Chronic lower extremity wound infection due to Kerstersia gyiorum in a patient with Buerger's disease: a case report

Kerstersia gyiorum isolated for the first time from two patients with neurodegenerative disease: report of two unusual cases and a review of the literature

With the development of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and 16S ribosomal RNA (rRNA) gene sequencing, increasing numbers of new microorganisms are being discovered. In this report, Kerstersia gyiorum was isolated for the first time from the sputum of two elderly patients with neurodegenerative disease, and integrated traditional Chinese and Western medicine was used for treatment. The bacteria's growth characteristics, biochemical reaction characteristics, sensitivity to antibiotics, and the patients' treatment are described, with a review of previous reports.

A case of Bordetella trematum and Kerstersia gyiorum infections in a patient with congestive dermatitis

Bordetella trematum and Kerstersia gyiorum are rare gram-negative bacilli that are not frequently detected in human infections. In this report, we describe a case of a 48-year-old man who presented to our hospital with an infected wound on his leg. Discharges from the cracks of the granulation were collected and evaluated in our microbiology laboratory. Gram staining of the specimen showed polymorphonuclear leukocytes and abundant gram-negative bacilli. Three types of colonies were isolated on blood agar and were identified as B. trematum and Alcaligenes faecalis using VITEK MS. Moreover, K. gyiorum and B. trematum were identified and confirmed via 16S ribosomal RNA (rRNA) gene sequencing. The patient successfully recovered following application of meropenem antibacterial therapy and surgical debridement. This is the first reported case of complex wound infection caused by both B. trematum and K. gyiorum. Identification of B. trematum has recently been made possible by routine bacterial identification using matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF MS). However, K. gyiorum isolation is still rare, and species identification requires 16S rRNA sequencing. Thus, this case highlighted the importance of using multiple methods, such as MALDI-TOF MS and 16S rRNA gene sequencing, for identification of rarely isolated species from clinical specimens.

Ringing bells: Morganella morganii fights for recognition

OBJECTIVES

The global increase in rare opportunistic microbial infections is alarming. The current review was undertaken to study the diversified disease spectrum, pathogenicity, and resistance patterns of Morganella morganii.

STUDY DESIGN

This study is a review of the diversified disease spectrum of M. morganii.

METHODS

The articles used in this review were all extracted from PubMed and Google Scholar, using the terms 'M. morganii', 'prevalence', 'virulence factors', 'infections', 'resistance pattern', and 'genomics'. This review includes original articles, reviews, and case reports focusing on M. morganii, hospital-based prevalence studies, and studies on resistance in M. morganii published between 1906 and April 2019. Articles published in English, French, Spanish, and Chinese were reviewed.

RESULTS

M. morganii has had a significant impact as a clinical pathogen and the pace of its occurrence and the increase in its resistance rates puts this bacterium on the path to becoming the next 'superbug'. These developments not only impact M. morganii, but as a result of gene and plasmid transfer evolution, other clinical pathogens have been able to acquire their diverse intrinsic and acquired virulence genes. Its vast host range raises concerns around its capacity to generate new infections through novel symbiotic relationships.

CONCLUSIONS

M. morganii opportunism is being increasingly reported across the globe. This bacterium is accumulating intrinsic and acquired multidrug resistance genes, resulting in increased morbidity and mortality rates for M. morganii infections and complicating its treatment. M. morganii should be recognized as a clinically significant pathogen, and clinicians should place this microorganism in the list of causative possibilities during patient care. It is important for both the infection control activities in hospitals and in public health sector.

Genomic characterization of Kerstersia gyiorum SWMUKG01, an isolate from a patient with respiratory infection in China

BACKGROUND

The Gram-negative bacterium Kerstersia gyiorum, a potential etiological agent of clinical infections, was isolated from several human patients presenting clinical symptoms. Its significance as a possible pathogen has been previously overlooked as no disease has thus far been definitively associated with this bacterium. To better understand how the organism contributes to the infectious disease, we determined the complete genomic sequence of K. gyiorum SWMUKG01, the first clinical isolate from southwest China.

RESULTS

The genomic data obtained displayed a single circular chromosome of 3, 945, 801 base pairs in length, which contains 3, 441 protein-coding genes, 55 tRNA genes and 9 rRNA genes. Analysis on the full spectrum of protein coding genes for cellular structures, two-component regulatory systems and iron uptake pathways that may be important for the success of the bacterial survival, colonization and establishment in the host conferred new insights into the virulence characteristics of K. gyiorum. Phylogenomic comparisons with Alcaligenaceae species indicated that K. gyiorum SWMUKG01 had a close evolutionary relationships with Alcaligenes aquatilis and Alcaligenes faecalis.

CONCLUSIONS

The comprehensive analysis presented in this work determinates for the first time a complete genome sequence of K. gyiorum, which is expected to provide useful information for subsequent studies on pathogenesis of this species.