An unusual case of Erysipelothrix rhusiopathiae prosthetic joint infection from the Canadian Arctic: whole genome sequencing unable to identify a zoonotic source.

BACKGROUND: Erysipelothrix rhusiopathiae is a zoonotic pathogen that causes erysipeloid and is most frequently associated with exposure to domestic swine. Infection of native and prosthetic joints is a rarely reported manifestation. CASE PRESENTATION: We describe a case of E. rhusiopathiae prosthetic joint infection in a woman with a history of exposure to wild animals in the Canadian Arctic. Patient management involved a 1-stage surgical revision exchange with an antibiotic impregnated cement spacer and 6 weeks of intravenous penicillin G followed by 6 weeks of oral amoxicillin. Ten previously reported cases of E. rhusiopathiae joint infection are reviewed. Recent increases in mortality due to infection with this organism among host animal populations in the Canadian Arctic have generated concern regarding a potential increase in human infections. However, whole genome sequencing (WGS) of the organism was unable to identify a zoonotic origin for this case. CONCLUSIONS: Consideration should be given to E. rhusiopathiae as a cause of joint infections if the appropriate epidemiologic and host risk factors exist. Expanded use of WGS in other potential animal hosts and environmental sources may provide important epidemiologic information in determining the source of human infections.

Erysipelothrix rhusiopathiae isolates recovered from fish, a harbour seal (Phoca vitulina) and the marine environment are capable of inducing characteristic cutaneous lesions in pigs.

In order to determine the diversity and pathogenicity of Erysipelothrix spp. isolates recovered from marine fish, a harbour seal (Phoca vitulina) and the marine environment, 14 isolates were characterized by genotyping, serotyping, determination of the surface protective antigen (spa) gene type and assessment of virulence in a pig bioassay. All 14 isolates were Erysipelothrix rhusiopathiae. Isolates were determined to be of serotypes 2 (n = 3), 3 (n = 1), 4 (n = 1), 12 (n = 1), 15 (n = 1) or 21 (n = 6), and one isolate cross-reacted with serotypes 5 and 21. The spa gene analysis determined that 64.3% (n = 9) were spaA and 35.7% (n = 5) were spaB1. In pigs, 10/14 isolates induced small plaques to diamond-shaped cutaneous lesions consistent with Erysipelothrix spp. infection. The results of this study indicate that the marine E. rhusiopathiae isolates have greater genetic and antigenic diversity than pig isolates and are capable of inducing classical skin lesions in pigs.

Characterization of Erysipelothrix rhusiopathiae isolates from laying hens and poultry red mites (Dermanyssus gallinae) from an outbreak of erysipelas.

Infection with the zoonotic bacterium Erysipelothrix rhusiopathiae causes severe disease outbreaks (erysipelas) in poultry flocks. As this bacterium has been isolated from the poultry red mite (Dermanyssus gallinae), this parasite has been suggested as a possible means of transmission of E. rhusiopathiae on and between poultry farms. To further elucidate the capacity of the mite as a reservoir, we analysed and compared 56 bacterial isolates from laying hens and nine isolates from mites by pulsed-field gel electrophoresis (PFGE), using the restriction enzyme SmaI. The isolates originated from one outbreak in a laying hen flock housed in an indoor litter-based aviary system. Except for two isolates, a homogeneous banding pattern was obtained from all isolates analysed, suggesting that a single strain was the cause of the outbreak. Another finding was that isolates from individual hens could exhibit slightly different PFGE patterns. Mites collected from the same house at the end of the production period of the following flock were negative for the presence of E. rhusiopathiae. An increasing number of erysipelas outbreaks as well as escalating problems with D. gallinae are expected in other European countries related to the forthcoming changes in housing systems for laying hens. Consequently, further studies are needed to investigate the importance of erysipelas in poultry and the importance of D. gallinae in the transmission of E. rhusiopathiae.

Erysipelothrix rhusiopathiae.

Erysipelothrix rhusiopathiae is a facultative, non-spore-forming, non-acid-fast, small, Gram-positive bacillus. The organism was first established as a human pathogen late in the nineteenth century. Three forms of human disease have been recognised since then. These include a localised cutaneous lesion form, erysipeloid, a generalised cutaneous form and a septicaemic form often associated with endocarditis. The organism is ubiquitous and able to persist for a long period of time in the environment, including marine locations. It is a pathogen or a commensal in a wide variety of wild and domestic animals, birds and fish. Swine erysipelas caused by E. rhusiopathiae is the disease of greatest prevalence and economic importance. Diseases in other animals include erysipelas of farmed turkeys, chickens, ducks and emus, and polyarthritis in sheep and lambs. Infection due to E. rhusiopathiae in humans is occupationally related, principally occurring as a result of contact with contaminated animals, their products or wastes, or soil. Erysipeloid is the most common form of infections in humans. While it has been suggested that the incidence of human infection could be declining due to technological advances in animal industries, infection still occurs in specific environments. Additionally, infection by the organism is possibly under-diagnosed due to the resemblance it bears to other infections, and problems encountered in isolation and identification. Various virulence factors have been suggested as being involved in the pathogenicity of E. rhusiopathiae. The presence of a hyaluronidase and neuraminidase has been recognised, and it was shown that neuraminidase plays a significant role in bacterial attachment and subsequent invasion into host cells. The role of hyaluronidase in the disease process is controversial. The presence of a heat labile capsule has been reported as important in virulence. Control of animal disease by sound husbandry, herd management, good sanitation and immunization procedures is recommended.

Experimental study on possible transmission of the bacterium Erysipelothrix rhusiopathiae to chickens by the poultry red mite, Dermanyssus gallinae.

The vector potential of the poultry red mite, Dermanyssus gallinae De Geer (Acari: Dermanyssidae), in relation to chicken erysipelas was investigated under experimental conditions. Chickens were inoculated intramuscularly with the bacterium Erysipelothrix rhusiopathiae, and mites were allowed to feed on the inoculated chickens for 5 days. After 20 days of starvation, the mites were allowed to feed on healthy chickens to enable transmission of bacteria. Blood samples were collected from the birds and analysed for the presence of E. rhusiopathiae, and ELISA tests were performed for seropositivity. The internal presence of E. rhusiopathiae in the mites after feeding of inoculated birds was also investigated. It could not be demonstrated that mites take up and transmit E. rhusiopathiae under the experimental conditions described. However, since there are case reports as well as other in vitro studies indicating the potential of D. gallinae to act as a reservoir and potential vector for infections agents, we cannot exclude the possibility that the red poultry mite transmits E. rhusiopathiae between chickens under field conditions.

A case of Erysipelothrix rhusiopathiae causing bilateral endogenous endophthalmitis.

This report describes a case of bilateral endogenous endophthalmitis caused by Erysipelothrix rhusiopathiae, an occupational zoonotic pathogen, which was successfully treated with intravenous penicillin G followed by oral linezolid. This is believed to be the first report of E rhusiopathiae causing endogenous endophthalmitis.

Genetic differences in internal transcribed spacer 1 between Dermanyssus gallinae from wild birds and domestic chickens.

We investigated the presence of the poultry red mite or the chicken mite, Dermanyssus gallinae De Geer, Acari: Dermanyssidae, in wild bird populations in four different geographical regions of Sweden. The mites identified as D. gallinae were compared genetically with D. gallinae from egg-producing poultry farms in the same regions. The small subunit (SSU) gene, the 5.8S ribosomal RNA (rRNA) gene and the two internal transcribed spacers (ITS) of the rRNA genes were used in the genetic analysis. All D. gallinae mites had identical SSU rRNA, 5.8S rRNA and ITS2 sequences independent of their origin. By contrast, we identified significant differences in the ITS1 sequences. Based on the differences in the ITS1 sequences, the mites could be divided into two genotypes, of wild and domesticated origin, with no variation within the groups. These results imply that wild bird populations are of low importance, if any, as natural reservoirs of D. gallinae in these four geographical regions of Sweden.

Investigations of the vertical transmission of Erysipelothrix rhusiopathiae in laying hens.

Erysipelas was diagnosed in a layer breeder flock in Sweden in 2002. Although vertical transmission of Erysipelothrix rhusiopathiae has not been previously described in chickens, the potential of erysipelas infection to adversely affect hatching eggs was of concern. To clarify the possible impact of erysipelas on hatching eggs and their progeny, an experiment was done using 200 hatching eggs collected from the infected flock. The eggs were incubated for 21 days, and the egg shells, infertile eggs, dead-in-shell embryos, and a sample of day-old hatched chicks and blood samples from 5-day-old chicks were cultured for E. rhusiopathiae. In addition, after 28 days of grow-out, the male chickens were euthanatized and cultured for the bacterium, and the remaining female chickens were placed as a backyard flock and observed over a 4-mo period. Bacteriological test results of the above-mentioned samples were negative for E. rhusiopathiae. Mortality rates were not excessive, and no clinical symptoms of erysipelas were observed during the period of observation. The result of the investigation suggests that in layer breeder chickens, E. rhusiopathiae is not vertically or egg transmitted and that the disease outbreak in the parent stock had no adverse impact on the quality of hatching eggs in terms of increased embryo mortality.

Erysipelothrix rhusiopathiae endocarditis: a preventable zoonosis?

BACKGROUND: Erysipelothrix rhusiopathiae is a bacterium ubiquitous in the environment. It can cause a variety of diseases and the risk of infection is closely related to the level of occupational exposure to infected or colonised animals. AIMS: To discuss the clinical features and treatment of this zoonosis, to increase awareness of this pathogen and to emphasise the need for meticulous attention to hygienic work practices in reducing the risk of infection. METHOD: A case report of a farmer with E. rhusiopathiae endocarditis and the management of the infection. RESULTS: The patient was successfully treated with valve replacement surgery and antimicrobial therapy. CONCLUSIONS: Early identification of this microorganism is essential for appropriate treatment of endocarditis. Greater awareness and safe work practices can help reduce the risk of human infection by this microorganism.

The poultry red mite, Dermanyssus gallinae, a potential vector of Erysipelothrix rhusiopathiae causing erysipelas in hens.

Erysipelas is a bacterial disease caused by Erysipelothrix rhusiopathiae, which may infect swine as well as several other species of mammals and birds, including domestic fowl. In poultry, erysipelas may cause sudden high mortality due to septicemia. This communication describes the first isolation of E. rhusiopathiae from the haematophagous poultry red mite, Dermanyssus gallinae DeGeer (Acari: Dermanyssidae), that was collected on three farms where hen erysipelas was diagnosed. The bacteria were isolated from the integument as well as from the interior of the mites. Serotypes 1a and 1b of E. rhusiopathiae found in the mites corresponded with those isolated from the diseased birds. These findings imply that D. gallinae is a potential vector of E. rhusiopathiae. The current lack of effective measures to control D. gallinae causes recurring mite problems in poultry facilities once afflicted by this parasite. Consequently, mites containing E. rhusiopathiae may act as reservoir hosts of this bacterium, allowing it to persist in the poultry house between flock cycles as a source of infection for the replacement pullets. The zoonotic potentials of both E. rhusiopathiae and D. gallinae should also be considered.

[Erysipelothrix rhusiopathiae bacteremia after dog bite]. / Erysipelothrix rhusiopathiae-bakteriaemi efter hundebid.

A case of erysipeloid with bacteraemia caused by Erysipelothrix rhusiopathiae (ER) in a previously healthy 41-year old man is presented. The bacterium was probably introduced by the bite of a dog. He was treated successfully with penicillin V. The ER bacteraemia occurred without complications of endocarditis.

Unusual aspects of bacterial water-borne illnesses.

Various water-borne bacteria can cause significant illness. Illness most often results from ingestion of contaminated water or seafood, with gastrointestinal entry of pathogens or their byproducts. The skin and soft tissues are also common entry points, either through trauma in or near the water, or by seawater contamination of an existing wound or break in the skin. Clinically significant water-borne illnesses are still rare. However, because humans are increasingly exposed to contaminated water sources through recreation or habitat, the rate of water-borne illnesses can be expected to increase. In patients who present with gastrointestinal illness or infections that do not respond to conventional therapy, water-borne pathogens should be considered in the differential diagnosis. A complete history, with attention to seafood ingestion and exposure to marine or freshwater life-forms, in conjunction with a high index of suspicion (especially in immunocompromised patients), will increase diagnostic accuracy in patients with water-borne illnesses.

Isolation of Erysipelothrix rhusiopathiae from a 55 year old man and a positive tracing of the infection to chicken-raising premise.

Erysipelothrix rhusiopathiae was isolated from the swollen finger of a 55 year old man. The swelling was due to a peck by an infected chicken. Tracing the infection to the chicken-raising premises has proven that the bacterium was present in some of the chicken and manure samples.

[Erysipelothrix rhusiopathiae infections. General review of 31 cases of septicemia with endocarditis reported in the literature (author's transl)]. / Les infections à Erysipelothrix rhusiopathiae. Revue générale à propos de 31 cas de septicémies avec endocardite relevés dans la littérature.

Erysipelothrix rhusiopathiae is widely distributed in nature (animal, soil). It is commonly known as the causative agent of cutaneous lesions called "erysipeloid of Rosenbach". Only 31 cases of bacterial endocarditis have been reported in the literature. The etiologic diagnosis of Esysipelothrix infection was established by the presence of bacteria in blood cultures or heart-valve cultures. Immunological study is unusual owing to the rapid course of the infection. The histologic observation of heart lesions corroborates the diagnosis. The patient's receptivity depends on his occupation, general health (importance of rheumatic heart disease), sex (male), age (from 40 to 60 years old), but also on the season (from July to October) and climate (temperate). With the exception of the few cases where it is possible to recognize a portal of entry of infection or the appearance of typical cutaneous manifestations, bacterial endocarditis due to Erysipelothrix presents a clinical picture similar to that of most other bacterial endocarditis. The antibiotic treatment is an association of penicillin-streptomycin, administered in large doses over a period of at least four weeks. In spite of intensive therapy, many patients died.