A Case of <i>Ignatzschineria indica</i> Bacteremia following Maggot Colonization

Muse, Hugh; Jenkins, Rachel L.; Oliver, Meredith B; Kim, Soomin; Grantier, Richard L.; Malhotra, Bharat; Parham, Jason; Stover, Kayla R.

doi:10.1155/2017/3698124

Cited by 21 publications

(29 citation statements)

References 7 publications

(18 reference statements)

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“…Combined microbiological and entomological research is needed to determine Ignatzschineria's pathogenicity and geographic distribution. Antibiotic treatment with beta-lactam antibiotics showed favorable results in our case as well as the cases reported in the literature [2][3][4][6][7][8].…”

Section: Discussionsupporting

confidence: 79%

“…Myiasis-maggot infestation of a live body-is most commonly found in domestic sheep, but rarely seen in humans with chronic wounds. Recent case reports described an association between maggot infestation and bloodstream infections in humans by gram-negative rod bacteria, which could later be identified as Ignatzschineria species by 16S rRNA gene amplification and sequencing after matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) was unsuccessful [1][2][3][4][5][6][7] (excluding one case [8]). The Ignatzschineria genus is composed of three species (I. indica, I. larvae, and I. ureiclastica) living as a gut-associated bacteria in larvae and adult forms of flesh flies, of which mostly Wohlfahrtia magnifica was described as vector for the pathogen [9].…”

Section: Introductionmentioning

confidence: 99%

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Sepsis Due to Ignatzschineria ureiclastica Caused by Maggot-Infested Wounds in a Homeless Man in Germany: a Case Report

Tanida

Wichert

Hentschke³

et al. 2019

SN Compr. Clin. Med.

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The gram-negative rod bacteria Ignatzschineria inhabits the digestive tract of larvae and adult forms of flesh flies and mostly causes bloodstream infections in animals, but rarely in humans with chronic wounds. This is the second case report of sepsis due to Ignatzschineria ureiclastica worldwide and the first reported case of Ignatzschineria species in Germany. We present a case report of 57-year-old homeless male with chronic leg and foot ulcers with maggot infestation. Blood cultures revealed gramnegative rod bacteria, which later could be identified by 16S rRNA sequence analysis as Ignatzschineria ureiclastica. Intravenous antibiotic treatment with ampicillin/sulbactam and later oral ciprofloxacin as well as local wound management lead to complete wound healing. Blood cultures of patients with chronic wounds and maggot infestation should be analyzed with 16S rRNA sequence analysis when commercial-automated devices lead to indecisive results. Live and preserved samples of insect infestation should be acquired for further entomological characterization. Susceptibility testing of rare pathogens should be performed and published. Antibiotic treatment of bloodstream infections due to Ignatzschineria species with ampicillin/sulbactam showed good clinical outcome.

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Section: Discussionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Sepsis Due to Ignatzschineria ureiclastica Caused by Maggot-Infested Wounds in a Homeless Man in Germany: a Case Report

Tanida

Wichert

Hentschke³

et al. 2019

SN Compr. Clin. Med.

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“…This genera belongs to the family Xanthomonadaceae, class Gammaproteobacteria, and was first described in 2001 [28]. Species within this genus are anaerobic, and have been associated with maggots colonizing wounds, and also with blow flies and flesh flies colonizing carcasses [29][30][31][32][33]. We cannot rule out that these organisms were not present at the earlier timepoints, however if so, they fell below detection levels.…”

Section: Discussionmentioning

confidence: 99%

Microbial succession from a subsequent secondary death event following mass mortality

et al. 2020

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Background Each death event can be characterized by its associated microbes – a living community of bacteria composed of carcass, soil, and insect-introduced bacterial species – a necrobiome. With the possibility for close succession of these death events, it may be beneficial to characterize how the magnitude of an initial death event may impact the decomposition and necrobiomes of subsequent death events in close proximity. In this paper we hope to characterize the microbial communities associated with a proximate subsequent death event, and distinguish any changes within those communities based on the magnitude of an initial death event and the biomass of preexisting carcass (es) undergoing decomposition. For this experiment, 6 feral swine carcasses in containers were placed in the vicinity of preexisting and ongoing carcass decomposition at sites of three different scales of decomposing carcass biomass. Swab samples were collected from the skin and eye sockets of the container pigs and subjected to 16 s rRNA sequencing and OTU assignment. Results PERMANOVA analysis of the bacterial taxa showed that there was no significant difference in the bacterial communities based on initial mortality event biomass size, but we did see a change in the bacterial communities over time, and slight differences between the skin and ocular cavity communities. Even without soil input, necrobiome communities can change rapidly. Further characterization of the bacterial necrobiome included utilization of the Random Forest algorithm to identify the most important predictors for time of decomposition. Sample sets were also scanned for notable human and swine-associated pathogens. Conclusions The applications from this study are many, ranging from establishing the environmental impacts of mass mortality events to understanding the importance of scavenger, and scavenger microbial community input on decomposition.

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“…W chitiniclastica and I indica are aerobic, gram-negative rods that are nonmotile and nonspore-forming. [10,11] Both of these bacteria are unusual human pathogens, but they have been documented in relation to maggot infestations in the last few years. [2,4–7,9,11–15] Just as myiasis may indicate an underlying bacterial infection, the presence of bacteremia with either W chitiniclastica or I indica in humans with no observable larvae may indicate occult myiasis.…”

Section: Introductionmentioning

confidence: 99%

Myiasis-induced sepsis: a rare case report of Wohlfahrtiimonas chitiniclastica and Ignatzschineria indica bacteremia in the continental United States

et al. 2018

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Rationale:The presentation of sepsis and bacteremia in cutaneous and cavitary myiasis is uncommon. We present a patient, residing in a temperate region of the United States, with myiasis and sepsis from the emerging human pathogens Wohlfahrtiimonas chitiniclastica and Ignatzschineria indica.Patient concerns:A 37-year-old male patient with an 8-month history of chronic lymphedema and ulcers of the lower left extremity presented with myiasis of the left foot and leg. The patient was initially seen by his family practitioner many times and was prescribed antibiotics which he could not afford. Debridement of the myiasis was not conducted by the family practitioner due to the belief that the patient's current state of myiasis would effectively debride and eventually heal the chronic ulcers along with multiple antibiotic regimens. Over the 8-month period, the patient developed a progressive, painful, necrotizing infection of his lower left extremity.Diagnoses:Physical examination clearly showed myiasis of the patient's lower left extremity, believed to be caused by Lucilia sericata (green bottle fly). Blood cultures revealed the presence of Providencia stuartii, W chitiniclastica, and I indica to be the underlying cause of sepsis and bacteremia.Interventions:All visible maggots were extracted, debridement of devitalized tissue was performed, and the leg ulcers were wrapped in pH neutral bleach. The patient was initially treated with a broad-spectrum antibiotic regimen of vancomycin, clindamycin, piperacillin, and tazobactam which, following clinical improvement, was de-escalated to cefepime.Outcomes:The fly larvae and maggots were removed from the extremity by scrubbing, pulse lavage, and filing away the callused tissue. Additionally, the patient's sepsis and bacteremia, caused by W chitiniclastica and I indica, were successfully treated through antibiotic intervention. Amputation was avoided.Lessons:The use of pulse lavage and chlorhexidine-soaked brushes for the removal of cavitary myiasis is an effective and minimally invasive procedure which does not cause additional damage to surrounding tissue. W chitiniclastica and I indica are emerging bacteria that have known association to parasitic fly myiasis in humans and are capable of causing sepsis and/or bacteremia if not accurately identified and treated promptly.

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A Case of Ignatzschineria indica Bacteremia following Maggot Colonization

Cited by 21 publications

References 7 publications

Sepsis Due to Ignatzschineria ureiclastica Caused by Maggot-Infested Wounds in a Homeless Man in Germany: a Case Report

Sepsis Due to Ignatzschineria ureiclastica Caused by Maggot-Infested Wounds in a Homeless Man in Germany: a Case Report

Microbial succession from a subsequent secondary death event following mass mortality

Myiasis-induced sepsis: a rare case report of Wohlfahrtiimonas chitiniclastica and Ignatzschineria indica bacteremia in the continental United States

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