A case of subacute infective endocarditis and blood access infection caused by Enterococcus durans

Kenzaka, Tsuneaki; Takamura, Noriko; Kumabe, Ayako; Takeda, Koichi

doi:10.1186/1471-2334-13-594

Cited by 25 publications

(20 citation statements)

References 10 publications

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“…In addition, regular needle punctures during hemodialysis may provide a means for bacteria to enter the bloodstream. However, some authors have reported that infections affecting arteriovenous fistulas cause bloodstream infections (14), although the contrast-enhanced CT scans did not suggest a fistula infection in the present patient.…”

Section: Discussioncontrasting

confidence: 47%

Bacteremia with an Iliopsoas Abscess and Osteomyelitis of the Femoral Head Caused by <i>Enterococcus avium</i> in a Patient with End-stage Kidney Disease

2015

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A 70-year-old man on hemodialysis for end-stage kidney disease due to polycystic kidney disease presented with hip pain on extension and a high C-reactive protein level. Further examinations revealed an iliopsoas abscess and femoral head osteomyelitis caused by Enterococcus avium (E. avium) detected in blood and pus cultures. Complete resolution of the infection with ampicillin-resistant E. avium required six months of vancomycin therapy and two surgical drainage procedures. There have been no previous case reports in which both blood and abscess cultures confirmed E. avium infection. Careful attention should be paid to the detection of non-specific symptoms in patients on hemodialysis, with blood cultures being essential in such cases.

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Section: Discussioncontrasting

confidence: 47%

Bacteremia with an Iliopsoas Abscess and Osteomyelitis of the Femoral Head Caused by <i>Enterococcus avium</i> in a Patient with End-stage Kidney Disease

2015

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“…Almost all studies on bacteremia in Japan were case reports[11-13]. Sepsis was the second leading cause of death in infectious diseases in a study in Japan[14].…”

Section: Incidence Of Bacteremia In Hemodialysis Patientsmentioning

confidence: 99%

Bacteremia in hemodialysis patients

Suzuki

Satoh

Nakamura

et al. 2016

WJN

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Infection is a common complication and is the second leading cause of death in hemodialysis patients. The risk of bacteremia in hemodialysis patients is 26-fold higher than in the general population, and 1/2-3/4 of the causative organisms of bacteremia in hemodialysis patients are Gram-positive bacteria. The ratio of resistant bacteria in hemodialysis patients compared to the general population is unclear. Several reports have indicated that hemodialysis patients have a higher risk of methicillin-resistant Staphylococcus aureus infection. The most common site of infection causing bacteremia is internal prostheses; the use of a hemodialysis catheter is the most important risk factor for bacteremia. Although antibiotic lock of hemodialysis catheters and topical antibiotic ointment can reduce catheter-related blood stream infection (CRBSI), their use should be limited to necessary cases because of the emergence of resistant organisms. Systemic antibiotic administration and catheter removal is recommended for treating CRBSI, although a study indicated the advantages of antibiotic lock and guidewire exchange of catheters over systemic antibiotic therapy. An infection control bundle recommended by the Center for Disease Control and Prevention succeeded in reducing bacteremia in hemodialysis patients with either a catheter or arteriovenous fistula. Appropriate infection control can reduce bacteremia in hemodialysis patients.

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“…This organism (formerly Streptococcus durans) is an exceptional cause of human disease. It was anecdotally described as an agent of bacteremias (3), urinary tract infections (4), wound infections (5), and four endocarditis cases (6). Also, it has been found in dairy products and in human and animal milk microbiota (6)(7)(8).…”

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confidence: 99%

“…It was anecdotally described as an agent of bacteremias (3), urinary tract infections (4), wound infections (5), and four endocarditis cases (6). Also, it has been found in dairy products and in human and animal milk microbiota (6)(7)(8). E. durans appears as elongated nonmotile cells that are mostly arranged in pairs and short chains; it forms circular, smooth, entire, and nonpigmented colonies when grown on a blood medium, showing the Lancefield group D and, occasionally, group G antigen (8,9).…”

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Beta-Hemolytic, Multi-Lancefield Antigen-Agglutinating Enterococcus durans from a Pregnant Woman, Mimicking Streptococcus agalactiae

et al. 2014

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A beta-hemolytic Lancefield antigen A-, B-, C-, D-, F-, and G-positive Enterococcus durans strain was cultivated from the rectovaginal swab of a pregnant woman who underwent antenatal screening for Streptococcus agalactiae. The isolate raised concern as to what extent similar strains are misrecognized and lead to false diagnosis of group B streptococci. Streptococcus agalactiae (group B Streptococcus [GBS]) inhabits the human gut, from where it can then colonize the genitourinary tract (1). Up to 30% of pregnant women are asymptomatic GBS carriers, and neonates can therefore acquire the organism vertically at the time of birth unless penicillin or ampicillin is given intravenously as intrapartum antibiotic prophylaxis (IAP). Newborn colonization may establish in 50% of the cases and involves different mucosal and skin sites. One percent to 2% of neonates develop early GBS infection, including bacteremia and/or pneumonia and/or meningitis (1, 2). For these reasons, the CDC (Centers for Disease Control and Prevention) has suggested that women between the 35th and 37th weeks of gestation be screened for GBS carriage through rectovaginal cultures. As IAP has been shown to reduce the risk of vertical S. agalactiae transmission, all GBS-positive women receive prophylaxis as soon as labor begins or when rupture of the amniotic membranes occurs (1).GBS screening is based on the recognition of Gram-positive catalase-negative cocci, mostly beta-hemolytic (on sheep blood agar), showing the Lancefield group B antigen. Nonhemolytic (gamma-hemolytic) variants have been described, however, and may be missed because they are not easily detected. Hence, the CDC recommends the use of chromogenic media that are designed to highlight GBS growth through species-specific coloration of colonies (that may vary depending on the manufacturer) (1).A pregnant woman attending the Spirito Santo Hospital in Pescara, Italy, was screened for rectovaginal GBS colonization according to the CDC guidelines. On Trypticase soy agar (Liofilchem, Italy), beta-hemolytic (Fig. 1) catalase-negative colonies were grown. The isolate formed pairs and chains and showed group B antigen agglutination (detected with the Liofilchem Strepto B latex kit). It was therefore believed to be GBS. Nevertheless, it grew in purple colonies (Fig. 1) on Chromatic StrepB (Liofilchem), whereas this chromogenic medium is designed to support GBS growth in light blue-green colonies (based on the manufacturer's indication, the purple color we observed instead placed the isolate within the Enterococcus genus). Accordingly, the strain was found to produce a negative CAMP reaction (10) (mild enhancing of hemolysis was observed, however).Identification as Enterococcus durans was provided by the Vitek 2 GP card (bioMérieux, France) and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) using Bruker Biotyper software 2.0 (Bruker Daltonics, Germany) and the Vitek MS v2.0 system (bioMérieux). Sequencing of a 16S rRNA gene 1,458-bp amplicon, analyze...

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A case of subacute infective endocarditis and blood access infection caused by Enterococcus durans

Cited by 25 publications

References 10 publications

Bacteremia with an Iliopsoas Abscess and Osteomyelitis of the Femoral Head Caused by <i>Enterococcus avium</i> in a Patient with End-stage Kidney Disease

Bacteremia with an Iliopsoas Abscess and Osteomyelitis of the Femoral Head Caused by <i>Enterococcus avium</i> in a Patient with End-stage Kidney Disease

Bacteremia in hemodialysis patients

Beta-Hemolytic, Multi-Lancefield Antigen-Agglutinating Enterococcus durans from a Pregnant Woman, Mimicking Streptococcus agalactiae

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