JCM Accepts, published online ahead of print on 27 March 2013 J. Clin. Microbiol. doi:10.1128/JCM.00138-13 Copyright © 2013, American Society for Microbiology. All Rights Reserved.
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Title: Pseudoclavibacter bifida bacteremia in an immunocompromised host with COPD:
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first case-report
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Matthijs Oyaert1♯, Thierry De Baere2, Joke Breyne3, Emmanuel De Laere4, Stan Mariën5,
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Peter Waets6, Wim Laffut1
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Medicine, Heilig Hart Hospital Lier, Belgium; 6Department of Anaesthesiology and
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Reanimation, H. Hart Hospital Lier, Belgium; 3Department of Molecular Diagnostics, Heilig
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Hart Hospital Roeselare Menen, Belgium; 4Department of Microbiology, H. Hart Hospital
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Department of Microbiology, Heilig Hart Hospital Lier, Belgium; 5Department of Pulmonary
Roeselare Menen; 3Institute for Criminalistics and Criminology, Belgium.
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Running Title: An immunocompromised host with P. bifida septicemia
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♯ Corresponding author:
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Matthijs Oyaert
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Department of Microbiology
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Mechelsestraat 24,
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2500 Lier
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Belgium
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Tel: +32 (0)34/91 30 70
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Fax: +32 (0)34/91.30.89
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E-mail:
[email protected]
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ABSTRACT
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Pseudoclavibacter spp. are Gram-positive, aerobic, catalase positive, coryneform bacteria
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belonging to the family of Microbacteriaceae.
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Identification of these species with conventional biochemical assays is difficult. This case
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report of a P. bifida bacteremia occurring in an immunocompromised host diagnosed with an
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acute exacerbation of Chronic Obstructive Pulmonary Disease with lethal outcome confirms
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that this organism may be a human pathogen.
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Keywords: Pseudoclavibacter bifida, COPD, 16S rRNA sequencing
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CASE REPORT
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An 86-year-old male patient was admitted to our hospital, suffering from dyspnoea
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with severe respiratory distress and fever. In 2006, the patient was diagnosed with chronic
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obstructive pulmonary disease (COPD) class I, for which he was receiving inhaled
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glucocorticoids and long acting bronchodilators. A COPD exacerbation with a left lobular
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pneumonia led to hospitalization in July 2011. Treatment with amoxicillin clavulanic-acid
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was initiated, and switched to piperacillin-tazobactam due to respiratory insufficiency.
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Bronchial aspirates and blood cultures remained negative. Normalization of the lung function
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parameters and improvement in his general condition led to discharge from the hospital. Other
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relevant medical history comprised arrhythmia, renal failure and diabetes mellitus type II.
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In September 2011, he presented with dyspnoea and fever (body temperature 38.4°C).
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No other significant symptoms could be elicited. The patient was hemodynamically stable.
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Hematological investigations revealed a WBC count of 33,4 x 103 cells/μL with 96%
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neutrophils (reference range 46-64%), a hemoglobin level of 10,3 g/dL (reference range 12,6-
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17,4 g/dL); hematocrit of 31,0% (reference range 39,0-50,0%), and a platelet count of 245 x
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103/μL (reference range 150-450 x 103/μL). C-reactive protein level increased up to 29,5
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mg/dL (normal
