1
|
Zivkovic Zaric R, Canovic P, Zaric M, Vuleta M, Vuleta Nedic K, Jovanovic J, Zornic N, Nesic J, Spasic M, Jakovljevic S, Ilic M, Jovanovic D, Todorovic Z, Arsenijevic P, Sovrlic M, Milovanovic J. Antimicrobial treatment in invasive infections caused by Gordonia bronchialis: systematic review. Front Med (Lausanne) 2024; 11:1333663. [PMID: 38515988 PMCID: PMC10957228 DOI: 10.3389/fmed.2024.1333663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 02/13/2024] [Indexed: 03/23/2024] Open
Abstract
Background Corynebacterium, Nocardia, Rhodococcus, Mycobacterium, as well as Gordonia genera belongs to the genus Gordonia, Actinomycetia class. Gordonia bronchialis is a nitrate-reducing, urease-producing, non-motile, force aerobe with a rod-like figure that is known to arrangement into sessile, cord-like groups. This systematic review aimed to establish whether and what invasive infections in humans were caused by Gordonia bronchialis, and to evaluate outcomes of administered antibiotic treatment. Methods We have registered this systematic review in PROSPERO database of systematic reviews and meta-analyses with the number CRD42022369974. Results A total of 24 publications were included (22 case reports and two case series) with 28 individual cases. The oldest patients had 92 years, and the youngest patients had 13 years. Clinical signs of infection were present in six patients (21%). All isolates were susceptible to ciprofloxacin, imipenem, and amikacin. Vancomycin was the most frequently used antibiotic with nine cases followed by ciprofloxacin, ceftriaxone, and amoxicillin/clavulanic acid. Conclusion Although there are no standardized recommendations to date, successful treatment with a favorable outcome has most often been carried out with fluoroquinolones, vancomycin with or without aminoglycosides, as well as carbapenems.
Collapse
Affiliation(s)
- Radica Zivkovic Zaric
- Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Petar Canovic
- Department of Biochemistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Milan Zaric
- Department of Biochemistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Marko Vuleta
- Department of Cardiology, General Hospital Dragisa Misovic, Belgrade, Serbia
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Katarina Vuleta Nedic
- University Clinical Center Kragujevac, Kragujevac, Serbia
- Department of Nuclear Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Jovan Jovanovic
- University Clinical Center Kragujevac, Kragujevac, Serbia
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Nenad Zornic
- University Clinical Center Kragujevac, Kragujevac, Serbia
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Jelena Nesic
- University Clinical Center Kragujevac, Kragujevac, Serbia
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Marko Spasic
- University Clinical Center Kragujevac, Kragujevac, Serbia
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Stefan Jakovljevic
- University Clinical Center Kragujevac, Kragujevac, Serbia
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Milena Ilic
- Department of Pathology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Dalibor Jovanovic
- Department of Pathology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Zeljko Todorovic
- University Clinical Center Kragujevac, Kragujevac, Serbia
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Petar Arsenijevic
- University Clinical Center Kragujevac, Kragujevac, Serbia
- Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Miroslav Sovrlic
- Faculty of Medical Sciences, Center for Harm Reduction of Biological and Chemical Hazards, University of Kragujevac, Kragujevac, Serbia
| | - Jasmina Milovanovic
- Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| |
Collapse
|
2
|
Rasitha D, Devi S, Kumar N, Nair SR. Recurrent sternal wound infection caused by Gordonia bronchialis after open heart surgery. Indian J Med Microbiol 2024; 48:100562. [PMID: 38508492 DOI: 10.1016/j.ijmmb.2024.100562] [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: 06/28/2023] [Revised: 01/29/2024] [Accepted: 03/08/2024] [Indexed: 03/22/2024]
Abstract
Gordonia bronchialis is an aerobic gram-positive bacilli and also weakly acid fast. It requires a long incubation time and extensive biochemical reactions for identification. Therefore, use of broad-range polymerase chain reaction (PCR) for amplification of genes such as 16S rRNA or hsp65 followed by sequencing or advanced techniques like MALDI-TOF MS is needed for identification. Here, we present a case of persistent sternal wound infection following open heart surgery, caused by G. bronchialis in a 58 years old male, identified using MALDI-TOF MS-based system. The patient improved with oral Cefpodoxime 200 mg BD for four weeks.
Collapse
Affiliation(s)
- Desdemona Rasitha
- Department of Microbiology, Pondicherry Institute of Medical Sciences, Puducherry, India.
| | - Sheela Devi
- Department of Microbiology, Pondicherry Institute of Medical Sciences, Puducherry, India.
| | - Nirmal Kumar
- Department of Cardiothoracic and Vascular Surgery, Pondicherry Institute of Medical Sciences, Puducherry, India.
| | - Sanjay R Nair
- Department of Cardiothoracic and Vascular Surgery, Pondicherry Institute of Medical Sciences, Puducherry, India.
| |
Collapse
|
3
|
Pino-Rosa S, Medina-Pascual MJ, Carrasco G, Garrido N, Villalón P, Valiente M, Valdezate S. Focusing on Gordonia Infections: Distribution, Antimicrobial Susceptibilities and Phylogeny. Antibiotics (Basel) 2023; 12:1568. [PMID: 37998770 PMCID: PMC10668661 DOI: 10.3390/antibiotics12111568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 11/25/2023] Open
Abstract
The immunosuppression conditions and the presence of medical devices in patients favor the Gordonia infections. However, the features of this aerobic actinomycete have been little explored. Strains (n = 164) were characterized with 16S rDNA and secA1 genes to define their phylogenetic relationships, and subjected to broth microdilution to profile the antimicrobial susceptibilities of Gordonia species that caused infections in Spain during the 2005-2021 period. Four out of the eleven identified species were responsible for 86.0% of the infections: Gordonia sputi (53.0%), Gordonia bronchialis (18.3%), Gordonia terrae (8.5%) and Gordonia otitidis (6.1%). Respiratory tract infections (61.6%) and bacteremia (21.9%) were the most common infections. The secA1 gene resolved the inconclusive identification, and two major clonal lineages were observed for G. sputi and G. bronchialis. Species showed a wide antimicrobial susceptibility profile. Cefoxitin resistance varies depending on the species, reaching 94.2% for G. sputi and 36.0% for G. terrae. What is noteworthy is the minocycline resistance in G. sputi (11.5%), the clarithromycin resistance in G. bronchialis secA1 lineage II (30.0%) and the amoxicillin-clavulanate and cefepime resistance in G. terrae (21.4% and 42.8%, respectively). G. sputi and G. bronchialis stand out as the prevalent species causing infections in Spain. Resistance against cefoxitin and other antimicrobials should be considered.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Sylvia Valdezate
- Reference and Research Laboratory for Taxonomy, National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda, 28220 Madrid, Spain; (S.P.-R.); (M.J.M.-P.); (G.C.); (N.G.); (P.V.); (M.V.)
| |
Collapse
|
4
|
Lo CKF, Broderick C, Stefanovic A, Connors W, Murray M. Gordonia sputi-associated bloodstream infection in a renal transplant patient with chronic indwelling central venous catheter: a case report and literature review. Access Microbiol 2023; 5:acmi000560.v3. [PMID: 37424562 PMCID: PMC10323808 DOI: 10.1099/acmi.0.000560.v3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 06/09/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Although rare, human infections caused by Gordonia spp. have been reported, especially within the immunocompromised population and those with long-term indwelling devices. We report a case of Gordonia spp. bacteraemia in a renal transplant patient and present a literature review on microbiological identification methods of this organism. Case Presentation A 62-year-old female renal transplant recipient admitted to hospital with a 2-month history of dry cough and fevers occurring weekly when receiving electrolyte replacement infusions via a Groshong line. Over 2 weeks, blood cultures repeatedly isolated a Gram-positive bacillus solely in aerobic bottles, and this was initially reported as Rhodococcus spp. by the local microbiology laboratory. Chest computed tomography (CT) showed multiple ground-glass lung opacities suggestive of septic pulmonary emboli. As central line-associated bloodstream infection was suspected, empirical antibiotics were initiated and the Groshong line was removed. The Gram-positive bacillus was later confirmed by the reference laboratory as Gordonia sputi via 16S rRNA sequencing. Vancomycin and ciprofloxacin for a duration of 6 weeks were completed as targeted antimicrobial therapy. After treatment, the patient remained symptom-free with marked improvement on repeat CT chest imaging. Conclusion This case illustrates the challenges surrounding identification of Gordonia spp. and other aerobic actinomycetes. 16S rRNA gene sequencing may be a preferred identification method, especially when initial workup of a weakly acid-fast organism fails to make an identification or shows discrepant results using traditional diagnostic modalities.
Collapse
Affiliation(s)
- Calvin Ka-Fung Lo
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Conor Broderick
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Aleksandra Stefanovic
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Division of Medical Microbiology and Virology, Providence Health Care, St Paul’s Hospital, Vancouver, British Columbia, Canada
| | - William Connors
- Division of Infectious Diseases, University of British Columbia, Vancouver, British Columbia, Canada
| | - Melanie Murray
- Division of Infectious Diseases, University of British Columbia, Vancouver, British Columbia, Canada
- Oak Tree Clinic, BC Women’s Hospital, Vancouver, British Columbia, Canada
| |
Collapse
|
5
|
Recurrent Skin and Soft Tissue Infection following Breast Reduction Surgery Caused by Gordonia bronchialis: A Case Report. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2022; 10:e4395. [PMID: 35702356 PMCID: PMC9187191 DOI: 10.1097/gox.0000000000004395] [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: 03/03/2022] [Accepted: 05/06/2022] [Indexed: 11/29/2022]
Abstract
The expanding knowledge of the breast microbiome and its constituents necessitates understanding of how it plays into human disease. Consideration of how to identify novel organisms in breast tissue is a topic of hot debate. We report a case of a 26-year-old woman with repeat incisional break-down and sanguinopurulent drainage who required repeat incision and drainage procedures after bilateral breast reduction. Cultures revealed no growth until 4 months postoperation when matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) revealed Gordonia bronchialis, a fastidious, slow-growing organism. To date, there are fewer than 30 reported cases of G. bronchialis infections and only one with breast involvement. Our patient required 6 weeks of amoxicillin-clavulanate therapy and frequent follow-up for symptom resolution. This case demonstrates the need for additional microbiologic data in patients with delayed, persistent infections after breast surgery.
Collapse
|
6
|
Mormeneo Bayo S, Palacián Ruíz MP, Asin Samper U, Millán Lou MI, Pascual Catalán A, Villuendas Usón MC. Pacemaker-induced endocarditis by Gordonia bronchialis. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:255-257. [PMID: 35577444 DOI: 10.1016/j.eimce.2020.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/03/2020] [Indexed: 06/15/2023]
Abstract
PURPOSE Gordonia species are known to be opportunistic human pathogens causing secondary infections. We present the second case in the world of endocarditis caused by Gordonia bronchialis and a review of all the cases of endocarditis caused by Gordonia spp. METHODS The identification was performed by matrix-assisted desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing were performed to confirm the identification. Antimicrobial susceptibility was performed by MIC test Strip on Mueller-Hinton agar supplemented with 5% defibrinated sheep blood according to Clinical and Laboratory Standards Institute. RESULTS Pacemaker-induced endocarditis due to Gordonia bronchialis infection was determined in an 88-year old woman. The patient was treated with ceftriaxone and ciprofloxacin until completing 6 weeks from the pacemaker explant with a good evolution. CONCLUSION The case presented supports the pathogenic role of Gordonia bronchialis as an opportunistic pathogen and highlights the high risk of suffering infections caused by environmental bacteria.
Collapse
Affiliation(s)
- Saray Mormeneo Bayo
- Servicio de Microbiología, Hospital Universitario Miguel Servet Zaragoza, Spain.
| | | | - Uxua Asin Samper
- Servicio de Medicina Interna y Enfermedades Infecciosas, Hospital Universitario Miguel Servet Zaragoza, Spain
| | | | - Ascensión Pascual Catalán
- Servicio de Medicina Interna y Enfermedades Infecciosas, Hospital Universitario Miguel Servet Zaragoza, Spain
| | | |
Collapse
|
7
|
From NTM (Nontuberculous mycobacterium) to Gordonia bronchialis—A Diagnostic Challenge in the COPD Patient. Diagnostics (Basel) 2022; 12:diagnostics12020307. [PMID: 35204397 PMCID: PMC8871261 DOI: 10.3390/diagnostics12020307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/17/2022] [Accepted: 01/24/2022] [Indexed: 11/16/2022] Open
Abstract
In patients with chronic obstructive pulmonary disease, respiratory infections are of various aetiology, predominantly viral and bacterial. However, due to structural and immunological changes within the respiratory system, such patients are also prone to mycobacterial and other relatively rare infections. We present the 70-year old male patient with chronic obstructive pulmonary disease (COPD) and coexisting bronchial asthma, diagnosed due to cough with purulent sputum expectoration lasting over three months. The first microbiological investigation of the sputum sample revealed the growth of mycobacteria. The identification test based on protein MPT64 production indicated an organism belonging to NTM (nontuberculous mycobacterium). However, further species identification by genetic testing verified the obtained culture as not belonging to the Mycobacterium genus. Based on observed morphology, the new characterisation identified an aerobic actinomycete, possibly a Nocardia spp. The isolated strain was recultured on standard microbiological media. The growth of colonies was observed on Columbia blood agar plates and solid Löewenstein-Jensen medium. The Gram and Zhiel-Nielsen stains revealed the presence of Gram-positive acid-fast bacilli. The extraction protocol and identification were performed in two repetitions; the result was G. bronchialis, with a confidence value of 99% and 95%, respectively. The gene sequencing method was applied to confirm the species affiliation of this isolate. The resulting sequence was checked against the 16S ribosomal RNA sequences database (Bacteria and Archaea). The ten best results indicated the genus Gordonia (99.04–100%) and 100% similarity of the 16S sequenced region was demonstrated for Gordonia bronchialis. The case described indicates that the correct interpretation of microbiological test results requires the use of advanced microbiology diagnosis techniques, including molecular identification of gene sequences. From a clinical point of view, Gordonia bronchialis infection or colonization may present a mild course, with no febrile episodes and no significant patient status deterioration and thus, it may remain undiagnosed more often than expected.
Collapse
|
8
|
Nwaedozie S, Mojarrab JN, Gopinath P, Fritsche T, Nasser RM. Sternal osteomyelitis caused by Gordonia bronchialis in an immunocompetent patient following coronary artery bypass surgery. IDCases 2022; 29:e01548. [PMID: 35801008 PMCID: PMC9253898 DOI: 10.1016/j.idcr.2022.e01548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 06/22/2022] [Accepted: 06/22/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- Somto Nwaedozie
- Department of Internal Medicine, Marshfield Clinic Health System – Marshfield, Marshfield, WI 54449, USA
- Correspondence to: Department of Internal Medicine, Marshfield Clinic Health System – Marshfield, 1,000 North Oak Avenue 3K2, Marshfield, WI 54449, USA.
| | - Javad Najjar Mojarrab
- Department of Internal Medicine, Marshfield Clinic Health System – Marshfield, Marshfield, WI 54449, USA
| | - Prathima Gopinath
- Department of Internal Medicine, Marshfield Clinic Health System – Marshfield, Marshfield, WI 54449, USA
| | - Thomas Fritsche
- Department of Pathology, Marshfield Clinic Health System – Marshfield, Marshfield, WI 54449, USA
| | - Rana M. Nasser
- Department of Infectious Disease, Marshfield Clinic Health System – Marshfield, Marshfield, WI 54449, USA
| |
Collapse
|
9
|
Kang Y, Chen Y, Zhang Z, Shen H, Zhou W, Wu C. A case of peritoneal dialysis-associated peritonitis caused by Rhodococcus kroppenstedtii. BMC Infect Dis 2021; 21:565. [PMID: 34120601 PMCID: PMC8201711 DOI: 10.1186/s12879-021-06280-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 06/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rhodococcus kroppenstedtii is an aerobic, gram-positive bacterium firstly identified in the environment, which has not been reported in human-related infection. Herein, we reported the first case of peritoneal dialysis (PD)-associated peritonitis caused by R. kroppenstedtii which was identified by whole genome sequencing. CASE PRESENTATION A 69-year-old man was admitted to hospital with abdominal pain and fever. Over the last 2 years, he had been undergoing continuous ambulatory peritoneal dialysis (CAPD) due to end-stage renal disease. Clinical symptom and sign in combination with laboratory examinations supported the clinical diagnosis of PD-associated peritonitis. Thus, ceftizoxime and teicoplanin were empirically used after PD effluent was collected for bacterial culture. A gram-positive bacterium was found from the PD effluent culture, which could not be identified by either Vitek 2 Compact ANC card or matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The strain was finally confirmed to be R. kroppenstedtii by whole genome sequencing (WGS) through the average nucleotide identity (ANI) analysis. With a continuous treatment with teicoplanin and imipenem for 15 days and intraperitoneal catheter removed, the infection symptom was improved evidenced by a normal body temperature, also with white blood cell count (WBC), procalcitonin (PCT) and C-reactive protein (CRP) dropped to normal levels. Peritoneal dialysis effluent culture showed a negative result. Then, hemodialysis and arteriovenous fistula angioplasty were performed, but the patient developed a progressive blood pressure loss, accompanied by multiple organ disorder, and died on Feb 25, 2020. CONCLUSIONS To the best of our knowledge, this is the first time to report a peritoneal dialysis-associated peritonitis caused by R. kroppenstedtii which was identified by average nucleotide identity analysis based on WGS.
Collapse
Affiliation(s)
- Yi Kang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, 321# Zhongshan Road, Gulou District, Nanjing City, Jiangsu Province, 210008, P. R. China
| | - Yuxin Chen
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, 210008, P. R. China
| | - Zhifeng Zhang
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, 210008, P. R. China
| | - Han Shen
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, 210008, P. R. China
| | - Wanqing Zhou
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, 210008, P. R. China.
| | - Chao Wu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, 321# Zhongshan Road, Gulou District, Nanjing City, Jiangsu Province, 210008, P. R. China.
| |
Collapse
|
10
|
Mormeneo Bayo S, Palacián Ruíz MP, Asin Samper U, Millán Lou MI, Pascual Catalán A, Villuendas Usón MC. Pacemaker-induced endocarditis by Gordonia bronchialis. Enferm Infecc Microbiol Clin 2021; 40:S0213-005X(20)30412-2. [PMID: 33446400 DOI: 10.1016/j.eimc.2020.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/26/2020] [Accepted: 11/03/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE Gordonia species are known to be opportunistic human pathogens causing secondary infections. We present the second case in the world of endocarditis caused by Gordonia bronchialis and a review of all the cases of endocarditis caused by Gordonia spp. METHODS The identification was performed by matrix-assisted desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing were performed to confirm the identification. Antimicrobial susceptibility was performed by MIC test Strip on Mueller-Hinton agar supplemented with 5% defibrinated sheep blood according to Clinical and Laboratory Standards Institute. RESULTS Pacemaker-induced endocarditis due to Gordonia bronchialis infection was determined in an 88-year old woman. The patient was treated with ceftriaxone and ciprofloxacin until completing 6 weeks from the pacemaker explant with a good evolution. CONCLUSION The case presented supports the pathogenic role of Gordonia bronchialis as an opportunistic pathogen and highlights the high risk of suffering infections caused by environmental bacteria.
Collapse
Affiliation(s)
- Saray Mormeneo Bayo
- Servicio de Microbiología, Hospital Universitario Miguel Servet Zaragoza, Spain.
| | | | - Uxua Asin Samper
- Servicio de Medicina Interna y Enfermedades Infecciosas, Hospital Universitario Miguel Servet Zaragoza, Spain
| | | | - Ascensión Pascual Catalán
- Servicio de Medicina Interna y Enfermedades Infecciosas, Hospital Universitario Miguel Servet Zaragoza, Spain
| | | |
Collapse
|