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      A Case Of Recurrent Helicobacter cinaedi Prosthetic Joint Infection In An HIV-Infected Man

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          Abstract

          We describe the case of an HIV-infected man who developed twice a Helicobacter cinaedi prosthetic joint infection. In our knowledge, it is the first case to date. Furthermore, it illustrates the fact that this bacterium is difficult to isolate and that recurrences can occur even after apparently successful treatment.

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          Clinical and bacteriological characteristics of Helicobacter cinaedi infection.

          Yoshiaki Kawamura, Tatsuya Okamoto, Yuji Morita … (2014)
          Helicobacter cinaedi was first isolated from rectal cultures from homosexual men in 1984. In the 1980s to mid 1990s, the microorganism was mainly isolated from samples from homosexual men or immunocompromised patients; however, during the last two decades, H. cinaedi has been isolated from immunocompromised and from immunocompetent individuals worldwide. In Japan, the isolation of this microorganism was first reported in 2003. Since then, many cases have been reported in hospitals across the country. Despite many reports, the etiological properties and pathogenicity of H. cinaedi remain elusive; however, we are increasingly able to recognize some of the features and the clinical relevance of infection. In particular, a long incubation period is essential for detection in an automatic blood culture system and many of the recent isolates are resistant to both macrolides and quinolones. Furthermore, there is an association between infection and severe or chronic illnesses, such as meningitis or arteriosclerosis, in addition to mild diseases such as fever, abdominal pain, gastroenteritis, proctitis, diarrhea, erysipelas, cellulitis, arthritis, and bacteremia. In this review, we introduce the current knowledge and our latest findings relating to H. cinaedi. Copyright © 2014 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
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            Multicenter study to evaluate bloodstream infection by Helicobacter cinaedi in Japan.

            Etsuko Sawabe, Katsuko Okuzumi, A Yoneyama … (2007)
            Helicobacter cinaedi has being recognized as an important human pathogen which causes bloodstream infections. Although the first case of bacteremia with this pathogen in Japan was reported in 2003, the true prevalence of H. cinaedi as a pathogen of bloodstream infections in this country is not yet known. Therefore, the aim of our study was to assess the incidence of bacteremia with H. cinaedi in Japan. We conducted a prospective, multicenter analysis in 13 hospitals during 6 months in Tokyo, Japan. Among positive blood cultures from 1 October 2003 to 31 March 2004, isolates suspected of being Helicobacter species were studied for further microbial identification. Identification of the organisms was based on their biochemical traits and the results of molecular analysis of their 16S rRNA gene sequences. A total of 16,743 blood culture samples were obtained during the study period, and 2,718 samples (17.7%) yielded positive culture results for coagulase-negative staphylococci. Among nine isolates suspected to be Helicobacter species, six isolates were finally identified as H. cinaedi. The positivity rate for H. cinaedi in blood culture was 0.06% of total blood samples and 0.22% of blood samples with any positive culture results. All patients with bacteremia with H. cinaedi were found to have no human immunodeficiency virus (HIV) infection, but many of them had complications with either malignancy, renal failure, or a history of surgical operation. Therefore, our results suggest that bacteremia with H. cinaedi is rare but can occur in compromised hosts other than those with HIV infection in Japan.
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              Helicobacter cinaedi cellulitis and bacteremia in immunocompetent hosts after orthopedic surgery.

              Takaaki Akaike, Tomohiro Sawa, Tatsuya Okamoto … (2006)
              At various times after orthopedic operations (more than a few weeks, with an average of 29.9 days), 11 patients had a sudden onset of high temperature (average 38.9 degrees C) and local cellulitis at different sites on the operated sides. The wounds had completely healed, without complicated infections, when the cellulitis occurred. The clinical picture of cellulitis in all patients was atypical: diffuse salmon-pink skin color, local heat, swelling, spontaneous pain, and tenderness but no eruptions. No patient had any underlying immunocompromising conditions or had been given immunosuppressive agents. Gram-negative spiral bacteria were isolated from blood cultures and were identified as Helicobacter cinaedi on the basis of 16S rRNA gene sequencing and DNA-DNA hybridization using standard strains. By means of phylogenetic analysis, we divided these clinical isolates into two clones. The H. cinaedi strain isolated via fecal cultures from two patients without intestinal symptoms was the same clone as the blood isolate. All isolates were quite susceptible to various antibiotics, and clinical and inflammatory symptoms of bacteremia and cellulitis improved after treatment with penicillins and cephalosporins. A relatively high incidence of recurrence of the same disease was observed, however. Almost all patients responded immunologically to the infection, as evidenced by the production of serum antibody against H. cinaedi. We thus suggest that H. cinaedi should not be regarded as simply an opportunistic pathogen but that it may be a pathogen in immunocompetent hosts and may cause infections together with bacteremia and cellulitis.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Bone Jt Infect
                Journal ID (iso-abbrev): J Bone Jt Infect
                Journal ID (publisher-id): jbji
                Title: Journal of Bone and Joint Infection
                Publisher: Ivyspring International Publisher (Sydney )
                ISSN (Electronic): 2206-3552
                Publication date Collection: 2018
                Publication date (Electronic): 4 October 2018
                Volume: 3
                Issue: 4
                Pages: 230-233
                Affiliations
                [1 ]Service de Médecine Interne et Rhumatologie, Groupe Hospitalier Diaconesses-Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France.
                [2 ]Service de Médecine Interne et Rhumatologie & Centre de Référence des Infections Ostéo-Articulaires Complexes, Groupe Hospitalier Diaconesses-Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France.
                [3 ]Laboratoire de Biologie Médicale & Centre de Référence des Infections Ostéo-Articulaires Complexes, Groupe Hospitalier Diaconesses-Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France.
                [4 ]Centre National de Référence des Campylobacters et Helicobacters. CHU de Bordeaux-Pellegrin. Place Amélie Raba-Léon. 33076 Bordeaux Cedex.
                [5 ]Service de Maladies Infectieuses, Hôpital Bichat, 46 rue Henri Hussard, 75018 Paris.
                [6 ]Service de Chirurgie Osseuse et Traumatologique & Centre de Référence des Infections Ostéo-Articulaires Complexes, Groupe Hospitalier Diaconesses-Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France.
                Author notes
                ✉ Corresponding author: Joanna Kedra, Service de Médecine Interne et Rhumatologie, Groupe Hospitalier Diaconesses-Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France.

                Competing Interests: The authors have declared that no competing interest exists.

                Article
                Publisher ID: jbjiv03p0230
                DOI: 10.7150/jbji.28375
                PMC ID: 6215987
                PubMed ID: 30416949
                SO-VID: ac873794-1e60-47ab-bf17-01a3a09ca9df
                Copyright © © Ivyspring International Publisher
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) license ( https://creativecommons.org/licenses/by-nc/4.0/). See http://ivyspring.com/terms for full terms and conditions.

                History
                Date received : 8 July 2018
                Date accepted : 17 August 2018
                Categories
                Subject: Research Paper

                Keywords: helicobacter cinaedi,prosthetic joint infection,recurrence
                Data availability:
                Keywords: helicobacter cinaedi, prosthetic joint infection, recurrence

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