Severe sepsis caused by Parvimonas micra identified using 16S ribosomal RNA gene sequencing following patient death

Miyazaki, Mutsuko; Asaka, Tomoya; Takemoto, Masaaki; Nakano, Takuma

doi:10.1016/j.idcr.2019.e00687

Cited by 8 publications

(10 citation statements)

References 8 publications

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“…After reviewing the entire texts, 15 studies were excluded for the following reasons: two studies had been written in Korean or German, and in 13 studies, the samples used for detection were not blood samples. Finally, a total of 23 studies were identified, and 26 case reports were included in the final analysis ( Figure 1 ) [ 4 , 11 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ].…”

Section: Resultsmentioning

confidence: 99%

Infection Route of Parvimonas micra: A Case Report and Systematic Review

Shimizu¹,

Horinishi²,

Sano

et al. 2022

Healthcare

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Parvimonas micra (P. micra), a bacterium that colonizes the gastrointestinal tract, is often isolated from periodontitis and abscesses as part of a complex bacterial infection. However, reports of monobacterium infections due to P. micra are limited. Here, we report a case of monobacterial bacteremia caused by P. micra with the aim of identifying the source of the invasion and clarifying the clinical features. A 54-year-old patient presented with bacteremia due to P. micra and with an oral invasion that we suspected resulted from prior dental treatment. Using PubMed and Google Scholar databases, we undertook a systematic review of monobacteremia caused by P. micra. We identified 26 patients (mean age, 70.15 years) in our systematic review. P. micra bacteremia and its associated phenotypes were most frequently identified in spinal discitis, followed by epidural and lumbar abscesses, and infective endocarditis. The major risk factors were malignancy, diabetes mellitus, and post-arthroplasty. When P. micra is detected in blood cultures, evaluation and intervention for oral contamination may be indicated.

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Section: Resultsmentioning

confidence: 99%

Infection Route of Parvimonas micra: A Case Report and Systematic Review

Shimizu¹,

Horinishi²,

Sano

et al. 2022

Healthcare

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“…The size of P. micra is tiny (0.3–0.7 μm). P. micra was originally classified as Peptostreptococcus micros , then reclassified as Micromonas micros in 1999 and reclassified again as P. micra in 2006 ( 2 ). It is recognized as an oral pathogen ( 1 ); however, P. micra can also cause bloodstream infections, spinal infections, septic chest, and sepsis ( 3 , 4 ).…”

Section: Discussionmentioning

confidence: 99%

“…In data from Tsuyoshi's study, the 30-day clinical mortality rate for bloodstream infections with P. micra was only about 3.7%, ( 4 ) but it is still worth drawing the attention of clinicians to this issue. The majority of patients infected with P. micra also have underlying medical conditions ( 2 , 4 , 7 ), which suggests that the prevalence of P. micra infection is linked to human immunity. In our case, the patient had a long history of rheumatoid arthritis and was unaware that she had diabetes.…”

Section: Discussionmentioning

confidence: 99%

A case report of sepsis and death caused by Parvimonas micra, a rare anaerobe

Jiang

Qin²,

Li³

et al. 2022

Front. Public Health

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Parvimonas micra is a type of Gram-positive anaerobic cocci widely distributed in the oral cavity, gastrointestinal tract, respiratory tract, and female reproductive system mucosa. It is a conditional pathogen that can cause infections in the human oral cavity, wounds, and other areas as well as sepsis. In this case report, the patient's immune system was compromised by various underlying diseases and a pulmonary infection, which led to the entry of P. micra infection into the bloodstream. P. micra is a slow-growing organism (When a bloodstream infection occurs, flagging an anaerobic bottle of blood culture as positive will usually take >48 h), which makes it hard to secure timely blood culture results. Our patient's poor physical condition eventually led to sepsis, and she died after 5 days in the hospital.

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“…Although P. micra is typically susceptible to antibiotics such as penicillin, clindamycin, metronidazole, and imipenem, drug-resistant strains may also exist ( 9 , 25 ). In this case, amoxicillin clavulanate potassium and levofloxacin were administered successively.…”

Section: Discussionmentioning

confidence: 99%

“…Because it is anaerobic, P. micra is not a dominant bacterium in aerobic environments, including the lung. Although there are some reports of P. micra pneumonia due to aspiration, hematogenous P. micra pneumonia is rare ( 7 – 9 ). Moreover, to the best of our knowledge, there are no reports of P. micra -related pneumonia induced by bloodstream infection without a definitive, remote pathogenic source.…”

Section: Introductionmentioning

confidence: 99%

Case report: Successful management of Parvimonas micra pneumonia mimicking hematogenous Staphylococcus aureus pneumonia

Feng

Wu²,

Huang³

et al. 2022

Front. Med.

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Parvimonas micra is an anaerobic Gram-positive coccus frequently found in the oral cavity and gastrointestinal tract, but rarely in the lung. Therefore, pneumonia caused by P. micra is also rare. Although there are some reports of P. micra related pneumonia due to aspiration or blood-borne infection with definite remote infection source, there are no reported cases of hematogenous P. micra pneumonia in healthy adults lacking a remote source of infection. Herein, we described the intact disease of P. micra-related pneumonia mimicking hematogenous Staphylococcus aureus pneumonia in terms of chest imagery and diagnosed via metagenomic next-generation sequencing (mNGS). Interestingly, there was no clear remote pathogenic source identified in the patient. Microbiome analysis revealed dysbiosis of the oral flora possibly related to poor oral hygiene and a long history of smoking. The patient was treated with moxifloxacin for 3 months. Ultimately, computed tomography (CT) of the chest showed total resolution of the lung lesion. Clinicians need to update the etiology of community-acquired pneumonia. When antibiotic therapy is not effective, pathogen examination becomes very important. New methods of pathogen detection such as mNGS should be employed to this end. For the treatment of P. micra pneumonia, no standardized course of treatment was reported. Imaging absorption of lung infections may provide a more objective guidance for the duration of antibiotics in P. micra pneumonia.

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Severe sepsis caused by Parvimonas micra identified using 16S ribosomal RNA gene sequencing following patient death

Cited by 8 publications

References 8 publications

Infection Route of Parvimonas micra: A Case Report and Systematic Review

Infection Route of Parvimonas micra: A Case Report and Systematic Review

A case report of sepsis and death caused by Parvimonas micra, a rare anaerobe

Case report: Successful management of Parvimonas micra pneumonia mimicking hematogenous Staphylococcus aureus pneumonia

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