China ; Genes, Bacterial ; Sequence Analysis ; Streptococcus suis ; classification ; genetics ; isolation & purification ; Virulence Factors ; genetics

Streptococcus suis infection is an emerging zoonosis in Asia. The most common disease manifestation is meningitis, which is often associated with hearing loss and cochleovestibular signs. S. suis infection in humans mainly occurs among risk groups that have frequent exposure to pigs or raw pork. Here, we report a case of S. suis meningitis in a 67-yr-old pig carcass handler, who presented with dizziness and sensorineural hearing loss followed by headaches. Gram-positive diplococci were isolated from cerebrospinal fluid (CSF) and blood cultures and showed gray-white colonies with alpha-hemolysis. S. suis was identified from CSF and blood cultures by using a Vitek 2 system (bioMerieux, France), API 20 STREP (bioMerieux), and performing 16S rRNA and tuf gene sequencing. Even after receiving antibiotic treatment, patients with S. suis infection frequently show complications such as hearing impairment and vestibular dysfunction. To the best of our knowledge, this is the first case of S. suis meningitis in Korea. Prevention through public health surveillance is recommended, especially for individuals who have occupational exposures to swine and raw pork.
Aged ; Animals ; Bacterial Proteins/genetics ; Blood/microbiology ; Cerebrospinal Fluid/microbiology ; Hearing Loss, Bilateral/complications/*diagnosis/microbiology ; Humans ; Male ; Meningitis, Bacterial/complications/*diagnosis/microbiology ; Phylogeny ; RNA, Ribosomal, 16S/genetics ; Sequence Analysis, DNA ; Streptococcus suis/classification/genetics/*isolation & purification ; Swine ; Tomography, X-Ray Computed

Streptococcus suis is a swine pathogen that causes meningitis, septicemia, pneumonia, and endocarditis. The first case of human S. suis infection was reported in Denmark in 1968, and since then, this infection with has been reported in many countries, especially in Southeast Asia because of the high density of pigs in this region. We report the case of a patient with septic arthritis and bacteremia caused by S. suis. Cases in which S. suis is isolated from the joint fluid are very rare, and to the best of our knowledge, this is first case report of S. suis infection in Korea. The identity of this organism was confirmed by phenotypic characterization and 16S rRNA sequence analysis. An 81-yr-old Korean woman who presented with fever, arthralgia, and headache was admitted to a secondary referral center in Korea. Culture of aspirated joint fluid and blood samples showed the growth of S. suis biotype II, which was identified by the Vitek2 GPI and API 20 Strep systems (bioMerieux, USA), and this organism was susceptible to penicillin G and vancomycin. The 16S rRNA sequences of the blood culture isolates showed 99% homology with those of S. suis subsp. suis, which are reported in GenBank. The patient's fever subsided, and blood and joint cultures were negative for bacterial growth after antibiotic therapy; however, the swelling and pain in her left knee joint persisted. She plans to undergo total knee replacement.
Aged, 80 and over ; Anti-Bacterial Agents/administration & dosage ; Arthritis, Infectious/complications/*diagnosis/microbiology ; Bacteremia/complications/*diagnosis/microbiology ; Female ; Humans ; Injections, Intravenous ; Microbial Sensitivity Tests ; Phenotype ; RNA, Ribosomal, 16S/chemistry/genetics ; Sequence Analysis, DNA ; Streptococcal Infections/complications/*diagnosis/microbiology ; Streptococcus suis/genetics/*isolation & purification