Lab Med Online.  2019 Jul;9(3):177-180. 10.3343/lmo.2019.9.3.177.

A Case of Catabacter hongkongensis and Alistipes indistinctus Isolated from Blood Cultures of a Patient with Acute Appendicitis

• Ryu J
• Kim Y
• Lee J
• Cho SY
• Park TS
• Lee HJ

• KMID: 2450844
• DOI: http://doi.org/10.3343/lmo.2019.9.3.177

Abstract

Catabacter hongkongensis is an anaerobic gram-positive coccobacillus that was first isolated in Hong Kong. It is infectious and causes high mortality in patients with rare but underlying diseases. Alistipes indistinctus is an anaerobic gram-negative coccobacillus. This bacterium is a common member of the human intestinal microbiota. We report a case of C. hongkongensis and A. indistinctus isolated from blood cultures of a patient with acute appendicitis. A 35-year-old female patient with no specific medical history was admitted to the hospital due to abdominal pain, vomiting, nausea, and diarrhea experienced on the day before admission. On admission, laboratory tests revealed leukocytosis, neutropenia, and elevated C-reactive protein and procalcitonin levels. Following an abdominal computed tomography showing acute appendicitis with suspected perforation, emergency surgery was performed. Growth was observed in two anaerobic blood culture bottles after four days. After further culturing of the bacteria on Brucella Blood Agar, two types of bacteria were obtained. The two bacterial isolates, one gram-positive and one gram-negative, were unable to be identified using matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Thus, 16S rRNA gene sequence analysis was performed, resulting in identification of the bacteria as C. hongkongensis and A. indistinctus. The patient was administered antibiotics and discharged two days after surgery. Although MALDI-TOF MS enables fast and accurate identification of bacteria, C. hongkongensis and A. indistinctus were not listed in the spectral library, and 16S rRNA gene sequence analysis was useful for identifying the two bacteria.

Keyword

Catabacter hongkongensis; Alistipes indistinctus; MALDI-TOF MS; 16S rRNA gene sequence; Acute appendicitis

MeSH Terms

Abdominal Pain
Adult
Agar
Anti-Bacterial Agents
Appendicitis*
Bacteria
Brucella
Diarrhea
Emergencies
Female
Gastrointestinal Microbiome
Genes, rRNA
Hong Kong
Humans
Leukocytosis
Mass Spectrometry
Mortality
Nausea
Neutropenia
Sequence Analysis
Vomiting
Agar
Anti-Bacterial Agents

Figure

• 

  Fig. 1. Gram stain microscopy of isolates after 72 hours of anaerobic incubation on Brucella Blood Agar. (A) Microscopic examination (×1,000) of the isolate showed gram-positive coccobacilli (Catabacter hongkongensis). (B) Microscopic examination (×1,000) of the second isolate revealed gram-negative coccobacilli (Alistipes indistinctus).

Reference

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