title: Clinical and microbiological characteristics of Eggerthella lenta bacteremia.
abstract: Eggerthella lenta is an emerging pathogen that has been underrecognized due to historical difficulties with phenotypic identification. Until now, its pathogenicity, antimicrobial susceptibility profile, and optimal treatment have been poorly characterized. In this article, we report the largest cohort of patients with E. lenta bacteremia to date and describe in detail their clinical features, microbiologic characteristics, treatment, and outcomes. We identified 33 patients; the median age was 68 years, and there was no gender predominance. Twenty-seven patients (82%) had serious intra-abdominal pathology, often requiring a medical procedure. Of those who received antibiotics (28/33, 85%), the median duration of treatment was 21.5 days. Mortality from all causes was 6% at 7 days, 12% at 30 days, and 33% at 1 year. Of 26 isolates available for further testing, all were identified as E. lenta by both commercially available matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) systems, and none were found to harbor a vanA or vanB gene. Of 23 isolates which underwent susceptibility testing, all were susceptible to amoxicillin-clavulanate, cefoxitin, metronidazole, piperacillin-tazobactam, ertapenem, and meropenem, 91% were susceptible to clindamycin, 74% were susceptible to moxifloxacin, and 39% were susceptible to penicillin.
authors.affiliation: Monash Infectious Diseases, Monash Health, Clayton, Victoria, Australia bradgardiner@gmail.com.
authors.forename: B J
authors.initials: BJ
authors.lastname: Gardiner
authors.affiliation: Monash Infectious Diseases, Monash Health, Clayton, Victoria, Australia.
authors.forename: A Y
authors.initials: AY
authors.lastname: Tai
authors.affiliation: Monash Infectious Diseases, Monash Health, Clayton, Victoria, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Kotsanas
authors.affiliation: Microbiology, Monash Health, Clayton, Victoria, Australia.
authors.forename: M J
authors.initials: MJ
authors.lastname: Francis
authors.affiliation: Department of Microbiology, Auckland Hospital, Auckland, New Zealand.
authors.forename: S A
authors.initials: SA
authors.lastname: Roberts
authors.affiliation: Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia.
authors.forename: S A
authors.initials: SA
authors.lastname: Ballard
authors.affiliation: Monash Infectious Diseases, Monash Health, Clayton, Victoria, Australia.
authors.forename: R K
authors.initials: RK
authors.lastname: Junckerstorff
authors.affiliation: Monash Infectious Diseases, Monash Health, Clayton, Victoria, Australia Microbiology, Monash Health, Clayton, Victoria, Australia Department of Medicine, Monash University, Clayton, Victoria, Australia.
authors.forename: T M
authors.initials: TM
authors.lastname: Korman
mesh_terms: D039903:Actinobacteria / Q000737:chemistry / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality / Q000473:pathology*; D002648:Child; D005260:Female; D005798:Genes, Bacterial; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality / Q000473:pathology*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents