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Clostridium colicanis bacteraemia in an asthmatic patient diagnosed as acute respiratory infection
Bacteriemia por Clostridium colicanis en una paciente asmática diagnosticada de infección respiratoria aguda
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"identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Carmen" "apellidos" => "Ezpeleta-Baquedano" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Microbiología Clínica, Complejo Hospitalario de Navarra, Pamplona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Bacteriemia por <span class="elsevierStyleItalic">Clostridium colicanis</span> en una paciente asmática diagnosticada de infección respiratoria aguda" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 568 "Ancho" => 755 "Tamanyo" => 54273 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Gram stain of anaerobic blood culture (1000×): <span class="elsevierStyleBold">Gram positive</span> long and straight-ended bacilli.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Although obligate anaerobes are seldom isolated from patients with bacteraemia, the genus <span class="elsevierStyleItalic">Clostridium</span> is in second place behind the genus <span class="elsevierStyleItalic">Bacteroides</span> and represents approximately 1% of all positive blood cultures, with <span class="elsevierStyleItalic">Clostridium perfringens</span> being the most commonly isolated species. The risk factors associated with its isolation in blood are haemolysis, malignant intestinal neoplasia, inflammatory bowel disease and immunosuppression.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a> In most cases, its clinical meaning is unclear, representing contamination or transient bacteraemia, and its pathogenicity and virulence continue to be a subject of debate. <span class="elsevierStyleItalic">Clostridium colicanis</span> is a <span class="elsevierStyleItalic">Clostridium</span> species that has been rarely isolated in the blood, the first time in 2008 by Simmon et al., although it was not documented the episode.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a> Thus, we report the first documented case of bacteraemia by this microorganism in an immunocompetent patient diagnosed as acute respiratory infection.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We present the case of a 77-year-old woman with asthma and anticoagulation who was admitted to the Emergency Department due to symptoms of fever of up to 39<span class="elsevierStyleHsp" style=""></span>°C, chills, malaise, asthenia, dyspnoea, cough and decreased level of consciousness. The abdominal anamnesis was anodyne, and the patient presented no urinary symptoms, heart failure or oedema. The physical examination revealed a blood pressure of 120/63<span class="elsevierStyleHsp" style=""></span>mm Hg, a temperature of 37.7<span class="elsevierStyleHsp" style=""></span>°C and an oxygen saturation of 95%. The most noteworthy laboratory data were as follows: leukocytes count of 23.7<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">9</span>/L [4–11] with 89.4% [40–80] granulocytes and 4.6% [20–50] lymphocytes, prothrombin activity of 42% [70–120], international normalised ratio of 1.85 [0.8–1.85], total bilirubin of 1.7<span class="elsevierStyleHsp" style=""></span>mg/dL [0.2–1.2] and C-reactive protein of 41.9<span class="elsevierStyleHsp" style=""></span>mg/L [0–5]. Upon her arrival, the patient underwent blood cultures, influenza A/B virus detection using polymerase chain reaction in a nasopharyngeal exudate (negative) and urine culture (negative). Treatment was started with intravenous cefotaxime (1<span class="elsevierStyleHsp" style=""></span>g/8<span class="elsevierStyleHsp" style=""></span>h for 10 days) and oral levofloxacin (500<span class="elsevierStyleHsp" style=""></span>mg/day for 7 days), which resulted in the disappearance of the fever.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The blood cultures were processed in the BD BACTEC™ 9240 system (Becton-Dickinson and Company, NJ, USA). The two anaerobic bottles were positive after 26<span class="elsevierStyleHsp" style=""></span>h of incubation. Gram staining revealed the presence of long Gram-positive bacilli with straight ends (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), which were isolated under anaerobic conditions (Oxoid™ AnaeroGen™ 2.5-L sachet, ThermoFisher Scientific) in Schaedler agar at 48<span class="elsevierStyleHsp" style=""></span>h. The colonies were round, somewhat irregular, white-grey, catalase-negative measuring approximately 3<span class="elsevierStyleHsp" style=""></span>mm in diameter. The strain was identified as <span class="elsevierStyleItalic">C. colicanis</span> (log score: 2.122) using matrix-assisted laser desorption ionisation time of flight mass spectrometry (MALDI Biotyper® Microflex LT, Bruker Daltonik GmbH), and 16S rRNA sequencing (99%, GenBank accession number FJ957867.1). Antimicrobial susceptibility testing was carried out by the Etest gradient diffusion method (bioMérieux, Marcy ĺetoile, France) using a 0.5 McFarland bacterial suspension and <span class="elsevierStyleItalic">Brucella</span> blood agar with hemin and vitamin K1. The plates were incubated anaerobically for 48<span class="elsevierStyleHsp" style=""></span>h at 35–37<span class="elsevierStyleHsp" style=""></span>°C. The minimum inhibitory concentration (μg/mL) was interpreted as susceptible according to the recommendations for anaerobic bacteria (EUCAST and CLSI criteria)<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">3,4</span></a>: penicillin (0.016), amoxicillin-clavulanic acid (0.094), cefotaxime (0.015), piperacillin-tazobactam (0.016), clindamycin (2), metronidazole (1), meropenem (0.002) and tetracycline (1.5). After isolating <span class="elsevierStyleItalic">C. colicanis</span>, an abdominal ultrasound was requested, which showed no significant abnormalities. The patient progressed favourably and was discharged from the hospital.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">C. colicanis</span> is a bacillus measuring approximately 0.9–1.0<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3–10<span class="elsevierStyleHsp" style=""></span>μm and is Gram-positive, obligate anaerobic, sporulating, nonmotile, and catalase-negative. It can use a considerable number of substrates, producing various acids from glucose, lactose, maltose, mannose, ribose, cellobiose and galactose and can reduce nitrates to nitrites.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a> Its genome consists of a single chromosome (2.6 Mpb) and contains approximately 2160 protein-encoding genes.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">6</span></a> The colonies measure 3–5<span class="elsevierStyleHsp" style=""></span>μm in diameter and are round with rippled edges, slightly convex, opaque and white-grey. Its optimal growth temperature is 37–40<span class="elsevierStyleHsp" style=""></span>°C.</p><p id="par0025" class="elsevierStylePara elsevierViewall">This microorganism was first described after its isolation in the faeces of a male Labrador dog in 2003.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a> The microorganism is closely related phylogenetically with <span class="elsevierStyleItalic">C. absonum</span>, <span class="elsevierStyleItalic">C. baratii</span> and <span class="elsevierStyleItalic">Eubacterium multiforme</span>. <span class="elsevierStyleItalic">C. colicanis</span> bacteraemia was first reported in humans in 2008 in a scientific article that studied the genotypic diversity of anaerobic isolates from bloodstream infections.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a> This bacillus was subsequently encountered in 2014, in a study that compared the faecal microbiota of 13 Thai vegetarians and nonvegetarians and was found in a 61-year-old vegetarian who did not eat either yoghourt or eggs but did drink milk.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">7</span></a> A recent study reported that, in more than half of patients with gastric cancer, the most prevalent microorganisms in the gastric epithelium were bacteria of the species <span class="elsevierStyleItalic">Fusobacterium nucleatum</span> (whose pathogenic role in colorectal cancer is well-known) and <span class="elsevierStyleItalic">C. colicanis</span>, suggesting a possible contribution of these bacteria in the development or progression of stomach cancer.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">8</span></a> Our case corresponded to transient bacteraemia in a patient with laboratory data suggesting infection, and to date no signs of gastric or colon neoplasia have been found.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In conclusion, we reported the first documented case of <span class="elsevierStyleItalic">C. colicanis</span> bacteraemia in an immunocompetent patient, highlighting the importance of <span class="elsevierStyleItalic">C. colicanis</span> as a human pathogen. Further studies are needed to elucidate the pathogenesis and risk factors of <span class="elsevierStyleItalic">C. colicanis</span>-related invasive infections such as bacteraemia.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0035" class="elsevierStylePara elsevierViewall">None.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflicts of interest" ] 2 => array:2 [ "identificador" => "xack432522" "titulo" => "Acknowledgement" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 568 "Ancho" => 755 "Tamanyo" => 54273 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Gram stain of anaerobic blood culture (1000×): <span class="elsevierStyleBold">Gram positive</span> long and straight-ended bacilli.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0045" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gangrena gaseosa y otras enfermedades asociadas a <span class="elsevierStyleItalic">Clostridium</span>. Mandell, Douglas y Bennett. Enfermedades infecciosas Principios y Práctica" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.B. Onderdonk" 1 => "W.S. Garrett" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:6 [ "edicion" => "8th ed." "fecha" => "2016" "paginaInicial" => "2923" "paginaFinal" => "2927" "editorial" => "Elsevier" "editorialLocalizacion" => "Barcelona" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0050" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Genotypic diversity of anaerobic isolates from bloodstream infections" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K.E. Simmon" 1 => "S. Mirrett" 2 => "L.B. Reller" 3 => "C.A. Petti" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/JCM.02469-07" "Revista" => array:6 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "2008" "volumen" => "46" "paginaInicial" => "1596" "paginaFinal" => "1601" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18322067" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0055" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Breakpoint tables for interpretation of MICs and zone diameters. Version 6.0" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "The European Committee on Antimicrobial Susceptibility Testing" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "2016" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0060" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Performance standards for antimicrobial susceptibility testing. CLSI supplement M100S" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "CLSI" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "edicion" => "26th ed." "fecha" => "2016" "editorial" => "Clinical and Laboratory Standards Institute" "editorialLocalizacion" => "Wayne, PA" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0065" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Clostridium colicanis</span> sp. nov., from canine faeces" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H.L. Greetham" 1 => "G.R. Gibson" 2 => "C. Giffard" 3 => "H. Hippe" 4 => "B. Merkhoffer" 5 => "U. Steiner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1099/ijs.0.02260-0" "Revista" => array:7 [ "tituloSerie" => "Int J Syst Evol Microbiol" "fecha" => "2003" "volumen" => "53" "numero" => "pt 1" "paginaInicial" => "259" "paginaFinal" => "262" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12656182" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0070" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "First insights into the draft genome of <span class="elsevierStyleItalic">Clostridium colicanis</span> DSM 13634, isolated from canine feces" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Poehlein" 1 => "T. Schilling" 2 => "U. Bhaskar Sathya Narayanan" 3 => "R. Daniel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/genomeA.00385-16" "Revista" => array:4 [ "tituloSerie" => "Genome Announc" "fecha" => "2016" "volumen" => "4" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27688332" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0075" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Senior Thai fecal microbiota comparison between vegetarians and non-vegetarians using PCR-DGGE and real-time PCR" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. Ruengsomwong" 1 => "Y. Korenori" 2 => "N. Sakamoto" 3 => "B. Wannissorn" 4 => "J. Nakayama" 5 => "S. Nitisinprasert" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4014/jmb.1310.10043" "Revista" => array:6 [ "tituloSerie" => "J Microbiol Biotechnol" "fecha" => "2014" "volumen" => "24" "paginaInicial" => "1026" "paginaFinal" => "1033" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24743571" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0080" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Increased abundance of <span class="elsevierStyleItalic">Clostridium</span> and <span class="elsevierStyleItalic">Fusobacterium</span> in gastric microbiota of patients with gastric cancer in Taiwan" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y.Y. Hsieh" 1 => "S.Y. Tung" 2 => "H.Y. Pan" 3 => "C.W. Yen" 4 => "H.W. Xu" 5 => "Y.J. Lin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/s41598-017-18596-0" "Revista" => array:5 [ "tituloSerie" => "Sci Rep" "fecha" => "2018" "volumen" => "8" "paginaInicial" => "158" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29317709" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack432522" "titulo" => "Acknowledgement" "texto" => "<p id="par0045" class="elsevierStylePara elsevierViewall">Thanks to Carmen Martín Salas of the Servicio de Microbiología Clínica, Complejo Hospitalario de Navarra for her help in drafting the manuscript.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/2529993X/0000003700000009/v1_201911010649/S2529993X19302059/v1_201911010649/en/main.assets" "Apartado" => array:4 [ "identificador" => "63562" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/2529993X/0000003700000009/v1_201911010649/S2529993X19302059/v1_201911010649/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X19302059?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 1 | 3 |
| 2024 October | 12 | 1 | 13 |
| 2024 September | 21 | 1 | 22 |
| 2024 August | 15 | 3 | 18 |
| 2024 July | 11 | 4 | 15 |
| 2024 June | 16 | 3 | 19 |
| 2024 May | 15 | 4 | 19 |
| 2024 April | 12 | 9 | 21 |
| 2024 March | 14 | 4 | 18 |
| 2024 February | 23 | 2 | 25 |
| 2024 January | 14 | 2 | 16 |
| 2023 December | 8 | 2 | 10 |
| 2023 November | 14 | 3 | 17 |
| 2023 October | 19 | 2 | 21 |
| 2023 September | 12 | 1 | 13 |
| 2023 August | 14 | 0 | 14 |
| 2023 July | 14 | 3 | 17 |
| 2023 June | 7 | 0 | 7 |
| 2023 May | 35 | 2 | 37 |
| 2023 April | 41 | 0 | 41 |
| 2023 March | 36 | 1 | 37 |
| 2023 February | 22 | 3 | 25 |
| 2023 January | 38 | 1 | 39 |
| 2022 December | 32 | 6 | 38 |
| 2022 November | 21 | 7 | 28 |
| 2022 October | 14 | 7 | 21 |
| 2022 September | 25 | 9 | 34 |
| 2022 August | 18 | 11 | 29 |
| 2022 July | 19 | 5 | 24 |
| 2022 June | 20 | 4 | 24 |
| 2022 May | 24 | 5 | 29 |
| 2022 April | 28 | 9 | 37 |
| 2022 March | 54 | 10 | 64 |
| 2022 February | 65 | 3 | 68 |
| 2022 January | 64 | 3 | 67 |
| 2021 December | 27 | 10 | 37 |
| 2021 November | 25 | 5 | 30 |
| 2021 October | 15 | 8 | 23 |
| 2021 September | 10 | 10 | 20 |
| 2021 August | 13 | 4 | 17 |
| 2021 July | 10 | 11 | 21 |
| 2021 June | 12 | 5 | 17 |
| 2021 May | 26 | 8 | 34 |
| 2021 April | 60 | 9 | 69 |
| 2021 March | 11 | 5 | 16 |
| 2021 February | 12 | 9 | 21 |
| 2021 January | 8 | 11 | 19 |
| 2020 December | 12 | 5 | 17 |
| 2020 November | 11 | 5 | 16 |
| 2020 October | 11 | 3 | 14 |
| 2020 September | 7 | 6 | 13 |
| 2020 August | 12 | 4 | 16 |
| 2020 July | 5 | 5 | 10 |
| 2020 June | 11 | 1 | 12 |
| 2020 May | 10 | 12 | 22 |
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