Acinetobacter junii is a rare human pathogen associated with bacteraemia in neonates and paediatric oncology patients. We present a case of A. junii causing bacteraemia in an adult transplant patient with leukaemia. The correct identification of Acinetobacter species can highlight the clinical significance of the different species of this genus.

Listeria, Mycobacterium, or Streptococcus showed activation patterns that correspond to cross-immunity abilities. In summary, GAPDH 1-22 peptides appeared as putative candidates to include in multivalent dendritic based vaccine platforms for Listeria, Mycobacterium, or Streptococcus.

CASE REPORTA 3-year-old female was diagnosed with acute lymphoblastic leukemia (ALL), with intermediate risk (immunophenotype pre-B), when she was 23 months old. In order to start her chemotherapy, a central venous access device (subcutaneous port [SP]) was implanted in September 2009. The patient was treated with SHOP-05 (Spanish Pediatric Hematology Society-2005) protocols for high-risk ALL, and she was in complete remission after the induction phase and completed four consolidation and reinduction phases, as was mandatory. Near the end of the second year of maintenance, when she was receiving only oral mercaptopurine (50 mg/m 2 /daily) and intramuscular methotrexate (20 mg/m 2 / weekly), the patient had a fever peak 5 h after a blood collection from the SP. The patient was treated empirically with oral cefixime (8 mg/kg of body weight/daily) when the fever started because she had had a prior isolation documented as Klebsiella pneumoniae that was sensitive to cephalosporins, and since she was not neutropenic and had no other signs or symptoms of interest, outpatient management was tried first. We obtained one pediatric blood culture, which grew long, slightly curved, thin, nonbranching Gram-positive rods. Culture of blood samples after 48 h of incubation at 35°C Ϯ 2°C in 5% CO 2 on chocolate and blood agar showed small, rough, whitish colonies which did not produce aerial mycelium. The biochemical profile of the isolate obtained with the API Coryne identification system (bioMérieux, Marcy l'Etoile, France) after 48 h of incubation (2150004) corresponded to Rhodococcus spp. at a confidence level of 82.9%. By sequencing the 16S rRNA gene with the universal primers PA (5=-AGAGTTTGATCC TGGCTCAG-3=) and PLO6R (5=-GCGCTCGTTGCGGGACTTA ACC-3=) and the internal primer UP1R (5=-TTACCGCGGCTGC TGGCAC-3=), we obtained a sequence of 1,025 nucleotides that revealed maximal identity with Tsukamurella pulmonis (GenBank accession number AB564289). However, the 16S rRNA gene sequences of different Tsukamurella spp. were shown to be quite similar (99%).Two weeks later, due to the persistence of intermittent fever in spite of cefixime therapy and two subsequent blood culture sets again positive for the same bacterium (T. pulmonis), the patient was admitted to the hospital. Antibiotic susceptibility was determined after 48 to 72 h of incubation at 35°C Ϯ 2°C in ambient air by gradient diffusion (Etest; bioMérieux, Marcy l'Etoile, France) using Mueller-Hinton agar plates. Interpretations were based on CLSI breakpoints for mycobacteria, nocardiae, and other aerobic actinomycetes but not breakpoints for meropenem (MIC Ͼ 32 g/ml) and vancomycin (MIC, 2 g/ml) because they were not assessed in this document. The isolate was susceptible to amikacin (MIC, 1 g/ml), tobramycin (MIC, 4 g/ml), ciprofloxacin (MIC, 0.25 g/ml), clarithromycin (MIC, 0.125 g/ml), and linezolid (MIC, 1 g/ml) and resistant to amoxicillin-clavulanic acid (MIC Ͼ 256 g/ml) and ceftriaxone (MIC Ͼ 32 g/ml).For 3 days, she received ertapenem intravenously (15 mg/kg/12 h), ...

BackgroundTuberculosis (TB) control strategies are focused mainly on prevention, early diagnosis, compliance to treatment and contact tracing. The objectives of this study were to explore the frequency and risk factors of recent transmission of clinical isolates of Mycobacterium tuberculosis complex (MTBC) in Cantabria in Northern Spain from 2012 through 2013 and to analyze their clonal complexity for better understanding of the transmission dynamics in a moderate TB incidence setting.MethodsDNA from 85 out of 87 isolates from bacteriologically confirmed cases of MTBC infection were extracted directly from frozen stocks and genotyped using the mycobacterial interspersed repetitive units-variable number tandem repeat (MIRU-VNTR) method. The MIRU-VNTRplus database tool was used to identify clusters and lineages and to build a neighbor joining (NJ) phylogenetic tree. In addition, data were compared to the SITVIT2 database at the Pasteur Institute of Guadeloupe.ResultsThe rate of recent transmission was calculated to 24%. Clustering was associated with being Spanish-born. A high prevalence of isolates of the Euro-American lineage was found. In addition, MIRU-VNTR profiles of the studied isolates corresponded to previously found MIRU-VNTR types in other countries, including Spain, Belgium, Great Britain, USA, Croatia, South Africa and The Netherlands. Six of the strains analyzed represented clonal variants.ConclusionTransmission of MTBC is well controlled in Cantabria. The majority of TB patients were born in Spain. The population structure of MTBC in Cantabria has a low diversity of major clonal lineages with the Euro-American lineage predominating.