Rapid diagnosis of Capnocytophaga canimorsus septic shock in an immunocompetent individual using real-time Nanopore sequencing: a case report
Abstract Background Rapid diagnosis and appropriate treatment is imperative in bacterial sepsis due increasing risk of mortality with every hour without appropriate antibiotic therapy. Atypical infections with fastidious organisms may take more than 4 days to diagnose leading to calls for improved m...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-07-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12879-019-4173-2 |
| _version_ | 1818323092053688320 |
|---|---|
| author | Seweryn Bialasiewicz Tania P. S. Duarte Son H. Nguyen Vichitra Sukumaran Alexandra Stewart Sally Appleton Miranda E. Pitt Arnold Bainomugisa Amy V. Jennison Rikki Graham Lachlan J. M. Coin Krispin Hajkowicz |
| author_facet | Seweryn Bialasiewicz Tania P. S. Duarte Son H. Nguyen Vichitra Sukumaran Alexandra Stewart Sally Appleton Miranda E. Pitt Arnold Bainomugisa Amy V. Jennison Rikki Graham Lachlan J. M. Coin Krispin Hajkowicz |
| author_sort | Seweryn Bialasiewicz |
| collection | DOAJ |
| description | Abstract Background Rapid diagnosis and appropriate treatment is imperative in bacterial sepsis due increasing risk of mortality with every hour without appropriate antibiotic therapy. Atypical infections with fastidious organisms may take more than 4 days to diagnose leading to calls for improved methods for rapidly diagnosing sepsis. Capnocytophaga canimorsus is a slow-growing, fastidious gram-negative bacillus which is a common commensal within the mouths of dogs, but rarely cause infections in humans. C. canimorsus sepsis risk factors include immunosuppression, alcoholism and elderly age. Here we report on the application of emerging nanopore sequencing methods to rapidly diagnose an atypical case of C. canimorsus septic shock. Case presentation A 62 year-old female patient was admitted to an intensive care unit with septic shock and multi-organ failure six days after a reported dog bite. Blood cultures were unable to detect a pathogen after 3 days despite observed intracellular bacilli on blood smears. Real-time nanopore sequencing was subsequently employed on whole blood to detect Capnocytophaga canimorsus in 19 h. The patient was not immunocompromised and did not have any other known risk factors. Whole-genome sequencing of clinical sample and of the offending dog’s oral swabs showed near-identical C. canimorsus genomes. The patient responded to antibiotic treatment and was discharged from hospital 31 days after admission. Conclusions Use of real-time nanopore sequencing reduced the time-to-diagnosis of Capnocytophaga canimorsus in this case from 6.25 days to 19 h. Capnocytophaga canimorsus should be considered in cases of suspected sepsis involving cat or dog contact, irrespective of the patient’s known risk factors. |
| first_indexed | 2024-12-13T11:07:11Z |
| format | Article |
| id | doaj.art-2526c54e7d36480bb1638b33a4552740 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-13T11:07:11Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-2526c54e7d36480bb1638b33a45527402022-12-21T23:48:56ZengBMCBMC Infectious Diseases1471-23342019-07-011911510.1186/s12879-019-4173-2Rapid diagnosis of Capnocytophaga canimorsus septic shock in an immunocompetent individual using real-time Nanopore sequencing: a case reportSeweryn Bialasiewicz0Tania P. S. Duarte1Son H. Nguyen2Vichitra Sukumaran3Alexandra Stewart4Sally Appleton5Miranda E. Pitt6Arnold Bainomugisa7Amy V. Jennison8Rikki Graham9Lachlan J. M. Coin10Krispin Hajkowicz11Centre for Children’s Health Research, Children’s Health QueenslandInstitute for Molecular Bioscience, The University of QueenslandInstitute for Molecular Bioscience, The University of QueenslandInfectious Diseases Unit Royal Brisbane and Women’s Hospital, Level 6, Joyce Tweddell Building, Royal Brisbane and Women’s HospitalInfectious Diseases Unit Royal Brisbane and Women’s Hospital, Level 6, Joyce Tweddell Building, Royal Brisbane and Women’s HospitalQML PathologyInstitute for Molecular Bioscience, The University of QueenslandInstitute for Molecular Bioscience, The University of QueenslandForensic and Scientific Services, Queensland Department of HealthForensic and Scientific Services, Queensland Department of HealthInstitute for Molecular Bioscience, The University of QueenslandInfectious Diseases Unit Royal Brisbane and Women’s Hospital, Level 6, Joyce Tweddell Building, Royal Brisbane and Women’s HospitalAbstract Background Rapid diagnosis and appropriate treatment is imperative in bacterial sepsis due increasing risk of mortality with every hour without appropriate antibiotic therapy. Atypical infections with fastidious organisms may take more than 4 days to diagnose leading to calls for improved methods for rapidly diagnosing sepsis. Capnocytophaga canimorsus is a slow-growing, fastidious gram-negative bacillus which is a common commensal within the mouths of dogs, but rarely cause infections in humans. C. canimorsus sepsis risk factors include immunosuppression, alcoholism and elderly age. Here we report on the application of emerging nanopore sequencing methods to rapidly diagnose an atypical case of C. canimorsus septic shock. Case presentation A 62 year-old female patient was admitted to an intensive care unit with septic shock and multi-organ failure six days after a reported dog bite. Blood cultures were unable to detect a pathogen after 3 days despite observed intracellular bacilli on blood smears. Real-time nanopore sequencing was subsequently employed on whole blood to detect Capnocytophaga canimorsus in 19 h. The patient was not immunocompromised and did not have any other known risk factors. Whole-genome sequencing of clinical sample and of the offending dog’s oral swabs showed near-identical C. canimorsus genomes. The patient responded to antibiotic treatment and was discharged from hospital 31 days after admission. Conclusions Use of real-time nanopore sequencing reduced the time-to-diagnosis of Capnocytophaga canimorsus in this case from 6.25 days to 19 h. Capnocytophaga canimorsus should be considered in cases of suspected sepsis involving cat or dog contact, irrespective of the patient’s known risk factors.http://link.springer.com/article/10.1186/s12879-019-4173-2Nanopore sequencingDroplet digital PCRCapnocytophaga canimorsusDiagnosisSepsis |
| spellingShingle | Seweryn Bialasiewicz Tania P. S. Duarte Son H. Nguyen Vichitra Sukumaran Alexandra Stewart Sally Appleton Miranda E. Pitt Arnold Bainomugisa Amy V. Jennison Rikki Graham Lachlan J. M. Coin Krispin Hajkowicz Rapid diagnosis of Capnocytophaga canimorsus septic shock in an immunocompetent individual using real-time Nanopore sequencing: a case report BMC Infectious Diseases Nanopore sequencing Droplet digital PCR Capnocytophaga canimorsus Diagnosis Sepsis |
| title | Rapid diagnosis of Capnocytophaga canimorsus septic shock in an immunocompetent individual using real-time Nanopore sequencing: a case report |
| title_full | Rapid diagnosis of Capnocytophaga canimorsus septic shock in an immunocompetent individual using real-time Nanopore sequencing: a case report |
| title_fullStr | Rapid diagnosis of Capnocytophaga canimorsus septic shock in an immunocompetent individual using real-time Nanopore sequencing: a case report |
| title_full_unstemmed | Rapid diagnosis of Capnocytophaga canimorsus septic shock in an immunocompetent individual using real-time Nanopore sequencing: a case report |
| title_short | Rapid diagnosis of Capnocytophaga canimorsus septic shock in an immunocompetent individual using real-time Nanopore sequencing: a case report |
| title_sort | rapid diagnosis of capnocytophaga canimorsus septic shock in an immunocompetent individual using real time nanopore sequencing a case report |
| topic | Nanopore sequencing Droplet digital PCR Capnocytophaga canimorsus Diagnosis Sepsis |
| url | http://link.springer.com/article/10.1186/s12879-019-4173-2 |
| work_keys_str_mv | AT sewerynbialasiewicz rapiddiagnosisofcapnocytophagacanimorsussepticshockinanimmunocompetentindividualusingrealtimenanoporesequencingacasereport AT taniapsduarte rapiddiagnosisofcapnocytophagacanimorsussepticshockinanimmunocompetentindividualusingrealtimenanoporesequencingacasereport AT sonhnguyen rapiddiagnosisofcapnocytophagacanimorsussepticshockinanimmunocompetentindividualusingrealtimenanoporesequencingacasereport AT vichitrasukumaran rapiddiagnosisofcapnocytophagacanimorsussepticshockinanimmunocompetentindividualusingrealtimenanoporesequencingacasereport AT alexandrastewart rapiddiagnosisofcapnocytophagacanimorsussepticshockinanimmunocompetentindividualusingrealtimenanoporesequencingacasereport AT sallyappleton rapiddiagnosisofcapnocytophagacanimorsussepticshockinanimmunocompetentindividualusingrealtimenanoporesequencingacasereport AT mirandaepitt rapiddiagnosisofcapnocytophagacanimorsussepticshockinanimmunocompetentindividualusingrealtimenanoporesequencingacasereport AT arnoldbainomugisa rapiddiagnosisofcapnocytophagacanimorsussepticshockinanimmunocompetentindividualusingrealtimenanoporesequencingacasereport AT amyvjennison rapiddiagnosisofcapnocytophagacanimorsussepticshockinanimmunocompetentindividualusingrealtimenanoporesequencingacasereport AT rikkigraham rapiddiagnosisofcapnocytophagacanimorsussepticshockinanimmunocompetentindividualusingrealtimenanoporesequencingacasereport AT lachlanjmcoin rapiddiagnosisofcapnocytophagacanimorsussepticshockinanimmunocompetentindividualusingrealtimenanoporesequencingacasereport AT krispinhajkowicz rapiddiagnosisofcapnocytophagacanimorsussepticshockinanimmunocompetentindividualusingrealtimenanoporesequencingacasereport |