Polyclonal <i>Staphylococcus aureus</i> Bacteremia
Authors: Aleksandra Petrovic Fabijan, Nouri L. Ben Zakour, Josephine Ho, Ruby C.Y. Lin, Jonathan Iredell
Journal: Annals of Internal Medicine (2019)

Letters17 December 2019Polyclonal Staphylococcus aureus BacteremiaAleksandra Petrovic Fabijan, Nouri L. Ben Zakour, Josephine Ho, Ruby C.Y. Lin, and Jonathan Iredell, PhD, for the Westmead Bacteriophage Therapy Team (WBTT) and AmpliPhi Biosciences Corporation*Aleksandra Petrovic FabijanWestmead Institute for Medical Research and Westmead Hospital of Western Sydney Local Health District, Sydney, Australia (A.P.F., J.H.), Nouri L. Ben ZakourWestmead Institute for Medical Research and University of Sydney School of Medicine, Sydney, Australia (N.L.B.), Josephine HoWestmead Institute for Medical Research and Westmead Hospital of Western Sydney Local Health District, Sydney, Australia (A.P.F., J.H.), Ruby C.Y. LinWestmead Institute for Medical Research, Westmead Hospital of Western Sydney Local Health District, University of Sydney School of Medicine, and University of New South Wales School of Medical Sciences, Sydney, Australia (R.C.L.), and Jonathan Iredell, PhDWestmead Institute for Medical Research, Westmead Hospital of Western Sydney Local Health District, and University of Sydney School of Medicine, Sydney, Australia (J.I.), for the Westmead Bacteriophage Therapy Team (WBTT) and AmpliPhi Biosciences Corporation*Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0369 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Polyclonal, coagulase-negative staphylococci are common contaminants of blood cultures (1), but polyclonal, coagulase-positive staphylococci (Staphylococcus aureus) have yet to be unambiguously identified as a cause of bacteremia.Objective: To describe a patient with simultaneous and persistent bacteremia from 2 strains of S aureus.Case Report: A 36-year-old woman who used intravenous drugs was hospitalized in May 2018 for chest pain and fever. She was known to be infected with hepatitis B and C viruses. Blood cultures isolated methicillin-susceptible S aureus (Table and Figure), transthoracic echocardiography identified a vegetation on the septal leaflet of her tricuspid valve, and a chest ...References1. Van Wijngaerden E, Peetermans WE, Van Lierde S, et al. Polyclonal Staphylococcus endocarditis. Clin Infect Dis. 1997;25:69-71. [PMID: 9243035] CrossrefMedlineGoogle Scholar2. Petrovic A, Kostanjsek R, Rakhely G, et al. The first Siphoviridae family bacteriophages infecting Bordetella bronchiseptica isolated from environment. Microb Ecol. 2017;73:368-77. [PMID: 27628741] doi:10.1007/s00248-016-0847-0 CrossrefMedlineGoogle Scholar3. Lehman SM, Mearns G, Rankin D, et al. Design and preclinical development of a phage product for the treatment of antibiotic-resistant Staphylococcus aureus infections. Viruses. 2019;11. [PMID: 30669652] doi:10.3390/v11010088 CrossrefMedlineGoogle Scholar4. Asgeirsson H, Thalme A, Weiland O. Staphylococcus aureus bacteraemia and endocarditis – epidemiology and outcome: a review. Infect Dis (Lond). 2018;50:175-92. [PMID: 29105519] doi:10.1080/23744235.2017.1392039 CrossrefMedlineGoogle Scholar5. Khatib R, Sharma M, Naqvi SA, et al. Molecular analysis of Staphylococcus aureus blood isolates shows lack of polyclonal bacteremia. J Clin Microbiol. 2003;41:1717-9. [PMID: 12682167] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Westmead Institute for Medical Research and Westmead Hospital of Western Sydney Local Health District, Sydney, Australia (A.P.F., J.H.)Westmead Institute for Medical Research and University of Sydney School of Medicine, Sydney, Australia (N.L.B.)Westmead Institute for Medical Research, Westmead Hospital of Western Sydney Local Health District, University of Sydney School of Medicine, and University of New South Wales School of Medical Sciences, Sydney, Australia (R.C.L.)Westmead Institute for Medical Research, Westmead Hospital of Western Sydney Local Health District, and University of Sydney School of Medicine, Sydney, Australia (J.I.)Acknowledgment: The authors thank Joey Lai and Li Ma at Westmead Institute for Medical Research and the staff of the Pathogen Genomics Unit at Westmead Hospital and Ramaciotti Centre (University of New South Wales) for technical advice and sequencing support; Angela Netluch and Patricia Fa for pharmacy support; Stephanie Chan, Katherine Garnham, Sonya Natasha Hutabarat, Cecilia Li, Chris Robson, Andrew Ginn, and the staff of the New South Wales Pathology Microbiology laboratory at Westmead Hospital for help with data and sample collection; and Bethany Bowring for laboratory assistance.Financial Support: ABPH provided the investigational product AB-SA01 and partial financial support for work carried out at Western Sydney Local Health District and Westmead Institute for Medical Research to treat patients and analysis of samples, as investigator-led research sponsored and indemnified by Western Sydney Local Health District. Dr. Iredell is supported by grants 1104232 and 1107322 from the Australian National Health and Medical Research Council.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0369.This article was published at Annals.org on 17 September 2019.* For members of the WBTT and AmpliPhi Biosciences Corporation, see the Appendix. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe phages of staphylococci: critical catalysts in health and diseaseRight-sided endocarditis caused by polyclonal Staphylococcus aureus infectionAntibacterial Mechanism of Dihydrotanshinone IPHAGE Futures Congress Meeting Summary Washington, DC January 29 to 30, 2020Safety of bacteriophage therapy in severe Staphylococcus aureus infection 17 December 2019Volume 171, Issue 12Page: 940-941KeywordsAntibioticsBacteremiaBacteriophagesBloodDNAFeversHospital medicinePatientsResearch laboratoriesStaphylococcus aureus ePublished: 17 September 2019 Issue Published: 17 December 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...