Bacteremia and Skin Infections in Four Patients Caused by -Like Organisms

Overview

Journal Open Forum Infect Dis

Specialty Infectious Diseases

Date 2019 Jul 25

PMID 31338379

Authors

Josue Perez-Santiago

Miguel Ramirez-Gaona

Robert Holm-Kennedy

Davey M Smith

Joshua Fierer

Affiliations

Soon will be listed here.

Abstract

Background: Enterohepatic -like organisms (HLO) have been recognized as causes of human infection since 1984, primarily as a cause of bacteremia and cellulitis in immunocompromised individuals, but the spectrum of illness due to HLO has expanded based on numerous reports from Japan.

Methods: We report 4 epidemiologically unrelated immunocompetent patients with HLO bacteremia diagnosed within a 2-year period. Three patients had cellulitis and 1 patient had unexplained fever. 16S ribosomal deoxyribonucleic acid (rDNA) sequence analysis of 2 isolates suggested that they were , and whole-genome sequencing showed that they differed only slightly from reference strains.

Conclusions: We believe that this syndrome is more common than reported, but it is easily overlooked because the skin lesions resemble streptococcal cellulitis and respond very rapidly to β-lactam antibiotics, and the organism is difficult to isolate from the blood. All HLO in our series were isolated from blood using the ESP system and were not detected in 2 other widely used commercial blood culture systems.

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