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Difficulty with Gordonia bronchialis identification by Microflex mass spectrometer in a pacemaker-induced
Marie Titécat1,2, Caroline Loïez1,2, René J Courcol1,2
1Institute of Microbiology, University Hospital Centre, Lille, France.
JMM Case Reports
|June 2, 2018
Summary
This case report details the first known instance of pacemaker-induced endocarditis caused by Gordonia bronchialis infection. Advanced molecular techniques were essential for accurate bacterial identification, highlighting challenges in diagnosing rare infections.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Cardiology
Background:
- Pacemaker-induced endocarditis is a rare but serious complication.
- Gordonia bronchialis is an uncommon pathogen, particularly in device-related infections.
Purpose of the Study:
- To report the first documented case of pacemaker-induced endocarditis caused by Gordonia bronchialis.
- To highlight diagnostic challenges associated with this rare pathogen.
Main Methods:
- Case presentation of a 92-year-old male with pacemaker-induced endocarditis.
- Utilized matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) for bacterial identification.
- Employed 16S rRNA and rpoB gene sequencing for definitive strain identification when MALDI-TOF MS failed.
Main Results:
- The patient presented with pacemaker-induced endocarditis.
- Initial identification using MALDI-TOF MS was unsuccessful despite the taxon being in the database.
- 16S rRNA and rpoB gene sequencing confirmed the causative agent as Gordonia bronchialis.
Conclusions:
- Gordonia bronchialis infections are rare, primarily affecting immunocompromised individuals or those with medical devices.
- Accurate identification of G. bronchialis may necessitate molecular methods beyond standard mass spectrometry.
- This case underscores the importance of considering rare pathogens and utilizing advanced diagnostics in device-related infections.
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