PMID- 35088967
OWN - NLM
STAT- MEDLINE
DCOM- 20220201
LR  - 20220201
IS  - 0374-9096 (Print)
IS  - 0374-9096 (Linking)
VI  - 56
IP  - 1
DP  - 2022 Jan
TI  - [A case of Infective Endocarditis Caused by Pseudoclavibacter species].
PG  - 133-138
LID - 10.5578/mb.20229912 [doi]
AB  - Infective endocarditis is an infectious disease usually caused by bacteria, 
      including streptococci, staphylococci, and enterococci. In this report, a case of 
      infective endocarditis in which Pseudoclavibacter spp. detected as the causative 
      agent was presented. A 66-year-old female patient was admitted to our hospital 
      with weight loss, malaise, and lumbar pain. A 2/6 murmur was detected in the 
      physical examination of the patient, who had a history of mitral valve surgery 
      nine years earlier. Blood sample was collected for culture and vancomycin [1 g/24 
      hours, intravenously (IV)] and gentamicin (80 mg/8 hours, IV) therapy were 
      started. Gram-positive bacilli were detected on the second day of incubation in 
      the blood culture bottle incubated in the BacT/ALERT 3D microbial detection 
      system (bioMerieux, France). High uptake in the focal area of the mitral valve on 
      positron emission tomography-computerized tomography (PET-CT) was interpreted as 
      infective endocarditis. The patient was considered to be at very high risk for 
      surgery and she was discharged after the vancomycin treatment completed for 42 
      days. For bacterial identification, DNA was isolated using a commercial kit 
      (Invitrogen PureLink Genomic DNA Mini Kit; ThermoFisher Scientific, Waltham, MA, 
      USA), and the 16S rRNA gene was amplified by a polymerase chain reaction (PCR) 
      assay using universal primers 27F and 1492R. Sequence analysis of the PCR product 
      was carried out on an Applied Biosystems 3730XL DNA Analyzer with an Applied 
      Biosystems BigDye Terminator v3.1 Cycle Sequencing Kit (ThermoFisher Scientific, 
      Waltham, MA, USA). A 1366 bp long sequence of the isolate was analyzed using the 
      Basic Local Alignment Search Tool (BLAST) in GenBank and the sequence was 99% 
      compatible with Gulosibacter spp. (GenBank sequence ID: LR884222.1, identity 
      1365/1366 bp) and Pseudoclavibacter spp. (GenBank sequence ID: FJ375951.1, 
      identity 1364/1366 bp). Upon the negative result of nitrate reduction test of 
      bacterium that was oxidasepositive, the bacterium was considered as 
      Pseudoclavibacter spp. Linezolid, clindamycin, and tetracycline susceptibilities 
      were determined by using the disc diffusion method. The isolate was susceptible 
      to linezolid and resistant to clindamycin and tetracycline. It was also 
      susceptible to penicillin [minimum inhibitory concentration (MIC) = 0.002 microg/ml], 
      vancomycin (MIC= 0.25 microg/ml), and rifampicin (MIC= 0.003 microg/ml) and was 
      categorized as "susceptible, increased exposure" to ciprofloxacin (MIC= 0.25 
      microg/ml), as determined by using a gradient strip test. Pseudoclavibacter species 
      are non-spore-forming, non-motile, catalase-positive, aerobic gram-positive 
      bacilli belonging to the Microbacteriaceae family. A limited number of clinical 
      cases due to Pseudoclavibacter species have been reported. In the present case, 
      gram-positive bacilli were considered to be the causative agent of infective 
      endocarditis because of the growth of the same bacteria in six bottles of blood 
      cultures taken at different times and increased focal involvement on PET-CT. To 
      our knowledge, this is the second reported case of infective endocarditis due to 
      Pseudoclavibacter species. In conclusion, in cases of clinical compliance in 
      patients with prosthetic heart valves, gram-positive bacilli should be considered 
      causative agents of infective endocarditis and in such cases, a range of 
      microbiological assays should be used for identification.
FAU - Eryildiz, Canan
AU  - Eryildiz C
AD  - Trakya University Faculty of Medicine, Department of Medical Microbiology, 
      Edirne, Turkey.
FAU - Elmaslar Mert, Habibe Tulin
AU  - Elmaslar Mert HT
AD  - Trakya University Faculty of Medicine, Department of Infectious Diseases, Edirne, 
      Turkey.
FAU - Tabakcioglu, Kiymet
AU  - Tabakcioglu K
AD  - Trakya University Faculty of Medicine, Department of Medical Biology, Edirne, 
      Turkey.
LA  - tur
PT  - Case Reports
PT  - Journal Article
TT  - Pseudoclavibacter spp.'nin Etken Oldugu Enfektif Endokardit Olgusu.
PL  - Turkey
TA  - Mikrobiyol Bul
JT  - Mikrobiyoloji bulteni
JID - 7503830
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (RNA, Ribosomal, 16S)
RN  - 6Q205EH1VU (Vancomycin)
SB  - IM
MH  - Aged
MH  - Anti-Bacterial Agents/therapeutic use
MH  - *Endocarditis
MH  - *Endocarditis, Bacterial/diagnosis/drug therapy
MH  - Female
MH  - Humans
MH  - Positron Emission Tomography Computed Tomography
MH  - RNA, Ribosomal, 16S/genetics
MH  - Vancomycin
EDAT- 2022/01/29 06:00
MHDA- 2022/02/02 06:00
CRDT- 2022/01/28 08:55
PHST- 2022/01/28 08:55 [entrez]
PHST- 2022/01/29 06:00 [pubmed]
PHST- 2022/02/02 06:00 [medline]
AID - 10.5578/mb.20229912 [doi]
PST - ppublish
SO  - Mikrobiyol Bul. 2022 Jan;56(1):133-138. doi: 10.5578/mb.20229912.