Lab Med Online.  2012 Apr;2(2):105-110.

A Case of Catheter-Related Bloodstream Infection by Tsukamurella inchonensis in a Pediatric Patient Receiving Home Intravenous Antibiotic Treatment

• Seo Y
• Chung HS
• Lee Y
• Kim J
• Yong D
• Jeong SH
• Han SJ
• Lee K

Abstract

Bacteria belonging to the genus Tsukamurella are aerobic, gram-positive rods that are weakly acid-fast with no apparent branching. Infections of the Tsukamurella spp. are generally caused by the use of infected medical devices such as central venous catheters. The underreporting of these infections might be attributable to the frequent misdiagnosis of Tsukamurella infections as Corynebacterium or atypical Mycobacterium spp. infections. Therefore, when gram-positive aerobic rods are observed in the blood culture of a patient with a central venous catheter, it is important to consider Tsukamurella as one of the causative organisms. Here, we report the first case of a catheter-related blood stream infection caused by Tsukamurella inchonensis in a 3-yr-old Korean girl with underlying biliary atresia who underwent hepatoportoenterostomy.

Keyword

Catheter; Blood stream infection; Tsukamurella inchonensis; 16S ribosomal RNA

MeSH Terms

Bacteria
Biliary Atresia
Catheters
Central Venous Catheters
Corynebacterium
Diagnostic Errors
Gram-Positive Rods
Humans
Nontuberculous Mycobacteria
Rivers
RNA, Ribosomal, 16S
RNA, Ribosomal, 16S

Figure

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  Fig. 1 Macroscopic and microscopic features of the isolated strain. (A) Growth of the strain after 72 hr on blood agar plates; (B) A colony of the strain after 72-hr growth (×10); (C) Gram stain of the strain after a 48-hr growth (×1,000); (D) Modified acid-fast bacilli (AFB) stain of the strain after a 48-hr growth (&1,000)

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  Fig. 2 A dendrogram illustrating the phylogenetic relationships between our clinical isolate (YMC11-5-B1957) and T. inchonensis, T. paurometabola, T. tyrosinosolvens, T. strandjordae, T. pulmonis, T. carboxydivorans, T. pseudospumae, T. spumae, T. sunchonensis, and T. spongiae strains based on the 16S rRNA gene sequencing. The scale indicates the similarity index.

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