewish Medical Center, New Hyde Park, NY 11040, USA
| | | | | | | | - David Mack
- Children's Hospital of Eastern Ontario, Ottawa, ON K1H 8L1 Canada
| | - Sandra Kim
- Nationwide Children's Hospital, Columbus, OH 43228, USA
| | | | - Jeffrey Hyams
- Connecticut Children's Medical Center, Hartford, CT 06106, USA
| | - Curtis Huttenhower
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.,Department of Biostatistics, Harvard School of Public Health, Boston, MA 02115, USA
| | - Rob Knight
- BioFrontiers Institute, University of Colorado, Boulder, Colorado 80309, USA.,Department of Chemistry and Biochemistry, University of Colorado, Boulder, CO 80309, USA.,Howard Hughes Medical Institute, Boulder, CO 80309, USA
| | - Ramnik J Xavier
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.,Gastrointestinal Unit and Center for the Study of Inflammatory Bowel Disease, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.,Center for Computational and Integrative Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
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20
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Khan ST, Ahamed M, Musarrat J, Al-Khedhairy AA. Anti-biofilm and antibacterial activities of zinc oxide nanoparticles against the oral opportunistic pathogensRothia dentocariosaandRothia mucilaginosa. Eur J Oral Sci 2014; 122:397-403. [DOI: 10.1111/eos.12152] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2014] [Indexed: 01/21/2023]
Affiliation(s)
- Shams T. Khan
- Department of Zoology; College of Science; King Saud University; Riyadh Saudi Arabia
| | - Maqusood Ahamed
- King Abdullah Institute for Nanotechnology; King Saud University; Riyadh Saudi Arabia
| | - Javed Musarrat
- Department of Agricultural Microbiology; Faculty of Agricultural Sciences; Aligarh Muslim University; Aligarh India
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21
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Rothia bacteremia: a 10-year experience at Mayo Clinic, Rochester, Minnesota. J Clin Microbiol 2014; 52:3184-9. [PMID: 24951810 DOI: 10.1128/jcm.01270-14] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Rothia spp. are Gram-positive cocco-bacilli that cause a wide range of serious infections, especially in immunocompromised hosts. Risk factors for Rothia mucilaginosa (previously known as Stomatococcus mucilaginosus) bacteremia include prolonged and profound neutropenia, malignancy, and an indwelling vascular foreign body. Here, we describe 67 adults at the Mayo Clinic in Rochester, MN, from 2002 to 2012 with blood cultures positive for Rothia. Twenty-five of these patients had multiple positive blood cultures, indicating true clinical infection. Among these, 88% (22/25) were neutropenic, and 76% (19/25) had leukemia. Common sources of bacteremia were presumed gut translocation, mucositis, and catheter-related infection. One patient died with Rothia infection. Neutropenic patients were less likely to have a single positive blood culture than were nonneutropenic patients. Antimicrobial susceptibility testing was performed on 21% of the isolates. All of the tested isolates were susceptible to vancomycin and most beta-lactams; however, four of six tested isolates were resistant to oxacillin. There was no difference between the neutropenic and nonneutropenic patients in need of intensive care unit care, mortality, or attributable mortality.
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