Two Cases of Kerstersia gyiorum Isolated from Sites of Chronic Infection

Abstract

c Kerstersia gyiorum is infrequently associated with human infection. We report the isolation of Kerstersia gyiorum from two patients: the first, a patient with chronic ear infections, and the second, a patient with a chronic leg wound. Both isolates were resistant to ciprofloxacin, which has not been previously reported. CASE REPORTSC ase 1. A 55-year-old man with a past medical history of chronic ear disease, alcoholism, and smoking (2 packs/day) was seen in the Barnes-Jewish Hospital otolaryngology clinic with a chief complaint of bilateral ear drainage. At the ages of 13 and 16, he had undergone canal wall-down mastoidectomies of the right and left ears, respectively. Since that time, he had reported some hearing loss and bilateral ear drainage. One month prior to his current encounter, the patient complained of increasing drainage from his left ear, which reportedly exhibited a reddish hue and an odor of "dead fish." At that time, the patient was prescribed 0.3% ciprofloxacin-0.1% dexamethasone otic solution (four drops, twice daily). At a follow-up visit 1 month later, he admitted to being only partially compliant with his prescribed regimen. During the same visit, the left mastoid cavity was suctioned and cleaned and a specimen was taken from the posterior pocket at the sinodural angle and submitted for aerobic bacterial culture. The patient was instructed to continue using ciprofloxacindexamethasone drops and expressed that he would make an effort to be more compliant.The direct Gram stain of the specimen submitted from the mastoid cavity showed no polymorphonuclear cells, moderate numbers of Gram-positive bacilli, and moderate numbers of Gram-negative bacilli. The culture grew abundant amounts of Corynebacterium amycolatum, as well as an abundant amount of a Gram-negative coccobacillus, which appeared in singles, pairs, and short chains on Gram stain (Fig. 1A). The isolate formed flat, opaque, gray colonies with spreading edges on blood (Fig. 1B) and chocolate agar, with a colony morphology somewhat resembling that of Alcaligenes spp. but lacking the characteristic "fruity" odor associated with this genus. On MacConkey agar, the isolate was non-lactose fermenting, but colonies had a slight lavender hue (Fig. 1C), which was especially evident when the colonies were picked up using a swab (Fig. 1D). The isolate was oxidase negative, spot indole negative, catalase positive, and nonmotile. An oxidation/fermentation (OF) glucose test was performed; the isolate was found to be a nonutilizer of glucose. Disks containing vancomycin and penicillin were added to subculture plates to obtain additional information about the isolate; there was no inhibition around the vancomycin disk, and a zone size of 16 mm was measured around the penicillin disk. A Vitek 2 Gram-negative identification (GNI) card (bioMérieux, Durham, NC) resulted in no identification. A RapID NF plus assay (Thermo Fisher Scientific, Lenexa, KS) was performed and gave a biocode of 010200, which resulted in an identification of Pseudomonas oryzihabi...

Isolation of culturable aerobic bacteria and evidence of Kerstersia gyiorum from the blowhole of captive Yangtze finless porpoises

“…The detection of K. gyiorum in sputum and bronchoalveolar samples suggests that this bacterium can colonize the lower and the upper respiratory tract, and could cause a respiratory infection. There are only four prior descriptions of this species exhibiting spreading edge morphology on blood and chocolate agar plates (Bostwick et al 2015;Deutscher et al 2014;Pence et al 2013). This phenotype appears to be characteristic of K. gyiorum.…”

“…This is the first case of K. gyiorum isolated from an animal. In previous studies, K. gyiorum was found in rare cases to cause infections in humans resulting in otitis media (Almuzara et al 2012;Mwalutende et al 2014), bacteremia (Bostwick et al 2015), a chronic tracheostomy (Deutscher et al 2014), chronic ear infections (Pence et al 2013) and a chronic leg wound (Pence et al 2013). The bacterium has also been isolated from human fecal material and sputum (Coenye et al 2003).…”

“…K. gyiorum forms white opaque colonies with spreading edge margins on a blood agar plate. Arrows show colonies of K. gyiorum A, B, C, D and E are Kerstersia gyiorum species from references (Pence et al 2013), (Mwalutende et al 2014), (Deutscher et al 2014), (Bostwick et al 2015) and (Almuzara et al 2012), respectively. F is Alcaligenes faecalis species from reference (Coenye et al 2003).…”

“…The scale bar indicates a 0.2 % difference in nucleotide sequences Bostwick et al 2015;Coenye et al 2003;Deutscher et al 2014;Mwalutende et al 2014;Pence et al 2013) (Table 2), and were different from the K. similis isolate ( Table 2). As shown in Table 3, the antibiotic sensitivity of the K. gyiorum isolate in our study is consistent with previous reports (Almuzara et al 2012;Deutscher et al 2014;Mwalutende et al 2014;Pence et al 2013), except for several antimicrobial agents of the isolate C (Bostwick et al 2015). It is not surprising since different strains of the same bacterial species can have different antibiotic sensitivity.…”

Kerstersia gyiorum: An Unusual Pathogen Causing Chronic Suppurative Otitis Media

“…Son zamanlarda, nadir bir patojen olan K. gyiorum'un kronik süpüratif otitis media etkeni olduğu az sayıda olgu da bildirilmiştir (3,4,7). Ülkemizden yapılan tek bildirim olan Uysal ve arkadaşları (4)'nın çalışmasında K. gyiorum bir kronik süpüratif otitis media hastasından izole edilmiş, köken MALDI-TOF/MS ve 16S rRNA analiziyle tanımlanmıştır.…”