Clinical and bacteriological characteristics of Helicobacter cinaedi infection

Abstract

Helicobacter cinaedi was first isolated from rectal cultures from homosexual men in 1984. In the 1980s to mid 1990s, the microorganism was mainly isolated from samples from homosexual men or immunocompromised patients; however, during the last two decades, H. cinaedi has been isolated from immunocompromised and from immunocompetent individuals worldwide. In Japan, the isolation of this microorganism was first reported in 2003. Since then, many cases have been reported in hospitals across the country. Despite many reports, the etiological properties and pathogenicity of H. cinaedi remain elusive; however, we are increasingly able to recognize some of the features and the clinical relevance of infection. In particular, a long incubation period is essential for detection in an automatic blood culture system and many of the recent isolates are resistant to both macrolides and quinolones. Furthermore, there is an association between infection and severe or chronic illnesses, such as meningitis or arteriosclerosis, in addition to mild diseases such as fever, abdominal pain, gastroenteritis, proctitis, diarrhea, erysipelas, cellulitis, arthritis, and bacteremia. In this review, we introduce the current knowledge and our latest findings relating to H. cinaedi.

Pyogenic Spondylitis and Diskitis Caused by <i>Helicobacter cinaedi</i> in an Immunocompetent Adult Patient

“…In the BACTEC system (Becton, Dickinson and Company, Sparks, USA), approximately 50% of cases were reported to require an incubation period of 5 or more days, and 13% required cultivation of more than 1 week (11). In contrast, it has been suggested that the BacT/ ALERT system is not adequate for detecting H. cinaedi (17). However, in our case, the BacT/ALERT system successfully detected H. cinaedi with an incubation period of 5 days.…”

Vertebral Osteomyelitis Caused by Helicobacter cinaedi

“…An epidemiologic study of patients with H. cinaedi-associated illness (4) reported that treatment with penicillin, tetracycline, or aminoglycoside may be more effective than treatment with cephalosporins, erythromycin, or ciprofloxacin. Moreover, various isolates of H. cinaedi in Japan have shown increased resistance to penicillins, macrolides, and quinolones (14). In the present case, amoxicillin and ampicillin decreased the CRP level to some extent; however, the patient's low back pain and fever were not alleviated, and blood culture continued to be positive during the treatment.…”

Epithelial Coculture and l -Lactate Promote Growth of Helicobacter cinaedi under H 2 -Free Aerobic Conditions

“…Strains are notable for poor, film-like growth on agar plates, a preference for biphasic culture (broth over agar), and decreased viability on subculture (24,25). Recommended medium conditions for H. cinaedi are not standardized.…”

“…In a recent study, Levinthal broth (MuellerHinton broth with horse serum) was proposed as a favorable medium for susceptibility testing of clinical isolates (20). H. cinaedi is considered microaerophilic, like many members of the class Epsilonproteobacteria, and demonstrates a strong preference for H 2 gas (24,27,28). The latter phenomenon is presumably due to H 2 serving as a respiratory electron donor (29), although this mechanism has not been demonstrated explicitly.…”