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Tsukamurella: a cause of catheter-related bloodstream infections

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Abstract

Tsukamurellae are strictly aerobic Gram-positive rods that can be easily misidentified as Corynebacterium species, Rhodococcus species, Nocardia species, Mycobacterium species, or other Gram-positive aerobic rods. They have been uncommonly reported as a cause of different human infections, including bloodstream infections. We describe 2 new cases of catheter-related bloodstream infections (CR-BSI) caused by Tsukamurella species and review 12 similar cases reported in the literature. Conventional procedures have often misidentified Tsukamurella species as other aerobic Gram-positive rods. This misidentification could be avoided using genotyping. All cases ultimately required the withdrawal of the infected line. The literature provides no firm conclusions regarding ideal choice or duration of antimicrobial therapy for this infection. Tsukamurella species should be added to the list of agents able to produce CR-BSI. Genotypic methods such as PCR 16S rRNA can allow a reliable identification at the genus level of Tsukamurella strains faster than a combination of conventional phenotypic methods.

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References

  1. Tsukamura M, Mizuno S (1971) A new species Gordona aurantiaca occurring in sputa of patients with pulmonary disease. Kekkaku 46(4):93–98

    PubMed  CAS  Google Scholar 

  2. Kattar MM, Cookson BT, Carlson LD, Stiglich SK, Schwartz MA, Nguyen TT et al (2001) Tsukamurella strandjordae sp. nov., a proposed new species causing sepsis. J Clin Microbiol 46:1467–1476

    Article  Google Scholar 

  3. Yassin AF, Rainey FA, Burghardt J, Brzezinka H, Schmitt S, Seifert P et al (1997) Tsukamurella tyrosinosolvens sp. nov. Int J Syst Bacteriol 47:607–614

    PubMed  CAS  Google Scholar 

  4. Yassin AF, Rainey FA, Brzezinka H, Burghardt J, Rifai M, Seifert P et al (1996) Tsukamurella pulmonis sp. nov.. Int J Syst Bacteriol 46:429–436

    PubMed  CAS  Google Scholar 

  5. Yassin AF, Rainey FA, Brzezinka H, Burghardt J, Lee HJ, Schaal KP (1995) Tsukamurella inchonensis sp. nov. Int J Syst Bacteriol 45:522–527

    CAS  Google Scholar 

  6. Glickman SE, Kilburn JO, Butler WR, Ramos LS (1994) Rapid identification of mycolic acid patterns of mycobacteria by high-performance liquid chromatography using pattern recognition software and a Mycobacterium library. J Clin Microbiol 32(3):740–745

    PubMed  CAS  Google Scholar 

  7. Patel JB, Wallace RJ Jr, Brown-Elliott BA, Taylor T, Imperatrice C, Leonard DG et al (2004) Sequence-based identification of aerobic actinomycetes. J Clin Microbiol 42(6):2530–2540

    Article  PubMed  CAS  Google Scholar 

  8. Woo PC, Ngan AH, Lau SK, Yuen KY (2003) Tsukamurella conjunctivitis: a novel clinical syndrome. J Clin Microbiol 41(7):3368–3371

    Article  PubMed  Google Scholar 

  9. Lai KK (1993) A cancer patient with central venous catheter-related sepsis caused by Tsukamurella paurometabolum (Gordona aurantiaca). Clin Infect Dis 17(2):285–287

    PubMed  CAS  Google Scholar 

  10. Elshibly S, Doherty J, Xu J, McClurg RB, Rooney PJ, Millar BC et al (2005) Central line-related bacteraemia due to Tsukamurella tyrosinosolvens in a haematology patient. Ulster Med J 74(1):43–46

    PubMed  CAS  Google Scholar 

  11. Sheridan EA, Warwick S, Chan A, Dall’Antonia M, Koliou M, Sefton A (2003) Tsukamurella tyrosinosolvens intravascular catheter infection identified using 16S ribosomal DNA sequencing. Clin Infect Dis 36(5):69–70

    Article  Google Scholar 

  12. Maertens J, Wattiau P, Verhaegen J, Boogaerts M, Verbist L, Wauters G (1998) Catheter-related bacteremia due to Tsukamurella pulmonis. Clin Microbiol Infect 4(1):51–53

    Article  PubMed  Google Scholar 

  13. Jones RS, Fekete T, Truant AL, Satishchandran V (1994) Persistent bacteremia due to Tsukamurella paurometabolum in a patient undergoing hemodialysis: case report and review. Clin Infect Dis 18(5):830–832

    PubMed  CAS  Google Scholar 

  14. Clausen C, Wallis CK (1994) Bacteremia caused by Tsukamurella species. Clin Microbiol Newsl 16(1):6–8

    Article  Google Scholar 

  15. Shapiro CL, Haft RF, Gantz NM, Doern GV, Christenson JC, O’Brien R et al (1992) Tsukamurella paurometabolum: a novel pathogen causing catheter-related bacteremia in patients with cancer. Clin Infect Dis 14(1):200–203

    PubMed  CAS  Google Scholar 

  16. Schwartz MA, Tabet SR, Collier AC et al (2002) Central venous catheter-related bacteremia due to Tsukamurella species in the immunocompromised host: a case series and review of the literature. Clin Infect Dis 35(7):72–77

    Article  Google Scholar 

  17. Brown JM, McNeil MM (1999) Nocardia, Rhodococcus, Gordona, Actinomadura, Streptomyces, and other actinomycetes of medical importance. In: Manual of clinical microbiology. American Society for Microbiology, Washington, DC, pp 370–398

    Google Scholar 

  18. Metchock B, Nolte F, Wallace R Jr (1999) Mycobacterium. In: Manual of clinical microbiology. American Society for Microbiology, Washington, DC, pp 399–437

    Google Scholar 

  19. Steingrube VA, Wilson RW, Brown BA, Jost KC Jr, Blacklock Z, Gibson JL et al (1997) Rapid identification of clinically significant species and taxa of aerobic actinomycetes, including Actinomadura, Gordona, Nocardia, Rhodococcus, Streptomyces, and Tsukamurella isolates, by DNA amplification and restriction endonuclease analysis. J Clin Microbiol 35(4):817–822

    PubMed  CAS  Google Scholar 

  20. O’Grady NP, Alexander M, Dellinger EP, Gerberding JL, Heard SO, Maki DG et al (2002) Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention. MMWR Recomm Rep 51(RR-10):1–29

    PubMed  Google Scholar 

  21. Collins M, Smida J, Dorssch M, Stackebrandt E (1988) Tsukamurella gen nov. harboring Corynebacterium paurometabolum and Rhodococcus aurantiacus. Int J Syst Bacteriol 38:385–391

    Article  CAS  Google Scholar 

  22. Almehmi A, Pfister AK, McCowan R, Matulis S (2004) Implantable cardioverter-defibrillator infection caused by Tsukamurella. W V Med J 100(5):185–186

    PubMed  Google Scholar 

  23. Shaer AJ, Gadegbeku CA (2001) Tsukamurella peritonitis associated with continuous ambulatory peritoneal dialysis. Clin Nephrol 56(3):241–246

    PubMed  CAS  Google Scholar 

  24. Prinz G, Ban E, Fekete S, Szabo Z (1985) Meningitis caused by Gordona aurantiaca (Rhodococcus aurantiacus). J Clin Microbiol 22(3):472–474

    PubMed  CAS  Google Scholar 

  25. Woo PC, Ngan AH, Lau SK, Yuen KY (2003) Tsukamurella conjunctivitis: a novel clinical syndrome. J Clin Microbiol 41:3368–3371

    Article  PubMed  Google Scholar 

  26. Alcaide ML, Espinoza L, Abbo L (2004) Cavitary pneumonia secondary to Tsukamurella in an AIDS patient. First case and a review of the literature. J Infect 49(1):17–19

    Article  PubMed  Google Scholar 

  27. Tsukamura M, Kawakami K (1982) Lung infection caused by Gordona aurantiaca (Rhodococcus aurantiacus). J Clin Microbiol 16(4):604–607

    PubMed  CAS  Google Scholar 

  28. Larkin JA, Lit L, Sinnott J, Wills T, Szentivanyi A (1999) Infection of a knee prosthesis with Tsukamurella species. South Med J 92(8):831–832

    PubMed  CAS  Google Scholar 

  29. Tsukamura M, Hikosaka K, Nishimura K, Hara S (1988) Severe progressive subcutaneous abscesses and necrotizing tenosynovitis caused by Rhodococcus aurantiacus. J Clin Microbiol 26(2):201–205

    PubMed  CAS  Google Scholar 

  30. Granel F, Lozniewski A, Barbaud A, Lion C, Dailloux M, Weber M et al (1996) Cutaneous infection caused by Tsukamurella paurometabolum. Clin Infect Dis 23(4):839–840

    PubMed  CAS  Google Scholar 

  31. Chong Y, Lee K, Chon CY, Kim MJ, Kwon OH, Lee HJ (1997) Tsukamurella inchonensis bacteremia in a patient who ingested hydrochloric acid. Clin Infect Dis 24(6):1267–1268

    PubMed  CAS  Google Scholar 

  32. Auerbach SB, McNeil MM, Brown JM, Lasker BA, Jarvis WR (1992) Outbreak of pseudoinfection with Tsukamurella paurometabolum traced to laboratory contamination: efficacy of joint epidemiological and laboratory investigation. Clin Infect Dis 14(5):1015–1022

    PubMed  CAS  Google Scholar 

  33. McNeil MM, Brown JM (1994) The medically important aerobic actinomycetes: epidemiology and microbiology. Clin Microbiol Rev 7(3):357–417

    PubMed  CAS  Google Scholar 

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Acknowledgements

We thank Thomas O’Boyle for his help in the preparation of this manuscript. Alfonso Pérez Parra MD is contracted by the Fundación para la Investigación Biomédica del Hospital General Universitario Gregorio Marañón and Fondo de Investigación Sanitaria (FIS) CM06/00037.

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Authors and Affiliations

  1. Department of Clinical Microbiology and Infectious Diseases Service, Hospital General Universitario Gregorio Marañón, Doctor Esquerdo 46, 28007, Madrid, Spain

    E. Bouza, A. Pérez-Parra, M. Rosal, P. Martín-Rabadán, M. Rodríguez-Créixems & M. Marín

  2. Red Española de Investigación en Patología Infecciosa (REIPI), RD06/0008/1025, 2008-2010, Madrid, Spain

    E. Bouza

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  1. E. Bouza
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Correspondence to A. Pérez-Parra.

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Bouza, E., Pérez-Parra, A., Rosal, M. et al. Tsukamurella: a cause of catheter-related bloodstream infections. Eur J Clin Microbiol Infect Dis 28, 203–210 (2009). https://doi.org/10.1007/s10096-008-0607-2

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