1887

Abstract

Introduction:

is an obligate anaerobic, non-spore-forming, Gram-positive rod found as a normal commensal of the human intestinal flora, which is capable of reducing digoxin into several metabolites. Disease caused by this micro-organism is unusual, although more frequent than reported.

Case presentation:

A 74-year-old man presented to the emergency room and was admitted with a mild acute cholangitis syndrome. One anaerobic blood culture became positive after 5 days of incubation. After an additional 5 days, the usual aerobic subcultures were negative, whereas anaerobically incubated Columbia blood agar presented tiny smooth colonies. The isolate was capable of reducing digoxin and was identified as . Adequate antibiotic treatment with meropenem had been started and the patient recovered fully.

Conclusion:

We have described a patient with a potentially fatal bacteraemia with that may have gone unnoticed. More case reports are necessary, not only to understand the pathogenicity and clinical course of infections by this neglected bacterium, but also to investigate its digoxin degradation and antimicrobial susceptibility variability.

Loading

Article metrics loading...

/content/journal/jmmcr/10.1099/jmmcr.0.000077
2015-10-09
2024-03-29
Loading full text...

Full text loading...

/deliver/fulltext/jmmcr/2/5/jmmcr000077.html?itemId=/content/journal/jmmcr/10.1099/jmmcr.0.000077&mimeType=html&fmt=ahah

References

  1. Arias M., Sesar A., Requena I. 2006; [Recurrent meningoencephalitis caused by Eubacterium lentum]. Med Clin (Barc) 127:599 (in Spanish). [PubMed] [CrossRef]
    [Google Scholar]
  2. Bok C. W., Ng Y. S. 2009; Eggerthella lenta as a cause of anaerobic spondylodiscitis. Singapore Med J 50:e393–e396[PubMed]
    [Google Scholar]
  3. Brook I., Frazier E. H. 1993; Significant recovery of nonsporulating anaerobic rods from clinical specimens. Clin Infect Dis 16:476–480 [View Article][PubMed]
    [Google Scholar]
  4. Karsten T. M., van Gulik T. M., Spanjaard L., Bosma A., van der Bergh Weerman M. A., Dingemans K. P., Dankert J., Gouma D. J. 1998; Bacterial translocation from the biliary tract to blood and lymph in rats with obstructive jaundice. J Surg Res 74:125–130 [View Article][PubMed]
    [Google Scholar]
  5. Lamy B., Seifert H. 2012; Septicemia. In European Manual of Clinical Microbiology pp 101–110Edited by Cornaglia G., Courcol R., Hermann J.-L., Kahlmeter G., Pelgue-Lafeulle H., Villa J. Paris: Société Française de Microbiologie;
    [Google Scholar]
  6. Lau S. K., Woo P. C., Fung A. M., Chan K. M., Woo G. K., Yuen K. Y. 2004a; Anaerobic, non-sporulating, Gram-positive bacilli bacteraemia characterized by 16S rRNA gene sequencing. J Med Microbiol 53:1247–1253 [View Article][PubMed]
    [Google Scholar]
  7. Lau S. K., Woo P. C., Woo G. K., Fung A. M., Wong M. K., Chan K. M., Tam D. M., Yuen K. Y. 2004b; Eggerthella hongkongensis sp. nov. and eggerthella sinensis sp. nov., two novel Eggerthella species, account for half of the cases of Eggerthella bacteremia. Diagn Microbiol Infect Dis 49:255–263 [View Article][PubMed]
    [Google Scholar]
  8. Lee M. R., Huang Y. T., Liao C. H., Chuang T. Y., Wang W. J., Lee S. W., Lee L. N., Hsueh P. R. 2012; Clinical and microbiological characteristics of bacteremia caused by Eggerthella Paraeggerthella, and Eubacterium species at a university hospital in Taiwan from 2001 to 2010. J Clin Microbiol 50:2053–2055 [View Article][PubMed]
    [Google Scholar]
  9. Lu L., Wu Y., Zuo L., Luo X., Large P. J. 2014; Intestinal microbiome and digoxin inactivation: meal plan for digoxin users?. World J Microbiol Biotechnol 30:791–799 [View Article][PubMed]
    [Google Scholar]
  10. Mosca A., Summanen P., Finegold S. M., De Michele G., Miragliotta G. 1998; Cellular fatty acid composition, soluble-protein profile, and antimicrobial resistance pattern of Eubacterium lentum . J Clin Microbiol 36:752–755 9508307
    [Google Scholar]
  11. Pardo Sánchez F., Romero Jung P. A., Martínez Lamas L., Arca Barca B. 2008; [Septic bursitis due to Eggerthella lenta]. Reumatol Clin 4:82–84 (in Spanish). [View Article][PubMed]
    [Google Scholar]
  12. Robertson L. W., Chandrasekaran A., Reuning R. H., Hui J., Rawal B. D. 1986; Reduction of digoxin to 20R-dihydrodigoxin by cultures of Eubacterium lentum . Appl Environ Microbiol 51:1300–1303 3729400
    [Google Scholar]
  13. Rodríguez-Cavallini E., Vargas P., Rodríguez C., Quesada-Gómez C., Gamboa-Coronado M. M. 2011; Phenotypic identification of over 1000 isolates of anaerobic bacteria recovered between 1999 and 2008 in a major Costa Rican hospital. Clin Microbiol Infect 17:1043–1047 [View Article][PubMed]
    [Google Scholar]
  14. Salameh A., Klotz S. A., Zangeneh T. T. 2012; Disseminated infection caused by Eggerthella lenta in a previously healthy young man: a case report. Case Rep Infect Dis 2012:517637 23346432
    [Google Scholar]
  15. Saunders E., Pukall R., Abt B., Lapidus A., Glavina Del Rio T., Copeland A., Tice H., Cheng J. F., Lucas S., other authors. 2009; Complete genome sequence of Eggerthella lenta type strain (IPP VPI 0255). Stand Genomic Sci 1:174–182 [View Article][PubMed]
    [Google Scholar]
  16. Shinagawa N., Osanai H., Hirata K., Furuhata T., Mizukuchi T., Yanai Y., Hata F., Taniguchi M., Sasaki K., other authors. 2011; [Bacteria isolated from surgical infections and its susceptibilities to antimicrobial agents – special references to bacteria isolated between April 2009 and March 2010]. Jpn J Antibiot 64:125–169 21861307
    [Google Scholar]
  17. Sung J. Y., Costerton J. W., Shaffer E. A. 1992; Defense system in the biliary tract against bacterial infection. Dig Dis Sci 37:689–696 [View Article][PubMed]
    [Google Scholar]
  18. Thota V. R., Dacha S., Natarajan A., Nerad J. 2011; Eggerthella lenta bacteremia in a Crohn's disease patient after ileocecal resection. Future Microbiol 6:595–597 [View Article][PubMed]
    [Google Scholar]
  19. Venugopal A. A., Szpunar S., Johnson L. B. 2012; Risk and prognostic factors among patients with bacteremia due to Eggerthella lenta . Anaerobe 18:475–478 [View Article][PubMed]
    [Google Scholar]
  20. Yokoyama S., Oshima K., Nomura I., Hattori M., Suzuki T. 2011; Complete genomic sequence of the equol-producing bacterium Eggerthella sp. strain YY7918, isolated from adult human intestine. J Bacteriol 193:5570–5571 [View Article][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmmcr/10.1099/jmmcr.0.000077
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