Article Text

PDF
Correspondence
Central venous catheter-related bacteraemia due to Microbacterium paraoxydans in a patient with no significant immunodeficiency
  1. David A Enoch1,
  2. Martin P Richardson2,
  3. Robert L R Hill3,
  4. Paul M Scorer1,
  5. Andrew Sismey1
  1. 1Clinical Microbiology and Public Health Laboratory, Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough City Hospital, Peterborough, UK
  2. 2Department of Paediatrics, Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough District Hospital, Peterborough, UK
  3. 3Antibiotic Resistance Evaluation Unit, ARMRL, HPA Microbiological Services Colindale, London, UK
  1. Correspondence to Dr David A Enoch, Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough City Hospital, Bretton Gate, Peterborough PE3 9GZ, UK; david.enoch{at}pbh-tr.nhs.uk

Statistics from Altmetric.com

Microbacterium paraoxydans is a rare cause of bacteraemia. We describe a case requiring line removal to affect a cure. We highlight the role of coryneform bacteria in patients with prosthetic devices and raise awareness of limitations in commonly used identification and susceptibility methods for these organisms.

A 15-year-old girl presented with a 4-week history of lethargy and generalised aches and pains. She had undergone a Nissen's fundoplication 4 weeks before her symptoms developed. Her medical history included congenital gut enteropathy (of unknown origin) with severe intestinal failure, and she has been dependent on total parenteral nutrition 5 nights a week (via a Hickman line) since the age of 3 months. She also had an IgG4 subclass deficiency, gastro-oesophageal reflux and left internal jugular vein thrombosis, for which she was anticoagulated with warfarin. A laparoscopic cholecystectomy had been performed 5 years previously and there were 13 subsequent Hickman line-associated bacteraemic episodes due to coagulase-negative staphylococci. No obvious reason for this high number of bacteraemic episodes was identified, and the current line had been in situ for ∼2 years without signs of infection at the insertion site. Examination was unremarkable except for a low-grade fever (37.5°C). Inflammatory markers were normal (white cell count 5.5×109/l (normal range (4–11)×109/l); C-reactive protein <10 mg/l).

Blood cultures (BacT/ALERT …

View Full Text

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.