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Published on: July 1, 2018
Culture-Negative Streptococcus suis Infection Diagnosed by Metagenomic Next-Generation Sequencing
Yuanyuan Dai1, Li Chen1, Wenjiao Chang1
1Department of Clinical Laboratory, First Affiliated Hospital of University of Science and Technology of China, Hefei, China.
Abstract:
Background: Streptococcus suis is a zoonotic pathogen that can cause severe infections such as meningitis and septicemia in both swine and humans. Rapid and accurate identification of the causative agent is very important for guiding clinical choices in administering countermeasures. Case Report: Here, we report a case of fatal S. suis infection in a patient who worked as a butcher in China. The 59-year-old man, who had previously undergone splenectomy, injured his finger while processing pork and developed severe sepsis. While blood cultures were negative following antibiotic treatment, S. suis was determined to be the causative agent by metagenomic next-generation sequencing (mNGS) and Sanger sequencing. Conclusion: Identification of etiological agents using techniques such as blood culture prior to antibiotic treatment is very important. mNGS may represent a useful method for diagnosis of infectious diseases, especially post-antibiotic treatment.
Insights
Streptococcus suis caused a fatal infection in a butcher post-splenectomy. Metagenomic sequencing identified the pathogen after negative blood cultures, highlighting its diagnostic utility.
Area of Science:
- Infectious Diseases
- Microbiology
- Genomics
Background:
- Streptococcus suis is a zoonotic bacterium causing severe meningitis and septicemia in humans and swine.
- Accurate identification of S. suis is crucial for effective clinical management and treatment.
- Zoonotic bacterial infections pose significant public health risks, necessitating advanced diagnostic approaches.
Observation:
- A 59-year-old butcher with a history of splenectomy developed fatal sepsis after a finger injury while handling pork.
- Standard blood cultures were negative following antibiotic administration.
- Metagenomic next-generation sequencing (mNGS) and Sanger sequencing successfully identified Streptococcus suis as the causative agent.
Findings:
- mNGS provided definitive pathogen identification in a complex sepsis case.
- The study demonstrates the limitations of conventional methods like blood cultures in specific post-antibiotic scenarios.
- S. suis infection can be severe, particularly in asplenic individuals.
Implications:
- mNGS offers a valuable tool for diagnosing infectious diseases, especially when conventional methods fail or are compromised by prior treatment.
- Early and accurate etiological diagnosis is paramount for guiding antimicrobial therapy and improving patient outcomes.
- This case underscores the importance of considering zoonotic pathogens in occupational settings and in immunocompromised individuals.
