A Case Report on Nutritionally Deficient Bacteria: Abiotrophia adiacens

Abstract

Abiotrophia is a nutrition-deficient gram-positive cocci comprising of mainly two species (A. adiacens and A. defective). The name Abiotrophia is derived from the Greek language meaning "life nutrition deficiency". Abiotrophia species is part of normal flora of the human upper respiratory, gastrointestinal, and urogenital tracts. It has been associated with serious infections like bacteremia and endocarditis. This paper discusses a case of A. adiacens causing bacteremia and vertebral osteomyelitis. A 62-year-old male presented with back pain, fever and chills. Spinal imaging study showed spinal abscess and spinal osteomyelitis, and the blood culture grew A. adiacens. Abiotrophia species, formerly referred to as nutritionally variant streptococci, needs supplemented media for growth and survival. There are extremely few cases that have been reported with spinal involvement due to Abiotrophia species. Resistance to multiple antibiotics has been described in this species. Abiotrophia-associated infections are rare but could be life-threatening. Clinicians should be cognizant of its potential in causing severe infections. We report this case in an attempt to increase awareness about this organism.

Skipped vertebral spontaneous spondylodiscitis caused by Granulicatella adiacens: Case report and a systematic literature review

“…Overall, 6 patients were conservatively managed with antibiotic therapy (66%), 15e17 whereas 3 in combination with surgery (33%). 19,20 Among them, one case diagnosed for vertebral osteomyelitis was treated with a posterior decompression, a corpectomy with prosthetic replacement, and fusion, 20 one case with a posterior decompression and fusion 19 ; whereas our patient was treated with a posterior decompression only.…”

“…21 All patients received targeted antibiotic therapy resulting in a quick improvement of clinical symptoms and a final favorable outcome. Endocarditis seemed to be the most frequent risk factor for SD by Granulicatella adiacens, being reported in 4 patients (44%), 15,16,20 followed by diabetes mellitus in 2 cases (22%), 19,21 and a recent dental procedures, in 1 case (11%). 19 The diagnosis was based on blood cultures in 7 cases (77%), 15e20 and on CT-guided discal biopsy in 2 (23%), 18,21 suggesting a challenging isolation of the germ from biopsy samples.…”

“…The preferred antimicrobial agents were: Gentamicin (55%),15e17 ,21 Penicillin (44%), 15e17 Ciprofloxacin (22%), 15 Vancomycin (22%), 20 Ceftriaxone (22%), 15 Ampicillin (11%), 18 Fusidic Acid (11%), 15 Amoxicillin (11%), 17 Ceftazidime (11%), 19 Rifampicin (11%) 16 in order of percentage of use. The mean duration of the antibiotic therapy was 55.1 ± 23.76 days.…”

Granulicatella adiacens and Abiotrophia defectiva Native Vertebral Osteomyelitis: Three Cases and Literature Review of Clinical Characteristics and Treatment Approach

“…Once known as nutritionally variant streptococci, G. adiacens and A. defectiva are a rare cause of native vertebral osteomyelitis. Discrepancies still exist in terms of correct taxonomic classification, being Granulicatella and Abiotrophia terms used interchangeably even in recent articles [9, 10, 13].…”