Polymicrobial Bacteremia InvolvingComamonas testosteroni

Abstract

Comamonas spp. are uncommon isolates in microbiology laboratories and have been rarely observed as an infectious agent in clinical practice. They have widespread environmental distribution and have been isolated from water, soil, and plants as well as from some hospital devices such as intravenous catheters and water contained in humidifier reservoirs used in respiratory treatment. The genus Comamonas originally contained the following species: acidovorans, testosteroni, kerstersii, terrigena, denitrificans, and nitrativorans. It now contains 17 species, while acidovorans spp. have been reclassified as Delftia acidovorans. In spite of its uncommon human pathogenesis, there are few reports on the aggressive manner of it as an opportunistic pathogen, mostly related to testosteroni spp. We present a case of polymicrobial bacteremia involving Comamonas testosteroni. The aim of this case report is to alert clinicians to the potential diagnosis of bloodstream infections caused by uncommon pathogens.

The 20th Comamonas Testosteroni Bacteremia Case in the Literature from Turkey: Mortal and Polymicrobial A Case Report and Literature Review

“…In the case by Opota et al, Streptococcus parasanguis and Ralstonia pickettii were identified along with C. testosteroni bacteremia [11] . Orsini et al reported that their case was the first bacteremia case with C. testosteroni and S. aureus [8] . In the literature, our case is the second case with both the organisms and is the first case to also have A. baumannii in the tracheal aspirate culture.…”

“…Only four cases were reported as polymicrobial by Orsini [8] , Barbaro [9] , Tsui [10] , and Opota [11] , and only Barbaro's newborn case with Streptococcus-positive culture died. In the case by Opota et al, Streptococcus parasanguis and Ralstonia pickettii were identified along with C. testosteroni bacteremia [11] .…”

“…treatments were initiated. During the treatments, the patient had subfebril fever, increased infection Atkinson [4] 31/F Blood None No Kanamycin tetracycline Cured Smith [7] 89/M Blood Environmental exposure No levofloxacin Cured Le Moal [14] 75/F Blood CVC breast cancer No Ceftazidime gentamicin Cured Cooper [15] 49/M Blood Infective endocarditis No Cefepime, gentamicin Cured then ampicillin Abraham [16] 54/F Blood Esophageal cancer No Cefepime then ciprofloxacin Cured with metastases to lung Chemotherapy, CVC Orsini [8] 80/F Blood Morbidly obese, Staphylococcus aureus Ceftriaxone then nafcillin Cured diabetes mellitus then cefazolin doripenem Barbaro [9] 4/M Blood None reported None reported None reported Cured Barbaro [9] 28/M Blood None reported None reported None reported Cured Barbaro [9] Newborn/F Blood Prematurity a-Hemolytic Streptococcus Ampicillin amikacin Died Gül [6] 22/M Blood Perforated appendicitis None reported cefazolin Cured Nseir [13] 64/F Blood diabetes mellitus, No Vancomycin rocephin Died end-stage kidney disease then ciprofloxacin gentamycin Tsui [10] 54/M Blood Cellulite No Oxacillin then ciprofloxacin Cured Tsui [10] 73/M Blood Hepatocellular carcinoma Acinetobacter baumannii Cefmetazon gentamicin Cured then levofloxacin Farshad [17] 10/M Blood Medulloblastoma No Ciprofloxacin amikacin Cured Farshad [17] 19/F Blood Osteosarcoma No Vancomycin imipenem Cured ciprofloxacin Swain [12] 50/F Blood Chronic renal disease, No Piperacillin-tazobactam then Died gluteal abscess cefoperazone-sulbactam Opota [11] 33/M Blood Chronic hepatitis C, Streptococcus parasanguis, Cefepime vancomycinthen Not chronic alcoholism, Ralstonia pickettii moxifloxacin reported drugaddiction Katırcıoğlu [18] 83/M Blood Old age, SVD No Piperacillin-tazobactam, Cured amikacin Pekintürk [19] parameters, and increased radiological consolidation; C. testosteroni was detected in the first blood cultures during admission. According to an antibiogram, C. testosteroni was resistant to piperacillin-tazobactam, imipenem, meropenem, and gentamycin and susceptible to colistin, levofloxacin, tigecycline, and cefepime.…”

An Uncommon Cause Of Bacteremia: Comamonas Testosteroni (A Case Report)

“…Orsini ve ark. (11) , 2014 yılında 80 yaşındaki morbid obez hastanın kan kültüründe üreyen metisiline duyarlı Staphylococcus aureus için nafsilin tedavisi başlanmıştır. Durumu düzelmeyen hastanın kan kültüründe seftazidim, karbapenem, piperasilin tazobaktam ve trimetoprimsulfametoksazole duyarlı olan C. testosteroni'yi üretmişlerdir.…”

Comamonas testosteroni-associated peritonitis in a pediatric peritoneal dialysis patient

“…Infection by C. testosteroni is infrequent, however there are some reports describing its potential causative role in bacteremia, meningitis, urinary tract infections, endocarditis, cellulitis, and pneumonia [1,2] . Isolation of C. testosteroni has also emerged in localized peritonitis as a complication of perforated appendicitis [3,4] .…”