Helicobacter cinaedi are motile, gram-negative spiral rods with a natural reservoir in the intestinal tract of hamsters and rhesus monkeys. In humans, H. cinaedi has been reported in different human infections like fever, abdominal pain, gastroenteritis, proctitis, diarrhoea, erysipelas, cellulitis, arthritis, and neonatal meningitis typically diagnosed by positive blood cultures. Even though H. cinaedi has been detected from human blood and stool the entry of H. cinaedi into the blood stream was undocumented until quite recently. The use of pulse-field gel electrophoresis (PFGE) demonstrated that stool- and blood-derived H. cinaedi strains were consistent. Here, we describe a rare Danish case of H. cinaedi bacteraemia in an immunocompetent 44-year-old male with diarrhoea. We isolated H. cinaedi from a blood culture taken at admission, and from a FecalSwab taken at day six despite ongoing antibiotic therapy. Next, we made a genetic comparison of both isolates by use of Multi-locus sequence typing (MLST)- and Single nucleotide polymorphism (SNP)-analysis. The two isolates were identical with zero SNPs and by use of MLST the isolate was identified as a novel ST20, confirming previous data of the intestinal tract as a route of H. cinaedi bacteraemia. The results of our AST showed a resistance pattern with higher MICs for ciprofloxacin and clarithromycin than for ampicillin, amoxicillin, gentamicin, and imipenem. The patient was cured with targeted therapy with pivampicillin; however, the primary source of transmission was unknown. In conclusion, this case of H. cinaedi bacteraemia secondary to enterocolitis in an immunocompetent patient provide clear evidence that one route of infection occurs through translocation from the intestinal tract to the bloodstream. Helicobacter cinaedi from blood and faeces were identical with a novel ST20, resistant to ciprofloxacin and clarithromycin however, the patient was cured with oral pivampicillin.

中文翻译：

---

免疫活性患者继发于小肠结肠炎的Cinaedi幽门螺杆菌菌血症

cinaedi Helicobacter cinaedi是能运动的革兰氏阴性螺旋杆，在仓鼠和恒河猴的肠道中具有天然贮藏池。在人类中，已经报道了猪流感嗜血杆菌感染了多种人类感染，如发烧，腹痛，肠胃炎，直肠炎，腹泻，丹毒，蜂窝织炎，关节炎和新生儿脑膜炎，通常可通过阳性血液培养来诊断。即使已经从人血和粪便中检测到了中华绒螯蟹，但直到最近才有记载中华绒螯蟹进入血流。脉冲场凝胶电泳（PFGE）的使用证明粪便和血源的H. cinaedi菌株是一致的。在这里，我们描述了在具有免疫能力的44岁男性腹泻患者中罕见的H. cinaedi菌血症丹麦病例。我们从入院时采集的血液培养物中分离了H. cinaedi，尽管正在进行抗生素治疗，但在第六天还是从FecalSwab中提取的。接下来，我们通过使用多基因座序列分型（MLST）和单核苷酸多态性（SNP）分析对两种分离物进行了遗传比较。这两个分离株的SNP均为零，通过MLST鉴定该分离株为新型ST20，这证实了先前肠道中的数据是H. cinaedi菌血症的一种途径。我们的AST结果显示，对环丙沙星和克拉霉素的抗药性比对氨苄西林，阿莫西林，庆大霉素和亚胺培南的MIC高。该患者接受了吡匹西林靶向治疗治愈；但是，主要的传播来源尚不清楚。总之，这种情况下为H。具有免疫功能的患者继发于小肠结肠炎的纳奈氏菌血症提供了明确的证据，即一种感染途径是通过从肠道到血流的转移而发生的。血液和粪便中的那支幽门螺杆菌与新型ST20相同，对环丙沙星和克拉霉素有抗药性，但是患者口服匹维霉素可以治愈。