Leptotrichia species Bacteremia in Hematological Malignancies

Year 2022, , 130 - 135, 17.09.2022

Evann E. Hilt Patricia Ferrieri

https://doi.org/10.5799/jmid.1176551

Abstract

Here we present four clinical cases of immunocompromised patients experiencing bacteremia caused by Leptotrichia species in a few months with no common epidemiological link. Leptotrichia species are thin anaerobic gram-negative rods that inhabit multiple areas in the human body, including the oral microbiota. Many infections with Leptotrichia species occur in immunocompromised individuals classifying Leptotrichia species as opportunistic pathogens. Utilization of standard microbial identification methods of matrix-assisted laser-desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) initially yielded the same identification for all four Leptotrichia isolates as Leptotrichia buccalis. However, 16S ribosomal RNA sequencing confirmed the identification of only one of the four isolates as L. buccalis, while two of the four isolates were identified as Leptotrichia trevisanii. These four cases highlight the clinical importance of considering opportunistic infection in immunocompromised patients with unusual organisms considered members of the normal oral flora. J Microbiol Infect Dis 2022; 12(3):130-135.

Keywords

Leptotrichia, bacteremia, immunocompromised

References

• 1. Eribe ER, Olsen I. Leptotrichia species in human infections. Anaerobe 2008; 14(3): 131-137.
• 2. Eribe ERK, Olsen I. Leptotrichia species in human infections II. J Oral Microbiol 2017; 9(1): 1368848.
• 3. Baquero F, Fernández J, Dronda F, et al. Capnophilic and anaerobic bacteremia in neutropenic patients: an oral source. Rev Infect Dis 1990; 12 Suppl 2: S157-160.
• 4. Fontanals D, García-Miralles C, Ballester R, Cochs B, Orellana R, Capilla S. Chorioamnionitis due to Leptotrichia trevisanii. Anaerobe 2018; 49: 18-20.
• 5. Smid MC, Dotters-Katz SK, Plongla R, Boggess KA. Leptotrichia buccalis: A Novel Cause of Chorioamnionitis. Infect Dis Rep 2015; 7(2): 5801.
• 6. Duperval R, Béland S, Marcoux JA. Infective endocarditis due to Leptotrichia buccalis: a case report. Can Med Assoc J 1984; 130(4): 422-424.
• 7. Caram LB, Linefsky JP, Read KM, et al. Leptotrichia endocarditis: report of two cases from the International Collaboration on Endocarditis (ICE) database and review of previous cases. Eur J Clin Microbiol Infect Dis 2008; 27(2): 139-143.
• 8. Eribe ERK, Paster BJ, Caugant DA, et al. Genetic diversity of Leptotrichia and description of Leptotrichia goodfellowii sp. nov., Leptotrichia hofstadii sp. nov., Leptotrichia shahii sp. nov. and Leptotrichia wadei sp. nov. Int J Syst Evol Microbiol 2004; 54(Pt 2): 583-592.
• 9. Altschul SF, Gish W, Miller W, Myers EW, Lipman DJ. Basic local alignment search tool. J Mol Biol 1990; 215(3): 403-410.
• 10. Cole JR, Wang Q, Fish JA, et al. Ribosomal Database Project: data and tools for high throughput rRNA analysis. Nucleic Acids Res 2014; 42(Database issue): D633-642.
• 11. Ivanova N, Gronow S, Lapidus A, et al. Complete genome sequence of Leptotrichia buccalis type strain (C-1013-b). Stand Genomic Sci 2009; 1(2): 126-132.
• 12. Couturier MR, Slechta ES, Goulston C, Fisher MA, Hanson KE. Leptotrichia bacteremia in patients receiving high-dose chemotherapy. J Clin Microbiol 2012; 50(4): 1228-1232.
• 13. Dewhirst FE, Chen T, Izard J, et al. The human oral microbiome. J Bacteriol 2010; 192(19): 5002-5017.
• 14. Cho EH, Park KS, Yang M, et al. Laboratory Identification of Leptotrichia species Isolated from Bacteremia Patients at a Single Institution. Ann Lab Med 2017; 37(3): 272-276.
• 15. Tee W, Midolo P, Janssen PH, Kerr T, Dyall-Smith ML. Bacteremia due to Leptotrichia trevisanii sp. nov. Eur J Clin Microbiol Infect Dis 2001; 20(11): 765-769.
• 16. Hanff PA, Rosol-Donoghue JA, Spiegel CA, Wilson KH, Moore LH. Leptotrichia sanguinegens sp. nov., a new agent of postpartum and neonatal bacteremia. Clin Infect Dis 1995; 20 Suppl 2: S237-239.
• 17. Richards VP, Alvarez AJ, Luce AR, et al. Microbiomes of Site-Specific Dental Plaques from Children with Different Caries Status. Infect Immun 2017; 85(8): e00106-117.
• 18. Listgarten MA, Lai CH. Unusual cell wall ultrastructure of Leptotrichia buccalis. J Bacteriol 1975; 123(2): 747-749.
• 19. Gustafson RL, Kroeger AV, Gustafson JL, Vaichulis EM. The biological activity of Leptotrichia buccalis endotoxin. Arch Oral Biol 1966; 11(11): 1149-1162.