Risk and prognostic factors among patients with bacteremia due to Eggerthella lenta

Venugopal, Anilrudh A.; Szpunar, Susanna; Johnson, Leonard B.

doi:10.1016/j.anaerobe.2012.05.005

Cited by 43 publications

(40 citation statements)

References 15 publications

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“…Our cohort has some differences from previous case series. Venugopal et al (14) provided detailed clinical information on 25 cases but no microbiological data. They reported a higher proportion of health care onset bacteremias (50%).…”

Section: Discussionmentioning

confidence: 99%

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Clinical and Microbiological Characteristics of Eggerthella lenta Bacteremia

et al. 2015

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e Eggerthella lenta is an emerging pathogen that has been underrecognized due to historical difficulties with phenotypic identification. Until now, its pathogenicity, antimicrobial susceptibility profile, and optimal treatment have been poorly characterized. In this article, we report the largest cohort of patients with E. lenta bacteremia to date and describe in detail their clinical features, microbiologic characteristics, treatment, and outcomes. We identified 33 patients; the median age was 68 years, and there was no gender predominance. Twenty-seven patients (82%) had serious intra-abdominal pathology, often requiring a medical procedure. Of those who received antibiotics (28/33, 85%), the median duration of treatment was 21.5 days. Mortality from all causes was 6% at 7 days, 12% at 30 days, and 33% at 1 year. Of 26 isolates available for further testing, all were identified as E. lenta by both commercially available matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) systems, and none were found to harbor a vanA or vanB gene. Of 23 isolates which underwent susceptibility testing, all were susceptible to amoxicillin-clavulanate, cefoxitin, metronidazole, piperacillin-tazobactam, ertapenem, and meropenem, 91% were susceptible to clindamycin, 74% were susceptible to moxifloxacin, and 39% were susceptible to penicillin.

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Section: Discussionmentioning

confidence: 99%

“…E. lenta is part of the normal human intestinal microbiome (10) and has been most commonly associated with infections from a gastrointestinal tract (GIT) source, which are often polymicrobial (11). Severe, disseminated disease has been described (12), and overall mortality is significant, ranging from 36% to 43% (13,14).…”

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Clinical and Microbiological Characteristics of Eggerthella lenta Bacteremia

et al. 2015

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“…Along with other Gram-positive anaerobes such as Clostridium, Propionibacterium, Bifidobacterium, Eubacterium, and Lactobacillus, E. lenta is part of the normal human colonic microbiome (6) and as such has been most commonly associated with intra-abdominal infections (7-10), which are often polymicrobial. The overall mortality appears to be significant, ranging from 36% to 43% (11,12). Infected decubitus ulcers (13) and more unusual presentations such as frontal sinusitis (14) and pyomyositis (15, 16) are also described.…”

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confidence: 99%

Eggerthella lenta Bacteremia Complicated by Spondylodiscitis, Psoas Abscess, and Meningitis

2014

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b Eggerthella lenta bacteremia is uncommon and generally associated with abdominal sepsis. The organism and its clinical significance have not been well characterized due to historical difficulties with identification. We report a case of severe infection in a paraplegic man complicated by psoas abscess, osteomyelitis, and meningitis and discuss treatment challenges. CASE REPORTA 70-year-old man with a long-standing history of complete T4 paraplegia secondary to transverse myelitis presented with fevers and night sweats. His past medical history included myocardial infarction and multiple complications from his paraplegia, including recurrent catheter-related urinary tract infections and constipation requiring traumatic manual disimpactions.A computed tomography (CT) scan of his abdomen performed 1 month prior to presentation revealed abnormalities in the T6 and L1 and L2 (L1/2) vertebral bodies. A subsequent bone scan demonstrated increased osteoblastic activity in these areas, and a magnetic resonance imaging (MRI) scan of the lumbar spine ( Fig.

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“…These data emphasize the importance of further investigation for bacterial virulence factors. It is suspected that transfer of E. lenta from an intra-abdominal abscess to the bloodstream may reflect a defect in the gastrointestinal tract; E. lenta is normally a gut commensal bacterium [13,14]. Some reports found that E. lenta infection caused morbidity and mortality associated with septic shock and multiple organ failure.…”

Section: Discussionmentioning

confidence: 99%

Bacteremia Caused byEggerthella lentain an Elderly Patient with an Intra-abdominal Abscess

Eom

Kim

et al. 2016

Lab Med Online

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A 73-yr-old male presented with fever, vomiting, and dyspnea.His medical history included a prior cerebrovascular attack and multiple complications caused by hemiplegia, including recurrent urinary tract infections and pressure sores requiring continuous medical care.On the day of admission, his body temperature, pulse rate, respiratory rate, and blood pressure were 40.4°C, 108/min, 39/min, and 170/90 mmHg, respectively. Abdominal examina-tion revealed diffuse tenderness and guarding with absence of bowel sounds. The initial laboratory test data were as follows: Hb, 14.9 g/dL; white blood cell count, 7,250/μL (neutrophils, 78.0%); and platelets, 110,000/μL. His procalcitonin level was elevated to 28.46 ng/mL. Sputum and urine cultures were negative. PCR to detect Eggerthella lenta is an anaerobic, non-spore-forming, non-motile, gram-positive bacillus that can be isolated from human feces and a few other clinical specimens. Bacteremia caused by the organism is rare but, when present, is always of clinical significance. E. lenta is an emerging pathogen that has been under-recognized because of difficulties with its laboratory identification. Few reports on E. lenta infections and the optimal treatment thereof are available. We describe a case of bacteremia caused by E. lenta in an elderly patient with an intra-abdominal abscess. We also review the current literature.

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Risk and prognostic factors among patients with bacteremia due to Eggerthella lenta

Cited by 43 publications

References 15 publications

Clinical and Microbiological Characteristics of Eggerthella lenta Bacteremia

Clinical and Microbiological Characteristics of Eggerthella lenta Bacteremia

Eggerthella lenta Bacteremia Complicated by Spondylodiscitis, Psoas Abscess, and Meningitis

Bacteremia Caused byEggerthella lentain an Elderly Patient with an Intra-abdominal Abscess

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