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Abstract

Introduction. Microbacterium spp. are yellow-pigmented Gram-positive coryneform rods found in various environmental sources, such as soil and water samples. They rarely cause human infection, mostly infecting immunocompromised patients and catheter insertion sites, making them challenging to identify in clinical settings.

Case presentation. We report a case of a 61-year-old female on long-term prednisone therapy for sarcoidosis with minimal exposure to environmental sources, who presented with an overtly infected Hickman catheter site and presyncope. The patient had a central venous catheter (CVC) that had been in place for the previous 6 years for treatment of refractory hypertension and congestive heart failure. Blood cultures obtained from the CVC on initial presentation were positive for a mixed infection, which was subcultured and grew Staphylococcus aureus, Staphylococcus epidermidis, Acinetobacter radioresistens and Leifsonia aquatica based on the Becton Dickinson Phoenix Automated Microbiology System. The L. aquatica, designated as isolate 4120, was further analysed, since infections associated with this organism are uncommon, and it was the only organism to grow from the patient’s catheter tip. Matrix-assisted laser desorption ionization–time of flight MS identified isolate 4120 as Microbacterium paraoxydans. To resolve the conflicting results, additional analyses of isolate 4120 were carried out and compared to several reference strains. Isolate 4120 was found to have intermediate susceptibility to ciprofloxacin and non-susceptibility to vancomycin. Morphology, susceptibility, biochemical characteristics and whole-genome sequencing confirmed the clinical isolate as Microbacterium paraoxydans.

Conclusion. In this case, we identified an organism that is rarely seen in clinical settings and characterized it with a comprehensive laboratory analysis. The patient in our case responded to replacement of the CVC, and treatment with levofloxacin by mouth and intravenous vancomycin.

  • This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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2018-10-31
2024-10-08
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References

  1. Funke G, Falsen E, Barreau C. Primary identification of Microbacterium spp. encountered in clinical specimens as CDC coryneform group A-4 and A-5 bacteria. J Clin Microbiol 1995; 33:188–192[PubMed]
    [Google Scholar]
  2. Lau SK, Woo PC, Woo GK, Yuen KY. Catheter-related Microbacterium bacteremia identified by 16S rRNA gene sequencing. J Clin Microbiol 2002; 40:2681–2685 [View Article][PubMed]
    [Google Scholar]
  3. Choi HS, Bae EH, Ma SK, Kim SW. Peritoneal dialysis-related peritonitis caused by Microbacterium paraoxydans. Jpn J Infect Dis 2017; 70:195–196 [View Article][PubMed]
    [Google Scholar]
  4. Laffineur K, Avesani V, Cornu G, Charlier J, Janssens M et al. Bacteremia due to a novel Microbacterium species in a patient with leukemia and description of Microbacterium paraoxydans sp. nov. J Clin Microbiol 2003; 41:2242–2246 [View Article][PubMed]
    [Google Scholar]
  5. Enoch DA, Richardson MP, Hill RL, Scorer PM, Sismey A. Central venous catheter-related bacteraemia due to Microbacterium paraoxydans in a patient with no significant immunodeficiency. J Clin Pathol 2011; 64:179–180 [View Article][PubMed]
    [Google Scholar]
  6. Miyamoto M, Sakurada T, Oishi D, Koitabashi K, Hanada K et al. The first case report of peritoneal dialysis related peritonitis caused by Microbacterium paraoxydans. Clin Nephrol 2013; 79:402–406 [View Article][PubMed]
    [Google Scholar]
  7. Patel R. MALDI-TOF MS for the diagnosis of infectious diseases. Clin Chem 2015; 61:100–111 [View Article][PubMed]
    [Google Scholar]
  8. CLSI Performance Standards for Antimicrobial Susceptibility Testing, 26th ed.. Wayne, PA:: Clinical and Laboratory Standards Institute; 2015
    [Google Scholar]
  9. Adderson EE, Boudreaux JW, Hayden RT. Infections caused by coryneform bacteria in pediatric oncology patients. Pediatr Infect Dis J 2008; 27:136–141 [View Article][PubMed]
    [Google Scholar]
  10. Alonso-Echanove J, Shah SS, Valenti AJ, Dirrigl SN, Carson LA et al. Nosocomial outbreak of Microbacterium species bacteremia among cancer patients. J Infect Dis 2001; 184:754–760 [View Article][PubMed]
    [Google Scholar]
  11. Yusuf E, Wybo I, François K, Pipeleers L, Echahidi F et al. Microbacterium spp. as a cause of peritoneal-dialysis-related peritonitis in two patients. J Microbiol Immunol Infect 2016; 49:464–465 [View Article][PubMed]
    [Google Scholar]
  12. Gneiding K, Frodl R, Funke G. Identities of Microbacterium spp. encountered in human clinical specimens. J Clin Microbiol 2008; 46:3646–3652 [View Article][PubMed]
    [Google Scholar]
  13. Almuzara MN, de Mier C, Rodríguez CR, Famiglietti AM, Vay CA. [Evaluation of API Coryne System, version 2.0, for diphteroid gram-positive rods identification with clinical relevance]. Rev Argent Microbiol 2006; 38:197–201 (in Spanish) [PubMed]
    [Google Scholar]
  14. Hudspeth MK, Hunt Gerardo S, Citron DM, Goldstein EJ. Evaluation of the RapID CB Plus system for identification of Corynebacterium species and other gram-positive rods. J Clin Microbiol 1998; 36:543–547[PubMed]
    [Google Scholar]
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