Calvin Ka-Fung Lo, Conor Broderick, Aleksandra Stefanovic, William Connors, Melanie Murray
{"title":"肾移植患者慢性留置中心静脉导管伴脓Gordonia相关血流感染1例报告并文献复习。","authors":"Calvin Ka-Fung Lo, Conor Broderick, Aleksandra Stefanovic, William Connors, Melanie Murray","doi":"10.1099/acmi.0.000560.v3","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Although rare, human infections caused by <i>Gordonia</i> spp. have been reported, especially within the immunocompromised population and those with long-term indwelling devices. We report a case of <i>Gordonia</i> spp. bacteraemia in a renal transplant patient and present a literature review on microbiological identification methods of this organism.</p><p><strong>Case presentation: </strong>A 62-year-old female renal transplant recipient admitted to hospital with a 2-month history of dry cough and fevers occurring weekly when receiving electrolyte replacement infusions via a Groshong line. Over 2 weeks, blood cultures repeatedly isolated a Gram-positive bacillus solely in aerobic bottles, and this was initially reported as <i>Rhodococcus</i> spp. by the local microbiology laboratory. Chest computed tomography (CT) showed multiple ground-glass lung opacities suggestive of septic pulmonary emboli. As central line-associated bloodstream infection was suspected, empirical antibiotics were initiated and the Groshong line was removed. The Gram-positive bacillus was later confirmed by the reference laboratory as <i>Gordonia sputi</i> via 16S rRNA sequencing. Vancomycin and ciprofloxacin for a duration of 6 weeks were completed as targeted antimicrobial therapy. After treatment, the patient remained symptom-free with marked improvement on repeat CT chest imaging.</p><p><strong>Conclusion: </strong>This case illustrates the challenges surrounding identification of <i>Gordonia</i> spp. and other aerobic actinomycetes. 16S rRNA gene sequencing may be a preferred identification method, especially when initial workup of a weakly acid-fast organism fails to make an identification or shows discrepant results using traditional diagnostic modalities.</p>","PeriodicalId":6956,"journal":{"name":"Access Microbiology","volume":"5 6","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10323808/pdf/","citationCount":"0","resultStr":"{\"title\":\"<i>Gordonia sputi</i>-associated bloodstream infection in a renal transplant patient with chronic indwelling central venous catheter: a case report and literature review.\",\"authors\":\"Calvin Ka-Fung Lo, Conor Broderick, Aleksandra Stefanovic, William Connors, Melanie Murray\",\"doi\":\"10.1099/acmi.0.000560.v3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Although rare, human infections caused by <i>Gordonia</i> spp. have been reported, especially within the immunocompromised population and those with long-term indwelling devices. We report a case of <i>Gordonia</i> spp. bacteraemia in a renal transplant patient and present a literature review on microbiological identification methods of this organism.</p><p><strong>Case presentation: </strong>A 62-year-old female renal transplant recipient admitted to hospital with a 2-month history of dry cough and fevers occurring weekly when receiving electrolyte replacement infusions via a Groshong line. Over 2 weeks, blood cultures repeatedly isolated a Gram-positive bacillus solely in aerobic bottles, and this was initially reported as <i>Rhodococcus</i> spp. by the local microbiology laboratory. Chest computed tomography (CT) showed multiple ground-glass lung opacities suggestive of septic pulmonary emboli. As central line-associated bloodstream infection was suspected, empirical antibiotics were initiated and the Groshong line was removed. The Gram-positive bacillus was later confirmed by the reference laboratory as <i>Gordonia sputi</i> via 16S rRNA sequencing. Vancomycin and ciprofloxacin for a duration of 6 weeks were completed as targeted antimicrobial therapy. After treatment, the patient remained symptom-free with marked improvement on repeat CT chest imaging.</p><p><strong>Conclusion: </strong>This case illustrates the challenges surrounding identification of <i>Gordonia</i> spp. and other aerobic actinomycetes. 16S rRNA gene sequencing may be a preferred identification method, especially when initial workup of a weakly acid-fast organism fails to make an identification or shows discrepant results using traditional diagnostic modalities.</p>\",\"PeriodicalId\":6956,\"journal\":{\"name\":\"Access Microbiology\",\"volume\":\"5 6\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10323808/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Access Microbiology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1099/acmi.0.000560.v3\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Access Microbiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1099/acmi.0.000560.v3","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Gordonia sputi-associated bloodstream infection in a renal transplant patient with chronic indwelling central venous catheter: a case report and literature review.
Introduction: Although rare, human infections caused by Gordonia spp. have been reported, especially within the immunocompromised population and those with long-term indwelling devices. We report a case of Gordonia spp. bacteraemia in a renal transplant patient and present a literature review on microbiological identification methods of this organism.
Case presentation: A 62-year-old female renal transplant recipient admitted to hospital with a 2-month history of dry cough and fevers occurring weekly when receiving electrolyte replacement infusions via a Groshong line. Over 2 weeks, blood cultures repeatedly isolated a Gram-positive bacillus solely in aerobic bottles, and this was initially reported as Rhodococcus spp. by the local microbiology laboratory. Chest computed tomography (CT) showed multiple ground-glass lung opacities suggestive of septic pulmonary emboli. As central line-associated bloodstream infection was suspected, empirical antibiotics were initiated and the Groshong line was removed. The Gram-positive bacillus was later confirmed by the reference laboratory as Gordonia sputi via 16S rRNA sequencing. Vancomycin and ciprofloxacin for a duration of 6 weeks were completed as targeted antimicrobial therapy. After treatment, the patient remained symptom-free with marked improvement on repeat CT chest imaging.
Conclusion: This case illustrates the challenges surrounding identification of Gordonia spp. and other aerobic actinomycetes. 16S rRNA gene sequencing may be a preferred identification method, especially when initial workup of a weakly acid-fast organism fails to make an identification or shows discrepant results using traditional diagnostic modalities.