De Paulis Adriana N, Bertona Eugenia, Gutiérrez Miguel A, Ramírez María S, Vay Carlos A, Predari Silvia C
Departamento de Microbiología, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
Department of Biological Science, California State University Fullerton, Fullerton, CA, USA.
JMM Case Rep. 2018 Jan 16;5(2):e005137. doi: 10.1099/jmmcr.0.005137. eCollection 2018 Feb.
is an extremely rare cause of human infections.
An 83-year-old male with a painless, ten-day-old, erythematous skin abscess on his left flank, which had showed a purulent discharge for 48 h, was admitted to the Emergency service. He was treated with cephalexin, disinfection with Codex water and spray of rifampicin. Five days later, surgical drainage of the abscess was proposed due to the torpid evolution of the patient. Samples were taken for culture, and antibiotic treatment with trimethoprim-sulfamethoxazole was established. The patient returned after 10 days showing healing of the abscess. Microbiological studies showed a few Gram-positive cocci present as single cells and short chains that grew after 72 h of incubation at 35 °C with CO on 5 % sheep blood agar. Colonies presented a strong sauerkraut odour. Initial biochemical test results were negative for catalase, aesculin and bile-aesculin, and positive for pyrrolidonyl arylamidase, leucine aminopeptidase and growth in 6.5 % NaCl broth, which prompted the preliminary identification of species or . The positive result for arginine deamination and negative result for hippurate hydrolysis, failure to produce acid from mannitol, sucrose, sorbitol or trehalose, plus the distinctive sauerkraut odour identified the organism as . The phenotypic identification was confirmed by 16S rRNA gene sequence analysis. The strain seemed to be susceptible to the antimicrobials tested but had decreased susceptibility to carbapenems.
This case provides more insights into the phenotypic characteristics and antimicrobial resistance profile of .
是人类感染极其罕见的病因。
一名83岁男性因左侧胁腹有无痛性、已持续10天的红斑性皮肤脓肿入院急诊,该脓肿已出现48小时脓性分泌物。给予头孢氨苄治疗,用复方聚维酮碘溶液消毒并喷利福平。五天后,因患者病情进展缓慢,建议脓肿切开引流。采集样本进行培养,并开始用甲氧苄啶 - 磺胺甲恶唑进行抗生素治疗。10天后患者复诊,脓肿已愈合。微生物学研究显示,在5%羊血琼脂上于35°C含5%二氧化碳条件下培养72小时后,有少量革兰氏阳性球菌以单个细胞和短链形式生长。菌落有强烈的酸菜气味。初步生化试验结果显示,过氧化氢酶、七叶苷和胆汁七叶苷试验为阴性,吡咯烷酮芳基酰胺酶、亮氨酸氨肽酶试验及在6.5%氯化钠肉汤中生长试验为阳性,这提示初步鉴定为或属的菌种。精氨酸脱氨基试验阳性、马尿酸盐水解试验阴性、不能利用甘露醇、蔗糖、山梨醇或海藻糖产酸,加上独特的酸菜气味,确定该菌为。通过16S rRNA基因序列分析证实了表型鉴定。该菌株似乎对所测试的抗菌药物敏感,但对碳青霉烯类药物敏感性降低。
本病例为提供了更多关于其表型特征和抗菌药物耐药性的见解。