Bacteroides finegoldii. A new bacterial pathogen?

Elsevier

Available online 28 December 2022, 102690

AnaerobeAuthor links open overlay panelAbstract

Bacteoides finegoldii is a Gram-negative, rod-shaped and obligate anaerobic bacteria isolated in human feces during studies of intestinal microbiota. We present a case report in which B. finegoldii was isolated and identified from the blood culture of a 93-year-old patient with abdominal pain. Microbiological identification was performed by MALDI-TOF MS and confirmed later by 16S rRNA sequencing. An abdomino-pelvic CT scan was conducted, showing a mass of neoplastic appearance that infiltrated the sigmoid colon and bladder, probably producing a colo-vesical fistula. Up to now, this is the first report of B. finegoldii causing human infection.

Introduction

Bacteoides finegoldii is a Gram-negative, rod-shaped and obligate anaerobic bacteria that was first isolated from human feces during studies of intestinal microbiota [1]. Phylogenetic analysis through 16S rRNA sequencing have demonstrated similarities with other species of genus Bacteroides such as Bacteroides ovatus or Bacteroides thetaiotaomicron. This anaerobic microorganism has not been previously reported as a cause of human infection, but in this manuscript we describe the first case of B. finegoldii causing human infection in a 93-year-old patient.

Section snippetsCase

A 93-year-old man, with a history of Alzheimer's disease, hypertension and a Gleason 7 (3 + 4) prostate adenocarcinoma treated15 years before, attended the emergency department for abdominal pain, fecal vomiting, dark and foul-smelling (purulent) urine, loss of appetite and fever of several days. The patient presented no other medical history of interest, neither family history of interest and he did not smoke or consume alcohol (no information about employment history). Prior to diagnosis, the

Microbiology and other laboratory findings

The serological study was negative for HIV, Hepatitis B and C and Treponema pallidum. Urinalysis (urine strip) showed leukocyte esterase of 500, negative nitrites negative, density of 1,015, pH of 7,0, proteins of 500; normal glucose, ketones of 5; urobilinogen of 12, bilirubin of 1; hemoglobin/red blood cells/myoglobin of 250. In urine culture >100,000 colonies of Escherichia coli were isolated. This microorganism was susceptibleto piperacillin + tazobactam, cotrimoxazole, ciprofloxacin,

Evolution

During admission the patient was treated with 4 g/500 mg of IV piperacillin/tazobactam each 8 hours, 1 g of IV acetaminophen each 8 h, 1 mg of oral haloperidol at night and 40 mg of oral pantoprazole each 24 h. The patient remained afebrile with slight general improvement, but with persistent abdominal pain and liquid diarrhea (with negative stool cultures). An abdomino-pelvic CT scan was performed (Fig. 3), which showed a mass of neoplastic appearance dependent of the left kidney and another

Discussion

In this case, we describe a bacteremia caused by B. finegoldii in an immunocompromised patient with findings of lesions compatible with colo-vesical fistula and malignancy (as the main reasons the translocation of the microorganism to the blood and subsequent infection). The patient was in the end stage of the life, being this the reason to stop unnecessary treatments. To our knowledge, this is the first report of B. finegoldii causing human infection in the scientific literature.

Anaerobic

Funding source

No funding.

Ethics

This manuscript follows the ethical principles included in the declaration of Helsinki.

Consent to participate

The patient consented to undergo all procedures described in this manuscript.

Consent to publish

Not applicable due to insufficient data to recognize the patient.

Availability of data and materials

Not applicable because there are not supplementary material.

Declaration of competing interest

The authors have no conflicts of interest to declare.

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