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The Journal of the Japanese Society for Clinical Microbiology |
Biblioraphy Information
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[Vol.24 No.2 contents] Japanese / English |
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| ArticleTitle | A Case of Polymicrobial Septic Shock Caused by PenicillinG Highly-Resistant and Multi-drug Resistant Granulicatella adiacens Isolated from Blood Culture |
| Language | J |
| AuthorList | Michiko Furugaito1), Hiroshi Enari3), Atsushi Yoshida4, 5), Katsuko Okuzumi4), Hirofumi Toda1), Koji Utsunomiya1), Hiromi Matsuura1), Toshihiro Yamaguchi1), Toshinori Kamisako2) |
| Affiliation |
1) Department of Clinical Laboratory, Kinki University Hospital 2) Department of Clinical Laboratory Medicine, Kinki University School of Medicine 3) Research & Development Division, Kyokuto Pharmaceutical Industrial Co., Ltd. 4) Division of Infection Control, Dokkyo Medical University Hospital 5) Department of Clinical Laboratory Medicine, Dokkyo Medical University Hospital |
| Publication | J.J.C.M.: 24 (2), 138-145, 2014 |
| Received | November 29, 2013 |
| Accepted | February 16, 2014 |
| Abstract | We report Granulicatella adiacens known as nutritionally variant streptococci (NVS) which showed penicillinG (PCG) highly-resistance and multi-drug resistance and isolated from blood culture of septic patient with Pseudomonas aeruginosa. The patient was a 46-year-old man who was diagnosed with Behcet's disease and chronic kidney failure, and underwent Bentall operation with aortic valve and thoracic aortic replacement. He was administered various antimicrobial agents to treat unidentified fever during three months before admission. The VITEK2 system identified NVS as G. elegans, but the Rapid ID32 STREP kit identified it as G. adiacens. Additional tests of hippurate and arginine hydrolysis were negative. Sequencing analysis of the 16S rRNA identified as G. adiacens. Antimicrobial susceptibility test based on Clinical and Laboratory Standards Institute M45-A2 showed resistance to penicillin, cephalosporin, carbapenem, macrolide antibiotics. Minimum inhibitory concentration (MIC) of PCG, minimum bactericidal concentration (MBC) and MIC/MBC were 16 μg/ml, > 512 μg/ml, > 32, respectively. Antecedent medications were considered as a cause of multi-drug resistance. Now, there is no report such a PCG highly-resistant and multi-drug resistant NVS strain. Identification and antimicrobial susceptibility test of NVS must be rapid and accurate because multi-drug resistant NVS like our case could be exist. |
| Keywords | nutritionally variant streptococci, penicillin tolerance, penicillin resistance, Granulicatella adiacens |
| Copyright © 2002 The Japanese Society for Clinical Microbiology All rights reserved. |