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Bacteremia caused by Anaerococcus SPP: Is this an underdiagnosed infection?
Anaerobe ( IF 2.3 ) Pub Date : 2021-06-18 , DOI: 10.1016/j.anaerobe.2021.102405
Fernando Cobo 1 , Virginia Pérez-Carrasco 1 , Adrián González 1 , Victoria Sánchez-Martin 1 , José Antonio García-Salcedo 1 , José María Navarro-Marí 1
Affiliation  

The objectives of this study were to report 10 episodes of clinically significant bacteremia caused by species of the genus Anaerococcus isolated between July 2018 and February 2021 from the microbiology laboratory of a tertiary hospital in Granada (Spain). None of the isolates were identified by MALDI-TOF MS, and the definitive species identification was performed by 16 S rRNA gene sequencing. No reference spectra of the Anaerococcus species were present in the MALDI-TOF MS database. Eight isolates were finally identified as A. octavius, one isolate as A. tetradius and the other as A. urinomassiliensis. The majority of these infections were seen in patients aged >70 years. Risk factors for anaerobic infection were observed in eight patients, especially diabetes mellitus, surgery, and the presence of cancer. Fever was present in all patients. Three patients died, but only one death was attributed to the infection. Mean detection time of positive blood cultures was 47.5 h (range 24–92 h). Antimicrobial susceptibility to penicillin, amoxicillin-clavulanate, imipenem, moxifloxacin, clindamycin, metronidazole, and piperacillin-tazobactam was tested using the gradient diffusion technique and EUCAST breakpoints (except for moxifloxacin). No resistance to amoxicillin-clavulanate, metronidazole, imipenem, or piperacillin-tazobactam was detected; however, the majority of isolates were resistant to clindamycin.

When MALDI-TOF MS does not provide a correct identification at genus or species level, as in some isolates of Gram-positive anaerobic cocci, microbiologists should perform an additional confirmatory technique, such as gene sequencing analysis, to obtain a definitive diagnosis.



中文翻译:

由厌氧球菌 SPP 引起的菌血症:这是一种未确诊的感染吗?

本研究的目的是报告2018 年 7 月至 2021 年 2 月期间从格拉纳达(西班牙)一家三级医院的微生物实验室中分离出的厌氧球菌属物种引起的 10 次临床显着菌血症。没有一个分离株被 MALDI-TOF MS 鉴定,最终的物种鉴定是通过 16 S rRNA 基因测序进行的。MALDI-TOF MS 数据库中不存在厌氧球菌属物种的参考光谱。八株终于确定为A.屋大维,一个分离为A. tetradius,另一个为A. urinomassiliensis. 大多数感染见于年龄 > 70 岁的患者。在 8 名患者中观察到厌氧菌感染的危险因素,特别是糖尿病、手术和癌症的存在。所有患者均出现发热。三名患者死亡,但只有一名死亡归因于感染。阳性血培养的平均检测时间为 47.5 小时(范围 24-92 小时)。使用梯度扩散技术和 EUCAST 断点(莫西沙星除外)测试了对青霉素、阿莫西林-克拉维酸、亚胺培南、莫西沙星、克林霉素、甲硝唑和哌拉西林-他唑巴坦的抗生素敏感性。未检测到对阿莫西林-克拉维酸、甲硝唑、亚胺培南或哌拉西林-他唑巴坦的耐药性;然而,大多数分离株对克林霉素具有抗性。

当 MALDI-TOF MS 不能在属或种水平上提供正确的鉴定时,如在某些革兰氏阳性厌氧球菌分离物中,微生物学家应执行额外的确认技术,如基因测序分析,以获得明确的诊断。

更新日期:2021-06-30
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