Laribacter hongkongensis is an emerging pathogen in patients with community-acquired gastroenteritis and traveler's diarrhea. We herein report a case of L. hongkongensis infection in a 24-yr-old male with liver cirrhosis complicated by Wilson's disease. He was admitted to a hospital with only abdominal distension. On day 6 following admission, he complained of abdominal pain and his body temperature reached 38.6degrees C. The results of peritoneal fluid evaluation revealed a leukocyte count of 1,180/microL (polymorphonuclear leukocyte 74%). Growth on blood culture was identified as a gram-negative bacillus. The isolate was initially identified as Acinetobacter lwoffii by conventional identification methods in the clinical microbiology laboratory, but was later identified as L. hongkongensis on the basis of molecular identification. The patient was successfully treated with cefotaxime. To the best of our knowledge, this case is the first report of hospital-acquired L. hongkongensis bacteremia with neutrophilic ascites.
Acinetobacter/isolation & purification ; Acinetobacter Infections/complications/diagnosis/microbiology ; Bacteremia/complications/*microbiology ; Cefotaxime/therapeutic use ; Diagnosis, Differential ; Gastroenteritis/complications/*diagnosis/*microbiology ; Hepatolenticular Degeneration/complications/microbiology ; Humans ; Liver Cirrhosis/complications/microbiology ; Male ; Neisseriaceae/*isolation & purification ; Phylogeny ; Republic of Korea ; Young Adult

OBJECTIVETo explore the influence of non-gonococcal Neisseria on the diagnosis and treatment of male genitourinary infection.

METHODSThe samples of urethral exudates, prostatic secretions or/and semen were collected from 8 cases of male patients with acute urethritis or chronic prostatitis, then inoculated into gonococcal agar medium, blood agar medium, Sabouraud agar medium and Mycoplasma agar medium, respectively. Neisseria gonorrhoeae, Mycoplasmae, fungi and other bacteria were isolated, Chlamydiae examined by Gemenez staining, and the gram-negative diplococci from the samples identified by oxidase test, biochemical examination and drug sensitivity test. The PCR products of the cryptic plasmid pJD1 gene of the isolated strains were amplified for the identification of Neisseria gonorrhoeae. Based on the results of drug sensitivity tests, intravenous or oral antibiotics were selected for treatment.

RESULTSEight strains of gram-negative diplococci were isolated in this study, 3 identified as N. mucosa, 4 as N. cinerea and the other 1 as N. lactamica. The PCR identification test of the cryptic plasmid pJD1 gene showed the same positive results in all the strains as in N. gonorrhoeae. The non-gonococcal Neisseria isolated from the male genital tract secretions exhibited a multidrug resistance, especially to quinolones and fosfomycin. All the symptoms disappeared and no pathogens were detected in the patients after a 7-day treatment with Cephalosporins or/and Minocycline.

CONCLUSIONSome Neisseria species normally parasitizing the upper respiratory tract can also cause male genitourinary infections, such as gonorrhea-like urethritis and chronic prostatitis. Neisseria gonorrhea could be clinically and etiologically misdiagnosed through such conventional methods as morphological examination, oxidase test and PCR identification test of cryptic plasmid and other nonspecific genes. Intravenous and/or oral antibiotic medication based on the results of drug sensitivity tests can cure acute urethritis and chronic prostatitis induced by non-gonococcal Neisseria in males. Drug resistance of non-gonococcal Neisseria directly affects the success of treatment.

Adult ; Anti-Bacterial Agents ; therapeutic use ; Humans ; Male ; Middle Aged ; Neisseria ; isolation & purification ; Neisseriaceae Infections ; diagnosis ; drug therapy ; microbiology ; Prostatitis ; diagnosis ; drug therapy ; microbiology ; Urethritis ; diagnosis ; drug therapy ; microbiology

OBJECTIVETo survey the prevalence of enterotoxigenic Escherichia coli (ETEC) and Laribacter hongkongensis (LH) and their drug resistance in diarrhea patients in Guangzhou.

METHODSWe detected 646 fecal cases collected between Sep 2008 and Oct 2009 from the out-patient and emergency departments in a hospital. EC enriched culture medium was used for enrichment. MAC- and CMAC-specific culture media were used to isolate ETEC and LH from the specimens. The biochemical agents API20NE and API20E were employed for biochemical identification, and PCR was used for genetic identification. K-B disk diffusion method was used for antimicrobial susceptibility testing.

RESULTSNo LH was detected in the total 646 patients, and 38 patients were positive for ETEC, with a detection rate of 6%. Antibiotics resistance test showed that 38 strains of ETEC had a high resistance rate to penicillin, tetracycline and sulfa, but remained sensitive to cephalosporins.

CONCLUSIONSLH may have a low prevalence in Guangzhou. The incidence of diarrhea caused by ETEC tends to decrease as compared with that a decade ago, and further multi-center survey is needed for confirmation. Consumption of aquatic products may be one of the major risk factors for ETEC infection. Cephalosporins can be used for ETEC-induced diarrhea.

Adolescent ; Adult ; Bacterial Infections ; epidemiology ; microbiology ; Cephalosporins ; pharmacology ; Child ; Child, Preschool ; China ; epidemiology ; Diarrhea ; epidemiology ; microbiology ; Drug Resistance, Bacterial ; Enterotoxigenic Escherichia coli ; drug effects ; isolation & purification ; Escherichia coli Infections ; epidemiology ; microbiology ; Female ; Humans ; Infant ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Neisseriaceae ; drug effects ; isolation & purification ; Prevalence ; Young Adult