Post-Mastitis Bacteremia Caused by Penicillin-Resistant Aerococcus Viridans

Year 2013, Volume: 15 Issue: 3, 52 - 53, 01.12.2013

C Elif Öztürk Ahmet Şahin Harun Güneş Fatma Avcıoğlu

Abstract

Aerococcus viridans is a coccus that is Gram positive, microaerophylic, catalase and oxidasenegative, non-motile. It is mostly saprophytic but it may rarely cause opportunistic infectionsand bacteremia. A rare bacteremia case caused by Aerococcus viridans in a 28 year-old patientwho was in post-partum lactation period and admitted to emergency room due to mastitis andfever was presented in this report. Ceftriaxone treatment was started empirically after bloodcultures of patient had been taken. A bacteria which was Gram positive, catalase, and oxidasenegative, and in the form of a coccus morpholocillay was isolated in blood cultures and it wasidentified as Aerococcus viridans. When the isolate was stained with Gram stain, cocci formingtetrades were seen and alpha hemolytic colonies were detected on sheep blood agar. It was foundto be resistant to penicillin, and erythromycin, and susceptible to clindamycin, vancomycin,teicoplanin, cloramphenicol, ampicillin, cefotaxime, ceftriaxone, linesolide, and ofloxacine withantibiotic susceptibility test using Kirby-Bauer disc diffusion method.The case was succesfullytreated with ceftriaxone (2 X 1 g/day) and completely recovered without any complication. Inconclusion, it sould be remembered that Aerococcus viridans may be the causitive agent ofmastitis in post-partum lactation period, and the treatment should be directed according to resultsof antibiotic susceptibility tests

Keywords

Aerococcus viridans, bacteremia, mastitis

Mastit Sonrası Gelişen Penisilin Dirençli Aerococcus Viridans Bakteremisi

Abstract

Aerococcus viridans, Gram pozitif, mikroaerofilik, katalaz ve oksidaz negatif, hareketsiz birkoktur. Çoğunlukla saprofit olup, nadiren bakteremiye ve fırsatçı enfeksiyonlara nedenolmaktadır. Bu raporda mastit ve ateş nedeniyle acile başvuran 28 yaşında postpartumlaktasyonda olan hastada, Aerococcus viridans‘ın neden olduğu nadir bir bakteremi olgususunulmaktadır. Hastadan kan kültürleri alındıktan sonra ampirik olarak seftriakson tedavisibaşlanmıştır. Kan kültüründe üreyen Gram pozitif kok morfolojisindeki katalaz negatif bakteriAerococcus viridans olarak tanımlanmıştır. İzolatın Gram ile boyanmasında, tetrat yapan koklargörülmüş, koyun kanlı agarda alfa-hemolitik koloniler saptanmıştır. Kirby-Bauer disk difüzyonmetodu ile yapılan antibiyotik duyarlılık testinde, penisilin ve eritromisin dirençli, klindamisin,vankomisin, teikoplanin, kloramfenikol, ampisilin, sefotaksim, seftriakson, linezolid veofloksasin duyarlı olduğu tespit edilmiştir. Olgu, seftriakson (2 x 1 g/gün) ile başarıyla tedaviedilmiş ve komplikasyonsuz olarak iyileşmiştir. Sonuç olarak, Aerococcus viridans‘ınpostpartum laktasyon döneminde mastit enfeksiyonu etkeni olabileceği akılda tutulmalı veantibiyotik duyarlılık testlerine göre tedavi uygulanmalıdır

Keywords

Aerococcus viridans, bakteremi, mastit

References

• Euzeby JP. List of bacterial names with standing in nomenclature: a folder available on the internet. Int J Syst Bacteriol.1997; 47: 590-592.
• Ruoff KL: Aerococcus, Abiotrophia and other infrequently isolated aerobic catalase-negative gram-positive cocci. In Murray PR, Baron EJ, Jorgensen JH, Pfaller MA, Yolken RH (eds): Manual of Clinical Microbiology: 8. baskı, Washington DC. ASM Pres, 2003; 434-444.
• Winn WJr, Allen S, Janda W, et al. Koneman’s Color Atlas and Textbook of Diagnostic Microbiology, 6th ed. Lippincott Williams& Wilkins, Philadelphia, 2006; 704-6.
• Kern W, Vanek E. Aerococcus bacteremia associated with granulocytopenia. Eur J Clin Microbiol. 1987; 6:670-673.
• Kerbaugh MA, Evans JB. Aerococcus viridans in the hospital enviroment. Appl Microbiol. 1968; 6: 670-673.
• Pien FD, Wilson WR, Kunz K, et al. Aerococcus viridans endocarditis. Mayo Clin Proc. 1984; 59: 47-48.
• Nathavitharana KA, Arseculeratne SN, Aponso HA, et al. Acute meningitis in early childhood caused by Aerococcus viridans. BMJ 1983; 286: 1248.
• Taylor PW, Trueblood MC. Septic artritis due to Aerococcus viridans. J Rheumatol 1985;12: 1004-1005.
• Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. 18th Informational Supplement. 2011. CLSI Document M100- S18. CLSI, Wayne, Pennsylvania.
• Facklam R, Elliott JA. Identification, classification, and clinical relevance of catalase-negative, gram-positive cocci, excluding the streptococci and enterococci. Clin Microbiol Rev. 1995; 8: 479-495.
• Swanson H, Cutts E, Lepow M. Penicillin-resistant Aerococcus viridans bacteremia in a child receiving prophylaxis for sickle-cell disease. Clin Infect Dis. 1996; 22: 387-388.
• Tekin Koruk S, Bayraktar M, Özgönül A, Tümer S. Safra Kesesi Kanseri Olan Bir Hastada Operasyon Sonrası Gelişen Çok İlaca Dirençli Aerococcus Viridans Bakteremisi. Mikrobiyoloji Bülteni 2010; 44: 123-126.
• Bilgehan H, Klinik Mikrobiyolojik Tanı, 5. basım, Fakülteler kitabevi 2002; 5: 496-497.
• Uh Y, Son JS, Jang IH, Yoon KJ, Hong SK. Penicillin-resistant Aerococcus granulocytopenia. J Korean Med Sci 2002; 17: 113-5. associated with
• Augustine T, Thirunavukkarasu, Bhat BV, Bhatia BD. Aerococcus viridans endocarditis. Case report. Indian Pediatr 1994; 31: 599-601.