Two cases of bacteremia due to an unusual pathogen, Comamonas testosteroni in Iran and a review literature

Abstract

Here we describe two cases of bacteremia caused by Comamonas testosteroni in two malignant patients, a 10-year-old boy with brain medulloblastoma and a 19-year-old girl with osteosarcoma admitted in the same hospital at short intervals. This is the first report in Iran on this low inherent virulence organism as a human pathogen.

Comamonas Testosteroni Peritonitis Secondary to Dislocated Intrauterine Device and Laparoscopic Intervention in a Continuous Ambulatory Peritoneal Dialysis Patient

“…In past reports, the predisposing factors have been malignant disease, perforated appen dicitis, and intravenous drug abuse, among others (7). Before this event, our patient had not experienced any peritonitis.…”

Comamonas testosteroni-associated peritonitis in a pediatric peritoneal dialysis patient

“…C. testosteroni is usually sensitive to a broad range of antibiotics, including aminoglycosides, cephalosporins, fluoroquinolones, carbapenems, piperacillintazobactam, cephalosporins, and trimethoprimsulfamethoxazole [15] . According to the survey by Farshad et al [1] , 32 out of 35 reported cases of human infection by this bacterium were Parolin M et al . C. testosteroni peritonitis in children promptly responsive to antibiotic treatment.…”

“…testosteroni is a gramnegative aerobic bacillus that is found in various environments, including soil, water, plants, and animals. In spite of its wide environmental distribution, there are few reports on its involvement in human infections [1] . Most of the reported infections by this organism are communityacquired, however some authors suggested that it can also survive for a long time in the hospital setting.…”

“…These results supported the molecular biological basis of the potential pathogenicity of this bacterium. Along with its own virulence factors, pathogenicity of C. testosteroni seems to be emphasized in patients with some degree of immunosuppression such as malignancy, prematurity, primary or secondary immunodeficiency induced by chronic liver disease and endstage renal disease [1,12] . Moreover, bacterial translocation from the gastrointestinal tract seems to play an important role in the pathogenesis of infections [13] .…”

“…Infection by C. testosteroni is infrequent, however there are some reports describing its potential causative role in bacteremia, meningitis, urinary tract infections, endocarditis, cellulitis, and pneumonia [1,2] . Isolation of C. testosteroni has also emerged in localized peritonitis as a complication of perforated appendicitis [3,4] .…”