Ruminococcus gnavus bacteraemia in a patient with multiple haematological malignancies. Issue 8 (7th October 2019)

• Record Type: Journal Article
• Authors: Gren, Caroline; Spiegelhauer, Malene Roed; Rotbain, Emelie Curovic; Ehmsen, Boje Kvorning; Kampmann, Peter; Andersen, Leif Percival
• Is Part Of: Access microbiology. Volume 1:Issue 8(2019)
• Publication Date: 2019-10-07
• Subjects: Microbiology -- Bacteremia -- Ruminococcus gnavus -- hematology -- MALDI-TOF MS, gut commensals; Microbiology -- Periodicals; 579
• DOI: 10.1099/acmi.0.000048
• Languages: English
• ISSNs: 2516-8290

Abstract

Abstract : We present a case of Ruminococcus gnavus sepsis in a woman suffering from multiple myeloma and myelodysplastic syndrome. R. gnavus, a Gram-positive coccus and a gut commensal, has been described in nine cases of infection in the literature, with most infections having occurred in patients with either gastrointestinal symptoms or prosthesis infections. In this case, R gnavus was identified by mass spectrometry, and showed susceptibility to penicillin, meropenem, tetracycline, metronidazole and clindamycin. The patient was successfully treated initially with intravenous piperacillin/tazobactam and metronidazole, and then switched to oral penicillin and metronidazole. The cause of infection is hypothesized to have been a shift in the gut microbiota towards an excess growth of R. gnavus caused by immunosuppression, and bacterial translocation across a vulnerable mucosal barrier due to prednisolone treatment and severe thrombocytopenia.