Detection of Streptobacillus moniliformis in whole blood by real-time PCR and review of clinical cases 2004-2015 in New York State

Abstract

Objectives: Early identification of Streptobacillus moniliformis infections that cause rat bite fever (RBF) can be challenging and treatment of these infections is important for the reduction of morbidity and mortality. We report a rapid and sensitive real-time PCR assay for use on whole blood (WB) specimens in less than 3 hrs. Materials and Methods: We developed a novel two-target real-time PCR assay and assessed sensitivity, specificity, and compared assay performance to 16S rDNA analysis. A retrospective study of 9 clinical specimens received from 2004-2015 was performed and available epidemiological data was compiled. Results: This assay was found to have a limit of detection of <1 colony forming unit in WB and to be specific for S. moniliformis as well as provide detection of S. felis, S. notomytis, and S. ratti. Analysis of retrospective specimens determined this assay to be 100% concordant with 16S rDNA analysis and epidemiological data review provided insight into exposures, symptoms and treatment. Conclusion: This real-time PCR assay represents a valuable tool as it can be performed with instrumentation available in many public health and clinical laboratories, providing results within 3 hours from receiving a WB specimen. Its utilization may improve the detection of RBF and further the understanding of the burden of this disease. J Microbiol Infect Dis 2017; 7(2): 88-92 

Keywords

• Streptobacillus moniliformis,Rat Bite Fever,blood,real-time PCR,clinical

References

1. 1. Elliott SP. Rat bite fever and Streptobacillus moniliformis. Clin Microbiol Rev 2007; 20:13- 22.
2. 2. Wouters EG, Ho HT, Lipman LJ, Gaastra W. Dogs as vectors of Streptobacillus moniliformis infection? Vet Microbiol 2008; 128:419-22.
3. 3. Boot R, Oosterhuis A, Thuis HC. PCR for the detection of Streptobacillus moniliformis. Lab Animal 2002; 36:200-208.
4. 4. Khatchadourian K, Ovetchkine P, Minodier P, Lamarre V, Lebel MH, Tapiero B. The rise of the rats: A growing paediatric issue. Paediatr & Child Health 2010; 15:131-134.
5. 5. Graves MH, Janda JM. Rat-bite fever (Streptobacillus moniliformis): a potential emerging disease. Int J Infect Dis 2001; 5:151-5.
6. 6. Hagelskjaer L, Sorensen I, Randers E. Streptobacillus moniliformis infection: 2 cases and a literature review. Scan J infect Dis 1998; 30:309-311.
7. 7. Anderson LC, Leary SL, Manning PJ. Ratbite fever in animal research laboratory personnel. Lab Animal Sci 1983; 33:292-294.
8. 8. Andre JM, Freydiere AM, Benito Y, et al. Rat bite fever caused by Streptobacillus moniliformis in a child: human infection and rat carriage diagnosed by PCR. Journal of clinical pathology. 2005; 58:1215-6.

9. 9. Albedwawi S, LeBlanc C, Shaw A, Slinger RW. A teenager with fever, rash and arthritis. Can Med Assoc J 2006; 175:354.
10. 10. Gaastra W, Boot R, Ho HT, Lipman LJ. Rat bite fever. Vet Microbiol 2009; 133:211-228.
11. 11. Stehle P, Dubuis O, So A, Dudler J. Rat bite fever without fever. Annals of the rheumatic diseases. 2003; 62:894-896.
12. 12. Eisenberg T, Nicklas W, Mauder N, et al. Phenotypic and Genotypic Characteristics of Members of the Genus Streptobacillus. PLoS ONE. 2015; 10(8): e0134312.
13. 13. Madhubashini M, George S, Chandrasekaran S. Streptobacillus moniliformis endocarditis: case report and review of literature. Indian heart journal. 2013; 65:442-6.
14. 14. Rupp ME. Streptobacillus moniliformis endocarditis: case report and review. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 1992; 14:769-72.
15. 15. Freels LK, Elliott SP. Rat bite fever: three case reports and a literature review. Clin Pediatr 2004;43:291-5.
16. 16. Adam JK, Varan AK, Pong AL, McDonald EC. MMWR 2014; 63:1210-1211.
17. 17. Banerjee P, Ali Z, Fowler DR. Rat bite fever, a fatal case of Streptobacillus moniliformis infection in a 14-month-old boy. J Forens Sci 2011; 56:531-3.
18. 18. Nakagomi D, Deguchi N, Yagasaki A, et al. Rat-bite fever identified by polymerase chain reaction detection of Streptobacillus moniliformis DNA. J Dermatol 2008; 35:667- 670.
19. 19. Berger C, Altwegg M, Meyer A, Nadal D. Broad range polymerase chain reaction for diagnosis of rat-bite fever caused by Streptobacillus moniliformis. Pediatr Inf Dis J 2001; 20:1181-2.
20. 20. Musser KA. Validation of New Molecular Tests for Microbiological Testing of Clinical Specimens. Clin Microbiol Newslet 2009; 31:185-192.
21. 21. Nazarian EJ, Bopp DJ, Saylors A, Limberger RJ, Musser KA. Design and implementation of a protocol for the detection of Legionella in clinical and environmental samples. Diagn Microbiol Inf Dis 2008; 62:125-32.