<i>Capnocytophaga canimorsus</i>as Cause of Fatal Sepsis

Hundertmark, Moritz; Williams, Tatjana; Vogel, Anja; Moritz, Maria; Bramlage, Peter; Pagonas, Nikolaos; Ritter, Oliver; Sasko, Benjamin

doi:10.1155/2019/3537507

Cited by 9 publications

(7 citation statements)

References 17 publications

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“…Capnocytophaga species are primarily commensals of the oral cavity in humans and animals, especially dogs and cats. They are recognized as opportunistic pathogens, leading to various extra-oral infections, including severe sepsis [ 2 ], bloodstream infections [ 3 ], abscess [ 4 , 5 ], vertebral osteomyelitis [ 6 ], pneumonia [ 7 ], and perinatal infections [ 8 ] in both immunocompetent and immunosuppressed patients. In addition, Capnocytophaga species have been thought to play a role in cancer development.…”

Section: Introductionmentioning

confidence: 99%

Isolation and Characterization of Capnocytophaga bilenii sp. nov., a Novel Capnocytophaga Species Detected in a Gingivitis Subject

2021

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Capnocytophaga species are commensal gliding bacteria that are found in human and animal oral microbiota and are involved in several inflammatory diseases, both in immunocompromised and immunocompetent subjects. This study contributes to increased knowledge of this genus by characterizing a novel species isolated from a dental plaque sample in a male with gingivitis. We investigated morphological and chemotaxonomic characteristics using different growth conditions, temperature, and pH. Cellular fatty acid methyl ester (FAME) analysis was employed with gas chromatography/mass spectrometry (GC/MS). Phylogenetic analysis based on 16S rRNA, orthologous average nucleotide identity (OrthoANI), and digital DNA–DNA hybridization (dDDH) relatedness were performed. The Marseille-Q4570T strain was found to be a facultative aerobic, Gram-negative, elongated, round-tipped bacterium that grew at 25–56 °C and tolerated a pH of 5.5 to 8.5 and an NaCl content ranging from 5 to 15 g/L. The most abundant fatty acid was the branched structure 13-methyl-tetradecanoic acid (76%), followed by hexadecanoic acid (6%) and 3-hydroxy-15-methyl-hexadecanoic acid (4%). A 16S rDNA-based similarity analysis showed that the Marseille-Q4570T strain was closely related to Capnocytophaga leadbetteri strain AHN8855T (97.24% sequence identity). The OrthoANI and dDDH values between these two strains were, respectively, 76.81% and 25.6%. Therefore, we conclude that the Marseille-Q4570T strain represents a novel species of the genus Capnocytophaga, for which the name Capnocytophaga bilenii sp. nov. is proposed (=CSUR Q4570).

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Section: Introductionmentioning

confidence: 99%

Isolation and Characterization of Capnocytophaga bilenii sp. nov., a Novel Capnocytophaga Species Detected in a Gingivitis Subject

2021

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“…The original paper stated that 'bacterial pathogen identification was carried out by using the Metaphlan2 program, which revealed Capnocytophaga sp and Veillonella sp in sample 2 and none in sample 1, and both bacteria identified were not known for their pathogenicity' This is clearly wrong -Capnocytophaga and Lautropia are there, but there are so many other pathogenic species. Also Capnocytophaga, found in the saliva of humans, dogs and cats can be pathogenic [129]. There are many more species, just listed top 10 here.…”

Section: Discussionmentioning

confidence: 99%

SARS-Cov2 enables anaerobic bacteria (Prevotella, et al) to colonize the lungs disrupting homeostasis, causing long-drawn chronic symptoms, and acute severe symptoms (ARDS, septic shock, clots, arterial stroke) which finds resonance, with key differences, in the ‘forgotten disease’ Lemierre Syndrome, enabled by Epstein Barr Virus

Chakraborty¹

2020

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Metagenomic studies of Covid19 patient sequencing data from different countries (China, Brazil, Peru, Cambodia, USA) shows a pattern that SARS-Cov2 enables anaerobic bacteria (eg Prevotella, Veil- lonella, Capnocytophaga, Fusobacterium, Oribacterium and Bacteroides) colonize the lungs, disrupting the homeostasis found in healthy patients. Long drawn symptoms in Covid19 have caused great con- sternation, and could be explained by persistence of biofilms. Some of these bacteria are implicated in increasing IL-6, cause ground glass opacity in lungs and are associated with cardiac injury - all symp- toms associated with Covid19. Many studies also show several bacterial infection markers - like D-dimer, LDH, C-reactive protein and ferritin - being significantly high, while the viral immune response is at- tenuated (reported by three studies till date). This is also confirmed here in the lung sample from a 74 year old deceased patient, showing high levels of IFITM3, ferritin and S100 calcium binding protein. Anaerobic bacteria causing initial symptoms like persistent fever, chills, pain and later symptoms like ARDS, blood clots, arterial stroke and septic shock finds resonance in a ”forgotten disease” - Lemierre syndrome (LS). While, LS is enabled by Epstein Barr Virus - possibly by ‘a transient depression of T cell immunity’, two recent studies show that IFN-λ might promote bacterial superinfection in Covid19. Also, 16S rRNA bacterial genes and endotoxins (LPS) were discovered in 18/19 severely ill pneumonia patients in one study, suggesting dissemination of endotoxins, and not actual bacteria, might suffice to cause severity. Autopsies also show foci of acute bronchopneumonia. There are key differences with LS - for example origin of LS is the jugular vein while Covid19 starts in the lungs (and this difference should result in Covid19 to be easier to treat). Co-infection of EBV and SARS-Cov2 leads to greater symptoms (fever, higher CRP) in a study of 67 patients. SARS-2003 showed a lot of similar symptoms, which did not get enough media attention. There was a specific warning issued in 2004 for ‘an increased vigilance against stroke and other thrombotic complications among critically-ill SARS patients in future outbreaks’. Enhanced pathogen testing kits, which include RT-PCT for bacterial genes and endotoxin tests, could confirm this disruption in Covid19, and thus anaerobic-specific antibiotics could significantly help in therapy.

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“…Symptoms can appear one to seven days after inoculation [ 4 ] with a wide clinical presentation ranging from a simple cellulitis to fulminant septic shock with disseminated intravascular coagulopathy (DIC). Mortality is estimated between 25 and 30% [ 5 ]. This high rate can be explained by the strong virulence of C. canimorsus caused by its abilities to escape phagocytosis [ 6 ] as well as its gliding motility allowing easier diffusion towards general circulation.…”

Section: Introductionmentioning

confidence: 99%

Routine use of 16S rRNA PCR and subsequent sequencing from blood samples in septic shock: about two case reports of Capnocytophaga canimorsus infection in immunocompetent patients

et al. 2022

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Background Capnocytophaga canimorsus infection happens frequently in immunosuppressed patients with reported domestic animal bites. Clinical presentation ranges from simple cellulitis to fulminant septic shock with disseminated intravascular coagulopathy, with an overall mortality of 30%. Conventional blood culture is often negative as this is a slow-growing pathogen. Nevertheless, the increasing use of 16S rRNA gene amplification and Sanger sequencing allows a much more rapid diagnostic confirmation. We present two case reports where 16S rRNA gene sequencing helped to diagnose Capnocytophaga canimorsus infection. Case presentation Case 1: A 53-year-old man with a history of non-cirrhotic chronic alcohol consumption was admitted to the intensive care unit (ICU) for septic shock and disseminated intravascular coagulopathy (DIC) of unknown origin. Blood cultures remained negative and a 16S rRNA PCR was performed leading to the identification of Capnocytophaga Canimorsus on day 4. Targeted antibiotic therapy with ceftriaxone for 14 days lead to overall recovery. Afterwards, the patient recalled a dog bite 2 days before hospitalization with a punctiform necrotic wound localized on a finger, which was not obvious at admission. Case 2: A 38-year-old man arrived to the emergency department for acute alcohol intoxication and history of a dog bite 2 days before. At admission, septic shock with purpura fulminans was diagnosed and required ICU hospitalization, invasive mechanical ventilation, vasopressor support and renal replacement therapy due to the rapid clinical deterioration. In the context of septic shock with purpura fulminans, DIC and recent dog bite, the diagnosis of Capnocytophaga canimorsus septic shock was suspected, and early confirmed by 16S rRNA PCR coupled to Sanger sequencing on day 2. Blood cultures became only positive for Capnocytophaga canimorsus 5 days after admission. Ceftriaxone alone was infused for 10 days in total, and the patient was discharged from the ICU on day 25. Conclusions 16S rRNA gene PCR proves an important diagnostic tool when facing a sepsis of unknown origin. In these two cases of septic shock related to Capnocytophaga canimorsus, initial blood cultures remained negative at 24 h, whereas the diagnosis was achieved by 16S rRNA PCR sequencing performed from blood samples obtained at admission.

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Capnocytophaga canimorsusas Cause of Fatal Sepsis

Cited by 9 publications

References 17 publications

Isolation and Characterization of Capnocytophaga bilenii sp. nov., a Novel Capnocytophaga Species Detected in a Gingivitis Subject

Isolation and Characterization of Capnocytophaga bilenii sp. nov., a Novel Capnocytophaga Species Detected in a Gingivitis Subject

Routine use of 16S rRNA PCR and subsequent sequencing from blood samples in septic shock: about two case reports of Capnocytophaga canimorsus infection in immunocompetent patients

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