Bacteremia caused by Enterobacter asburiae misidentified biochemically as Cronobacter sakazakii and accurately identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry: a case report
Abstract Background Biochemical analyses of causative bacteria do not always result in clear identification, and new technologies aimed at improving diagnostic accuracy continue to be developed. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry is a rapid and accurate tech...
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| Format: | Article |
| Language: | English |
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BMC
2022-01-01
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| Series: | Journal of Medical Case Reports |
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| Online Access: | https://doi.org/10.1186/s13256-021-03241-2 |
| _version_ | 1798025122388377600 |
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| author | Noboru Horinouchi Seiji Shiota Takeshi Takakura Atsushi Yoshida Ken Kikuchi Akira Nishizono Eishi Miyazaki |
| author_facet | Noboru Horinouchi Seiji Shiota Takeshi Takakura Atsushi Yoshida Ken Kikuchi Akira Nishizono Eishi Miyazaki |
| author_sort | Noboru Horinouchi |
| collection | DOAJ |
| description | Abstract Background Biochemical analyses of causative bacteria do not always result in clear identification, and new technologies aimed at improving diagnostic accuracy continue to be developed. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry is a rapid and accurate technique for bacterial identification. Misidentification of Cronobacter sakazakii is related to clinical and industrial problems. Here, we encountered a case of rare bacteremia in which the causative organism Enterobacter asburiae was biochemically misidentified as C. sakazakii before being correctly identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Case presentation An 87-year-old Asian man with no diabetes or active disease developed bacteremia and was admitted to our hospital. While the route of infection could not be determined despite various examinations, the clinical course was good following antibiotic therapy. Biochemical analyses identified the causative organism as C. sakazakii, but colonies on the blood agar medium showed a grayish coloration, differing from the yellowish coloration of typical Cronobacter colonies. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry was therefore performed, identifying the bacterium as E. asburiae on three independent analyses. This result was confirmed by multilocus sequence analysis using five housekeeping genes. Conclusions Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry may reduce misidentification of bacteria as C. sakazakii and improve the reporting rate of E. asburiae. This technique should be considered when biochemical bacterial misidentification is suspected. |
| first_indexed | 2024-04-11T18:13:16Z |
| format | Article |
| id | doaj.art-e30819fb7da542908feda97fb28cddd5 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-04-11T18:13:16Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-e30819fb7da542908feda97fb28cddd52022-12-22T04:10:02ZengBMCJournal of Medical Case Reports1752-19472022-01-011611410.1186/s13256-021-03241-2Bacteremia caused by Enterobacter asburiae misidentified biochemically as Cronobacter sakazakii and accurately identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry: a case reportNoboru Horinouchi0Seiji Shiota1Takeshi Takakura2Atsushi Yoshida3Ken Kikuchi4Akira Nishizono5Eishi Miyazaki6Department of General Medicine, Almeida Memorial HospitalDepartment of General Medicine, Almeida Memorial HospitalDepartment of General Medicine, Almeida Memorial HospitalDepartment of Infectious Diseases, Tokyo Women’s Medical UniversityDepartment of Infectious Diseases, Tokyo Women’s Medical UniversityDepartment of Microbiology, Faculty of Medicine, Oita UniversityDepartment of General Medicine, Faculty of Medicine, Oita UniversityAbstract Background Biochemical analyses of causative bacteria do not always result in clear identification, and new technologies aimed at improving diagnostic accuracy continue to be developed. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry is a rapid and accurate technique for bacterial identification. Misidentification of Cronobacter sakazakii is related to clinical and industrial problems. Here, we encountered a case of rare bacteremia in which the causative organism Enterobacter asburiae was biochemically misidentified as C. sakazakii before being correctly identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Case presentation An 87-year-old Asian man with no diabetes or active disease developed bacteremia and was admitted to our hospital. While the route of infection could not be determined despite various examinations, the clinical course was good following antibiotic therapy. Biochemical analyses identified the causative organism as C. sakazakii, but colonies on the blood agar medium showed a grayish coloration, differing from the yellowish coloration of typical Cronobacter colonies. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry was therefore performed, identifying the bacterium as E. asburiae on three independent analyses. This result was confirmed by multilocus sequence analysis using five housekeeping genes. Conclusions Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry may reduce misidentification of bacteria as C. sakazakii and improve the reporting rate of E. asburiae. This technique should be considered when biochemical bacterial misidentification is suspected.https://doi.org/10.1186/s13256-021-03241-2Enterobacter asburiaeCronobacter sakazakiiMatrix-assisted laser desorption/ionization time-of-flight mass spectrometry |
| spellingShingle | Noboru Horinouchi Seiji Shiota Takeshi Takakura Atsushi Yoshida Ken Kikuchi Akira Nishizono Eishi Miyazaki Bacteremia caused by Enterobacter asburiae misidentified biochemically as Cronobacter sakazakii and accurately identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry: a case report Journal of Medical Case Reports Enterobacter asburiae Cronobacter sakazakii Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry |
| title | Bacteremia caused by Enterobacter asburiae misidentified biochemically as Cronobacter sakazakii and accurately identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry: a case report |
| title_full | Bacteremia caused by Enterobacter asburiae misidentified biochemically as Cronobacter sakazakii and accurately identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry: a case report |
| title_fullStr | Bacteremia caused by Enterobacter asburiae misidentified biochemically as Cronobacter sakazakii and accurately identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry: a case report |
| title_full_unstemmed | Bacteremia caused by Enterobacter asburiae misidentified biochemically as Cronobacter sakazakii and accurately identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry: a case report |
| title_short | Bacteremia caused by Enterobacter asburiae misidentified biochemically as Cronobacter sakazakii and accurately identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry: a case report |
| title_sort | bacteremia caused by enterobacter asburiae misidentified biochemically as cronobacter sakazakii and accurately identified by matrix assisted laser desorption ionization time of flight mass spectrometry a case report |
| topic | Enterobacter asburiae Cronobacter sakazakii Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry |
| url | https://doi.org/10.1186/s13256-021-03241-2 |
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