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First Reported Case of Campylobacter Lanienae Enteritis in a Human Simon Levesque, 1 Fred Eric Lemay,2,3 Sadjia Bekal,1 Eric H

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First Reported Case of Campylobacter Lanienae Enteritis in a Human Simon Levesque, 1 Fred Eric Lemay,2,3 Sadjia Bekal,1 Eric H JMM Case Reports (2016) DOI 10.1099/jmmcr.0.005045 Case Report First reported case of Campylobacter lanienae enteritis in a human Simon Levesque, 1 Fred eric Lemay,2,3 Sadjia Bekal,1 Eric H. Frost2,3 and Sophie Michaud2 Correspondence 1Laboratoire de sante publique du Quebec/Institut national de sante publique du Quebec, Sainte- Simon Levesque Anne-de-Bellevue, Quebec, Canada [email protected] 2Faculte de Medecine et des sciences de la sante de l’Universite de Sherbrooke, Sherbrooke, Quebec, Canada 3Centre de recherche du Centre hospitalier universitaire de Sherbrooke(CHUS), Sherbrooke, Quebec, Canada Introduction: Campylobacters are the most frequently identified bacteria causing diarrhoea in humans worldwide. Campylobacter lanienae was isolated for the first time in 2000 from faecal samples of two asymptomatic abattoir workers in Switzerland during a routine hygiene screen, but has never been associated with human disease. Case presentation: At hospital admission, the patient reported diarrhoea, lower abdominal cramps, nausea, one episode of bilious vomiting and low-grade fever of 38 C. The patient was having 10 or more diarrheic stools per day as well as during the night, and had noticed blood mixed with the stools on several occasions. Stool cultures were negative for species of Salmonella and Shigella, Escherichia coli O157:H7 and Yersinia enterocolitica, but were positive for C. lanienae. Identification was made by classical biochemical testing, as well as 16S rRNA gene and cpn60 sequencing. The patient slowly improved without antibiotic treatment and was discharged nine days after admission with complete resolution of symptoms. Conclusion: On the whole it seems very likely that C. lanienae was the causative agent. Clinical microbiologists should be aware of this micro-organism which can be identified by phenotypic and molecular methods. The real burden of C. lanienae infection in humans might be underestimated and should be further investigated as a potential cause of human diarrhoea Received 7 March 2016 disease. Accepted 29 April 2016 Keywords: Campylobacter; enteritis; campylobacteriosis. Introduction (Oporto & Hurtado, 2011), and from bovine faeces in Alberta (Inglis et al., 2003, 2004, 2005) as well as in Quebec Campylobacters are the most frequently identified bacteria (Guevremont et al., 2008). Recently, the bacterium was also causing diarrhoea in humans worldwide (Allos, 2001). isolated from laboratory chinchillas in the USA (Turowski Camplylobacter lanienae was isolated for the first time in et al., 2014). In this study we report what seems to be, to 2000 from faecal samples of two asymptomatic abattoir our knowledge, the first case of a symptomatic human workers in Switzerland during a routine hygiene screen infection with C. lanienae. (Logan et al., 2000), but has never been reported in humans since. C. lanienae has also been isolated from pig and wild boars faeces in Japan (Sasaki et al., 2003, 2013), Hungary Case report (Schweitzer et al., 2011), Korea (Shin & Lee, 2009) and In March 2009, a 39-year-old female sought treatment at the USA (Jay-Russell et al., 2012), from wild ruminants in the emergency department of the Centre Hospitalier Uni- Spain (Carbonero et al., 2014; Navarro-Gonzalez et al., versitaire de Sherbrooke, reporting a 5-day history of diar- 2014), from sheep in Turkey (Acik et al., 2013) and Spain rhoea, lower abdominal cramps, nausea, one episode of bilious vomiting and low-grade fever of 38 C. She was hav- The GenBank/EMBL/DDBJ accession number for the 16S rRNA gene ing 10 or more diarrheic stools per day as well as during the sequence of strain 001A-0718 is HM770742. night, and had noticed blood mixed with the stools on ã 2016 The Authors Published by Microbiology Society 1 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/). S. Levesque and others several occasions. She denied any infectious contact, recent reflux disease, hypothyroidism and refractory interstitial antibiotic treatment or travel outside the province of Que- cystitis, and had a total hysterectomy. Her daily medication bec. She was living on a hog farm and usually drank water included esomeprazole, levothyroxine, phenazopyridine, from a private well. One year prior to the consultation, the amitriptyline, pentosan polysulfate sodium and pregabalin. patient had a diagnosis of irritable bowel syndrome and a Physical examination showed sinus tachycardia with normal colonoscopy performed then was normal. For the past few blood pressure and a temperature of 37.5 C. The abdomen months, she was experiencing three loose stools a day. The was diffusely tender but soft with normal bowel sounds. patient had also been diagnosed with gastroesophageal The complete blood count, serum electrolytes, 16S 95 96 97 98 99 100 001A-0718 (HM770742) Campylobacter lanienae NCTC 13004 (AF043425) 1.3 Campylobacter lanienae UB 993 (AF043423) Campylobacter canadensis (EF621894) 0.1 5.0 Campylobacter curvus (DQ17 4165) 1.0 0.4 Campylobacter rectus (L04317) 0.2 1.4 0.9 Campylobacter showae (DQ17 4156) 0.1 Campylobacter sputorum (DQ17 4151) 0.2 2.5 0.6 1.5 Campylobacter hominis (AJ251584) 1.7 Campylobacter ureolyticus (GU797876) 0.5 0.1 Campylobacter gracilis (DQ17 4168) 2.6 Campylobacter concisus (L04322) 1.0 0.1 1.4 Campylobacter mucosalis (DQ17 4173) 0.7 Campylobacter hyointestinalis subsp. hyointestinalis (M65010) 0.3 0.9 1.3 Campylobacter fetus subsp. venerealis (M65011) 1.3 0.3 Campylobacter fetus subsp. fetus (DQ17 4127) 0.2 0.2 0.4 Campylobacter hyointestinalis subsp. lawsonii (NR_024948) Campylobacter helveticus (DQ17 4163) 0.5 0.9 Campylobacter upsaliensis ATCC (AY621113) 0.0 0.1 Campylobacter cuniculorum (DQ400345) 1.2 0.3 Campylobacter troglodytis (EU559332) 2.3 0.4 Campylobacter avium (EU623473) 1.3 Campylobacter insulaenigrae (AJ620504) 0.5 0.1 Campylobacter lari subsp. concheus (AM922330) 0.3 Campylobacter lari subsp. lari (AY621114) 0.4 Campylobacter subantarcticus (AM933371) 1.1 Campylobacter volucris (FM883694) 0.0 0.1 Campylobacter peloridis (AM922331) 0.0 Campylobacter coli (L04312) 0.4 0.4 Campylobacter hyoilei (GQ167676) 0.1 Campylobacter jejuni subsp. doylei (AY621111) 0.2 Campylobacter jejuni subsp. jejuni NC002163 Fig. 1. Phylogenetic tree based on the neighbour-joining method representing the genetic relatedness between partial 16S rRNA gene sequences for campylobacters. The bar represents the percentage of similarity, and numbers on the tree indicate internal branch distances within the resulting trees obtained by bootstrap analysis (1000 replicates). GenBank accession num- bers are in parentheses. 2 JMM Case Reports First reported case of Campylobacter lanienae enteritis in a human creatinine, and liver and pancreatic enzymes were normal. also negative. Stool cultures done two days apart were nega- A pelvic and abdominal ultrasound showed only a left ovar- tive for species of Salmonella and Shigella, Escherichia coli ian cyst. The patient was admitted to our hospital for intra- O157:H7 and Yersinia enterocolitica, but showed a ‘Cam- venous hydration and observation. Because of the pylobacter-like’ organism. Because the patient’s symptoms persistence of symptoms five days after admission, a colo- were not compatible with a viral infection, no viral detec- noscopy was performed and revealed mild inflammation in tion tests were performed. The patient slowly improved the left colon. Biopsies confirmed discrete acute focal colitis. without antibiotic treatment and was discharged nine days The Clostridium difficile toxin assay and a stool examination after admission with complete resolution of her symptoms. for ova and parasites were negative. Blood cultures were Fig. 2. Phylogenetic tree based on the unweighted pair group method with arithmetic mean (UPGMA) method representing the genetic relatedness between sequences of the partial 16S rRNA gene for C. lanienae. The bar represents the percentage of similarity. C. jejuni was used as an outgroup. http://jmmcr.microbiologyresearch.org 3 S. Levesque and others Investigations some cattle were found to be shedding exceptionally large À numbers of cells (approximately 108 cells g 1), and num- The stool sample was initially streaked on Karmali agar and bers of C. lanienae released in the environment in cattle fae- incubated under microaerobic conditions generated in a jar 12 ces could exceed 10 cells per animal per day(Inglis et al., with a CampyGen sachet (Oxoid) at 42 C for 48 h. Small, 2004). Inglis et al. reported that C. lanienae dwells in the grey, flat, irregular or round and moist colonies were large intestine, including the caecum, proximal ascending observed but growth was poor compared to the Campylo- colon, distal descending colon, and rectum of cattle bacter jejuni control strain. The Gram stain revealed slender, (Inglis et al., 2005) and suggested that C. lanienae may be curved Gram-negative rods. The organism was oxidase- and pathogenic to cattle (Inglis et al., 2004). catalase-positive, hippurate-negative, indoxyl acetate-nega- tive, resistant to both nalidixic acid and cephalothin, and Inglis et al. also observed that PCR-based detection methods susceptible both to erythromycin and ciprofloxacin by the were substantially more effective for detecting C. lanienae disc diffusion method. from faecal specimens than conventional culture methods (Inglis et al., 2003). They isolated C. lanienae from cattle The Laboratoire de Sante Publique du Quebec (LSPQ) fur-
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