A case of <i>Clostridium symbiosum</i> infection for which separate culture and identification from positive blood culture bottles were difficult

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  • 血液培養陽性ボトルからの分離培養および同定に難渋した<i>Clostridium symbiosum</i>の1例

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Abstract

We encountered a case of Clostridium symbiosum infection for which separate culture and identification from positive blood culture bottles were difficult. A 65-year-old female underwent thoracic aorta stent graft interpolation in May 2013. The blood culture prepared in June 2013 was positive only in the anaerobic bottle. Gram-negative rod-shaped cells were observed in a gram stain of the blood culture although their growth was not seen in their subcultures. Then, another blood culture was carried out by adding the first positive culture to human blood, which was then inoculated into fresh blood culture bottles. We entrusted Gifu University to perform direct 16S rRNA genetic analysis of the first blood culture. In the second blood culture, the anaerobic bottle again showed positive culture the following day. Using Brucella HK agar medium (Kyokuto Pharmaceutical), cell growth was observed under anaerobic cultivation the next day. The bacteria showed a negative result in the Ryu test. The property confirmatory test showed that the cells were CV-HK-sensitive, bile-HK-resistant, ES-HK-negative, and H2S-positive. The results of analysis of biochemical properties, mass spectrometry, and 16S rRNA genetic analysis indicate that the bacterium is C. symbiosum. Positive blood cultures should enable rapid identification of bacteria. Therefore, when it is difficult to identify them in one’s own facilities, it is necessary to entrust an outside agency with their identification as early as possible. For the present bacterium, 16S rRNA genetic analysis and mass spectrometry were useful for the final identification, whereas the Ryu test and property confirmatory test supported its identification.

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