The First Case of Otitis in Korea Caused by Brevibacterium otitidis

Seon-Ho Mun; A-Jin Lee; Sang-Gyung Kim; Chang-Ho Jeon; Cheon-Gang Park; Hun Suk Suh

doi:10.3343/lmo.2019.9.3.181

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Mun, Lee, Kim, Jeon, Park, and Suh: The First Case of Otitis in Korea Caused by Brevibacterium otitidis

Original Article

Lab Med Online 2019;9(3):181-184.

Published online: 20 July 2019

DOI: https://doi.org/10.3343/lmo.2019.9.3.181

The First Case of Otitis in Korea Caused by Brevibacterium otitidis

Seon-Ho Mun, M.D., A-Jin Lee, M.D., Sang-Gyung Kim, M.D., Chang-Ho Jeon, M.D., Cheon-Gang Park, M.D., Hun Suk Suh, M.D.

Department of Laboratory Medicine, Daegu Catholic University School of Medicine, Daegu, Korea

Corresponding author: Hun Suk Suh, M.D., Ph.D. https://orcid.org/0000-0001-6364-5525 Department of Laboratory Medicine, Daegu Catholic University School of Medicine, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu 42472, Korea Tel: +82-53-650-4143, Fax: +82-53-653-8672, E-mail: hssuh@cu.ac.kr

Received 11 September 2018 Revised 8 December 2018 Accepted 10 December 2018

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

Brevibacterium spp. are gram-positive rods that are considered to be strictly nonpathogenic, and a very few cases of their infection in humans have been reported. In this study, we report a case of otitis caused by Brevibacterium otitidis. A 53-year-old woman, who visited the hospital, complained of symptoms, such as otorrhea from both ears, ear fullness, tinnitus, and hearing impairment, for several months. Ear discharge was cultured on blood agar for pathogen identification. Bacteria from the isolated colony were initially identified as Actinomyces odontolyticus by VITEK 2 (bioMerieux, France), whereas VITEK^® MS (bioMerieux, France) identified them as Brevibacterium luteolum. Subsequently, bacteria from the isolated colony were confirmed as B. otitidis by 16S rRNA sequencing. Antimicrobial susceptibility testing confirmed their sensitivity to vancomycin and linezolid and resistance to clindamycin and penicillin. To our knowledge, this is the first reported case of otitis caused by B. otitidis in Korea.

Keywords: Brevibacterium otitidis, 16S Ribosomal RNA, Otitis

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Fig. 1.

Images of microscopic findings and colony morphology of Brevibacterium otitidis. (A) Gram staining of ear discharge observed under 1,000× shows many neutrophils and gram-positive v-shaped or rod shaped diplobacilli. (B) Growth of yellowish, smooth, circular colonies on blood agar plate.

Table 1.

Disc diffusion test of Brevibacterium otitidis

Antibiotic	Inhibition zone diameter (mm)	Breakpoint∗ (mm)	Result
CC	10	20	Resistant
VA	44	17	Susceptible
E	28	NA^†	NA^†
IPM	40	NA^†	NA^†
LZD	26	25	Susceptible
P	16	29	Resistant

^∗ From Corynebacterium spp. disc diffusion breakpoint of the EUCAST. Breakpoint tables for interpretation of MICs and zone diameters. Version 6.0, 2016

^† No breakpoint exists for erythromycin and imipenem.

Abbreviations: CC, clindamycin; VA, vancomycin; E, erythromycin; IPM, imipenem; LZD, linezolid; P, penicillin; EUAST, European Committee on Antimicrobial Susceptibility Testing.

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