Isolation of Bordetella Species from Unusual Infection Sites

Abstract

Introduction: Bordetella hinzii has been isolated mainly from respiratory specimens and fromblood of immunocompromised patients, and Bordetella trematum from ear infections or leg, armand ankle wounds and from diabetic foot ulcers. Bordetella holmesii is instead associated withbactaeremia in young adults, mostly with underlying conditions. Only three septic arthritis casesdue to this species have been described in the literature.Case presentation: Herein we describe four cases of infections due to Bordetella species thathave been recovered from unusual infection sites: two cases of B. hinzii infections, one recoveredfrom the urine of a patient with chronic prostatitis and the other from a liver cyst in animmunocompetent patient; one B. trematum case from a bone biopsy of a patient with chronicosteomyelitis of the hip; and one B. holmesii case isolated from the joint fluid of animmunocompetent patient with diagnosed septic arthritis.The organisms were identified usingstandard biochemical tests, by API 20 NE version 6.0, by automated system VITEK 2, by massspectrometry using the Bruker Daltonics MicroFlex LT spectrometer with MALDI Biotyper 3.1,and by PCR amplification of 16S rRNA.Antibiotic susceptibility testing was performed using the VITEK 2 system, except for B. holmesii,for which the epsilometric method (Etest technique; bioMe´rieux) was used.Conclusion: We highlight the importance of isolating Bordetella species from severe infectionsand unusual sites, and also of combining both phenotypic and genotypic methods for definitiveidentification.