Rare Species of Actinomyces as Causative Pathogens in Breast Abscess

Attar, Kaka Hama; Waghorn, David; Lyons, M. J.; Cunnick, Giles

doi:10.1111/j.1524-4741.2007.00472.x

Cited by 40 publications

(26 citation statements)

References 12 publications

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“…that have a predilection for causing invasive infections at specific body sites (2). Our study confirmed previous reports of the association of A. graevenitzii with pulmonary infections (33,34) and of A. radingae with SSTA infections of the upper body associated with chest or breast abscesses (35). In our study, we found that A. odontolyticus was the most common and diverse cause of invasive actinomycosis, including intraabdominal abscesses, osteomyelitis, pulmonary infections, and sepsis.…”

Section: Discussionsupporting

confidence: 81%

Species-Level Identification of Actinomyces Isolates Causing Invasive Infections: Multiyear Comparison of Vitek MS (Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry) to Partial Sequencing of the 16S rRNA Gene

2016

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Actinomyces species are uncommon but important causes of invasive infections. The ability of our regional clinical microbiology laboratory to report species-level identification of Actinomyces relied on molecular identification by partial sequencing of the 16S ribosomal gene prior to the implementation of the Vitek MS (matrix-assisted laser desorption ionization-time of flight mass spectrometry [MALDI-TOF MS]) system. We compared the use of the Vitek MS to that of 16S rRNA gene sequencing for reliable species-level identification of invasive infections caused by Actinomyces spp. because limited data had been published for this important genera. A total of 115 cases of Actinomyces spp., either alone or as part of a polymicrobial infection, were diagnosed between 2011 and 2014. Actinomyces spp. were considered the principal pathogen in bloodstream infections (n ‫؍‬ 17, 15%), in skin and soft tissue abscesses (n ‫؍‬ 25, 22%), and in pulmonary (n ‫؍‬ 26, 23%), bone (n ‫؍‬ 27, 23%), intraabdominal (n ‫؍‬ 16, 14%), and central nervous system (n ‫؍‬ 4, 3%) infections. Compared to sequencing and identification from the SmartGene Integrated Database Network System (IDNS), Vitek MS identified 47/115 (41%) isolates to the correct species and 10 (9%) isolates to the correct genus. However, the Vitek MS was unable to provide identification for 43 (37%) isolates while 15 (13%) had discordant results. Phylogenetic analyses of the 16S rRNA sequences demonstrate high diversity in recovered Actinomyces spp. and provide additional information to compare/confirm discordant identifications between MALDI-TOF and 16S rRNA gene sequences. This study highlights the diversity of clinically relevant Actinomyces spp. and provides an important typing comparison. Based on our analysis, 16S rRNA gene sequencing should be used to rapidly identify Actinomyces spp. until MALDI-TOF databases are optimized.A ctinomyces species are uncommon human bacterial pathogens that can cause a wide variety of invasive infections (1). The Actinomyces genus is part of the family Actinomycetaceae, of which there are currently 47 published species, but several novel Actinomyces taxa have recently been described by molecular analyses targeting the ribosomal 16S rRNA gene (2). For example, the Human Oral Microbiome Database (www.homd.org) currently reports many species-level Actinomyces taxa that have not yet been named (3). The pathogenic role of known and novel Actinomyces spp. in contributing alone or as part of polymicrobial flora to human invasive infections is underappreciated because many clinical microbiology laboratories continue to rely on phenotypic methods for identification (4-7). Because Actinomyces spp. grow best under anaerobic conditions and are notoriously fastidious, slow -growing organisms, they may be missed as important pathogens by routine aerobic culture techniques and incubation periods (2,8).Upon microscopic examination, Actinomyces isolates typically appear as Gram-positive bacilli that may be coryneform-like with palisading or branching ...

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Section: Discussionsupporting

confidence: 81%

Species-Level Identification of Actinomyces Isolates Causing Invasive Infections: Multiyear Comparison of Vitek MS (Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry) to Partial Sequencing of the 16S rRNA Gene

2016

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“…The first case report of an A. radingae breast infection (in a male patient that also lived in The Netherlands) was described by Attar et al in 2007 [2].…”

Section: Discussionmentioning

confidence: 99%

“…The most common isolated pathogen in breast actinomycosis is A. israelii. More recently, breast infections due to A. viscosus, A. turicensis, A. europaeus, A. odontolyticus, A. neuii and A. radingae have been described [2,3,9,10]. Breast actinomycosis may either present as a sinus tract, or with mass-like features mimicking malignancy, or may mimic mastitis.…”

Section: J Microbiol Infect Dis Wwwjmidonlineorg Vol 6 No 2 June mentioning

confidence: 99%

A breast abscess caused by Actinomyces radingae

Hoogewerf¹

2016

Journal of Microbiology and Infectious Diseases

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“…There was no clearly predominant Actinomyces species. Five cases reported coinfecting anaerobes (17,24), and one case reported coinfecting Staphylococcus aureus (20), with no mention of coinfecting organisms in 11 of 17 cases. Seven cases were recurrent infections, and a range of different treatment combinations were required to reach abscess resolution.…”

Section: Lothian Casesmentioning

confidence: 99%

“…This ranged from 2 to 3 weeks of oral antibiotics to incision and drainage with prolonged antibiotics for 2 to 6 months; the most extreme treatment was tumorectomy of the breast (22). As with our cohort of patients, prior to the diagnosis of Actinomyces breast infection, some patients had been repeatedly treated without success (14,17,20).…”

Section: Lothian Casesmentioning

confidence: 99%

Actinomyces species isolated from breast infections

Bing¹,

Loh²,

Helgason³

et al. 2014

European Journal of Surgical Oncology

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Actinomycosis is a chronic infection caused by Actinomyces species characterized by abscess formation, tissue fibrosis, and draining sinuses. The spectrum of infections caused by Actinomyces species ranges from classical invasive actinomycosis to a less invasive form of superficial skin and soft tissue infection. We present a review detailing all Actinomyces species isolated from breast infections in NHS Lothian between 2005 and 2013, Actinomyces species isolated from breast infections referred to the United Kingdom Anaerobe Reference Unit between 1988 and 2014, and cases describing Actinomyces breast infections published in the medical literature since 1994. Actinomyces species are fastidious organisms which can be difficult to identify and are likely to be underascertained as a cause of breast infections. Due to improved diagnostic methods, they are increasingly associated with chronic, recurrent breast infections and may play a more significant role in these infections than has previously been appreciated.

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Rare Species of Actinomyces as Causative Pathogens in Breast Abscess

Cited by 40 publications

References 12 publications

Species-Level Identification of Actinomyces Isolates Causing Invasive Infections: Multiyear Comparison of Vitek MS (Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry) to Partial Sequencing of the 16S rRNA Gene

Species-Level Identification of Actinomyces Isolates Causing Invasive Infections: Multiyear Comparison of Vitek MS (Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry) to Partial Sequencing of the 16S rRNA Gene

A breast abscess caused by Actinomyces radingae

Actinomyces species isolated from breast infections

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