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KMID : 1100820220120010068
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Laboratory Medicine Online
2022 Volume.12 No. 1 p.68 ~ p.73
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A Case of Catheter-Related Bloodstream Infection Caused by Tsukamurella tyrosinosolvens
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Kim Seung-Hwan
Kim Taek-Soo
Park Hyun-Woong
Park Jae-Hyeon
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Abstract
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The genus Tsukamurella is an aerobic actinomycete found in soil, and rarely infects humans. Herein, we report a case of catheter-related bloodstream infection caused by T. tyrosinosolvens. An 8-year-old girl with a central line for home parenteral nutrition was admitted via the emergency room due to fever. Gram-positive bacilli were detected in two aerobic blood culture bottles among the three pairs of blood cultures. The isolate was not identified by VITEK 2 (bioMerieux, USA) but was identified as Tsukamurella spp. by matrix-assisted laser desorption ionization time-of-flight mass spectrometry using the microflex LT (Bruker Daltonics, Germany). The 16S rRNA sequences of these bacteria indicated over 99.73% identity match with T. tyrosinosolvens, T. hominis, and T. ocularis. The groEL gene was sequenced because of low interspecies 16S rRNA sequence variability in the genus Tsukamurella. The isolate showed 99.51% identity with T. tyrosinosolvens. The patient was treated with antibiotics, including vancomycin and piperacillin/tazobactam. T. tyrosinosolvens was detected in one aerobic blood culture bottle among the three pairs of blood cultures on the second day of hospital stay. Three sequential follow-up blood cultures were negative for the microorganisms. To our knowledge, this is the first report of catheter-related bloodstream infection caused by T. tyrosinosolvens in Korea. This study demonstrated the usefulness of groEL gene sequencing for accurate identification of Tsukamurella spp.
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KEYWORD
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Tsukamurella tyrosinosolvens, Catheter-related blood stream infection, 16S rRNA, groEL
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