Recurrent Intravascular-Catheter-Related Bacteremia Caused by Delftia acidovorans in a Hemodialysis Patient

Chotikanatis, Kobkul; Bäcker, Martín; Rosas-Garcia, Gabriela; Hammerschlag, Margaret R.

doi:10.1128/jcm.00625-11

Cited by 36 publications

(35 citation statements)

References 17 publications

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“…Although they are ubiquitously distributed in the environment (soil and water), Comamonas and Delftia species are rarely associated with infections in humans. However, several publications have incriminated C. testosteroni and D. acidovorans in particular in human diseases, including severe invasive infections such as bacteremia and meningitis (7,(11)(12)(13)(14)(15)(16)(17).…”

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confidence: 99%

Bacteremia Caused by Comamonaskerstersii in a Patient with Diverticulosis

et al. 2014

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We report for the first time a case of bacteremia caused by Comamonas kerstersii in a 65-year-old patient with sign of diverticulosis. In addition, we review the isolation of Comamonas sp. and related organisms in our hospital over 25 years. CASE REPORTC omamonas kerstersii is a nonfermenting betaproteobacterium described in 2003 that has long been considered nonpathogenic (1). This organism has recently been associated with intraabdominal infection due to perforation of the digestive tract (2). Here we describe a case of polymicrobial bacteremia due to C. kerstersii and Bacteroides fragilis in a 65-year-old diabetic man who was admitted to the emergency department of a hospital because of the sudden onset of fever and chills. The patient reported episodes of vomiting and diarrhea and mentioned that he had drunk water from a small river. Stool cultures performed after the beginning of antibiotic treatment did not disclose Salmonella, Shigella, Aeromonas, Campylobacter species, or C. kerstersii. The detection of Clostridium difficile toxins A and B and glutamate dehydrogenase antigen with the commercial C. difficile detection kit from Techlab was also negative. Blood samples (two pairs of culture bottles) were drawn from a peripheral vein, and the patient was discharged under treatment with oral ciprofloxacin for gastroenteritis of unknown origin. The blood cultures were processed by a Bactec FX automated blood culture system (Becton, Dickinson, Sparks, MD). A first aerobic blood culture bottle became positive 16 h 8 min after sampling, and Gram staining revealed the presence of long, filamentous, Gram-negative bacilli (Fig. 1). Bacterial identification by matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (Bruker Daltonics GmbH, Leipzig, Germany) was performed on the same day by using a protocol that we recently developed on the basis of the analyses of a bacterial pellet preparation from the blood culture bottles (3-5). The strain was identified as C. kerstersii, a Gram-negative nonfermenting bacterium, and prompted the hospitalization of the patient. The patient was afebrile at that time, but palpation of the left lower abdominal quadrant was painful. An abdominal computed tomography (CT) scan revealed diverticulosis without evidence of diverticulitis. The anaerobic blood culture bottles from the same pair of samples became positive for Bacteroides fragilis 24 h 2 min after sample collection. We determined the following MICs (mg/liter) for the C. kerstersii strain by the Etest method

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confidence: 99%

Bacteremia Caused by Comamonaskerstersii in a Patient with Diverticulosis

et al. 2014

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“…with antibiotic resistance phenomena has been referenced in the literature but is very limited overall (43)(44)(45). To our knowledge, this is the first report of D. acidovorans tolerance to a broad-spectrum biocide, such as CHX.…”

Section: Discussionmentioning

confidence: 90%

“…Several strains of D. acidovorans (as C. acidovorans) isolated from clinical specimens have been found to be resistant to various groups of antibiotics, such as ␤-lactams, aminoglycosides, and quinolones (43). Chotikanatis et al (44) summarized the previously reported antibiotic susceptibilities of D. acidovorans and concluded that it was resistant to gentamicin in all cases, resistant to all aminoglycosides in some cases, and generally susceptible to cephalosporins, piperacillin, aztreonam, carbapenems, quinolones, and trimethoprim-sulfamethoxazole. A positive correlation between D. acidovorans (as C. acidovorans) and residual chlorine was found in contaminated dental water units, indicating a strong resistance of this bacterium to chlorine (45).…”

Section: Discussionmentioning

confidence: 99%

Microscopic and Spectroscopic Analyses of Chlorhexidine Tolerance in Delftia acidovorans Biofilms

Rema

Lawrence

Dynes

et al. 2014

Antimicrob Agents Chemother

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The physicochemical responses of Delftia acidovorans biofilms exposed to the commonly used antimicrobial chlorhexidine (CHX) were examined in this study. A CHX-sensitive mutant (MIC, 1.0 g ml ؊1 ) was derived from a CHX-tolerant (MIC, 15.0 g ml ؊1 ) D. acidovorans parent strain using transposon mutagenesis. D. acidovorans mutant (MT51) and wild-type (WT15) strain biofilms were cultivated in flow cells and then treated with CHX at sub-MIC and inhibitory concentrations and examined by confocal laser scanning microscopy (CLSM), scanning transmission X-ray microscopy (STXM), and infrared (IR) spectroscopy. Specific morphological, structural, and chemical compositional differences between the CHX-treated and -untreated biofilms of both strains were observed. Apart from architectural differences, CLSM revealed a negative effect of CHX on biofilm thickness in the CHX-sensitive MT51 biofilms relative to those of the WT15 strain. STXM analyses showed that the WT15 biofilms contained two morphochemical cell variants, whereas only one type was detected in the MT51 biofilms. The cells in the MT51 biofilms bioaccumulated CHX to a similar extent as one of the cell types found in the WT15 biofilms, whereas the other cell type in the WT15 biofilms did not bioaccumulate CHX. STXM and IR spectral analyses revealed that CHX-sensitive MT51 cells accumulated the highest levels of CHX. Pretreating biofilms with EDTA promoted the accumulation of CHX in all cells. Thus, it is suggested that a subpopulation of cells that do not accumulate CHX appear to be responsible for greater CHX resistance in D. acidovorans WT15 biofilm in conjunction with the possible involvement of bacterial membrane stability.

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“…Delftia acidovorans is a low virulence, environmental Gram negative bacillus with a wide geographical distribution, and is an uncommon clinical isolate [1]. Since its initial discovery in 1929 [2], it has been reported with gradual increasing frequency in the academic literature as a pathogenic organism, often in immunocompromised individuals [1].…”

Section: Discussionmentioning

confidence: 99%

Delftia acidovorans Skin Infection Occurring in a Diabetic with Peripheral Edema

Khan¹,

Krishnan²

2014

JCR

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Abstract:We present the first reported case of Delftia acidovorans skin infection, occurring in a diabetic patient with significant peripheral oedema. D. acidovorans is a strictly aerobic, motile, Gram negative bacillus with similar rRNA genotype and microbiological phenotype as Pseudomonas. From a clinical perspective, this microorganism presents with similar risk factors, clinical manifestations and treatment options as those of Pseudomonal infections. Importantly, there is a high prevalence of aminoglycoside resistance. With increasing rates of iatrogenic immunosuppression, as well as increasing use of invasive devices, this normally lowvirulence, environmental microorganism may become increasingly prevalent as an opportunistic pathogen in both immunocompromised and immunocompetent patients.

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Recurrent Intravascular-Catheter-Related Bacteremia Caused by Delftia acidovorans in a Hemodialysis Patient

Cited by 36 publications

References 17 publications

Bacteremia Caused by Comamonaskerstersii in a Patient with Diverticulosis

Bacteremia Caused by Comamonaskerstersii in a Patient with Diverticulosis

Microscopic and Spectroscopic Analyses of Chlorhexidine Tolerance in Delftia acidovorans Biofilms

Delftia acidovorans Skin Infection Occurring in a Diabetic with Peripheral Edema

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