Culture-negative Brain Abscess with &lt;i&gt;Streptococcus intermedius&lt;/i&gt; Infection with Diagnosis Established by Direct Nucleotide Sequence Analysis of the 16S Ribosomal RNA Gene

Saito, Naoko; Hida, Ayumi; Koide, Yuri; Ooka, Tadasuke; Ichikawa, Yaeko; Shimizu, Jun; Mukasa, Akitake; Nakatomi, Hirofumi; Hatakeyama, S.; Hayashi, Tetsuya; Tsuji, Shoji

doi:10.2169/internalmedicine.51.6419

Cited by 22 publications

(15 citation statements)

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“…diagnosed culture-negative brain abscesses with Streptococcus intermedius through direct nucleotide sequence analysis of the 16 s ribosomal RNA gene [30]. Al Masalma et al performed a 16S rDNA-based metagenomic analysis of cerebral abscesses from patients diagnosed from 2006 through 2010.…”

Section: Resultsmentioning

confidence: 99%

A retrospective study on the aetiology, management, and outcome of brain abscess in an 11-year, single-centre study from China

Zhang

et al. 2014

BMC Infect Dis

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BackgroundBrain abscesses continue to pose diagnostic and therapeutic challenges in developed and developing countries. Their aetiology and management remain complex and unclear, making improvement of treatments and outcome difficult.MethodsTo determine the demographics, management, and the variables that affect the outcome in subjects with brain abscesses treated at a single centre over an 11-year period, we retrospectively analysed data in 60 patients with brain abscesses surgically treated with stereotactically guided aspiration or open craniotomy excision in Shanghai Changzheng Hospital between January 2001 and December 2011. Such variables as age, gender, Glasgow Coma Scale (GCS) score at admission, clinical presentation, location, number of lesions, predisposing factors, mechanism of infection, aetiological agent, and therapy were analysed independently.ResultsOur analysis demonstrated that patient age and gender were factors that influence the occurrence of brain abscess; female patients and patients greater than 40 years of age were most likely to suffer a brain abscess. We also found that a patient’s GCS score upon admission did not influence outcome. While frequency of successful culturing of the infectious agent was low, positive cultures were obtained in only 8 of the cases (13.33%), in which the most common isolate was Streptococcus milleri. Outcome was favourable in 78.33% of the subjects, while the mortality rate was 20%. The outcome of one patient was poor due to the abscess in the basal ganglia region.ConclusionsStereotactically guided aspiration is an effective treatment for brain abscess with an overall favourable outcome. Mortality due to brain abscess was not directly related to surgery nor surgical technique. Additional studies will continue to reveal patients trends that may improve treatment for brain abscess.

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Section: Resultsmentioning

confidence: 99%

A retrospective study on the aetiology, management, and outcome of brain abscess in an 11-year, single-centre study from China

Zhang

et al. 2014

BMC Infect Dis

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“…Also a case is known of an elderly woman with brain abscess whose aspirates were culture negative, and the causative agent was identified only by sequencing of the 16S rRNA gene [12]. Streptococcus intermedius and Streptococcus constellatus constitute a group, which is sometimes referred to as Streptococcus milleri group, demonstrating a great serologic and hemolitic variety and varying immunogenicity.…”

Section: Case Discussionmentioning

confidence: 99%

Identification of the atypical bacterial strain Streptococcus intermedius that caused brain abscess in the patient using Sanger sequencing of the 16S rRNA gene from the DNA extracted from a pus sample

Gordukova¹,

Divilina²,

Mishukova³

et al. 2017

Bulletin of RSMU

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ИДЕНТИФИКАЦИЯ НЕТИПИЧНОГО БАКТЕРИАЛЬНОГО ВИДА STREPTOCOCCUS INTERMEDIUS, ВЫЗВАВШЕГО АБСЦЕСС ГОЛОВНОГО МОЗГА, СЕКВЕНИРОВАНИЕМ ПО СЭНГЕРУ ГЕНА 16S РРНК ИЗ ДНК ОБРАЗЦА ГНОЯПредставлено описание клинического случая: наблюдали девочку в возрасте 14 лет 11 мес с абсцессом головного мозга, для которого не удалось установить возбудителя стандартными микробиологическими методами. До и в те-чение периода госпитализации у ребенка отсутствовала лихорадка, а многие антибиотики вызывали аллергические реакции, в связи с чем диагностика и терапия инфекции были затруднены. Пациентке были выполнены три опера-ции. Четырежды производили посев гноя из абсцесса, но ни разу не наблюдали роста культуры. Дважды проводи-ли ПЦР-анализ, но в обоих случаях результаты исследования были отрицательными. Тогда был амплифицирован и секвенирован по Сэнгеру ген 16S рРНК из образца ДНК, экстрагированной из гноя. С помощью программы BLAST была показана высокая гомология (99 %) определенной последовательности с последовательностью гена 16S рРНК бактерии Streptococcus intermedius (штамм ChDC B589, KF733728.1), для которой ранее была описана роль в раз-витии абсцессов головного мозга. Терапия ex juvantibus против этого микроорганизма, начатая еще до получения результатов секвенирования, привела к положительной динамике и купированию процесса у ребенка. Таким образом, в отдельных случаях секвенирование может являться практически единственным способом идентификации потенци-ального возбудителя. IDENTIFICATION OF THE ATYPICAL BACTERIAL STRAIN STREPTOCOCCUS INTERMEDIUS THAT CAUSED BRAIN ABSCESS IN THE PATIENT USING SANGER SEQUENCING OF THE 16S RRNA GENE FROM THE DNA EXTRACTED FROM A PUS SAMPLEIn this article we present a clinical case of brain abscess in a girl aged 14 years and 11 months caused by a pathogen that could not be identified by routine microbiological testing. Before admission and during her stay in the hospital, the teenager did not have fever. Diagnosis and treatment were impeded by allergic responses to a wide range of antibiotics. The patient underwent three surgical interventions. Pus culture was performed 4 times, showing no growth. A PCR assay was run twice, but both times the results came out negative. Therefore, a decision was made to amplify and Sanger-sequence the 16S rRNA gene from the DNA extracted from patient's pus. BLAST showed a 99 % homology of the obtained nucleotide sequence to the sequence of the 16S rRNA gene of Streptococcus intermedius (strain ChDC B589, KF733728.1) which had been previously shown to play a role in brain abscess development. Treatment ex juvantibus against the pathogen was started before sequencing results were available. The patient responded positively, the symptoms were alleviated and the condition improved. Thus, we conclude that in some cases sequencing may be the only diagnostic technique capable of identifying the pathogen.

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“…However, metagenomic analysis and nucleotide sequence analysis is being used in some centers to identify the responsible organism and they have been able to identifybacteria that have never been incriminated as a cause for brain abscess. 2,14 Complications included minor rashes probably…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Management of Otogenic Brain Abscess and Suppurative Otitis Media: Retrospective analysis

et al. 2016

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Intracranial complications of Chronic Suppurative Otitis Media(CSOM) are common. Brain abscess is the commonest intracranial complication. Traditionally, life threatening brain abscess was managed first and the causative otitis dealt later. However, with the aim of dealing with both at the outset, we have started treating these problems in the same anesthesia setting. Retrospective analysis of the consecutive patients treated simultaneously is presented.Nepal Journal of Neuroscience 13:19-22, 2016

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Culture-negative Brain Abscess with <i>Streptococcus intermedius</i> Infection with Diagnosis Established by Direct Nucleotide Sequence Analysis of the 16S Ribosomal RNA Gene

Cited by 22 publications

References 20 publications

A retrospective study on the aetiology, management, and outcome of brain abscess in an 11-year, single-centre study from China

A retrospective study on the aetiology, management, and outcome of brain abscess in an 11-year, single-centre study from China

Identification of the atypical bacterial strain Streptococcus intermedius that caused brain abscess in the patient using Sanger sequencing of the 16S rRNA gene from the DNA extracted from a pus sample

Simultaneous Management of Otogenic Brain Abscess and Suppurative Otitis Media: Retrospective analysis

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