title: Evidence of Archaeal Methanogens in Brain Abscess.
abstract: Methanogens are antibiotic-resistant anaerobic archaea that escape routine detection in clinical microbiology. We hypothesized that methanogens are part of the anaerobic community that cause brain abscess.
  
  
  
  Methanogens were investigated in 1 index sample using specific polymerase chain reaction (PCR) sequencing and culture. The pathogenesis of a methanogen isolate was assessed in a mouse model. Archaea-specific quantitative (q) PCR and metagenomics were used to detect specific archaeal sequences in brain abscess samples and controls.
  
  
  
  In 1 index sample, routine culture found Porphyromonas endodontalis and Streptococcus intermedius, and specific culture found Methanobrevibacter oralis susceptible to metronidazole and fusidic acid. Archaea-targeted PCR sequencing and metagenomics confirmed M. oralis along with 14 bacteria, including S. intermedius. Archaea-specific qPCR yielded archaea in 8/18 brain abscess specimens and 1/27 controls (P < .003), and metagenomics yielded archaea, mostly methanogens, in 28/32 brain abscess samples, and no archaea in 71 negative controls (P < 10-6). Infection of mice brains yielded no mortality in 14 controls and death in 17/22 M. oralis-inoculated mice (P < 10-6), 32/95 S. intermedius-inoculated mice (P < 10-6), and 75/104 mice inoculated with M. oralis mixed with S. intermedius (P < 10-6) 7 days post-inoculation.
  
  
  
  Methanogens belong to the anaerobic community responsible for brain abscess, and M. oralis may participate in the pathogenicity of this deadly infection. In mice, a synergy of M. oralis and S. intermedius was observed. Antibiotic treatment of brain abscess should contain anti-archaeal compounds such as imidazole derivatives in most cases.
authors.affiliation: Unité de recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM63 CNRS 7278, IRD198, Inserm U1095.
authors.forename: Michel
authors.initials: M
authors.lastname: Drancourt
authors.affiliation: Unité de recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM63 CNRS 7278, IRD198, Inserm U1095.
authors.forename: Vanessa Demonfort
authors.initials: VD
authors.lastname: Nkamga
authors.affiliation: Unité de recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM63 CNRS 7278, IRD198, Inserm U1095.
authors.forename: Ndèye Aïssatou
authors.initials: NA
authors.lastname: Lakhe
authors.affiliation: Department of Stereotaxic and Functional Neurosurgery, Gamma-knife Unit, Inserm U751, Aix-Marseille University, APHM, Marseille, France.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Régis
authors.affiliation: Neurosurgery Department, Assistance Publique-Hôpitaux de Marseille, Faculté de Médecine, Aix-Marseille Université, Marseille, France.
authors.forename: Henry
authors.initials: H
authors.lastname: Dufour
authors.affiliation: Unité de recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM63 CNRS 7278, IRD198, Inserm U1095.
authors.forename: Pierre-Edouard
authors.initials: PE
authors.lastname: Fournier
authors.affiliation: Unité de recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM63 CNRS 7278, IRD198, Inserm U1095.
authors.forename: Yassina
authors.initials: Y
authors.lastname: Bechah
authors.affiliation: University of Virginia, Department of Medicine, Division of Infectious Diseases and International Health, Charlottesville.
authors.forename: W Michael
authors.initials: WM
authors.lastname: Scheld
authors.affiliation: Unité de recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM63 CNRS 7278, IRD198, Inserm U1095.
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001922:Brain Abscess / Q000382:microbiology* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D019641:DNA, Archaeal / Q000235:genetics; D004269:DNA, Bacterial / Q000235:genetics; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D041581:Methanobrevibacter / Q000235:genetics*; D051379:Mice; D008875:Middle Aged; D045202:Porphyromonas endodontalis / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies; D034367:Streptococcus intermedius / Q000235:genetics; D055815:Young Adult
chemical_list: D019641:DNA, Archaeal; D004269:DNA, Bacterial
keywords: Methanobrevibacter oralis; brain abscess; culture; methanogen; microbiology