Mycetoma Involving the Heart

Szarf, Gilberto; Obac, Alex Rocha; Puchnick, Andrea; Verrastro, Carlos Gustavo Yuji; Rodrigues, Alfredo Augusto Eyer; Uellendahl, Marly; Santos, Manuel Lopes dos; Colombo, Arnaldo Lopes; Fernandes, Artur da Rocha Corrêa; Lederman, Henrique Manoel

doi:10.1161/circulationaha.112.000846

Cited by 2 publications

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“…Streptomyces somaliensis is the main species responsible for Streptomyces actinomycetoma and was identified in >10% of cases of mycetoma in a recent meta-analysis [ 3 ]. Actinomycetoma presents as a painless tumor often localized on the extremities [ 4 , 5 ], but local extension may lead to severe complications when vital organs are invaded [ 6 , 7 ].…”

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Identification of Streptomyces spp. in a Clinical Sample: Always Contamination? Results of a French Retrospective Study

Gras

Bergeron

Pugès

et al. 2022

Open Forum Infectious Diseases

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Background Streptomyces are environmental Gram-positive bacilli that can cause ubiquitous mycetoma and, more rarely, invasive infections. We describe the clinical relevance of Streptomyces spp. identified in human samples and characteristics of patients with invasive Streptomyces infections. Methods We conducted a retrospective (2006-2017) study of Streptomyces isolates identified in clinical samples in French microbiology laboratories. Streptomyces genus was confirmed by a specific 16S rRNA PCR and antibiotic susceptibility testing was performed by disk diffusion and trimethoprim-sulfamethoxazole MIC (E-test) if resistance was suspected. Patient characteristics, treatment and outcomes were collected. Invasive infection was defined as a positive culture from a sterile site with signs of infection but without cutaneous inoculation. Results Of 137 Streptomyces isolates, all were susceptible to amikacin (113/113) and linezolid (112/112) and 92.9% to imipenem (105/113). Using disk diffusion, 50.9% (57/112) of isolates were susceptible to trimethoprim-sulfamethoxazole but most of apparently-resistant isolates (25/36, 69.4%) tested by E-test were ultimately classified as susceptible. Clinical data were obtained for 63/137 (45.9%) isolates: 30 (47.6%) invasive infections, 8 (12.7%) primary cutaneous infections, 22 (34.9%) contaminations, 3 (4.7%) respiratory colonization. Patients with invasive infection were more frequently receiving corticosteroids than patients without invasive infection (11/30, 36.7% vs 2/25, 8.0%, P = 0.03) and at 6-months follow-up, 14 of them were cured, three had relapsed, four were dead and nine were lost to follow-up. Conclusions Half of the clinical samples that grew Streptomyces were from patients with invasive infection. In that case, antimicrobial therapy should include one or two antibiotics among linezolid, amikacin or imipenem.

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