title: Central venous catheter sepsis caused by unusual Gordona (Rhodococcus species: identification with a digoxigenin-labeled rDNA probe.
abstract: We describe central line sepsis caused by Gordona (Rhodococcus) species in two patients, which complicated receipt of long-term total parenteral nutrition at home. Species identification was attempted by conventional biochemical analysis and analysis of polymorphisms in the ribosomal RNA genes with use of a digoxigenin-labeled rDNA probe. Using these techniques, we identified our first patient's isolate as Gordona terrae. The isolate from our second patient was biochemically atypical and could not be reliably matched to any of the recognized Gordona (Rhodococcus) species. To our knowledge, these patients are the first to have been reported with systemic infection caused by Gordona (Rhodococcus) species. The first patient's infection resolved after 6 weeks of intravenous therapy with vancomycin with the catheter left in situ; however, infection in the second patient required catheter removal for cure. These cases show that immunocompetent patients receiving long-term parenteral nutrition may develop central line infections with these unusual species of microorganisms.
authors.affiliation: Division of Digestive Diseases, Emory University School of Medicine, Atlanta, Georgia 30322.
authors.forename: A L
authors.initials: AL
authors.lastname: Buchman
authors.forename: M M
authors.initials: MM
authors.lastname: McNeil
authors.forename: J M
authors.initials: JM
authors.lastname: Brown
authors.forename: B A
authors.initials: BA
authors.lastname: Lasker
authors.forename: M E
authors.initials: ME
authors.lastname: Ament
mesh_terms: D000193:Actinomycetales Infections / Q000188:drug therapy / Q000382:microbiology*; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D015342:DNA Probes / Q000235:genetics; D004269:DNA, Bacterial / Q000235:genetics; D004275:DNA, Ribosomal / Q000235:genetics; D004076:Digoxigenin; D005260:Female; D006801:Humans; D008826:Microbial Sensitivity Tests; D012240:Rhodococcus / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*
chemical_list: D015342:DNA Probes; D004269:DNA, Bacterial; D004275:DNA, Ribosomal; D004076:Digoxigenin