Clinical and Microbiological Characteristics of Eggerthella lenta Bacteremia

Abstract

e Eggerthella lenta is an emerging pathogen that has been underrecognized due to historical difficulties with phenotypic identification. Until now, its pathogenicity, antimicrobial susceptibility profile, and optimal treatment have been poorly characterized. In this article, we report the largest cohort of patients with E. lenta bacteremia to date and describe in detail their clinical features, microbiologic characteristics, treatment, and outcomes. We identified 33 patients; the median age was 68 years, and there was no gender predominance. Twenty-seven patients (82%) had serious intra-abdominal pathology, often requiring a medical procedure. Of those who received antibiotics (28/33, 85%), the median duration of treatment was 21.5 days. Mortality from all causes was 6% at 7 days, 12% at 30 days, and 33% at 1 year. Of 26 isolates available for further testing, all were identified as E. lenta by both commercially available matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) systems, and none were found to harbor a vanA or vanB gene. Of 23 isolates which underwent susceptibility testing, all were susceptible to amoxicillin-clavulanate, cefoxitin, metronidazole, piperacillin-tazobactam, ertapenem, and meropenem, 91% were susceptible to clindamycin, 74% were susceptible to moxifloxacin, and 39% were susceptible to penicillin.

Bacteremia Caused byEggerthella lentain an Elderly Patient with an Intra-abdominal Abscess

“…Recent reports have shown that several E. lenta infections were associated with the use of intrauterine devices, spondylodiscitis, female genital tract infections, cutaneous abscesses, and bacteremia (in Crohn's disease patients) [1][2][3][4]12]. These data emphasize the importance of further investigation for bacterial virulence factors.…”

“…Eggerthella lenta is part of the normal human intestinal flora and has been most commonly associated with infections arising from the gastrointestinal tract [1]. Predisposing conditions include gastrointestinal tract disease, malignancies, hepatobiliary disease, immobilization, bedsores, diabetes mellitus, and stroke [2][3][4].…”

Paediatric splenic and rectovesical pouch abscesses caused byEggerthella lenta

“…We kept using meropenem as an empiric therapy after the laparoscopic drainage and debridement of the rectovesical pouch abscess because the causative bacterium was unknown. After 1 week , E. lenta , which is susceptible to antibiotics with much smaller spectra than meropenem,11 was isolated from the cultures of the pus collected from the rectovesical pouch abscess. However, we kept administering meropenem because we did not know whether the splenic abscesses had been caused by E. lenta alone.…”

Health and disease imprinted in the time variability of the human microbiome

“…Furthermore, research has recently confirmed a clear relationship between Actinomyces and conventional adenoma (66), one of the two main precursors of colorectal cancer. Finally, Eggerthella is an opportunistic pathogen often associated with serious gastrointestinal pathology (67). One might question the role of these taxa as key players in the phase transition of the microbiota and wonder whether they are more susceptible to perturbations than the most abundant taxa.…”