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Ng J, Downton T, Davidson N, Marangou J. Corynebacterium diphtheriae-infective endocarditis in a patient with an atrial septal defect closure device. BMJ Case Rep 2019; 12:12/5/e229478. [PMID: 31076496 DOI: 10.1136/bcr-2019-229478] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
An 18-year-old woman presented to our institution with fever, bilateral flank pain, headache and photophobia. She had a previous atrial septal defect (ASD) closure device inserted at the age of 9 years. Blood cultures on admission were positive for Corynebacterium diphtheriae, and transoesophageal echocardiogram (TOE) revealed an echodensity associated with the ASD closure device, most consistent with a vegetation. She was treated for infective endocarditis with 6 weeks of intravenous benzylpenicillin, and follow-up TOE showed resolution of the echodensity. To our knowledge, no cases of C. diphtheriaeendocarditis of an ASD closure device have previously been reported.
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Affiliation(s)
- Jacinta Ng
- Department of General Medicine, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
| | - Teesha Downton
- Department of General Medicine, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
| | - Natalie Davidson
- Department of Infectious Disease, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
| | - James Marangou
- Department of Cardiology, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
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Santos AS, Ramos RT, Silva A, Hirata R, Mattos-Guaraldi AL, Meyer R, Azevedo V, Felicori L, Pacheco LGC. Searching whole genome sequences for biochemical identification features of emerging and reemerging pathogenic Corynebacterium species. Funct Integr Genomics 2018; 18:593-610. [PMID: 29752561 DOI: 10.1007/s10142-018-0610-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 03/28/2018] [Accepted: 04/16/2018] [Indexed: 12/24/2022]
Abstract
Biochemical tests are traditionally used for bacterial identification at the species level in clinical microbiology laboratories. While biochemical profiles are generally efficient for the identification of the most important corynebacterial pathogen Corynebacterium diphtheriae, their ability to differentiate between biovars of this bacterium is still controversial. Besides, the unambiguous identification of emerging human pathogenic species of the genus Corynebacterium may be hampered by highly variable biochemical profiles commonly reported for these species, including Corynebacterium striatum, Corynebacterium amycolatum, Corynebacterium minutissimum, and Corynebacterium xerosis. In order to identify the genomic basis contributing for the biochemical variabilities observed in phenotypic identification methods of these bacteria, we combined a comprehensive literature review with a bioinformatics approach based on reconstruction of six specific biochemical reactions/pathways in 33 recently released whole genome sequences. We used data retrieved from curated databases (MetaCyc, PathoSystems Resource Integration Center (PATRIC), The SEED, TransportDB, UniProtKB) associated with homology searches by BLAST and profile Hidden Markov Models (HMMs) to detect enzymes participating in the various pathways and performed ab initio protein structure modeling and molecular docking to confirm specific results. We found a differential distribution among the various strains of genes that code for some important enzymes, such as beta-phosphoglucomutase and fructokinase, and also for individual components of carbohydrate transport systems, including the fructose-specific phosphoenolpyruvate-dependent sugar phosphotransferase (PTS) and the ribose-specific ATP-binging cassette (ABC) transporter. Horizontal gene transfer plays a role in the biochemical variability of the isolates, as some genes needed for sucrose fermentation were seen to be present in genomic islands. Noteworthy, using profile HMMs, we identified an enzyme with putative alpha-1,6-glycosidase activity only in some specific strains of C. diphtheriae and this may aid to understanding of the differential abilities to utilize glycogen and starch between the biovars.
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Affiliation(s)
- André S Santos
- Bioinformatics Post-Graduate Program, Institute of Biological Sciences, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Institute of Health Sciences, Federal University of Bahia (UFBA), Salvador, BA, Brazil
| | - Rommel T Ramos
- Institute of Biological Sciences, Federal University of Pará (UFPA), Belém, PA, Brazil
| | - Artur Silva
- Institute of Biological Sciences, Federal University of Pará (UFPA), Belém, PA, Brazil
| | - Raphael Hirata
- Faculty of Medical Sciences, Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil
| | - Ana L Mattos-Guaraldi
- Faculty of Medical Sciences, Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil
| | - Roberto Meyer
- Institute of Health Sciences, Federal University of Bahia (UFBA), Salvador, BA, Brazil
| | - Vasco Azevedo
- Bioinformatics Post-Graduate Program, Institute of Biological Sciences, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Liza Felicori
- Bioinformatics Post-Graduate Program, Institute of Biological Sciences, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Luis G C Pacheco
- Institute of Health Sciences, Federal University of Bahia (UFBA), Salvador, BA, Brazil.
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Rajamani Sekar S, Veeraraghavan B, Anandan S, Devanga Ragupathi N, Sangal L, Joshi S. Strengthening the laboratory diagnosis of pathogenicCorynebacteriumspecies in the Vaccine era. Lett Appl Microbiol 2017; 65:354-365. [DOI: 10.1111/lam.12781] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 07/06/2017] [Accepted: 07/20/2017] [Indexed: 01/06/2023]
Affiliation(s)
- S.K. Rajamani Sekar
- Department of Clinical Microbiology; Christian Medical College; Vellore India
| | - B. Veeraraghavan
- Department of Clinical Microbiology; Christian Medical College; Vellore India
| | - S. Anandan
- Department of Clinical Microbiology; Christian Medical College; Vellore India
| | | | - L. Sangal
- World Health Organization (WHO) Country Office; New Delhi India
| | - S. Joshi
- World Health Organization (WHO) Country Office; New Delhi India
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