title: First case report of infection due to Cupriavidus gilardii in a patient without immunodeficiency: a case report.
abstract: Cupriavidus gilardii is an aerobic, Gram-negative, glucose-nonfermenting rod that was first identified in 1999. Because of the difficulty in accurate species identification of C. gilardii, there are few case reports of infection caused by this organism. In previous reports, C. gilardii has been characterized as an organism with low pathogenicity that causes opportunistic infections.
  
  
  
  We encountered a case of pacemaker-associated bloodstream infection caused by C. gilardii in a 90-year old woman without obvious immunodeficiency. We identified the isolates as C. gilardii by sequencing of the 16S rRNA gene. The patient was treated with removal of the lead and administration of antimicrobial agents. Because of the acquisition of antibiotic resistance during antibiotic treatment, the antimicrobial agent was changed during the course of treatment.
  
  
  
  To our knowledge, this is the first report of an infection caused by this organism in a patient without obvious immunodeficiency. Although the true pathogenicity of C. gilardii is unclear, the possibility that it exerts pathogenicity not only in persons with immunodeficiency but also in immunocompetent persons is suggested.
authors.affiliation: Department of Infection Prevention and Control, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.|Department of Microbiology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan.
authors.forename: Takehito
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Department of Infection Prevention and Control, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan. task300@tokyo-med.ac.jp.
authors.forename: Itaru
authors.initials: I
authors.lastname: Nakamura
authors.affiliation: Department of Infection Prevention and Control, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.|Department of Microbiology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Fujita
authors.affiliation: Department of Infection Prevention and Control, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.|Department of Microbiology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan.
authors.forename: Ayaka
authors.initials: A
authors.lastname: Tsukimori
authors.affiliation: Department of Infection Prevention and Control, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Sato
authors.affiliation: Department of Infection Prevention and Control, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Fukushima
authors.affiliation: Department of Microbiology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan.
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Ohkusu
authors.affiliation: Department of Microbiology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Matsumoto
mesh_terms: D000369:Aged, 80 and over; D049921:Cupriavidus; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000382:microbiology*; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000382:microbiology; D010138:Pacemaker, Artificial / Q000382:microbiology; D012336:RNA, Ribosomal, 16S / Q000235:genetics
chemical_list: D012336:RNA, Ribosomal, 16S
keywords: Antimicrobial resistance; Case report; Cupriavidus gilardii; Glucose non-fermenting gram-negative rod; Immunocompetent patient; Pacemaker-associated bloodstream infection; Sequencing analysis of the 16S rRNA gene