1887

Abstract

is a Gram-positive coccus and a commensal bacterium of the human gastrointestinal tract with a potential to cause invasive infections. We report the presence of in the blood of a 25-year-old male patient with Crohn’s disease, short bowel syndrome treated with home parenteral nutrition, and a history of recurrent bloodstream infections, admitted to our hospital with fever and malaise. A polymicrobial culture of and was identified from blood, for which treatment with meropenem and metronidazole was initiated. The literature was searched for previous cases of infection with . In total, 14 reports describing infection of 28 patients were found, most cases presenting with bacteremia. The previous reports have described variable susceptibility to antibiotics; however, all were reported to be vancomycin resistant. Because of its similarities to other vancomycin-resistant cocci, isolates of might be difficult to identify with traditional methods. Infection may be facilitated by its natural vancomycin resistance, leading to severe infection in hosts with underlying diseases. We describe the treatment of previous cases of infection and suggest treatment methods shown effective in other cases. Vancomycin is often used as treatment of infection with Gram-positive organisms, but this may need to be reevaluated, as several pathogenic bacteria are intrinsically vancomycin resistant. A review on reported treatments of bacteremia by suggests the use of daptomycin, amoxicillin-clavulanate or piperacillin/tazobactam as recommendable antibiotic regimens.

Loading

Article metrics loading...

/content/journal/acmi/10.1099/acmi.0.000119
2020-03-26
2020-04-03
Loading full text...

Full text loading...

/deliver/fulltext/acmi/10.1099/acmi.0.000119/acmi000119.html?itemId=/content/journal/acmi/10.1099/acmi.0.000119&mimeType=html&fmt=ahah

References

  1. Collins MD, Samelis J, Metaxopoulos J, Wallbanks S. Taxonomic studies on some leuconostoc-like organisms from fermented sausages: description of a new genus Weissella for the Leuconostoc paramesenteroides group of species. J Appl Bacteriol 1993; 75: 595 603 [CrossRef] [PubMed]
    [Google Scholar]
  2. Fusco V, Quero GM, Cho G-S, Kabisch J, Meske D et al. The genus Weissella: taxonomy, ecology and biotechnological potential. Front Microbiol 2015; 6: 155 [CrossRef] [PubMed]
    [Google Scholar]
  3. Green M, Wadowsky RM, Barbadora K. Recovery of vancomycin-resistant Gram-positive cocci from children. J Clin Microbiol 1990; 28: 484 488 [CrossRef] [PubMed]
    [Google Scholar]
  4. Olano A, Chua J, Schroeder S, Minari A, La Salvia M et al. Weissella confusa (basonym: Lactobacillus confusus) bacteremia: a case report. J Clin Microbiol 2001; 39: 1604 1607 [CrossRef] [PubMed]
    [Google Scholar]
  5. Parte AC. LPSN--list of prokaryotic names with standing in nomenclature. Nucleic Acids Res 2014; 42: D613 D616 [CrossRef] [PubMed]
    [Google Scholar]
  6. Lee M-R, Huang Y-T, Liao C-H, Lai C-C, Lee P-I et al. Bacteraemia caused by Weissella confusa at a university hospital in Taiwan, 1997-2007. Clin Microbiol Infect 2011; 17: 1226 1231 [CrossRef] [PubMed]
    [Google Scholar]
  7. Salimnia H, Alangaden GJ, Bharadwaj R, Painter TM, Chandrasekar PH et al. Weissella confusa: an unexpected cause of vancomycin-resistant gram-positive bacteremia in immunocompromised hosts. Transpl Infect Dis 2011; 13: 294 298 [CrossRef] [PubMed]
    [Google Scholar]
  8. Medford R, Patel SN, Evans GA. A confusing case - Weissella confusa prosthetic joint infection: A case report and review of the literature. Can J Infect Dis Med Microbiol 2014; 25: 173 175 [CrossRef] [PubMed]
    [Google Scholar]
  9. Flaherty JD, Levett PN, Dewhirst FE, Troe TE, Warren JR et al. Fatal case of endocarditis due to Weissella confusa . J Clin Microbiol 2003; 41: 2237 2239 [CrossRef] [PubMed]
    [Google Scholar]
  10. Riebel WJ, Washington JA. Clinical and microbiologic characteristics of pediococci. J Clin Microbiol 1990; 28: 1348 1355 [CrossRef] [PubMed]
    [Google Scholar]
  11. Shin JH, Kim DI, Kim HR, Kim DS, Kook J-K et al. Severe infective endocarditis of native valves caused by Weissella confusa detected incidentally on echocardiography. J Infect 2007; 54: e149 e151 [CrossRef] [PubMed]
    [Google Scholar]
  12. Kumar A, Augustine D, Sudhindran S, Kurian AM, Dinesh KR et al. Weissella confusa: a rare cause of vancomycin-resistant Gram-positive bacteraemia. J Med Microbiol 2011; 60: 1539 1541 [CrossRef] [PubMed]
    [Google Scholar]
  13. Vasquez A, Pancholi P, Balada-Llasat J-M. Photo quiz: confusing bacteremia in a Crohn's disease patient. J Clin Microbiol 2015; 53: 2015 [CrossRef]
    [Google Scholar]
  14. Vasquez A, Balada-Llasat JM. Reply to “Confused by Weissella confusa Bacteremia”. J Clin Microbiol 2002; 2015: 53
    [Google Scholar]
  15. Lawhon SD, Lopez FR, Joswig A, Black HC, Watts AE et al. Weissella confusa septicemia in a foal. J VET Diagn Invest 2014; 26: 150 153 [CrossRef]
    [Google Scholar]
  16. Vela AI, Porrero C, Goyache J, Nieto A, Sánchez B et al. Weissella confusa infection in primate (Cercopithecus mona). Emerg Infect Dis 2003; 9: 1307 1309 [CrossRef] [PubMed]
    [Google Scholar]
  17. Bantar CE, Relloso S, Castell FR, Smayevsky J, Bianchini HM. Abscess caused by vancomycin-resistant Lactobacillus confusus . J Clin Microbiol 1991; 29: 2063 2064 [CrossRef] [PubMed]
    [Google Scholar]
  18. Green M, Barbadora K, Michaels M. Recovery of vancomycin-resistant gram-positive cocci from pediatric liver transplant recipients. J Clin Microbiol 1991; 29: 2503 2506 [CrossRef] [PubMed]
    [Google Scholar]
  19. Fusco V, Quero GM, Stea G, Morea M, Visconti A. Novel PCR-based identification of Weissella confusa using an AFLP-derived marker. Int J Food Microbiol 2011; 145: 437 443 [CrossRef] [PubMed]
    [Google Scholar]
  20. Fairfax MR, Lephart PR, Salimnia H. Weissella confusa: problems with identification of an opportunistic pathogen that has been found in fermented foods and proposed as a probiotic. Front Microbiol 2014; 5: 254 [CrossRef] [PubMed]
    [Google Scholar]
  21. Kulwichit W, Nilgate S, Chatsuwan T, Krajiw S, Unhasuta C et al. Accuracies of Leuconostoc phenotypic identification: a comparison of API systems and conventional phenotypic assays. BMC Infect Dis 2007; 7: 69 [CrossRef] [PubMed]
    [Google Scholar]
  22. Kamboj K, Vasquez A, Balada-Llasat J-M. Identification and significance of Weissella species infections. Front Microbiol 2015; 6: 120 [CrossRef]
    [Google Scholar]
  23. Lee W, Cho S-M, Kim M, Ko Y-G, Yong D et al. Weissella confusa bacteremia in an immune-competent patient with underlying intramural hematomas of the aorta. Ann Lab Med 2013; 33: 459 462 [CrossRef] [PubMed]
    [Google Scholar]
  24. Harlan NP, Kempker RR, Parekh SM, Burd EM, Kuhar DT. Weissella confusa bacteremia in a liver transplant patient with hepatic artery thrombosis. Transpl Infect Dis 2011; 13: 290 293 [CrossRef] [PubMed]
    [Google Scholar]
  25. Svec P, Sevcíková A, Sedlácek I, Bednárová J, Snauwaert C et al. Identification of lactic acid bacteria isolated from human blood cultures. FEMS Immunol Med Microbiol 2007; 49: 192 196 [CrossRef] [PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/acmi/10.1099/acmi.0.000119
Loading
/content/journal/acmi/10.1099/acmi.0.000119
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error