Klin Padiatr 2014; 226(02): 68-71
DOI: 10.1055/s-0033-1363959
Case Report
© Georg Thieme Verlag KG Stuttgart · New York

Catheter-related Mycobacterium fortuitum Bloodstream Infection: Rapid Identification Using MALDI-TOF Mass Spectrometry

Zentralvenenkatheter-Infektion durch Mycobacterium fortuitum – rapide Identifizierung mittels MALDI TOF Mass Spectrometry
M. J. Artacho-Reinoso*
1   Department of Infectious Diseases, Microbiology and Preventive Medicine, University Hospital Virgen del Rocio, Sevilla, Spain
,
P. Olbrich*
2   Paediatric Infectious Diseases and Immunopathology Unit, University ­Hospital Virgen del Rocio, Sevilla, Spain
,
P. Solano-Paéz
3   Department of Paediatric Oncology, University Hospital Virgen del Rocio, Sevilla, Spain
,
P. Ybot-Gonzalez
4   Department of Paediatrics, University Hospital Virgen del Rocio, Sevilla, Spain
,
J. A. Lepe
1   Department of Infectious Diseases, Microbiology and Preventive Medicine, University Hospital Virgen del Rocio, Sevilla, Spain
,
O. Neth
2   Paediatric Infectious Diseases and Immunopathology Unit, University ­Hospital Virgen del Rocio, Sevilla, Spain
,
J. Aznar
1   Department of Infectious Diseases, Microbiology and Preventive Medicine, University Hospital Virgen del Rocio, Sevilla, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
19 February 2014 (online)

Abstract

We present the case of a 6-year-old boy diagnosed with stage III mediastinal Non Hodgkin Lymphoblastic T cell Lymphoma who suffered from catheter-related bloodstream infection (CRBI) due to Mycobacterium fortuitum whilst receiving chemotherapy. Isolation of this rare pathogen was done directly from blood culture and identification was made rapidly within 48 h using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectro­metry as well as specific polymerase chain reaction (PCR)-reverse hybridization method. This allowed prompt directed antibiotic therapy apart from central venous catheter removal and resulted in an excellent clinical response. This case highlights the potential benefit of using MALDI-TOF mass spectrometry, a fast, cost-effective and precise methodology, in the diagnosis and subsequent management of invasive bacterial infection.

Zusammenfassung

Wir präsentieren einen 6 Jahre alten Jungen mit lymphoblastischem Non-Hodgkin-T-Zell-Lymphom, der an einer durch Mycobacterium fortuitum verursachten Zentralvenenkatheter(ZVK)-Infektion erkrankte. Die Isolierung dieses seltenen Mikroorganismus erfolgte direkt aus der Blutkulturflasche. Die korrekte Identifizierung gelang innerhalb von 48 h mittels Matrix-assisted Laser Desorption/Ionization Time-of-Flight (MALDI-TOF) Mass Spectro­metry und wurde durch die para­llel durchgeführte spezifische Polymerase-Chain-Reaction(PCR)-re­verse Hybridisationsmethode bestätigt. Dieses Vorgehen ermöglichte eine schnelle und organismusgezielte Antibio­tikatherapie und resultierte zusammen mit der prompten Entfernung des ZVK zu einem exzellenten klinischen Erfolg. Der hier präsentierte Fall verdeutlicht die Relevanz der MALDI-TOF Mass Spectrometry als schnelle, kostengünstige und präzise Diagnostikmethode in der Identifizierung und Behandlung schwerer bakterieller Infekte.

*  These two authors are shared 1st author/contributed equally.


 
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