1887

Abstract

Small-colony variants are slow-growing subpopulations of bacteria known to be involved in latent or recurrent infections, especially in deep-seated foci. Their atypical growth in small colonies can hamper prompt and correct identification in clinical specimens. Here, we present the first case of multiple spinal abscesses and spondylodiscitis associated with an Enterococcus faecium small-colony-variant in an immunocompetent patient. This case demonstrates the diagnostic challenges when encountering this phenotype in the diagnostic laboratory.

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2019-03-27
2020-01-20
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References

  1. Proctor RA, von Eiff C, Kahl BC, Becker K, McNamara P et al. Small colony variants: a pathogenic form of bacteria that facilitates persistent and recurrent infections. Nat Rev Microbiol 2006;4:295–305 [CrossRef]
    [Google Scholar]
  2. Wellinghausen N, Chatterjee I, Berger A, Niederfuehr A, Proctor RA et al. Characterization of clinical Enterococcus faecalis small-colony variants. J Clin Microbiol 2009;47:2802–2811 [CrossRef]
    [Google Scholar]
  3. Gröbner S, Beck J, Schaller M, Autenrieth IB, Schulte B. Characterization of an Enterococcus faecium small-colony variant isolated from blood culture. Int J Med Microbiol 2012;302:40–44 [CrossRef]
    [Google Scholar]
  4. Benes J, Dzupova O, Setina M, Feuereisl R, Svec P et al. Relapsing endocarditis caused by Enterococcus faecalis forming small colony variants. Scand J Infect Dis 2013;45:800–803 [CrossRef]
    [Google Scholar]
  5. Ogihara S, Saito R, Sawabe E, Hagihara M, Tohda S. First Japanese case of infectious endocarditis due to Enterococcus faecalis small-colony variants. J Infect Chemother 2016;22:716–719 [CrossRef]
    [Google Scholar]
  6. Kubota N, Kuzumoto K, Hidaka E, Yoshizawa K, Yumoto K et al. First isolation of oleate-dependent Enterococcus faecalis small-colony variants from the umbilical exudate of a paediatric patient with omphalitis. J Med Microbiol 2013;62:1883–1890 [CrossRef]
    [Google Scholar]
  7. Egido SH, Ruiz MS, Inés Revuelta S, García IG, Bellido JLM. Enterococcus faecium small colony variant endocarditis in an immunocompetent patient. New Microbes New Infect 2016;9:47–49 [CrossRef]
    [Google Scholar]
  8. Bundesamt fur Verbraucherschutz und LebensmittelsicherheitPaul-Ehrlich-Gesellschaft für Chemotherapie e.VGERMAP 2015–Report on the consumption of antimicrobials and the spread of antimicrobial resistance in human and veterinary medicine in Germany 2016
  9. Massey RC, Buckling A, Peacock SJ. Phenotypic switching of antibiotic resistance circumvents permanent costs in Staphylococcus aureus. Curr Biol 2001;11:1810–1814 [CrossRef]
    [Google Scholar]
  10. Tuchscherr L, Kreis CA, Hoerr V, Flint L, Hachmeister M et al. Staphylococcus aureus develops increased resistance to antibiotics by forming dynamic small colony variants during chronic osteomyelitis. J Antimicrob Chemother 2016;71:438–448 [CrossRef]
    [Google Scholar]
  11. Chuard C, Vaudaux PE, Proctor RA, Lew DP. Decreased susceptibility to antibiotic killing of a stable small colony variant of Staphylococcus aureus in fluid phase and on fibronectin-coated surfaces. J Antimicrob Chemother 1997;39:603–608 [CrossRef]
    [Google Scholar]
  12. Bundesamt für Verbraucherschutz und Lebensmittelsicherheit P-E-GfCeVGERMAP 2015–Bericht über den Antibiotikaverbrauch und die Verbreitung von Antibiotikaresistenzen in der Human- und Veterinärmedizin in Deutschland InBundesamt für Verbraucherschutz und Lebensmittelsicherheit P-E-GfCeV (editor) Rheinbach: Antiinfectives Intelligence; 2016
  13. Vestergaard M, Paulander W, Ingmer H. Activation of the SOS response increases the frequency of small colony variants. BMC Res Notes 2015;8:749 [CrossRef]
    [Google Scholar]
  14. Sinel C, Cacaci M, Meignen P, Guérin F, Davies BW et al. Subinhibitory concentrations of ciprofloxacin enhance antimicrobial resistance and pathogenicity of Enterococcus faecium. Antimicrob Agents Chemother 2017;61: [CrossRef]
    [Google Scholar]
  15. Garcia-Garrote F, Cercenado E, Bouza E. Evaluation of a new system, Vitek 2, for identification and antimicrobial susceptibility testing of enterococci. J Clin Microbiol 2000;38:2108–2111
    [Google Scholar]
  16. Seifert H, von Eiff C, Fätkenheuer G. Fatal case due to methicillin-resistant Staphylococcus aureus small colony variants in an AIDS patient. Emerg Infect Dis 1999;5:450–453 [CrossRef]
    [Google Scholar]
  17. Seifert H, Wisplinghoff H, Schnabel P, von Eiff C. Small colony variants of Staphylococcus aureus and pacemaker-related infection. Emerg Infect Dis 2003;9:1316–1318 [CrossRef]
    [Google Scholar]
  18. Tappe D, Claus H, Kern J, Marzinzig A, Frosch M et al. First case of febrile bacteremia due to a wild type and small-colony variant of Escherichia coli. Eur J Clin Microbiol Infect Dis 2006;25:31–34 [CrossRef]
    [Google Scholar]
  19. Roggenkamp A, Sing A, Hornef M, Brunner U, Autenrieth IB et al. Chronic prosthetic hip infection caused by a small-colony variant of Escherichia coli. J Clin Microbiol 1998;36:2530–2534
    [Google Scholar]
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