Bacteremia and Skin Infections in Four Patients Caused by Helicobacter-Like Organisms

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Genomics

Background:

• Enterohepatic Helicobacter-like organisms (HLO) are recognized causes of human infection, historically linked to immunocompromised individuals.
• Reports from Japan have expanded the known spectrum of HLO-associated illnesses.
• This study focuses on HLO infections in immunocompetent patients.

Purpose of the Study:

• To report on a series of immunocompetent patients with HLO bacteremia.
• To highlight the clinical presentation and diagnostic challenges of HLO infections.
• To emphasize the potential underdiagnosis of this condition.

Main Methods:

• Case series of 4 immunocompetent patients diagnosed with HLO bacteremia over a 2-year period.
• Clinical data including symptoms (cellulitis, fever) were recorded.
• 16S ribosomal deoxyribonucleic acid (rDNA) sequence analysis and whole-genome sequencing were used for isolate identification and characterization.

Main Results:

• Three of the four patients presented with cellulitis, and one had unexplained fever.
• Sequence analysis identified the isolates as Helicobacter cinaedi, with minor genomic differences from reference strains.
• The ESP blood culture system successfully isolated HLO, while two other commercial systems did not.

Conclusions:

• HLO bacteremia in immunocompetent individuals may be more common than currently reported.
• The condition is easily overlooked due to symptoms mimicking streptococcal cellulitis and rapid response to beta-lactam antibiotics.
• The difficulty in isolating HLO from blood using standard methods contributes to underdiagnosis.