Erysipelas of the right arm due to Bordetella trematum: a case report.

BACKGROUND: Bordetella trematum is unknown to most clinicians and microbiologists. However, this Gram-negative opportunistic bacterium can be responsible for ulcer superinfection but also bacteremia and sometimes death by septic shock. CASE REPORT: We report the case of erysipelas due to B. trematum with bacteremia in an immunocompromised 88-year-old Caucasian patient. CONCLUSION: In immunocompromised patients, unusual microbial agents such as B. trematum can be responsible for cutaneous and systemic infections, requiring specific antibiotic therapy. Therefore, clinicians should be aware of the need for specific bacterial identification such as matrix-assisted laser desorption ionization time-of-flight mass spectrometry and 16S ribosomal RNA sequencing in the context of atypical evolution of erysipelas in such patients.

Colonization of preservation solution in kidney transplantation: Clinical impact and risk of secondary acute graft pyelonephritis.

INTRODUCTION: Bacterial colonization of preservative solutions (PS) remains poorly described in renal transplantation. We investigated the bacterial colonization of the PS and its influence on graft pyelonephritis within one year from the renal transplantation. PATIENTS AND METHODS: We cultured 2 samples of PS from 424 patients who underwent a renal transplantation. The follow-up period was one year. An acute graft pyelonephritis was defined as a positive bacteriological urine analysis, with temperature higher than 38.5°C or graft pain. RESULTS: In total, 424 samples of PS were tested and 195 were positive for colonization (46%). Forty-five patients developed an acute graft pyelonephritis during the follow-up period (10.6%), of which, 21 (46.7%) showed a colonization of their PS. Twenty-four had no colonization (53.3%). This difference was not significant (P=0.697). DISCUSSION: Our data suggest that the bacterial colonization of PS samples does not seem to increase the risk of acute graft pyelonephritis in renal transplant recipients. LEVEL OF EVIDENCE: -3.

Assessment of the automated multiplex-PCR Unyvero i60 ITI® cartridge system to diagnose prosthetic joint infection: a multicentre study.

OBJECTIVES: Prosthetic joint infections (PJI) are responsible for significant morbidity and mortality and their number continues to rise. Their management remains complex, especially the microbiological diagnosis. Besides 'homemade' tests developed by several teams, new molecular biology methods are now available with different analytical performance and usability. METHODS: We studied the performances of one of these tests: ITI® multiplex PCR (mPCR) by the Curetis® company and compared it to either 'optimized' culture or 16S rRNA PCR. We performed a retrospective multicentre study to assess the contributions of mPCR in the diagnosis of PJI. We randomly selected 484 intraoperative specimens among 1252 of various types (biopsy, bone, tissue around the prosthesis, synovial fluid) from 251 patients in seven different hospitals. Each sample was treated according to the recommendations of the manufacturer. RESULTS: In all, 154 out of 164 (93.9%) samples negative in culture were negative with the mPCR. Among the 276 positive samples in culture, 251 (90.9%) were monomicrobial, of which 119 (47.4%) were positive with the mPCR, and 25 (9.1%) were polymicrobial, of which 12 (48%) were positive with the mPCR. The concordance rate of mPCR with culture was 58.1% (53.6%-62.7%) and the concordance rate with 16S rRNA PCR was 70.1% (65.5%-74.6%). CONCLUSION: This new standardized molecular test showed a lack of detection when the bacterial inoculum was low (number of positive media per sample and number of colonies per media) but can be useful when patients have received antibiotic therapy previously.

Analysis of the prophages carried by human infecting isolates provides new insight into the evolution of Group B Streptococcus species.

OBJECTIVES: Group B Streptococcus (GBS) emerged in the 1970s as a major cause of neonatal infections, and has been increasingly associated with infections in adults since the 1990s. Prophages have been suspected to have driven these epidemiological trends. We have characterized the prophages harboured by 275 human GBS isolates belonging to the major lineages. METHODS: We applied whole genome sequencing (WGS) to 14 isolates representative of the diversity within GBS species, located and identified their prophages. Using prediction tools, we searched for prophage elements potentially involved with the ability of GBS to infect humans. Using the data obtained by WGS, we designed a PCR-based tool and studied the prophage content of 275 isolates. RESULTS: WGS of the 14 isolates revealed 22 prophages (i) distributed into six groups (A-F), (ii) similar to phages and prophages from GBS and non-GBS streptococci recovered from livestock, and (iii) carrying genes encoding factors previously associated with host adaptation and virulence. PCR-based detection of prophages revealed the presence of at least one prophage in 72.4% of the 275 isolates and a significant association between neonatal infecting isolates and prophages C, and between adult infecting isolates and prophages A. CONCLUSIONS: Our results suggest that prophages (possibly animal-associated) have conditioned bacterial adaptation and ability to cause infections in neonates and adults, and support a role of lysogeny with the emergence of GBS as a pathogen in human.