Bloodstream infection due to Herbaspirillum sp.: case series and review of literature
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ORIGINAL ARTICLE
Bloodstream infection due to Herbaspirillum sp.: case series and review of literature I. Bloise 1 & G. V. Guedez-López 1 & M. Tejedor-Rodríguez 1 & M. P. Romero-Gómez 1 & J. García-Rodríguez 1 & J. Mingorance 1 & E. Cendejas-Bueno 1 Received: 6 June 2020 / Accepted: 14 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Herbaspirillum species are Gram-negative bacteria belonging to the class Betaproteobacteria, order Burkholderiales. The phylogenetic and phenotypic similarities among these groups easily lead to species misidentification. Herbaspirillum bacteraemia is an uncommon clinical entity. The objective of this review is to collect information to contribute to the management of this infection. We describe our own case series and review the cases reported in the literature. Cancer appears as the major underlying disease. The main source of bacteraemia was respiratory. Phenotypic identification methods often misidentify this species. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI–TOF MS) and molecular methods identify at genus level, but species assignment is not reliable. Herbaspirillum spp. showed a highly susceptible antimicrobial profile. β-Lactams showed good activity with low MIC values, except ampicillin. All isolates were resistant to colistin, suggesting an intrinsic resistance mechanism. Herbaspirillum spp. is an uncommon pathogen. MALDI-TOF MS or molecular methods are necessary to achieve a reliable genus identification. These species are not multidrug resistant. Piperacillin/tazobactam or ceftazidime might be a good treatment for this microorganism. Keywords Herbaspirillum . Bloodstream infection . Sepsis . Gram-negative bacteria . Antibiotics
Introduction Herbaspirillum species are Gram-negative, non-fermenting bacilli of the class Betaproteobacteria, which includes the genera Burkholderia, Ralstonia and others associated with plants [1]. It has phenotypic similarity to Burkholderia cepacia, which sometimes leads to a misidentification. The cells are curved or, sometimes, helical, strict aerobic, mobile with polar flagella and positive for urease, oxidase and catalase [2]. They are found in the environment, including systems for the distribution of soil, groundwater and drinking water [3]. Herbaspirillum species promote plant growth through production of phytohormones and participation in
* I. Bloise [email protected] 1
Clinical Microbiology Department, Hospital La Paz, IdiPaz, Madrid, Spain
biological nitrogen fixation [4]. Despite these beneficial effects, strains of phytopathogen Herbaspirillum spp. have been described [5]. A recently published study that compared the genomes of environmental and clinical Herbaspirillum spp. isolates suggest that these bacteria might be adapting to new environments, including human host colonization [6]. Reported cases of human disease caused by this microorganism are mostly bacteraemia in patients with underlying diseases, as cancer, cirrhosis or immunosuppress
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