Catheter-related bloodstream infection due to Tsukamurella pulmonis identified by MALDI-TOF spectrometry, 16S rRNA gene sequencing, and secA1 gene sequencing in an immunocompromised child: a case report and literature review

Diagn Microbiol Infect Dis. 2020 Jul;97(3):115052. doi: 10.1016/j.diagmicrobio.2020.115052. Epub 2020 Mar 29.

Abstract

Tsukamurella species are Gram-positive bacilli related to aerobic Actinomyces. Originally reported from the environment, Tsukamurella species have also been described in human infections, especially in bacteremia. A literature review analysis revealed that Tsukamurella spp. are often initially considered as contaminant microorganisms, especially due to bacterial identification issues. Here, we report a catheter-related bloodstream infection in an immunocompromised child caused by Tsukamurella pulmonis. Matrix-Assisted Laser Desorption/Ionization-Time Of Flight (MALDI-TOF) mass spectrometry allowed rapid genus-level identification and contributed to better patient care. However, accurate species-level identification required 16S rRNA gene sequencing and secA1 gene sequencing. Considering the increased number of Tsukamurella infections, the implementation of new Tsukamurella species in MALDI-TOF databases is required to be more discriminant.

Keywords: 16S rRNA; Bloodstream infection; Early identification; MALDI-TOF spectrometry; Tsukamurella pulmonis; secA1 gene.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Actinobacteria / chemistry
  • Actinobacteria / genetics
  • Actinobacteria / isolation & purification*
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / diagnosis*
  • Bacteremia / drug therapy
  • Bacteremia / immunology
  • Bacteremia / microbiology
  • Bacterial Proteins / genetics
  • Catheter-Related Infections / diagnosis*
  • Catheter-Related Infections / drug therapy
  • Catheter-Related Infections / immunology
  • Catheter-Related Infections / microbiology
  • Central Venous Catheters / adverse effects
  • DNA, Bacterial / genetics
  • Female
  • Humans
  • Immunocompromised Host*
  • Infant
  • RNA, Ribosomal, 16S / genetics
  • Sequence Analysis, DNA
  • Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • DNA, Bacterial
  • RNA, Ribosomal, 16S

Supplementary concepts

  • Tsukamurella pulmonis