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Walsh L, Clark SA, Derrick JP, Borrow R. Beyond the usual suspects: Reviewing infections caused by typically-commensal Neisseria species. J Infect 2023; 87:479-489. [PMID: 37797844 DOI: 10.1016/j.jinf.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/27/2023] [Accepted: 09/22/2023] [Indexed: 10/07/2023]
Abstract
OBJECTIVE Few data outside of individual case reports are available on non-meningococcal, non-gonococcal species of Neisseria as causative agents of invasive disease. This review collates disease, organism and patient information from case reports on the topic. METHODS A literature search was performed examining articles describing diseases caused by non-meningococcal and non-gonococcal Neisseria. FINDINGS Neisseria present as opportunistic pathogens causing a wide variety of diseases including serious presentations, endocarditis being the most common condition described and N. mucosa the most commonly presenting pathogen overall. Disease may occur in otherwise healthy patients, although risk factors for infection include recent surgery, an immunocompromised state, poor oral health, and intravenous drug use. CONCLUSIONS Commensal Neisseria infections are rare but can present serious invasive diseases. Further research is required to determine why some species cause disease more than others or why some are inclined towards particular manifestations.
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Affiliation(s)
- Lloyd Walsh
- Meningococcal Reference Unit, UK Health Security Agency, Manchester M13 9WL, United Kingdom.
| | - Stephen A Clark
- Meningococcal Reference Unit, UK Health Security Agency, Manchester M13 9WL, United Kingdom
| | - Jeremy P Derrick
- School of Biological Sciences, Faculty of Biology, Medicine, and Health, University of Manchester, Manchester M13 9PL, United Kingdom
| | - Ray Borrow
- Meningococcal Reference Unit, UK Health Security Agency, Manchester M13 9WL, United Kingdom
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Bernstein ZS, Vaillant JJ, Michelena HI, Pislaru SV, DeSimone DC. Recurrent Neisseria cinerea bacteremia secondary to cardiovascular implantable electronic device infection. IDCases 2023; 32:e01745. [PMID: 36949888 PMCID: PMC10025977 DOI: 10.1016/j.idcr.2023.e01745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 03/11/2023] Open
Abstract
We present the first case of cardiac implantable electronic device (CIED) infection due to Neisseria cinerea in a 64-year-old woman from Panama. She had a history of splenectomy, aortic valve stenosis requiring transcatheter aortic valve replacement (TAVR), and permanent pacemaker placement. She presented with relapsing N. cinerea bacteremia over a 3-month period. Transesophageal echocardiography revealed a lead vegetation in the superior vena cava. She was successfully treated with pacemaker removal and 2 weeks of IV antibiotic therapy. N. cinerea is an aerobic gram-negative commensal diplococcus typically found in the human nasopharynx. Infection in humans is rare with few case reports in the literature.
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Affiliation(s)
- Zachary S. Bernstein
- Center for Multiple Myeloma, Massachusetts General Hospital Cancer Center, Boston, MA 02114, USA
| | - James J. Vaillant
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
- Corresponding author.
| | - Hector I. Michelena
- Divisions of Structural Heart Disease and Cardiovascular Ultrasound, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Sorin V. Pislaru
- Divisions of Structural Heart Disease and Cardiovascular Ultrasound, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Daniel C. DeSimone
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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Patti R, Gupta SS, Bhardwaj S, Jha P, Ghatak A, Kupfer Y, Seneviratne C. Neisseria cinerea in a Post-splenectomy Patient: A Rare Potentially Fatal Bacteremia. Cureus 2018; 10:e3007. [PMID: 30250769 PMCID: PMC6145752 DOI: 10.7759/cureus.3007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Neisseria cinerea is a commensal which usually resides in the human respiratory tract. Very rarely, the organism finds its way into the bloodstream causing severe bacteremia. So far, very few cases of Neisseria bacteremia have been reported. We report a case of a 78-year-old male, post-splenectomy, who presented with high fever, cough and shortness of breath. The patient was initially managed for septic shock with fluid resuscitations, vasopressors and broad-spectrum antibiotics. Later, the blood cultures grew gram-negative coccobacilli, Neisseria cinerea. The patient was successfully treated with intravenous ceftriaxone. This is the first case ever of Neisseria cinerea bacteremia in a post-splenectomy patient and ninth case overall. This case illustrates that the physicians should maintain heightened awareness for Neisseria cinerea bacteremia in post-splenectomy patients.
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Affiliation(s)
| | | | | | - Prameeta Jha
- Internal Medicine, Maimonides Medical Center, Brooklyn, USA
| | - Arindam Ghatak
- Department of Critical Care Medicine, Maimonides Medical Center, Brooklyn, USA
| | - Yizhak Kupfer
- Critical Care, Maimonides Medical Center, Brooklyn, USA
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Neisseria cinerea bacteremia in a patient receiving eculizumab: a case report. Infection 2017; 46:271-274. [DOI: 10.1007/s15010-017-1090-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Accepted: 10/23/2017] [Indexed: 10/18/2022]
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Meningitis and Bacteremia Due to Neisseria cinerea following a Percutaneous Rhizotomy of the Trigeminal Ganglion. J Clin Microbiol 2015; 54:233-5. [PMID: 26511743 DOI: 10.1128/jcm.02041-15] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 10/26/2015] [Indexed: 11/20/2022] Open
Abstract
Neisseria cinerea is a human commensal. The first known case of meningitis and bacteremia due to Neisseria cinerea following percutaneous glycerol instillation of the trigeminal ganglion is reported. Conventional phenotypic methods and complete 16S RNA gene sequencing accurately identified the pathogen. Difficulties in differentiation from pathogenic neisseriae are discussed.
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Liu G, Tang CM, Exley RM. Non-pathogenic Neisseria: members of an abundant, multi-habitat, diverse genus. MICROBIOLOGY-SGM 2015; 161:1297-1312. [PMID: 25814039 DOI: 10.1099/mic.0.000086] [Citation(s) in RCA: 140] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The genus Neisseria contains the important pathogens Neisseria meningitidis and Neisseria gonorrhoeae. These Gram-negative coccoid bacteria are generally thought to be restricted to humans and inhabit mucosal surfaces in the upper respiratory and genito-urinary tracts. While the meningococcus and gonococcus have been widely studied, far less attention has been paid to other Neisseria species. Here we review current knowledge of the distribution of commensal Neisseria in humans and other hosts. Analysis of the microbiome has revealed that Neisseria is an abundant member of the oropharyngeal flora, and we review its potential impact on health and disease. Neisseria also exhibit remarkable diversity, exhibiting both coccoid and rod-shaped morphologies, as well as environmental strains which are capable of degrading complex organic molecules.
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Affiliation(s)
- Guangyu Liu
- Sir William Dunn School of Pathology, University of Oxford, South Parks Road, Oxford OX1 3RE, UK
| | - Christoph M Tang
- Sir William Dunn School of Pathology, University of Oxford, South Parks Road, Oxford OX1 3RE, UK
| | - Rachel M Exley
- Sir William Dunn School of Pathology, University of Oxford, South Parks Road, Oxford OX1 3RE, UK
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Yoo YP, Kang KW, Yoon HS, Yoo S, Lee MS. Infective endocarditis caused by Neisseria elongata on a native tricuspid valve and confirmed by DNA sequencing. Tex Heart Inst J 2014; 41:227-30. [PMID: 24808790 DOI: 10.14503/thij-13-3153] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Neisseria elongata, a common oral bacterium, has been recognized as a cause of infections such as infective endocarditis, septicemia, and osteomyelitis. Neisseria-induced infective endocarditis, although infrequently reported, typically arises after dental procedures. Without antibiotic therapy, its complications can be severe. We report the case of a 27-year-old man who presented with fever, severe dyspnea, and a leg abscess from cellulitis. An echocardiogram showed a vegetation-like echogenic structure on the septal leaflet of the patient's native tricuspid valve, and an insignificant Gerbode defect. Three blood cultures grew gram-negative, antibiotic-susceptible coccobacilli that were confirmed to be N. elongata. Subsequent DNA sequencing conclusively isolated N. elongata subsp nitroreducens as the organism responsible for the infective endocarditis. The patient recovered after 21 days of antibiotic therapy. In addition to the patient's unusual case, we discuss the nature and isolation of N. elongata and its subspecies.
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Affiliation(s)
- Yeon Pyo Yoo
- Division of Cardiology (Drs. Kang, Y.P. Yoo, and Yoon), Eulji University Hospital; and Division of Microbiology and Immunology (Drs. Lee and S. Yoo), Eulji University School of Medicine, Daejeon 302-799, Republic of Korea
| | - Ki-Woon Kang
- Division of Cardiology (Drs. Kang, Y.P. Yoo, and Yoon), Eulji University Hospital; and Division of Microbiology and Immunology (Drs. Lee and S. Yoo), Eulji University School of Medicine, Daejeon 302-799, Republic of Korea
| | - Hyeon Soo Yoon
- Division of Cardiology (Drs. Kang, Y.P. Yoo, and Yoon), Eulji University Hospital; and Division of Microbiology and Immunology (Drs. Lee and S. Yoo), Eulji University School of Medicine, Daejeon 302-799, Republic of Korea
| | - Seungmin Yoo
- Division of Cardiology (Drs. Kang, Y.P. Yoo, and Yoon), Eulji University Hospital; and Division of Microbiology and Immunology (Drs. Lee and S. Yoo), Eulji University School of Medicine, Daejeon 302-799, Republic of Korea
| | - Myung-Shin Lee
- Division of Cardiology (Drs. Kang, Y.P. Yoo, and Yoon), Eulji University Hospital; and Division of Microbiology and Immunology (Drs. Lee and S. Yoo), Eulji University School of Medicine, Daejeon 302-799, Republic of Korea
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Michaux-Charachon S, Lavigne JP, Le Flèche A, Bouziges N, Sotto A, Grimont PAD. Endocarditis due to a new rod-shaped Neisseria sp. J Clin Microbiol 2005; 43:886-9. [PMID: 15695696 PMCID: PMC548086 DOI: 10.1128/jcm.43.2.886-889.2005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report the first case of pacemaker endocarditis due to a new rod-shaped Neisseria sp. isolated from blood culture. On the basis of rrs sequencing, the isolate was found to be most closely related to an uncultured organism from human subgingival plaque and was identified as Neisseria sp. group AK105. A cure was achieved after a combination of surgical and antibiotic treatment. Oral flora-induced pacemaker endocarditis is a rare condition that reinforces the need for good oral hygiene as an important preventive measure.
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Affiliation(s)
- Sylvie Michaux-Charachon
- Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Nîmes, Groupe Hospitalo-Universitaire Caremeau, Place du Professeur Robert Debré, 30029 Nîmes Cedex 9, France
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