1887

Abstract

are Gram-negative, facultatively anaerobic rods or coccobacilli that are infrequently encountered as pathogens causing infection.

The range of invasive infection that cause is poorly described. The pathogenicity of species such as is debated.

To identify invasive infection due to species in a large healthcare organization and to characterize clinical syndromes, co-morbidities and risk factors.

All microbiological samples positive for species were identified by conventional culture or 16S rRNA PCR between October 2017 and March 2021. Electronic records for all patients with positive samples were reviewed and the infection syndrome classified for patients with invasive disease.

Twenty-seven patients with invasive infection were identified, with a statistically significant difference in species-specific patterns of invasive infection (=0.02) and a statistically significant association with residence in the 30 % most deprived households in the UK by postcode (<0.01). The three most common co-morbidities were periodontitis or recent dental work (29.6%), cardiovascular disease (25.9%) and diabetes (18.5 %).

We describe a novel association of with skin and soft tissue infection. The propensity of the species to cause invasive infection at different body sites and be associated with deprivation is reported. bacteraemia was associated with infective endocarditis, and was implicated in severe appendicitis and noted to cause brain abscess. Areas warranting future research include exploring the risk-factors required for invasive infection and those that may determine the species-specific differences in patterns of invasive disease.

  • This is an open-access article distributed under the terms of the Creative Commons Attribution License. This article was made open access via a Publish and Read agreement between the Microbiology Society and the corresponding author’s institution.
Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.001612
2022-12-13
2024-05-04
Loading full text...

Full text loading...

/deliver/fulltext/jmm/71/12/jmm001612.html?itemId=/content/journal/jmm/10.1099/jmm.0.001612&mimeType=html&fmt=ahah

References

  1. Klinger R. Untersuchungen über menschliche aktinomykose. Zentralbl Bakteriol 1912; 62:191–200
    [Google Scholar]
  2. Topley WWC, Wilson GS. The Principles of Bacteriology and Immunity London: Edward Arnold; 1929 pp 1–587
    [Google Scholar]
  3. Potts TV, Zambon JJ, Genco RJ. Reassignment of Actinobacillus actinomycetemcomitans to the genus Haemophilus as Haemophilus actinomycetemcomitans comb. nov. Int J Syst Bacteriol 1985; 35:337–341 [View Article]
    [Google Scholar]
  4. Nørskov-Lauritsen N, Kilian M. Reclassification of Actinobacillus actinomycetemcomitans, Haemophilus aphrophilus, Haemophilus paraphrophilus and Haemophilus segnis as Aggregatibacter actinomycetemcomitans gen nov. comb. nov., Aggregatibacter aphrophilus comb. nov. and Aggregatibacter segnis comb. nov., and emended description of Aggregatibacter aphrophilus to include V factor-dependent and V factor-independent isolates. Int J Syst Evol Microbiol 2006; 56:2135–2146 [View Article]
    [Google Scholar]
  5. Public Health England Identification of Haemophilus species and the HACEK group of organisms, UK Standards for Microbiology Investigations, ID 12, issue 4 London: Public Health England; 2020
    [Google Scholar]
  6. Nørskov-Lauritsen N, Claesson R, Birkeholm Jensen A, Åberg CH, Haubek D. Aggregatibacter actinomycetemcomitans: clinical significance of a pathobiont subjected to ample changes in classification and nomenclature. Pathogens 2019; 8:E243 [View Article]
    [Google Scholar]
  7. Sen Yew H, Chambers ST, Roberts SA, Holland DJ, Julian KA et al. Association between HACEK bacteraemia and endocarditis. J Med Microbiol 2014; 63:892–895 [View Article] [PubMed]
    [Google Scholar]
  8. Haubek D, Ennibi O-K, Poulsen K, Vaeth M, Poulsen S et al. Risk of aggressive periodontitis in adolescent carriers of the JP2 clone of Aggregatibacter (Actinobacillus) actinomycetemcomitans in Morocco: a prospective longitudinal cohort study. Lancet 2008; 371:237–242 [View Article]
    [Google Scholar]
  9. Paturel L, Casalta JP, Habib G, Nezri M, Raoult D. Actinobacillus actinomycetemcomitans endocarditis. Clin Microbiol Infect 2004; 10:98–118 [View Article] [PubMed]
    [Google Scholar]
  10. Revest M, Egmann G, Cattoir V, Tattevin P. HACEK endocarditis: state-of-the-art. Expert Rev Anti Infect Ther 2016; 14:523–530 [View Article] [PubMed]
    [Google Scholar]
  11. Zambon JJ, DeLuca C, Slots J, Genco RJ. Studies of leukotoxin from Actinobacillus actinomycetemcomitans using the promyelocytic HL-60 cell line. Infect Immun 1983; 40:205–212 [View Article] [PubMed]
    [Google Scholar]
  12. DiRienzo JM. Breaking the gingival epithelial barrier: role of the Aggregatibacter actinomycetemcomitans cytolethal distending toxin in oral infectious disease. Cells 2014; 3:476–499 [View Article]
    [Google Scholar]
  13. Wilson M, Henderson B. Virulence factors of Actinobacillus actinomycetemcomitans relevant to the pathogenesis of inflammatory periodontal diseases. FEMS Microbiol Rev 1995; 17:365–379 [View Article] [PubMed]
    [Google Scholar]
  14. Nørskov-Lauritsen N. Classification, identification, and clinical significance of Haemophilus and Aggregatibacter species with host specificity for humans. Clin Microbiol Rev 2014; 27:214–240 [View Article] [PubMed]
    [Google Scholar]
  15. Maraki S, Papadakis IS, Chronakis E, Panagopoulos D, Vakis A. Aggregatibacter aphrophilus brain abscess secondary to primary tooth extraction: case report and literature review. J Microbiol Immunol Infect 2016; 49:119–122 [View Article]
    [Google Scholar]
  16. King EO, Tatum HW. Actinobacillus actinomycetemcomitans and Hemophilus aphrophilus. J Infect Dis 1962; 111:85–94 [View Article]
    [Google Scholar]
  17. Roche M, Humphreys H, Smyth E, Phillips J, Cunney R et al. A twelve-year review of central nervous system bacterial abscesses; presentation and aetiology. Clin Microbiol Infect 2003; 9:803–809 [View Article] [PubMed]
    [Google Scholar]
  18. Di Bonaventura MP, DeSalle R, Pop M, Nagarajan N, Figurski DH et al. Complete genome sequence of Aggregatibacter (Haemophilus) aphrophilus NJ8700. J Bacteriol 2009; 191:4693–4694 [View Article] [PubMed]
    [Google Scholar]
  19. Hirunagi T, Kawanishi H, Mitsuma N, Goto Y, Mano K. Aggregatibacter segnis endocarditis mimicking antineutrophil cytoplasmic antibody-associated vasculitis presenting with cerebral hemorrhage: a case report. Rinsho Shinkeigaku 2015; 55:589–592 [View Article]
    [Google Scholar]
  20. Murra M, Lützen L, Barut A, Zbinden R, Lund M et al. Whole-genome sequencing of Aggregatibacter species isolated from human clinical specimens and description of Aggregatibacter kilianii sp. nov. J Clin Microbiol 2018; 56:e00053-18 [View Article]
    [Google Scholar]
  21. Office for National Statistics Ethnic Groups by Borough. London Datastore ( https://data.london.gov.uk/dataset/ethnic-groups-borough) London: Office for National Statistics; 2022
    [Google Scholar]
  22. Ministry of Housing, Communities & Local Government The English Indices of Deprivation 2019 – Statistical Release; 2019 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/835115/IoD2019_Statistical_Release.pdf
  23. UK Health Security Agency Collection – Standards for Microbiology Investigations (UK SMI). London: UK Health Security Agency; 2021 https://www.gov.uk/government/collections/standards-for-microbiology-investigations-smi
  24. Lampejo T, Ciesielczuk H, Lambourne J. Clinical utility of 16S rRNA PCR in pleural infection. J Med Microbiol 2021; 70:001366 [View Article] [PubMed]
    [Google Scholar]
  25. Lützen L, Olesen B, Voldstedlund M, Christensen JJ, Moser C et al. Incidence of HACEK bacteraemia in Denmark: a 6-year population-based study. Int J Infect Dis 2018; 68:83–87 [View Article]
    [Google Scholar]
  26. Dewhirst FE, Chen T, Izard J, Paster BJ, Tanner ACR et al. The human oral microbiome. J Bacteriol 2010; 192:5002–5017 [View Article] [PubMed]
    [Google Scholar]
  27. Tang G, Kitten T, Munro CL, Wellman GC, Mintz KP. EmaA, a potential virulence determinant of Aggregatibacter actinomycetemcomitans in infective endocarditis. Infect Immun 2008; 76:2316–2324 [View Article] [PubMed]
    [Google Scholar]
  28. Wang C-Y, Wang H-C, Li J-M, Wang J-Y, Yang K-C et al. Invasive infections of Aggregatibacter (Actinobacillus) actinomycetemcomitans. J Microbiol Immunol Infect 2010; 43:491–497 [View Article]
    [Google Scholar]
  29. Cortelli JR, Roman-Torres CVG, Aquino DR, Franco GCN, Costa FO et al. Occurrence of Aggregatibacter actinomycetemcomitans in Brazilians with chronic periodontitis. Braz Oral Res 2010; 24:217–223 [View Article] [PubMed]
    [Google Scholar]
  30. Akrivopoulou C, Green IM, Donos N, Nair SP, Ready D. Aggregatibacter actinomycetemcomitans serotype prevalence and antibiotic resistance in a UK population with periodontitis. J Glob Antimicrob Resist 2017; 10:54–58 [View Article] [PubMed]
    [Google Scholar]
  31. Krueger E, Brown AC. Aggregatibacter actinomycetemcomitans leukotoxin: from mechanism to targeted anti-toxin therapeutics. Mol Oral Microbiol 2020; 35:85–105 [View Article]
    [Google Scholar]
  32. Holm K, Collin M, Hagelskjær-Kristensen L, Jensen A, Rasmussen M. Three variants of the leukotoxin gene in human isolates of Fusobacterium necrophorum subspecies funduliforme. Anaerobe 2017; 45:129–132 [View Article] [PubMed]
    [Google Scholar]
  33. Altdorfer A, Gavage P, Moerman F. Aggregatibacter aphrophilus spinal epidural abscess. BMJ Case Rep 2020; 13:e235320 [View Article]
    [Google Scholar]
  34. Papakonstantinou I, Psaroudaki Z, Perivolioti E. An unusual case of Aggregatibacter aphrophilus liver abscess. Pan Afr Med J 2018; 31:115 [View Article]
    [Google Scholar]
  35. Okumura T, Soya K, Hihara Y, Muraoka S, Nishimura Y et al. The first known case of liver abscess caused by Aggregatibacter aphrophilus in Japan. Intern Med 2020; 59:1451–1455 [View Article]
    [Google Scholar]
  36. Aye AM, Law CW, Sabet NS, Karunakaran R, Hanifah YA et al. Isolation of Aggregatibacter aphrophilus from a patient with acute appendicitis. Eur Rev Med Pharmacol Sci 2011; 15:845–847 [PubMed]
    [Google Scholar]
  37. Bangsborg JM, Tvede M, Skinhøj P. Haemophilus segnis endocarditis. J Infect 1988; 16:81–85 [View Article] [PubMed]
    [Google Scholar]
  38. Welch WD, Southern PM, Schneider NR. Five cases of Haemophilus segnis appendicitis. J Clin Microbiol 1986; 24:851–852 [View Article]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.001612
Loading
/content/journal/jmm/10.1099/jmm.0.001612
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