Accepted Manuscript First report of human infection due to Streptococcus devriesei Pasquale Tammaro, Nadine Richard, Barbara Andre, Antoine Andremont, Hedi Mammeri PII:
S2052-2975(16)30121-4
DOI:
10.1016/j.nmni.2016.11.009
Reference:
NMNI 252
To appear in:
New Microbes and New Infections
Received Date: 16 August 2016 Revised Date:
3 November 2016
Accepted Date: 9 November 2016
Please cite this article as: Tammaro P, Richard N, Andre B, Andremont A, Mammeri H, First report of human infection due to Streptococcus devriesei, New Microbes and New Infections (2016), doi: 10.1016/ j.nmni.2016.11.009. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
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Manuscript category : First clinical case report
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First Report of Human Infection due to
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Streptococcus devriesei
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Running title : Cholecystitis due to Streptococcus devriesei
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Pasquale TAMMARO, 1 Nadine RICHARD, 2 Barbara ANDRE, 2 Antoine ANDREMONT, 2,3,4 and Hedi
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MAMMERI 2,3,4#
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Keywords : devreisei, Cholecystitis, mutans, bile, infection
13 1 APHP,
Hôpital Bichat Claude Bernard, Service de Chirurgie digestive, 75018 Paris.
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2 APHP,
Hôpital Bichat Claude Bernard, Laboratoire de Bactériologie, 75018 Paris.
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3 INSERM,
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4 Univ
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Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, F-75018 Paris, France.
Corresponding author. Mailing address: U1137 IAME. Faculté de médecine Paris Diderot Paris 7 - site
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IAME, UMR 1137, F-75018 Paris, France.
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Bichat - 16 rue Henri Huchard - 75890 Paris Cedex 18
Phone: +33 (0)1 57 27 75 34; Fax +33 (0)1 57 27 75 21. E-mail:
[email protected]
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Abstract
3 So far, Streptococcus devriesei, which belongs to the mutans streptococci group,
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has been incriminated in the formation of caries in Equidae. Herein, we report
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the first human infection due to this species in a 54-year-old man that suffered
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from grangenous cholecystitis. The patient was treated successfully by
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cholecystectomy and ceftriaxone.
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12 A 67-year-old man, who was born in Algeria and had been living in France for
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12 years, presented to emergency department with abdominal pains in the
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epigastrium and the right hypochondrium. The patient had a medical history of
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type 2 diabetes treated for 9 years. Diabetes-related complications included
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arteriopathy of lower limbs, and a microalbuminuria. Moreover, the patient
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suffered from dyspnea on mild exertion with a preserved cardiac function.
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During admission, laboratory findings revealed a white blood cell count of 20.1
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× cells.L-1, and a C-reactive protein (CRP) of 160 mg.L-1. Abdominal CT scan
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without contrast medium showed a severe cholelithiasis with peritoneal
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effusion. Intravenous ceftriaxone (1g daily in one dose) and metronidazole (1.5
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g daily in three doses) were immediately started and continued parenterally for
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5 days. On day 1, the patient underwent a laparoscopy that revealed a
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gangrenous gallbladder with areas of necrosis and purulent intra-peritoneal
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discharge. A cholecystectomy was then performed using a median laparotomy
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procedure. The postoperative course was uneventful. The patient was
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discharged at home on day 5. At a 3-week follow-up, the patient remained
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well.
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The intra-gallbladder bile, collected during laparotomy, was immediately
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analyzed. Gram staining revealed numerous leukocytes and Gram-positive
cocci in pairs or in short-chains. After one day of aerobic incubation, α-
haemolytic colonies grew on sheep-blood-supplemented (5 %) Columbia agar.
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MALDI-TOF mass spectrometry (Shimadzu, Marne la Vallée, France)
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identified S. devriesei with an accurate identification score to species level (>
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2). The molecular approach was carried out to further confirm the 2
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identification. The 16S rDNA was amplified and sequenced as previously
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described [1]. BLAST analysis of the resulting sequence identified the isolate
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as S. devriesei with a maximal identity of 100% for S. devriesei type strain
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CCGU 47156 (GenBank accession number AJ564067). The 16S rRNA gene
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sequence of our isolate was deposited under accession no. KX197202.
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MICs were determined using E-test strips (bioMérieux, Marcy l’Etoile,
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France). According to the Clinical and Laboratory Standards Institute criteria
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[2], the S. devriesei clinical isolate was susceptible to penicillin G (0.03 µg.ml-
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1), amoxicillin (0.06 µg.ml-1), cefotaxime (0.06 µg.ml-1), and levofloxacin
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(0.5 µg.ml-1) but it was resistant to erythromycin (16 µg.ml-1) and
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clindamycin (8 µg.ml-1).
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Phylogenetic analysis based on 16S rRNA gene sequences showed that S.
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devriesei belongs to the mutans streptococci group [3,4]. Streptococcus
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mutans, which is the type-species of this group, is today considered to play an
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important role in the development of dental caries in humans [5] and can cause
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endocarditis in patient at risk [6]. Otherwise, it is considered to be an
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opportunistic pathogen that rarely causes other invasive infections albeit it has
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never been reported as a cause of cholangitis or cholecystitis [7].
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S. devriesei, which is a transient inhabitant of the oral cavity of horses and ponies [3,4,8], has been shown to be strongly associated with caries in Equidae
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[8]. Our report shows for the first time that S. devriesei can also be responsible
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for human infection.
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