Human Infections by Wohlfahrtiimonas chitiniclastica: A Mini-Review and the First Report of a Burn Wound Infection after Accidental Myiasis in Central Europe
Abstract
:1. Introduction
2. Case Report
2.1. Pathogen Identification
2.2. Antimicrobial Susceptibility Profile of W. chitiniclastica
3. Review and Discussion
- Larvae should be removed from the wound (cutaneous myiasis); non-invasive removal of larvae is possible by occlusion or suffocation using petroleum jelly, beeswax, or liquid paraffin. Over the course of several hours, the larvae either leave the wound or die and can be removed more easily from the wound [33]. Surgical removal of larvae requires repeated debridement with an application of antiseptic agents. In the case of cavitary myiasis, surgical debridement, incision or even excision of the infected tissue may be necessary [6]. The larvae should be also preserved for potential future identification;
- Microbiological analysis focusing on the bacteria typically associated with accidental myiasis should be performed (e.g., Proteus mirabilis, Ignatzschineria indica, Providencia rettgeri, Morganella morganii, and Staphylococcus aureus). For the identification of rare pathogens, especially W. chitiniclastica, MALDI-TOF MS or 16S rRNA sequencing are recommended [17,22,24] because the use of the VITEK 2 system often leads to misclassification: for example, W. chitiniclastica was incorrectly classified as Acinetobacter lwoffii, Comamonas testosteroni or Rhizobium radiobacter [18,20,25]. As no data are available on the performance of other systems, a study evaluating the performance of other methods with respect to the identification of W. chitiniclastica can be valuable for clinical practice;
- The choice of antimicrobial therapy should be tailored to the overall microbiological findings; management should also be based on the severity of the infectious complication.
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Antibiotic | MIC Value (mg/L) | Interpretation |
---|---|---|
Amoxicillin/clavulanic acid | <2.0 | S |
Piperacillin/tazobactam | <4.0 | S |
Cefotaxime | 1.0 | S |
Ceftazidime | <0.5 | S |
Cefepime | <0.5 | S |
Ciprofloxacin | 0.25 | S |
Levofloxacin | 0.5 | S |
Ofloxacin | 0.25 | S |
Imipenem | <1.0 | S |
Meropenem | <0.5 | S |
Year [Ref.] | Country | Sex/age Years | Culture Site | Anatomic Localization | Associated Myiasis | Antibiotics | Outcome | Associated Bacteria |
---|---|---|---|---|---|---|---|---|
2009 [2] | France | F/60 | Blood culture | Scalp(head) | Yes | ceftriaxon | Survived | - |
2011 [17] | Argentina | M/70 | Blood culture | Inguinal regions | No | ciprofloxacin + ampicillin-sulbactam and later ceftazidime + amikacin | Died | |
2014 [18] | Estonia | M/64 | Resected bone | Right foot | No | amoxicillin-clavulonate | Survived | MYOD |
2015 [19] | India | M/43 | Ulcer swab | Right lower limb ulcer | No | cefoperazone-sulbactam followed by cefpodoxime (outpatient care) | Survived | |
2015 [20] | USA | M/26 | Ulcer swab | Right leg | No | cefpodoxime | Survived | PRVU, KLPN, MSSA |
2015 [21] | UK | F/82 | Blood culture | Excoriations of head, face, and neck | Yes | cefuroxime, metronidazole, clarithromycin, topical chloramphenicol, fucidic acid followed by flucloxacillin (outpatient care) | Survived | PRMI, PRRE, MSSA |
2016 [22] | USA | F/69 M/72 | F/Ulcer swab M/blood culture | F/Sacral decubitus M/Right foot and umbilical wound | F/No M/Yes | F/ceftaroline fosamil, meropenem, amoxicillin-clavulonate (outpatient care) M/piperacilline-tazobactam, vancomycin, clindamycin | F/Survived M/Died | F/Blood culture: ANSU Urine: PRMI Decubitus: MSSA, AEspp., STspp., BAFR M/ESCO |
2016 [23] | South Africa | M/17 | Blood culture | Right shoulder wound | No | ceftriaxone | Survived | |
2017 [24] | Germany | F/78 M/43 M/71 M/79 | F/78 Swabs from ulcers M/43 Swabs from ulcers M/71 Swabs from ulcers M/79 Swab from ulcer | F/78 Leg ulcer M/43 Leg ulcer M/71 Leg ulcer M/79 Leg ulcer | No No No No | F/78 no antibiotic treatment M/43 no antibiotic treatment M/71 no antibiotic treatment M/79 cefuroxime followed by levofloxacin and clindamycin | F/78 Survived M/43 Survived M/71 Survived M/79 Survived | F/78 PRMI, MSSA, SEMA, MOMO M/43 PRMI M/71 PRMI, PRST, PSAE M/79: ESCO |
2017 [25] | USA | F/41 | Blood culture and decubitus swab | Ischial decubitus or lower extremity bilateral excoriations | No | vancomycin, cefepim, metronidazole | Died due to other disease | Blood culture: PRMI Swab: MYIN, ENFA ENFA, BAspp. |
2017 [11] | Malaysia | F/47 | Blood culture | - | No | cefoperazone | Died due to other disease | |
2018 [26] | USA | M/37 | Blood culture | Left lower extremity ulcer | Yes | piperacilline-tazobactam, vancomycin, clindamycin later cefepime | Survived | PRST, IGIN |
2018 [27] | Japan | M/75 | Blood culture | Left shoulder lesion | Yes | vancomycin, cefepime, metronidazole | Survived | MOMO, STspp., BAspp., PRMI |
2018 [28] | USA | M/57 | Blood culture | Right ankle gangrene | Yes | Not stated | Died | PRAC, CNS |
2019 [29] | Australia | M/54 | Blood culture | Right foot wound | Yes | piperacilline-tazobactam + meropenem, ciprofloxacin (outpatient care) | Survived | MOMO |
2019 [30] | USA | M/63 F/87 | M/blood culture F/swab | M/Right foot ulcer F/Left lower extremity wound | Yes Yes | M/vancomycin+ piperacilin/tazobactam F/unknown | M/Died F/unknown | M/PRRE F/- |
2020 [31] | USA | M/82 | Blood culture | Right lower extremity | Yes | vancomycin and cefepim, later daptomycin and ceftriaxon | Survived | IGIN, MRSA |
2021 [32] | USA | M/70 | Blood culture | Ulcer of left temporal region | Yes | levofloxacin | Survived | MSSA, PRMI |
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Hladík, M.; Lipovy, B.; Kaloudova, Y.; Hanslianova, M.; Vitkova, I.; Deissova, T.; Kempny, T.; Svoboda, M.; Kala, Z.; Brychta, P.; et al. Human Infections by Wohlfahrtiimonas chitiniclastica: A Mini-Review and the First Report of a Burn Wound Infection after Accidental Myiasis in Central Europe. Microorganisms 2021, 9, 1934. https://doi.org/10.3390/microorganisms9091934
Hladík M, Lipovy B, Kaloudova Y, Hanslianova M, Vitkova I, Deissova T, Kempny T, Svoboda M, Kala Z, Brychta P, et al. Human Infections by Wohlfahrtiimonas chitiniclastica: A Mini-Review and the First Report of a Burn Wound Infection after Accidental Myiasis in Central Europe. Microorganisms. 2021; 9(9):1934. https://doi.org/10.3390/microorganisms9091934
Chicago/Turabian StyleHladík, Martin, Bretislav Lipovy, Yvona Kaloudova, Marketa Hanslianova, Ivana Vitkova, Tereza Deissova, Tomas Kempny, Martin Svoboda, Zdenek Kala, Pavel Brychta, and et al. 2021. "Human Infections by Wohlfahrtiimonas chitiniclastica: A Mini-Review and the First Report of a Burn Wound Infection after Accidental Myiasis in Central Europe" Microorganisms 9, no. 9: 1934. https://doi.org/10.3390/microorganisms9091934