Vertebral osteomyelitis due to Roseomonas species: case report and review of the evaluation of vertebral osteomyelitis

Septic arthritis and osteomyelitis due to Roseomonas; Case report and review of soft tissue, joint and bone infection

Roseomonas gilardii rarely causes infection in humans. We report that a patient with underlying rheumatoid arthritis and diabetes developed wrist septic arthritis and osteomyelitis due to Roseomonas after steroid joint injection. After antibiotic and surgical treatment, the condition of the patient improved. We reviewed previously reported cases of soft tissue, joint and bone infection related to Roseomonas to understand the characteristics of joint and bone infection of Roseomonas.

Phylotaxogenomics for the Reappraisal of the Genus Roseomonas With the Creation of Six New Genera

The genus Roseomonas is a significant group of bacteria which is invariably of great clinical and ecological importance. Previous studies have shown that the genus Roseomonas is polyphyletic in nature. Our present study focused on generating a lucid understanding of the phylogenetic framework for the re-evaluation and reclassification of the genus Roseomonas. Phylogenetic studies based on the 16S rRNA gene and 92 concatenated genes suggested that the genus is heterogeneous, forming seven major groups. Existing Roseomonas species were subjected to an array of genomic, phenotypic, and chemotaxonomic analyses in order to resolve the heterogeneity. Genomic similarity indices (dDDH and ANI) indicated that the members were well-defined at the species level. The Percentage of Conserved Proteins (POCP) and the average Amino Acid Identity (AAI) values between the groups of the genus Roseomonas and other interspersing members of the family Acetobacteraceae were below 65 and 70%, respectively. The pan-genome evaluation depicted that the pan-genome was an open type and the members shared 958 core genes. This claim of reclassification was equally supported by the phenotypic and chemotaxonomic differences between the groups. Thus, in this study, we propose to re-evaluate and reclassify the genus Roseomonas and propose six novel genera as Pararoseomonas gen. nov., Falsiroseomonas gen. nov., Paeniroseomonas gen. nov., Plastoroseomonas gen. nov., Neoroseomonas gen. nov., and Pseudoroseomonas gen. nov.

Roseomonas species infections in humans: a systematic review

Roseomonas species have been recognized to cause infections in immunocompromised individuals. The purpose of this study was to systemically review all published cases of Roseomonas infections in humans and describe the epidemiology, microbiology, antimicrobial susceptibility, treatment and outcomes of these infections in humans. We performed a systematic review of PubMed (through 20th Octrober 2019) for studies providing epidemiological, clinical, microbiological as well as treatment data and outcomes of Roseomonas species infections. A total of 37 studies, containing data of 99 patients, were included in the analysis. The most common Roseomonas infections were those of the bloodstream in 74.7% (74 patients), musculoskeletal infections in 8.1% (8 patients), skin and soft tissue infections (SSTIs) and peritoneal dialysis-associated peritonitis in 6.1% (6 patients) each. Epidemiology of these infections differed, with bacteremias being more prevalent in patients with malignancy and central venous lines, musculoskeletal infections being more prevalent after orthopedic surgery, and SSTIs occurring without any reported underlying cause. Resistance to beta-lactams was very high with penicillin, piperacillin/tazobactam resistance and cephalosporin resistance at 96.6%, 90.7% and 77.8% respectively, while quinolone resistance was 9.1%. Quinolones, carbapenems and cephalosporins are the most common agents used for treatment, irrespectively of the infection site. Overall mortality was 3% (3 patients), with the mortality attributed to Roseomonas being at 1% (1 patient).

Mycobacteriumabscessus-associated vertebral osteomyelitis in an immunocompetent patient: a rare case report and literature review

Introduction

Vertebral osteomyelitis (VO) is an uncommon infection with Staphylococcus aureus as the most commonly implicated organism. VO caused by nontuberculous mycobacteria (NTM) such as Mycobacteriumabscessus (M. abscesscus) is exceedingly rare with only eight cases reported in literature.

Case presentation

We report a rare case of an 82-year-old male with a remote history of trauma who was diagnosed with NTM vertebral osteomyelitis. The patient initially underwent a vertebroplasty of T12 and kyphoplasty of L1 for pathologic compression fractures. Subsequent cultures revealed M. abscessus. The patient further underwent an anterior T12-L2 corpectomy and debridement with instrumented fusion, as well as a posterior T9-L4 instrumentation and fusion. He received multi-agent antibiotic therapy; however, was ultimately unable to tolerate the aggressive treatment regimen and his prolonged postoperative course.

Discussion

Nontuberculous mycobacteria vertebral osteomyelitis is exceedingly rare. NTM vertebral osteomyelitis is challenging to treat. Surgical management plays a limited role in early VO, but is the mainstay treatment in chronic VO. Early recognition of the condition and shared patient management with multidisciplinary teams is key to successfully treating cases of NTM VO.

Infectious Spondylitis with Bacteremia Caused by Roseomonas mucosa in an Immunocompetent Patient

Roseomonas are a gram-negative bacteria species that have been isolated from environmental sources. Human Roseomonas infections typically occur in immunocompromised patients, most commonly as catheter-related bloodstream infections. However, Roseomonas infections are rarely reported in immunocompetent hosts. We report what we believe to be the first case in Korea of infectious spondylitis with bacteremia due to Roseomonas mucosa in an immunocompetent patient who had undergone vertebroplasty for compression fractures of his thoracic and lumbar spine.

RoseomonasInfection Associated With a Left Ventricular Assist Device

Roseomonasspecies have been increasingly noted as causes of human infection. We present what we believe is the first case of left ventricular assist device (LVAD) infection secondary toRoseomonas. The clinical characteristics ofRoseomonasinfection and the pertinent features of LVAD infection are reviewed.

A Case of Pericarditis Due to Roseomonas Gilardii in a Patient with Angiosarcoma of the Pericardium

Roseomonas gilardii is a Gram-negative slow growing coccobacillus that has been recognized as an opportunistic pathogen which can lead to infections, especially in immunocompromised and chronically ill patients. The organism is generally susceptible to carbapenems and aminoglycosides, but resistant to most of the cephalosporins. We report what we believe is the first case of a 72-year-old oncologic woman who developed a pericarditis caused by R. gilardii in Italy.

Roseomonas mucosa isolated from bloodstream of pediatric patient

We report a case of catheter-related bacteremia associated with Roseomonas mucosa isolated from an immunocompromised pediatric patient with a history of multiple episodes of urinary tract infection and bacteremia.

Septic arthritis due to Roseomonas gilardii in an immunocompetent adolescent

The genus Roseomonas comprises groups of slow-growing, Gram-negative coccobacilli, which only infrequently cause infection in humans. When identified, they are associated with immunocompromised adults, often causing bacteraemia. Due to their rarity, members of this genus can be overlooked or misidentified using automated laboratory identification systems. We report on an immunocompetent adolescent patient who developed septic arthritis due to Roseomonas gilardii following surgery for a sports injury. The isolate was initially misidentified as Bordetella bronchiseptica using the Vitek 2 system, but confirmed as R. gilardii based on 16S rRNA gene sequencing. To the best of our knowledge, this is the first case of a healthy paediatric patient with septic arthritis due to R. gilardii.

Chronic postoperative Roseomonas endophthalmitis

We report one case with chronic postoperative endophthalmitis caused by Roseomonas species. Roseomonas spp. induced chronic endophthalmitis, which might result in misdiagnosis and delayed treatment and causes ocular damage and severe visual loss. This report is the first one related to a case with postoperative endophthalmitis secondary to Roseomonas infection.

Central line-related bacteraemia due to Roseomonas mucosa in a neutropenic patient with acute myeloid leukaemia in Piraeus, Greece

A case of central venous catheter-related bacteraemia due to Roseomonas mucosa in a neutropenic patient with acute myelogenous leukaemia is reported. The patient was successfully treated with amikacin and piperacillin-tazobactam. The clinical isolate was identified as R. mucosa by 16S rRNA gene sequencing.

Catheter-related bacteremia due to Roseomonas species in pediatric hematology/oncology patients

Roseomonas is a newly described genus of pink-pigmented, gram-negative bacteria. Human infections caused by Roseomonas species are very rare. We report two cases of central venous catheter-related bacteremia associated with Roseomonas species (one case with R. gilardii and one with R. fauriae), and review the clinical spectrum of previously reported cases in the literature. Clinicals should be aware that Roseomonas species may cause serious infections in children.

Clinical significance of Roseomonas species isolated from catheter and blood samples: analysis of 36 cases in patients with cancer

This report analyzes 36 cases of bacteremia or catheter-related infection caused by Roseomonas species, a group of pink, slimy, waterborne, gram-negative coccobacilli. The causative species included the newly described Roseomonas mucosa (22 cases [61%]) and Roseomonas gilardii subspecies rosea (8 cases [22%]) and known species R. gilardii subspecies gilardii (5 cases [14%]) and Roseomonas genomospecies 4 (1 case [3%]). Twenty-nine (81%) of the cases were symptomatic, with fever being the most common symptom (in 27 [75%] of the cases). Twenty (56%) of the infections were monomicrobic. Six cases (17%) involved persistent catheter colonization, and 5 of these cases required removal of the catheter to clear the infection. All infections resolved, most with empirical antibiotic treatment. A summary of the antibiotic susceptibility pattern of these strains and other reported series show that Roseomonas species are consistently susceptible to amikacin and imipenem and frequently susceptible to ciprofloxacin and ticarcillin, but essentially nonsusceptible to ceftazidime and cefepime. This result may guide future therapy for infections due to Roseomonas species.

Roseomonas gilardii infection: case report and review

Roseomonas gilardii is a bacterium that has been indicated as a rare cause of human infections. The case of a patient presenting with cellulitis and bacteremia secondary to R. gilardii is described together with the clinical characteristics of infection with this organism obtained from a review of cases previously reported.

Peritonitis due to Roseomonas fauriae in a patient undergoing continuous ambulatory peritoneal dialysis

Roseomonas is a newly described genus of pink-pigmented, nonfermentative, gram-negative bacteria that have been recognized as a cause of human infections. Roseomonas fauriae is a species rarely isolated from clinical specimens. We report the first known case of peritonitis caused by R. fauriae in a patient receiving continuous ambulatory peritoneal dialysis.