Korean J Clin Microbiol.  2008 Apr;11(1):63-65. 10.5145/KJCM.2008.11.1.63.

A Case of Granulicatella adiacens Septicemia Identified by 16S rRNA Sequencing Analysis

• Shin KS
• Son BR
• Jeong HW

• KMID: 2089810
• DOI: http://doi.org/10.5145/KJCM.2008.11.1.63

Abstract

Granulicatella adiacens is one of the fastidious gram positive cocci previously described as nutritionally variant streptococci due to their requirement of L-cysteine, pyridoxal, or thiol compounds for growth. These bacteria have been identified as significant causative agents of endocarditis, opthalmic infections, and meningitis. We report a case of septicemia caused by G. adiacens in an 80-year-old patient with cholangiocarcinoma. The organism was identified by phenotypic and 16S rRNA sequencing analyses.

Keyword

Nutritionally variant streptococci; Granulicatella adiacens; Septicemia

MeSH Terms

Aged, 80 and over
Bacteria
Cholangiocarcinoma
Cysteine
Endocarditis
Gram-Positive Cocci
Humans
Meningitis
Pyridoxal
Sepsis
Cysteine
Pyridoxal

Figure

• 

  Fig. 1. Gram stain of Granulicatella adiacens isolated from the case. Smears were prepared directly from a positive blood culture vial (Bact/Alert 3D blood culture broth) (A), or from a culture grown again in the blood culture broth supplemented with 0.001% pyridoxal hydrochloride (B). Figure A shows characteristic gram-positive pleomorphic cocci in pairs and short chains. In addition yeast like cells were noted. Figure B shows characteristic gram-positive cocci in typical streptococcal chains.

Reference

References

1. Bouvet A, Grimont F, Grimont PAD. Streptococcus defectives sp. nov. and Streptococcus adiacens sp. nov., nutritionally variant streptococci from human clinical specimens. Int J Syst Bacteriol. 1989; 39:290–4.

2. Carey RB, Gross KC, Roberts RB. Vitamin B6-dependent Streptococcus mitior (mitis) isolated from patients with systemic infections. J Infect Dis. 1975; 131:722–6.

3. Roberts RB, Krieger AG, Schiller NL, Gross KC. Viridans streptococcal endocarditis; the role of various species, including pyridoxal-dependent streptococci. Rev Infect Dis. 1979; 1:955–65.

4. Frenkel A and Hirsch W. Spontaneous development of L forms of streptococci requiring secretions of other bacteria or sulphydryl compounds for normal growth. Nature (London). 1961; 191:728–30.

5. George RH. The isolation of symbiotic streptococci. J Med Microbiol. 1974; 7:77–83.

6. Namdari H, Kintner K, Jacksons BA, Namdari S, Hughes L, Peairs RR, et al. Abiotrophia species as a cause of endophthalmitis following cataract extraction. J Clin Microbiol. 1999; 37:1564–6.

7. Biermann C, Fries G, Jehnichen P, Bhakdi S, Husmann M, Isolation of Abiotrophia adiacens from a brain abscess which developed in a patient after neurosurgery. J Clin Microbiol. 1999; 37:769–71.

8. Lee SY and Pai CH. Two cases of nutritionally variant streptococci from patients with endocarditis. Korean J Clin Pathol. 1995; 15:273–80.

9. Kwon O, Park SD, Uh Y, Yoon KJ, Kwon SO, Kim HY. A case of septicemia by Granulicatella adiacens. Infect Chemother. 2005; 37:368–71.

10. Thornsberry C, Swenson JM, Baker CN, McDougal LK, Stocker SA, Hill BC. Methods for determining susceptibility of fastidious and unusual pathogens to selected antimicrobial agents. Diagn Microbiol Infect Dis. 1988; 9:139–53.

11. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; sixteenth informational supplement. CLSI document M100-S16, Wayne, PA; CLSI. 2006.

12. Kawamura Y, Hou XG, Sultana F, Liu S, Yamamoto H, Ezaki T. Transfer of Streptococcus adiacens and Streptococcus defectives to Abiotrophia gen. nov. as Abiotrophia adiacens comb. nov. and Abiotrophia defectives comb. nov., respectively. Int J Syst Bacteriol. 1995; 45:798–803.

13. Collins MD and Lawson PA. The genus Abiotrophia (Kawamura et al.) is not monophyletic; propose of Granulocatella gen. nov., Granulicatella adiacens comb. nov., Granulicatella elegans comb. nov. and Granulicatella balaenopterae comb. nov. Int J Syst Evol Microbiol. 2000; 50:365–9.

14. Carey RB, Brause BD, Roberts RB. Antimicrobial therapy of vitamin B6-dependent streptococcal endocarditis. Ann Intern Med. 1977; 87:150–4.

15. Tuohy MJ, Procop GW, Washington JA. Antimicrobial susceptibility of Abiotrophia adiacens and Abiotrophia defectiva. Diagn Microbiol Infect Dis. 2000; 38:189–91.