Postoperative spondylodiscitis due to Kytococcus schroeteri in a diabetic woman

Jacquier, Hervé; Allard, Anne; Richette, Pascal; Ea, Hang‐Korng; Pors, M. J. Sanson-Le; Berçot, Béatrice

doi:10.1099/jmm.0.010454-0

Cited by 13 publications

(18 citation statements)

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“…There are published antibiotic susceptibility patterns in four cases of K. schroeteri infections: two with endocarditis, one with spondylodiscitis, and one with a shunt infection (4)(5)(6)8). The present isolate had antibiotic susceptibility patterns similar to those in previously published data (Table 1).…”

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confidence: 84%

“…schroeteri is a recently defined member of the genus Kytococcus (1) that is a normal saprophyte of the human skin. However, K. schroeteri has been reported as a cause of infective endocarditis, mainly in patients with prosthetic valves (2, 10), and of spondylodiscitis (4). In immunocompromised patients, three cases of Kytococcus schroeteri pneumonia with growth in BAL fluid have been reported.…”

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Pneumonia and Bacteremia Due to Kytococcus schroeteri

et al. 2012

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Kytococcus schroeteri, a saprophyte of the human skin, may cause serious infections in the immunocompromised host. Here, we describe a case of pneumonia and bacteremia due to Kytococcus schroeteri in an immunocompromised patient, successfully treated with linezolid and trimethoprim-sulfamethoxazole. CASE REPORTA 43-year-old woman diagnosed with acute myeloid leukemia (AML) received induction therapy with daunorubicin and cytarabin with poor response and was given a new induction therapy with fludara, cytarabin, and idarubicin. She was also treated with flucloxacillin and ciprofloxacin due to a breast abscess. Ten days later, the patient was readmitted to hospital because of neutropenic fever. Chest X-ray showed a small infiltrate in the right lung, and antibiotic therapy with piperacillin-tazobactam was initiated. A chest computed tomography (CT) scan performed 4 days later showed three small, dense infiltrates in the middle and lower lobe in the right lung. Bronchoscopy with bronchoalveolar lavage (BAL) was performed, and the patient was treated with voriconazole, which later was switched to liposomal amphotericin B when fungal cultures of BAL fluid and galactomannan antigen were negative. Blood cultures, taken the day after bronchoscopy was performed, showed growth of a Kytococcus species in one aerobic blood culture vial out of a total of four blood culture vials, two aerobic and two anaerobic. Susceptibility testing by Etest showed that the strain had low MIC values for vancomycin, meropenem, linezolid, and trimethoprim-sulfamethoxazole. Despite concerns regarding the clinical significance of the isolate, as it was only recovered in one blood culture vial, the patient was treated with vancomycin, and piperacillintazobactam was switched to meropenem. The BAL fluid culture yielded a pure growth of 10 5 CFU/ml of the same Kytococcus species. The isolate was later identified, using sequencing, as Kytococcus schroeteri. The patient continued to deteriorate, and a new chest CT scan showed large, dense infiltrates in both lungs with necrosis in the middle lobe. Due to therapeutic failure and to reach better antibiotic concentrations in the lungs, vancomycin was switched to linezolid, and later, trimethoprim-sulfamethoxazole was added when the patient continued to deteriorate. Finally, 19 days after the BAL was performed, the leucopenia resolved and the patient improved. She was discharged with long-term treatment with trimethoprimsulfamethoxazole, and 4 months later, allogeneic stem cell transplantation was successfully performed.Blood samples were cultured using the BacT/Alert 3D (bioMérieux, Inc., Durham, NC) automated blood culture system. After 48 h of incubation, one aerobic blood culture vial signaled positive. Gram staining revealed Gram-positive cocci occurring in pairs and in tetrads. Broth from the aerobic bottle was subcultured onto blood and CLED (cystine-lactose-electrolyte-deficient) agar plates incubated in air, chocolate agar plates incubated in 5% CO 2 , and blood agar plates incubated in an anaero...

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Pneumonia and Bacteremia Due to Kytococcus schroeteri

et al. 2012

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“…However, K. schroeteri can also cause severe to fatal infections. So far, K. schroeteri has been identified as the causative agent in cases of prosthetic valve endocarditis (n55) (Aepinus et al, 2008;Becker et al, 2003;Mnif et al, 2006;Poyet et al, 2010;Renvoise et al, 2008), pneumonia (n53) (Hodiamont et al, 2010;Mohammedi et al, 2005), spondylodiscitis (n51) (Jacquier et al, 2010) and VPS infection (n51) (Jourdain et al, 2009).…”

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confidence: 99%

A bumpy road to the diagnosis of a Kytococcus schroeteri shunt infection

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Fiedler

et al. 2013

Journal of Medical Microbiology

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“…After its first isolation from the blood of a patient with prosthetic valve endocarditis in 2002 [9, 11], the clinical significance of K. schroeteri has been increasingly recognized in the past decade. Including our case, a total of 14 cases of K. schroeteri -related infections have been reported in the literature (Table 1), namely, six (43%) cases of prosthetic valve endocarditis [9, 11–16], five (36%) cases of pneumonia [17–20], one (7%) case of ventriculoperitoneal shunt infection [21], one case (7%) of folliculitis [19], one case (7%) of infective spondylodiscitis [22], and our case of chronic implant-related septic arthritis with contiguous osteomyelitis. The most common site of isolation of the organism was the blood (9/14; 64%), followed by respiratory tract secretions (5/14; 36%), bone (2/14; 14%), prosthetic heart valve (1/14; 7%), and cerebrospinal fluid (1/14; 7%).…”

Section: Discussionmentioning

confidence: 99%

“…Among the patients who did not have an infection of a prosthesis, the majority (5/6; 83%) had an immunocompromised state (use of prednisolone or acute myeloid leukemia). The other patient with lumbar spondylodiscitis developed the infection after an operation which compromised the local immunity [22]. Thus, similar to coagulase-negative staphylococci and micrococci, K. schroeteri is regarded as an opportunistic pathogen which is capable of causing prosthesis-related infections, skin infection, osteomyelitis, and fatal pneumonia in immunocompromised hosts.…”

Section: Discussionmentioning

confidence: 99%