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First case report of infective endocarditis associated with Microbacterium maritypicum

Eugene Y H Yeung1,2,3, M Fahad Chowdhury3,4, Robert W Slinger1,2

  • 1Department of Medical Microbiology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.

Idcases
|September 23, 2020
PubMed

Insights

This case report details a rare instance of infective endocarditis caused by Microbacterium maritypicum bacteremia. It highlights the need for careful antimicrobial susceptibility testing, even for commonly assumed effective drugs.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Cardiology

Background:

  • Microbacterium species are Gram-positive coryneforms often mistaken for contaminants in blood cultures, particularly with prolonged time-to-positivity (>48 hours).
  • Infective endocarditis (IE) is a serious infection of the heart valves, typically caused by bacteria or fungi.

Observation:

  • A case of infective endocarditis was identified in association with Microbacterium maritypicum bacteremia.
  • Blood cultures showed positivity after 48 hours of incubation in three out of four bottles, initially suggesting contamination.

Findings:

  • Antimicrobial management for Microbacterium species can be challenging, with vancomycin demonstrating a minimum inhibitory concentration of 4 μg/mL, indicating non-susceptibility in this case.
  • This represents the first reported case of infective endocarditis specifically linked to Microbacterium maritypicum.

Implications:

  • Clinicians should consider Microbacterium species as potential pathogens in cases of bacteremia, especially with prolonged culture times.
  • Accurate identification and antimicrobial susceptibility testing are crucial for effective treatment of Microbacterium infections, including infective endocarditis.
  • This case expands the known spectrum of pathogens causing infective endocarditis and underscores the importance of challenging traditional assumptions in microbiology and infectious disease management.
Keywords:
Antimicrobial susceptibilityBacteremiaCoryneformsDiptheroidsEndocarditisMeropenemMicrobacterium maritypicumVancomycin

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