Prosthetic valve endocarditis caused by Bordetella holmesii, an Acinetobacter lookalike

J Med Microbiol. 2012 Jun;61(Pt 6):874-877. doi: 10.1099/jmm.0.038695-0. Epub 2012 Mar 8.

Abstract

We report a case of fulminant endocarditis on a prosthetic homograft aortic valve caused by Bordetella holmesii, which was successfully managed by surgical valve replacement and antibiotic treatment. B. holmesii, a strictly aerobic, small, Gram-negative coccobacillus, has been implicated as an infrequent cause of a pertussis-like syndrome and other respiratory illnesses. However, B. holmesii is also a rare cause of septicaemia and infective endocarditis, mostly in immunocompromised patients. To our knowledge, this is the first report of B. holmesii endocarditis on a prosthetic aortic valve. Routine laboratory testing initially misidentified the strain as Acinetobacter sp. Correct identification was achieved by 16S rRNA gene and outer-membrane protein A (ompA) gene sequencing. Interestingly, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry also produced an accurate species-level identification. Subsequent susceptibility testing and review of the literature revealed ceftazidime, cefepime, carbapenems, aminoglycosides, fluoroquinolones, piperacillin/tazobactam, tigecycline and colistin as possible candidates to treat infections caused by B. holmesii.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / pharmacology
  • Bordetella / classification
  • Bordetella / isolation & purification*
  • Bordetella Infections / diagnosis*
  • Bordetella Infections / drug therapy
  • Bordetella Infections / microbiology
  • Bordetella Infections / surgery
  • DNA, Bacterial / chemistry
  • DNA, Bacterial / genetics
  • DNA, Ribosomal / chemistry
  • DNA, Ribosomal / genetics
  • Endocarditis, Bacterial / diagnosis*
  • Endocarditis, Bacterial / drug therapy
  • Endocarditis, Bacterial / microbiology
  • Endocarditis, Bacterial / surgery
  • Humans
  • Male
  • Molecular Sequence Data
  • Prosthesis-Related Infections / diagnosis*
  • Prosthesis-Related Infections / drug therapy
  • Prosthesis-Related Infections / microbiology
  • Prosthesis-Related Infections / surgery
  • RNA, Ribosomal, 16S / genetics
  • Sequence Analysis, DNA

Substances

  • Anti-Bacterial Agents
  • DNA, Bacterial
  • DNA, Ribosomal
  • RNA, Ribosomal, 16S

Associated data

  • GENBANK/JN664969
  • GENBANK/JQ650246