RESUMEN
The immunosuppression conditions and the presence of medical devices in patients favor the Gordonia infections. However, the features of this aerobic actinomycete have been little explored. Strains (n = 164) were characterized with 16S rDNA and secA1 genes to define their phylogenetic relationships, and subjected to broth microdilution to profile the antimicrobial susceptibilities of Gordonia species that caused infections in Spain during the 2005-2021 period. Four out of the eleven identified species were responsible for 86.0% of the infections: Gordonia sputi (53.0%), Gordonia bronchialis (18.3%), Gordonia terrae (8.5%) and Gordonia otitidis (6.1%). Respiratory tract infections (61.6%) and bacteremia (21.9%) were the most common infections. The secA1 gene resolved the inconclusive identification, and two major clonal lineages were observed for G. sputi and G. bronchialis. Species showed a wide antimicrobial susceptibility profile. Cefoxitin resistance varies depending on the species, reaching 94.2% for G. sputi and 36.0% for G. terrae. What is noteworthy is the minocycline resistance in G. sputi (11.5%), the clarithromycin resistance in G. bronchialis secA1 lineage II (30.0%) and the amoxicillin-clavulanate and cefepime resistance in G. terrae (21.4% and 42.8%, respectively). G. sputi and G. bronchialis stand out as the prevalent species causing infections in Spain. Resistance against cefoxitin and other antimicrobials should be considered.
RESUMEN
La mastitis granulomatosa idiopática es una entidad rara, benigna y crónica de causa desconocida que afecta a la mama. Es un diagnóstico de exclusión. Se deben descartar, entre otras etiologías, la tuberculosis, las infecciones, la sarcoidosis y otras enfermedades autoinmunes, como la arteritis de células gigantes. Los principales retos que plantea esta entidad son su diagnóstico diferencial con enfermedad maligna y su tratamiento. La afectación mamaria es anecdótica y ha sido solo reportada en relación con prótesis mamarias. Presentamos el caso de una paciente diagnosticada de mastitis granulomatosa idiopática complicada con un absceso de mama por Gordonia sputi.
Idiopathic granulomatous mastitis is a rare, benign, chronic entity of unknown cause affecting the breast. It is a diagnosis of exclusion. Among other aetiologies, tuberculosis, infections, sarcoidosis, and other autoimmune diseases such as giant cell arteritis must be ruled out. The main challenges posed by this entity are its differential diagnosis with malignant pathology and its treatment.Gordonia spp. are a group of emerging pathogens that are mainly associated with infections associated with medical devices, mainly catheters. Breast involvement is anecdotal and has only been reported in relation to breast prostheses.We present the case of a patient diagnosed with idiopathic granulomatous mastitis complicated with a breast abscess due to Gordonia sputi.