P0413 Emerging infectious diseases Janibacter terrae bacteraemia: two faces of the same organism M.I. Fernández-Natal1,2*, J.A. Sáez-Nieto 3, S. Valdezate-Ramos3, J.M. Guerra-Laso 4, R.H. Rodríguez-Pollán 1, M.I. Bresme-Trigo 1, F. Soriano 5. 1Department of Clinical Microbiology, Complejo Asistencial Universitario de León; 2Institute of Biomedicine (IBIOMED), León; 3Bacterial Taxonomy Laboratory, Centro Nacional de Microbiología-Instituto de Salud Carlos III, Madrid; 4Department of Internal Medicine, Complejo Asistencial Universitario de León. 5Public Health, School of Physiotherapy, Madrid. Key words: Janibacter terrae, bacteraemia, antimicrobial susceptibility Methods: Introduction and Objectives: During a three years period (2001-2003) we isolated an organism presumptively The genus Janibacter (family Intrasporangiaceae, class Actinobacteria) consists of identified as a Janibacter sp. from eight blood cultures belonging to four patients (two aerobic, gram-positive, asporogenous, nonmotile bacteria that show a rod-coccus cycle positive blood cultures per each). during growth, and have high guanine-cytosine content. It has been mainly isolated from Phenotypic methods, including API CoryneTM V2.0 (bioMérieux), were used. different ecological niches ranging from soil, sludge, air, corals, insect gut, and spoiled In addition 16S rDNA amplification and sequencing was also performed and results were oriental melon. Only two Janibacter bacteraemias in humans has been reported, always BLAST compared with the deposited GeneBank sequences. after a single positive blood culture. Herewith we present the microbiological and clinical Antimicrobial susceptibility testing was determined by Etest on MHA with 5% blood features related to four patients from whom J. terrae was isolated from blood cultures. plates and read after 48 h. Results were interpreted following the CLSI recommendations “January”.: Romanesque painting of San Isidoro. León (Spain ) for coryneform organisms. Clinical charts of all patients were retrospectively reviewed. Results: - The organisms were identified by 16S rDNA amplification as J. terrae (99.6% similarity). All strains presented the same Table 1. Clinical and microbiology dates of four patients with Janibacter terrae bacteraemia API profile (3112004). Positive reaction was observed for hydrolysis of gelatin and hippurate, α-glucosidase and maltose assimilation. On the other hand, the organisms were assacharolytic, unable to assimilate NAG and PAC negative. No. and type of positive Underlying Antimicrobial Strain Age Sex Diagnosis Manipulation Fever Outcome blood cultures/no conditions therapy total 2977 66 M 2 aerobics/2 Chronic obstructive Acute bronchitis No Yes Amoxicillin- Cure pulmonary disease clavulanate - All strains were inhibited by the O/129 (150 mg) factor showing an inhibition diameter between 46-48 mm. - All strains were susceptible to imipenem, vancomycin, linezolid, daptomycin, ciprofloxacin, erythromycin, gentamicin, severe tetracycline and cotrimoxazole but resistant to cefotaxime, clindamycin, rifampin, and quinupristin-dalfopristin. Three 1167 66 F 2 aerobics/3 Diabetes Cholangitis No Yes Amoxicillin- Cure strains were penicillin-susceptible (MIC, 1 mg/L) while the forth had an MIC of 2 mg/L. clavulanate Tobramycin 2540 67 F 2 aerobics/3 Non-Hodgkin Multilobar Hickman Yes Ceftazidime Exitus lymphoma pneumonia catheter Amikacin Post-chemotherapy Metronidazole aplasia 1260 77 M 2 aerobics/3 Gastric Myelodysplastic No Yes Piperacillin- Exitus adenocarcinoma syndrome tazobactam with liver metastasis Conclusion: This is the first report showing J. terrae bacteraemia in humans. The organisms were isolated from four patients attended in different period of time having all of them two positive blood cultures, by which the possibility of a laboratory contamination seems unlikely. This organism had been exclusively isolated from soil but it is showing another face behaving as a probable opportunistic human pathogen. Bacterial identification could be achieved by molecular methods but also using standard and commercial biochemical tests. Antimicrobial susceptibility should be determined in all significant clinical isolates. Microbiologists must be aware of this organism which needs adequate methods for an accurate identification. Funding support: Research Project-GRS698/A/11 .