Genseke Svea, Berisha Mirjeta, Teerstegen Aljoscha, Meyer Björn, Kaasch Achim J, Färber Jacqueline, Schalk Enrico, Zautner Andreas E, Esser Torben, Kahlfuß Sascha
Medical Faculty, Institute of Medical Microbiology and Hospital Hygiene, Otto von Guericke University Magdeburg, Magdeburg, Germany.
Medical Faculty, Department of Hematology, Oncology and Cell Therapy, Otto von Guericke University Magdeburg, Magdeburg, Germany.
Infection. 2025 Feb;53(1):457-462. doi: 10.1007/s15010-024-02388-6. Epub 2024 Sep 6.
Lautropia mirabilis is a Gram-negative, facultative anaerobic coccus, which has been detected mainly in respiratory sites of immunodeficient patients suffering from HIV or cystic fibrosis. To date, knowledge about the pathogenicity of L. mirabilis is spare due to the small numbers of documented cases.
We present a literature review and report the case of a 39-year-old female diagnosed with common variable immunodeficiency (CVID) with IgG and IgA deficiency suffering from a sepsis with L. mirabilis. As no fully closed L. mirabilis genome besides the type strain was available to date, we additionally performed complete genome sequencing of L. mirabilis.
The patient was admitted to our hospital with recurrent episodes of fever. Here, we detected L. mirabilis in two different blood cultures. The bacterium was tested susceptible to and treated with meropenem. As the origin of L. mirabilis sepsis, we observed an active periodontitis likely due to impaired IgA levels and mucosal insufficiency as a consequence of CVID. Whole genome sequencing of L. mirabilis revealed several genes important for host cell invasion and intracellular survival of the pathogen.
Our case highlights the importance of L. mirabilis in immunocompromised patients also in other compartments than the respiratory tract.
奇异劳特罗普菌是一种革兰氏阴性兼性厌氧球菌，主要在患有艾滋病或囊性纤维化的免疫缺陷患者的呼吸道部位被检测到。由于记录在案的病例数量较少，迄今为止，关于奇异劳特罗普菌致病性的了解还很有限。
我们进行了文献综述，并报告了一例39岁女性病例，该患者被诊断为常见可变免疫缺陷（CVID），伴有IgG和IgA缺乏，患有奇异劳特罗普菌败血症。由于迄今为止除了模式菌株外没有完全封闭的奇异劳特罗普菌基因组，我们还对奇异劳特罗普菌进行了全基因组测序。
该患者因反复发热入院。在这里，我们在两种不同的血培养物中检测到了奇异劳特罗普菌。该细菌对美罗培南敏感并接受了美罗培南治疗。作为奇异劳特罗普菌败血症的来源，我们观察到可能由于CVID导致的IgA水平受损和粘膜功能不全而引起的活动性牙周炎。奇异劳特罗普菌的全基因组测序揭示了几个对病原体宿主细胞入侵和细胞内存活很重要的基因。
我们的病例强调了奇异劳特罗普菌在免疫功能低下患者中的重要性，不仅在呼吸道，在其他部位也是如此。
