Recurrent joint infection caused by a multidrug-resistant capnophilic Escherichia coli ST131 O25H4 strain
Eileen Katherine Nenninger,
Sara Geffert,
Swapna Charla,
Charissa Chou,
Ece Dilber Gamsiz Uzun,
Deborah Sawyer,
Rozeen Badeel,
Tiffany Chargualaf,
Nouf K. Almaghlouth,
Tao Hong
Affiliations
Eileen Katherine Nenninger
Brown Medicine Division of Infectious Diseases, Rhode Island Hospital, Providence, RI 02903, USA
Sara Geffert
Brown Medicine Division of Infectious Diseases, Rhode Island Hospital, Providence, RI 02903, USA; Microbiology Laboratory, Rhode Island Hospital, Providence, RI 02903, USA; Department of Pathology and Laboratory Medicine, Rhode Island Hospital, Providence, RI 02903, USA; Department of Pathology and Laboratory Medicine, Brown University Alpert Medical School, Providence, RI 02903, USA
Swapna Charla
Microbiology Laboratory, Rhode Island Hospital, Providence, RI 02903, USA; Department of Pathology and Laboratory Medicine, Rhode Island Hospital, Providence, RI 02903, USA
Charissa Chou
Department of Pathology and Laboratory Medicine, Rhode Island Hospital, Providence, RI 02903, USA
Ece Dilber Gamsiz Uzun
Department of Pathology and Laboratory Medicine, Rhode Island Hospital, Providence, RI 02903, USA; Department of Pathology and Laboratory Medicine, Brown University Alpert Medical School, Providence, RI 02903, USA; Center for Computational Molecular Biology, Brown University, Providence, RI 02906, USA
Deborah Sawyer
Microbiology Laboratory, Rhode Island Hospital, Providence, RI 02903, USA
Rozeen Badeel
Microbiology Laboratory, Rhode Island Hospital, Providence, RI 02903, USA; Department of Pathology and Laboratory Medicine, Rhode Island Hospital, Providence, RI 02903, USA
Tiffany Chargualaf
Microbiology Laboratory, Rhode Island Hospital, Providence, RI 02903, USA
Nouf K. Almaghlouth
Brown Medicine Division of Infectious Diseases, Rhode Island Hospital, Providence, RI 02903, USA
Tao Hong
Microbiology Laboratory, Rhode Island Hospital, Providence, RI 02903, USA; Department of Pathology and Laboratory Medicine, Rhode Island Hospital, Providence, RI 02903, USA; Department of Pathology and Laboratory Medicine, Brown University Alpert Medical School, Providence, RI 02903, USA; Correspondence to: 593 Eddy Street, Providence, RI 02903, USA.
We report a case of a native knee septic arthritis and subsequent osteomyelitis due to a CO2-dependent (capnophilic) multidrug-resistant E. coli ST131 O25:H4 strain. Capnophilic phenotype made microbiology investigation challenging; susceptibility testing could not be performed and the organism did not grow in the urine culture using standard method. The combination of unique virotype and capnophilia may have contributed to the aggressiveness of this organism and the initial unsuccessful carbapenem course, leading to recurrent infection.
