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Park, Han, Kim, Jeong, Ku, Kim, Kim, Chung, Han, Choi, Kim, Yong, Song, Lee, and Kim: Development of Arthrobacter woluwensis Bacteremia in a Patient with Multiple Myeloma: A Case Report and Comprehensive Literature Review
Case Report
Infection & Chemotherapy

Infection & Chemotherapy 2012; 44(3): 205-209.

Published online: 30 June 2012

DOI: https://doi.org/10.3947/ic.2012.44.3.205

Development of Arthrobacter woluwensis Bacteremia in a Patient with Multiple Myeloma: A Case Report and Comprehensive Literature Review

Chan Hyuk Park1, Min Seok Han1, Jae Kyung Kim1, Su Jin Jeong1, 2, Nam Su Ku1, 2, Hyewon Kim1, 2, Sun Bean Kim1, 2, Hae-sun Chung3, Sang Hoon Han1, 2, Jun Yong Choi1, 2, Jin Seok Kim1, Dongeun Yong3, Young Goo Song1, 2, Kyungwon Lee3, June Myung Kim1, 2

1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

2AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.

3Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea.

Correspondence to Sang Hoon Han, M.D. Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Korea. Tel: +82-2-2228-1991, Fax: +82-2-393-6884, shhan74@yuhs.ac

Received 20 August 2011       Revised 28 November 2011       Accepted 12 December 2011

Copyright © 2012 by The Korean Society of Infectious Diseases and Korean Society for Chemotherapy

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Arthrobacter spp., which are coryneform gram-positive bacilli, are widely distributed in the environment, including soil. In humans, infection with Arthrobacter is recognized as an opportunistic infection. In particular, since the first reported case in 1996, human infection by A. woluwensis has been reported only four times. We report on a case of A. woluwensis bacteremia in a 76-year-old female patient with multiple myeloma. Performance of 16S rRNA gene sequence analyses resulted in identification of A. woluwensis. The patient was treated with teicoplanin, and the central venous port was removed. Since then, no growth has been observed on repeated blood cultures. The patient was discharged well after the fever subsided.

Keywords: Arthrobacter woluwensis, Multiple myeloma, Bacteremia

Figures and Tables

Figure 1
Flow sheet for clinical course and use of antibiotics.
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Figure 2
Gram positive bacilli were isolated from blood on the 26th hospital day (H&E stain, ×400).
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Figure 3
Gram positive bacilli isolated from blood formed white bacterial colonies on blood agar medium at 35℃ in ambient air on the 30th hospital day.
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Table 1
Clinical Characteristics of Five Patients with Arthrobacter woluwensis Bacteremia Reported to Date
ic-44-205-i001

N/D, no data; DAA, discharge against advise

Table 2
In vitro Antibiotic Susceptibility Test of Arthrobacter woluwensis Isolated from Bacteremic Patients
ic-44-205-i002

AMC, amoxicillin-clavulanic acid; AM, ampicillin; CRO, ceftriaxone; CXM, cefuroxime; CTX, cefotaxime; CE, cephalothin; C, chloramphenicol; CIP, ciprofloxacin; CLI, clindamycin; ERY, erythromycin; GM, gentamicin; OXA, oxacillin; IPM, imipenem; PE, penicillin G; RIF, rifampin; SXT, trimethoprim/sulfamethoxazole; TET, tetracycline; TEC, teicoplanin; VA, vancomycin; LIN, linezolid; MIC, minimal inhibitory concentration; S, susceptible; I, intermediate; R, resistant

References

1. Funke G, Hutson RA, Bernard KA, Pfyffer GE, Wauters G, Collins MD. Isolation of Arthrobacter spp. from clinical specimens and description of Arthrobacter cumminsii sp. nov. and Arthrobacter woluwensis sp. nov. J Clin Microbiol. 1996. 34:2356–2363.
crossref
2. Bernasconi E, Valsangiacomo C, Peduzzi R, Carota A, Moccetti T, Funke G. Arthrobacter woluwensis subacute infective endocarditis: case report and review of the literature. Clin Infect Dis. 2004. 38:e27–e31.
3. Shin KS, Hong SB, Son BR. A case of catheter-related bacteremia by Arthrobacter woluwensis. Korean J Lab Med. 2006. 26:103–106.
4. Funke G, Pagano-Niederer M, Sjödén B, Falsen E. Characteristics of Arthrobacter cumminsii, the most frequently encountered Arthrobacter species in human clinical specimens. J Clin Microbiol. 1998. 36:1539–1543.
crossref
5. Hou XG, Kawamura Y, Sultana F, Shu S, Hirose K, Goto K, Ezaki T. Description of Arthrobacter creatinolyticus sp nov, isolated from human urine. Int J Syst Bacteriol. 1998. 48:423–429.
crossref
6. Wauters G, Charlier J, Janssens M, Delmée M. Identification of Arthrobacter oxydans, Arthrobacter luteolus sp. nov., and Arthrobacter albus sp. nov., isolated from human clinical specimens. J Clin Microbiol. 2000. 38:2412–2415.
crossref
7. Kim GY, Suh JT, Choi SK, Lee HJ. A case of bacteremia caused by Arthrobacter woluwensis. Korean J Clin Microbiol. 2007. 10:160–163.
8. Chun J, Lee JH, Jung Y, Kim M, Kim S, Kim BK, Lim YW. EzTaxon: a web-based tool for the identification of prokaryotes based on 16S ribosomal RNA gene sequences. Int J Syst Evol Microbiol. 2007. 57:2259–2261.
crossref
9. Jorgensen JH, Patel JB, Hindler J, Schreckenberger PC, Citron DM, Turnidge JD, Cockerill FR, Walker RD, Fritsche TR, Welch DF, Funke G. Methods for antimicrobial dilution and disk susceptibility testing of infrequently isolated or fastidious bacteria; approved guideline. CLSI. 2006. 26:M45-A.
10. Mages IS, Frodl R, Bernard KA, Funke G. Identities of Arthrobacter spp. and Arthrobacter-like bacteria encountered in human clinical specimens. J Clin Microbiol. 2008. 46:2980–2986.
crossref
11. Mermel LA, Farr BM, Sherertz RJ, Raad II, O'Grady N, Harris JS, Craven DE. Infectious Diseases Society of America. American College of Critical Care Medicine. Society for Healthcare Epidemiology of America. Guidelines for the management of intravascular catheter-related infections. Clin Infect Dis. 2001. 32:1249–1272.
crossref
12. Khamis A, Raoult D, LaScola B. Comparison between rpoB and 16S rRNA gene sequencing for molecular identification of 168 clinical isolates of Corynebacterium. J Clin Microbiol. 2005. 43:1934–1936.
crossref
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