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      First report of chronic implant-related septic arthritis and osteomyelitis due to Kytococcus schroeteri and a review of human K. schroeteri infections

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          Abstract

          We report the first case of Kytococcus schroeteri implant-related septic arthritis and osteomyelitis, identified by phenotypic tests and 16S rRNA sequencing, which responded to implant removal and doxycycline. 16S rRNA sequencing was useful for the accurate and rapid identification of the organism as it exhibited three different colonial morphologies in vitro.

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          Group G beta-hemolytic streptococcal bacteremia characterized by 16S ribosomal RNA gene sequencing.

          Natalie Yuen, Patrick C. Y. Woo, Kar-Ming A. Fung … (2001)
          Little is known about the relative importance of the four species of Lancefield group G beta-hemolytic streptococci in causing bacteremia and the factors that determine the outcome for patients with group G beta-hemolytic streptococcal bacteremia. From 1997 to 2000, 75 group G beta-hemolytic streptococcal strains were isolated from the blood cultures of 66 patients. Sequencing of the 16S rRNA genes of the group G beta-hemolytic streptococci showed that all 75 isolates were Streptococcus dysgalactiae subspecies equisimilis. The API system (20 STREP) and Vitek system (GPI) successfully identified 65 (98.5%) and 62 (93.9%) isolates, respectively, as S. dysgalactiae subspecies equisimilis with >95% confidence, whereas the ATB Expression system (ID32 STREP) only successfully identified 49 isolates (74.2%) as S. dysgalactiae subspecies equisimilis with >95% confidence. The median age of the patients was 76 years (range, 33 to 99 years). Fifty-six patients (85%) were over 60 years old. All patients had underlying diseases. No source of the bacteremia was identified (primary bacteremia) in 34 patients (52%), whereas 17 (26%) had cellulitis and 8 (12%) had bed sore or wound infections. Fifty-eight patients (88%) had community-acquired group G streptococcal bacteremia. Sixty-two patients (94%) had group G Streptococcus recovered in one blood culture, whereas 4 patients (6%) had it recovered in multiple blood cultures. Fifty-nine patients (89%) had group G Streptococcus as the only bacterium recovered in their blood cultures, whereas in 7 patients other bacteria were recovered concomitantly with the group G Streptococcus in the blood cultures (Staphylococcus aureus in 3, Clostridium perfringens in 2, Citrobacter freundii in 1, and Bacteroides fragilis in 1). Overall, 10 patients (15%) died. Male sex, diagnosis other than cellulitis, hospital-acquired bacteremia, and multiple positive blood cultures were associated with mortality [P < 0.005 (relative risk [RR] = 7.6), P < 0.05 (RR = 3.7), P < 0.005 (RR = 5.6), and P < 0.05 (RR = 5.6), respectively]. Unlike group C beta-hemolytic streptococcal bacteremia, group G beta-hemolytic streptococcal bacteremia is not a zoonotic infection in Hong Kong.
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            Kytococcus schroeteri sp. nov., a novel Gram-positive actinobacterium isolated from a human clinical source.

            Karsten Becker, Jörg Wüllenweber, Georg Peters … (2002)
            A strain of a gram-positive, coccoid, yellow-pigmented bacterium was isolated from human blood. The bacterium was aerobic, non-encapsulated and non-motile. Phenotypically, the bacterium closely resembled Kytococcus sedentarius, but could be distinguished from this species by physiological tests and chemotaxonomic investigations. The peptidoglycan type is L-Lys-Glu2, variation A4alpha. The predominant menaquinones are MK-8 and MK-7. The major cellular fatty acids are iso-C17:1, iso-C17:0, iso-C15:0 and anteiso-C17:0. The strain contains catalase and does not produce acid from carbohydrates. The ability to hydrolyse Tween 80 and the lack of alpha-glucosidase activity are the most characteristic features. The results of comparative 16S rDNA analysis revealed that the strain represents a novel species within the genus Kytococcus, for which the name Kytococcus schroeteri sp. nov. is proposed. The type strain is strain Muenster 2000T (= DSM 13884T = CCM 4918T).
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              Streptococcus sinensis sp. nov., a novel species isolated from a patient with infective endocarditis.

              Kwok-Yung Yuen, Patrick C. Y. Woo, Susanna Lau … (2002)
              A bacterium was isolated from the blood culture of a patient with infective endocarditis. The cells were facultative anaerobic, nonsporulating, gram-positive cocci arranged in chains. The bacterium grows on sheep blood agar as alpha-hemolytic, gray colonies of 0.5 to 1 mm in diameter after 24 h of incubation at 37 degrees C in ambient air. Growth also occurs in 10 or 40% bile and on bile esculin agar but not in 6% NaCl. No enhancement of growth is observed in 5% CO(2). It is nongroupable with Lancefield groups A, B, C, D, F, or G antisera and is resistant to optochin and bacitracin. The organism is aflagellated and is nonmotile at both 25 and 37 degrees C. It is Voges-Proskauer test positive. It produces leucine arylamidase and beta-glucosidase but not catalase, urease, lysine decarboxylase, or ornithine decarboxylase. It hydrolyzes esculin and arginine. It utilizes glucose, lactose, salicin, sucrose, pullulan, trehalose, cellobiose, hemicellulase, mannose, maltose, and starch. 16S rRNA gene sequencing showed that there were 3.6, 3.7, 4.3, 4.7, and 5.9% differences between the 16S rRNA gene sequence of the bacterium and those of Streptococcus gordonii, Streptococcus intermedius, Streptococcus constellatus, Streptococcus sanguis, and Streptococcus anginosus, respectively. The G+C content of it (mean plus minus standard deviation) was 53.0% plus minus 2.9%. Based on phylogenetic affiliation, it belongs to the mitis or anginosus group of Streptococcus. For these reasons a new species, Streptococcus sinensis sp. nov., is proposed, for which HKU4 is the type strain. Further studies should be performed to ascertain the potential of this bacterium to become an emerging cause of infective endocarditis.
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                Author and article information

                Contributors
                : +85-2-22554892 , +85-2-28551241 , pcywoo@hkucc.hku.hk
                Journal
                Journal ID (nlm-ta): Infection
                Journal ID (iso-abbrev): Infection
                Title: Infection
                Publisher: Springer-Verlag (Berlin/Heidelberg )
                ISSN (Print): 0300-8126
                ISSN (Electronic): 1439-0973
                Publication date (Electronic): 6 March 2012
                Publication date PMC-release: 6 March 2012
                Publication date (Print): October 2012
                Volume: 40
                Issue: 5
                Pages: 567-573
                Affiliations
                [1 ]Department of Microbiology, Queen Mary Hospital, Pokfulam, Hong Kong SAR China
                [2 ]State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Pokfulam, Hong Kong SAR China
                [3 ]Research Centre of Infection and Immunology, The University of Hong Kong, Pokfulam, Hong Kong SAR China
                [4 ]Carol Yu Centre for Infection, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong SAR China
                Article
                Publisher ID: 250
                DOI: 10.1007/s15010-012-0250-9
                PMC ID: 3461212
                PubMed ID: 22392020
                SO-VID: 56c06244-0b07-47a5-a8a1-efbad6e0f0b4
                Copyright © © The Author(s) 2012
                History
                Date received : 30 November 2011
                Date accepted : 9 February 2012
                Categories
                Subject: Case Report
                Custom metadata
                issue-copyright-statement © Springer-Verlag Berlin Heidelberg 2012

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: osteomyelitis,arthritis,kytococcus schroeteri,implant,infection
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: osteomyelitis, arthritis, kytococcus schroeteri, implant, infection

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