Six hundred ninety nonduplicate isolates of Acinetobacter species were identified using a combination of detection of bla OXA-51-like and rpoB sequence cluster analysis. Although most isolates were identified as A. baumannii (78%), significant numbers of other species, particularly A. lwoffii/genomic species 9 (8.8%), A. ursingii (4%), genomic species 3 (1.7%), and A. johnsonii (1.7%), were received, often associated with bacteremias.

No abstract

We report the isolation and characterization of a hitherto unknown gram-negative, rod-shaped Neisseria-like organism from an infected wound resulting from a bite from a kinkajou. Based on both phenotypic and phylogenetic evidence, it is proposed that the unknown organism be classified as a new species, Kingella potus sp. nov.Animal bites represent a significant source of wound infections in humans. Most commonly the animals involved are cats and dogs, and a variety of gram-negative bacteria from these wound infections have been described (1,3,17,19,20). In this article we report a novel, gram-negative-staining Neisseria-like organism isolated from a wound infection caused by the bite of a kinkajou, an arboreal mammal found in the rain forests of Central and South America. Based on the phenotypic characteristics of the novel organism and the results of comparative 16S rRNA gene sequencing, we describe a hitherto unknown Kingella species, Kingella potus sp. nov.A previously healthy 53-year-old female zookeeper was referred to hospital with an infected wound on her right forearm. Three days earlier she had sustained a bite to the area from a kinkajou (Potus flavus). She was allergic to penicillin but otherwise had no history of note. The wound was cleaned following the bite, and she had been prescribed oral erythromycin. At presentation, she complained of pain over the anterior aspect of the right wrist and palm. She was apyrexial, her C-reactive protein level was 66.5 mg/liter, and her white blood cell count was 10.6 ϫ 10 9 with 7.41 ϫ 10 9 neutrophils. There were three puncture wounds noted on the volar surface of the right wrist surrounded by a 5-by 5-cm area of erythema and swelling. Pus was exuding from the bite, and she had tenderness over the wound and carpal tunnel. Infection of the flexor tendons and deep spaces of the wrist was suspected and urgent exploration undertaken. At operation, the sinuses extending from the bite wounds were excised and extended. There was a collection of pus deep into the fascia, which was sampled for culture. The wound was debrided and washed out. The tendon of flexor carpi radialis was frayed, and the belly of flexor pollicis longus was traumatized. Exploration of the carpal tunnel revealed thickened synovium but no pus. The flexor tendon sheaths were explored and washed out. She was treated with clarithromycin, ciprofloxacin, and metronidazole for 14 days, by which time the wound had healed. Culture of the pus, debrided tissue, and a swab from a tendon sheath yielded an alphahemolytic streptococcus, mixed anaerobic bacteria, and heavy growth of a gram-negative, rod-shaped organism.The dominant gram-negative-staining isolate was recovered and grown on chocolatized Columbia blood agar base (Oxoid) supplemented with 5% horse blood. Plates were incubated at 37°C under an aerobic atmosphere with 5% added CO 2 . The strain, designated 3/SID/1128 T , has been deposited in the National Collection of Type Cultures and the Culture Collection of the University of Göteborg under accession...

Cellulosimicrobium funkei is a rare, opportunistic pathogen. We describe a case of bacteremia and possibly prosthetic valve endocarditis by this organism in a nonimmunocompromised patient. Useful phenotypic tests for differentiating C. funkei from Cellulosimicrobium cellulans and Cellulosimicrobium terreum include motility, raffinose fermentation, glycogen, D-xylose, and methyl-␣-D-glucopyranoside assimilation, and growth at 35°C. CASE REPORTClinical aspects. An 81-year-old male presented to the Casualty Department with a 2-day history of back pain, acute confusion, and fever. He had undergone a Medtronic Mosaic tissue aortic valve replacement for aortic stenosis 7 months before. On examination, he had a temperature of 39°C and looked very unwell. He had no obvious focus of infection, and systemic examination was normal. The patient had two prior admissions to the hospital in the 7 months following his operation. The first was a month after his surgery, when he was admitted to the general intensive care unit with severe pneumonia and pseudomembranous colitis. All five sets of blood cultures taken during this admission were negative, and a transthoracic echocardiogram was reported as normal. Two months after this discharge, he was readmitted and treated for presumed Micrococcus luteus prosthetic valve endocarditis (PVE) with 6 weeks of intravenous flucloxacillin and 2 weeks of gentamicin. Though a transesophageal echocardiogram at the time did not show any vegetation, 2 of 3 blood culture sets grew Micrococcus luteus. During that admission, he also developed a peripherally inserted central catheter (PICC) line infection with Bacillus cereus, which was treated by line removal.One set of blood cultures was taken before patient therapy of intravenous amoxicillin-clavulanic acid at 1.2 g three times a day (TDS) commenced. After 24 h of incubation, the aerobic bottle in the blood culture set grew Gram-positive rods. Since the patient was improving clinically and a subsequent repeat blood culture was negative, it was presumed that the organism was a skin contaminant. No further identification was carried out, and the isolate was discarded. A transthoracic echocardiogram found no vegetations on the heart valves. No evidence of infection on a chest radiograph, abdominal ultrasound examination, computed tomography (CT) of the brain, magnetic resonance imaging (MRI) of the spine, or a bone scan was found. The patient received 10 days of antibiotics, during which time significant clinical improvement was noted, although his white cell count and C-reactive protein (CRP) level remained persistently elevated.Eighteen days later, the patient developed a fever with an increasing white cell count and CRP level. Three sets of blood cultures were taken. The next day, all six bottles were positive for a Gram-positive rod. Empirical treatment for presumed prosthetic valve endocarditis was started, with intravenous vancomycin at 1 g daily and gentamicin at 80 mg twice a day (BID). An urgent transesophageal echocardiogram confirmed the...

A case is reported of prosthetic valve endocarditis due to Neisseria elongata subsp. elongata in a patient with Klinefelter's syndrome. This is believed to be only the third case of endocarditis reported due to this subspecies. N. elongata is difficult to identify, and is morphologically and biochemically similar to Kingella spp. Sequencing of the 16S rRNA gene is useful for identification. The patient was successfully treated with amoxicillin and gentamicin, followed by ceftriaxone.