Ben Saïd Linda, Diancourt Laure, Rabeau Audrey, Gallet Virginie, Delvallez Gauthier, Grare Marion
Department of Microbiology, Toulouse University Hospital, 31059 Toulouse, France.
National Reference Center for Anaerobic Bacteria and Botulism, Institut Pasteur, Université Paris Cité, 75015 Paris, France.
Microorganisms. 2024 May 28;12(6):1095. doi: 10.3390/microorganisms12061095.
() is an anaerobic, spore-forming Gram-positive rod responsible for necrotizing gangrene, bacteremia in patients with cancer or gastrointestinal tract infection. virulence is due in large part to toxin production. In 2014, a new enterotoxin, BEC (binary enterotoxin of ) encoded by and genes, distinct from enterotoxin (CPE) encoded by the gene, has been described. BEC-producing strains can be causative agents of acute gastroenteritis in humans. We present herein the case of a 64-year-old man who presented to the emergency department of Toulouse University Hospital with pneumonia and septic shock, without digestive symptoms. Blood cultures showed bacteremia and despite appropriate antibiotic treatment the patient passed away 7 h after admission. The characterization of the strain by whole genome sequencing revealed the presence of typical genes of : gene (alpha-toxin, phospholipase C) and (theta-toxin, perfringolysine). Surprisingly, this strain also harbored and genes encoding the recently described BEC toxin. Interestingly, alpha-toxin typing of our isolate and other published BEC isolates showed that they belonged to different PLC subtypes, confirming the high genetic diversity of these strains. To our knowledge, it is the first clinical case reporting bacteremia due to a BEC-producing isolate.
（）是一种厌氧、形成芽孢的革兰氏阳性杆菌，可导致坏死性坏疽、癌症患者的菌血症或胃肠道感染。其毒力在很大程度上归因于毒素产生。2014年，一种新的肠毒素，即由和基因编码的BEC（的二元肠毒素）被描述，它不同于由基因编码的肠毒素（CPE）。产生BEC的菌株可能是人类急性胃肠炎的病原体。我们在此报告一例64岁男性病例，该患者因肺炎和感染性休克就诊于图卢兹大学医院急诊科，无消化症状。血培养显示菌血症，尽管给予了适当的抗生素治疗，患者在入院7小时后死亡。通过全基因组测序对该菌株进行鉴定，发现存在的典型基因：基因（α毒素，磷脂酶C）和（θ毒素，产气荚膜溶血素）。令人惊讶的是，该菌株还携带编码最近描述的BEC毒素的和基因。有趣的是，我们分离株和其他已发表的BEC分离株的α毒素分型显示它们属于不同的PLC亚型，证实了这些菌株的高度遗传多样性。据我们所知，这是首例报告由产生BEC的分离株引起菌血症的临床病例。
