Bloodstream infection caused by Campylobacter lari
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CASE REPORT
Bloodstream infection caused by Campylobacter lari Shota Morishita • Hiromitsu Fujiwara • Hiromi Murota • Yumi Maeda • Ayako Hara Toshinobu Horii
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Received: 25 April 2012 / Accepted: 19 August 2012 / Published online: 12 September 2012 Ó Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases 2012
Abstract We describe a case of bloodstream infection (BSI) caused by Campylobacter lari in a 58-year-old man diagnosed with lumbar pyogenic spondylitis. Anaerobic blood cultures, taken on the day of admission and on hospital day 4, were positive after 30 h of incubation, although no bacteria were detected by Gram staining. After subculture on 5 % sheep blood agar for 2 days at 35 °C in a 5 % CO2 environment, capnophilic, curved, gram-negative bacteria were recovered. The bacteria were identified as C. lari using a combination of phenotypic identification methods and partial 16S rRNA gene sequencing. The BSI was eradicated following combination therapy with intravenous tazobactam/piperacillin, oral erythromycin, and sulfamethoxazole/trimethoprim. These results suggest that accurate identification, to the species level, is important to determine effective treatment of BSI caused by Campylobacter spp. and can help us to understand the epidemiology. Keywords Campylobacter lari Bloodstream infection 16S rRNA gene sequencing
S. Morishita (&) H. Fujiwara H. Murota Y. Maeda A. Hara Division of Clinical Laboratory, Tottori University Hospital, 36-1, Nishi-cho, Yonago, Tottori 683-8504, Japan e-mail: [email protected] H. Fujiwara Infection Control Division, Tottori University Hospital, Yonago, Japan T. Horii Department of Infectious Disease, Hamamatsu University School of Medicine, Hamamatsu, Japan
Introduction Members of the Campylobacter genus are microaerophilic, motile, non-spore-forming, capnophilic, curved gram-negative rods found in the gastrointestinal tracts of animals, birds, and humans, as well as in the environment. Campylobacter spp., etiologic agents of zoonoses, cause gastrointestinal and systemic infections such as bloodstream infections (BSIs) in humans [1–5]. The main routes of dissemination of the infective agents are through contaminated water or raw milk, inadequately cooked food, and human-to-human transmission [2]. Campylobacter jejuni, Campylobacter coli, and C. lari cause human gastrointestinal infections such as enteritis and diarrhea, but rarely BSIs, whereas Campylobacter fetus is commonly responsible for systemic infections such as BSIs and meningitis in immunocompromised and immunosuppressed hosts [1–5]. The pathogenicity of Campylobacter lanienae remains unclear [6]. Antimicrobial therapies for Campylobacter infections differ depending upon the species causing the infection. Aminoglycosides (e.g., gentamicin) and b-lactams (e.g., imipenem and clavulanic acid/amoxicillin) are the drugs of first choice for patients with BSIs caused by C. fetus. Macrolides, however, are ineffective. For these infections, efficacious chemotherapeutics need
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