|Year : 2015 | Volume
| Issue : 4 | Page : 602-603
Comamonas testosteroni bacteraemia in a tertiary care hospital
B Swain, S Rout
Department of Microbiology, Institute of Medical Sciences and Sum Hospital, Siksha O Anusandhan University, Kalinga Nagar, Bhubaneswar, Odisha, India
|Date of Submission||07-Apr-2014|
|Date of Acceptance||05-Jan-2015|
|Date of Web Publication||16-Oct-2015|
Department of Microbiology, Institute of Medical Sciences and Sum Hospital, Siksha O Anusandhan University, Kalinga Nagar, Bhubaneswar, Odisha
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Swain B, Rout S. Comamonas testosteroni bacteraemia in a tertiary care hospital. Indian J Med Microbiol 2015;33:602-3
Comamonas testosteroni is an aerobic, Gram-negative, non-glucose-fermenting, motile, non-spore-forming bacillus found in soil belonging to the Comamonadacae family. Before 1987, it was named as Pseudomonas testosteroni following molecular genetic studies. Its name is derived due to its ability to decompose testosterone as the carbon source. It has rarely been implicated as an opportunistic human pathogen. Clinical conditions reported are intra-abdominal, bloodstream, central nervous system (CNS) and urinary tract infections., A 50-year-old lady was hospitalized in the intensive care unit (ICU) for septic shock who had a long standing diabetes mellitus complicated with chronic renal disease. On examination, she was febrile and had a gluteal abscess along with unstable vital condition with low blood pressure, tachycardia and tachypnea. Her haematological parameters were within normal range except for a leucopenia and biochemical parameters like serum creatinine; urea were in abnormal range. She had a positive reaction for C-reactive protein (CRP) and was human immunodeficiency virus (HIV) seronegative. After sending aspirated pus from gluteal abscess, urine and blood samples for aerobic culture, the patient was empirically treated with piperacillin-tazobactum 3.375 gm intravenous (IV) 6 hourly. Urine culture was negative by conventional method, whereas pus and automated blood culture by Bact/ALERT 3D, Biomerieux were positive. On blood agar and MacConkey agar, both the sample yield bacterial colonies with similar morphotypes. Biochemical reactions and antimicrobial susceptibility performed according to the Clinical and Laboratory Standards Institute (CLSI) guideline on Mueller Hinton agar by Kirby Bauer disk-diffusion method were similar in both the isolates. Both were identified as non-fermenters and belong to Pseudomonas species. Further identification up to species level and sensitivity was confirmed by VITEK-2 system with gram negative (GN) and antibiotic susceptibility (AST) cards. Blood culture repeated after 48 hours also showed the same result with the first blood culture report. It was stamped as Comamonas testosterone and was sensitive to ceftazidime, cefoperazone-sulbactam, meropenem and resistant to piperacillin-tazobactam, cefepime, ciprofloxacin, amikacin and gentamicin. In spite of all the efforts and changing the antibiotic from piperacillin-tazobactam to cefoperazone-sulbactam on fourth day, the patient succumbed on the same day due to septic shock. There was a single report of the infective role of Pseudomonas testosteroni in a human until 1987. Though it has been isolated later in different clinical specimens, it is a less frequent cause for blood stream infection as in our case. The present case is the first report of the role of Comamonas testosteroni in bacteremia in our hospital.
This species may be missed if identification cannot be done carefully in the microbiology laboratory. As this bacterium showed a variable resistant pattern to different antibiotics and causing fatal human infections, its isolation and early diagnosis with appropriate treatment will result in a better outcome.
| ~ Acknowledgements|| |
We are thankful to the S'O'A University, Kalinga Nagar, Bhubaneswar, Odisha for giving permission to perform this research work.
| ~ References|| |
Arda B, Aydemir S, Yamazhan T, Hassan A, Tunger A, Serter D. Comamonas testosteroni meningitis in a patient with recurrent cholesteatoma. APMIS 2003;111:474-6.
In: Koneman EW, Allen SD, Janda WM, Schreckenberger PC, Winn WC, editors. The non fermentative gram negative bacilli. color atlas and textbook of diagnostic microbiology. 5th
ed. Ch. 5. Philadelphia: Lippincott Williams and Wilkins; 1997. p. 253-321.
Horinouchi M, Yamamoto T, Taguchi K, Arai H, Kudo T. Meta-cleavage enzyme gene tesB is necessary for testosterone degradation in Comamonas testosteroni TA441. Microbiology 2001;147:3367-75.
Cooper GR, Staples ED, Iczkowski KA, Clancy CJ. Comamonas (Pseudomonas) testosteroni endocarditis. Cardiovasc Pathol 2005;14:145-9.
Lee SM, Kim MK, Lee JL, Wee WR, Lee JH. Experience of Comamonas acidovorans
keratitis with delayed onset and treatment response in immunocompromised cornea. Korean J Ophthalmol 2008;22:49-52.