Abstract
Purpose
Lautropia mirabilis is a Gram-negative, facultative anaerobic coccus, which has been detected mainly in respiratory sites of immunodeficient patients suffering from HIV or cystic fibrosis. To date, knowledge about the pathogenicity of L. mirabilis is spare due to the small numbers of documented cases.
Methods
We present a literature review and report the case of a 39-year-old female diagnosed with common variable immunodeficiency (CVID) with IgG and IgA deficiency suffering from a sepsis with L. mirabilis. As no fully closed L. mirabilis genome besides the type strain was available to date, we additionally performed complete genome sequencing of L. mirabilis.
Results
The patient was admitted to our hospital with recurrent episodes of fever. Here, we detected L. mirabilis in two different blood cultures. The bacterium was tested susceptible to and treated with meropenem. As the origin of L. mirabilis sepsis, we observed an active periodontitis likely due to impaired IgA levels and mucosal insufficiency as a consequence of CVID. Whole genome sequencing of L. mirabilis revealed several genes important for host cell invasion and intracellular survival of the pathogen.
Conclusions
Our case highlights the importance of L. mirabilis in immunocompromised patients also in other compartments than the respiratory tract.
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Data availability
The genome sequence presented in this study can be found in online repositories (NCBI GenBank, Accession: CP146356, BioProject: PRJNA1081434, BioSample: SAMN40175934): https://www.ncbi.nlm.nih.gov/nuccore/CP146356. The 16S rRNA gene sequence was deposited separately at NCBI GenBank and can be accessed through OR468380: https://www.ncbi.nlm.nih.gov/nuccore/OR468380. The bacterial isolate was deposited in the open collection of the Leibniz Institute DSMZ—German Collection of Microorganisms and Cell Cultures GmbH, was confirmed as L. mirabilis and assigned the identifier DSM Lautropia mirabilis 512852 (DSM 117694).
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Acknowledgements
We thank F. Meier, S. Jürgenfeldt, N. Schlüter and L. Siegmann for technical support and G. Geginat, K. Borucki and B. Schraven for critical discussion.
Funding
This work was supported by grants of the federal state of Saxony-Anhalt, Germany (SI2 and SI3) to the assistant professorship “Inflammation and Immunometabolism” (to. S.K.).
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Supervision: S.K. with T.E. and A. E. Z.; Drafting, Writing, and Experimentation: S.G. with S.K.; Clinical treatment: M.B., E.S., T.E.; MALDI-TOF identification and 16S Sequencing: A.Z. and J.F.; Image acquisition: B.M.; Significant intellectual input and expert opinion: A.J.K.; Editing, Approval of the final manuscript: All authors.
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As the data presented are retrospective and represent an incidental finding during routine clinical care, and no investigational interventions were performed, informed consent was not obtained for this anonymous case report.
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As the patient was lost to follow-up, no consent for publication could be given. The publication of anonymous, retrospective, and routine clinical data is in line with the general terms and conditions of the Magdeburg University Hospital. Identification of the patient on the basis of the data provided is not possible.
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Genseke, S., Berisha, M., Teerstegen, A. et al. Lautropia mirabilis sepsis in immunodeficiency: first report and genomic features. Infection (2024). https://doi.org/10.1007/s15010-024-02388-6
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DOI: https://doi.org/10.1007/s15010-024-02388-6