ROLE OF GRAM-NEGATIVE ANAEROBIC COCCI BELONGING TO THE GENUS VEILLONELLA IN INFECTIOUS COMPLICATIONS IN CANCER PATIENTS

We studied capabilities of the Bruker Microflex MALDI-TOF device for species identification of anaerobic gramnegative cocci isolated from clinical specimens of cancer patients. Seventy clinical isolates of Veillonella spp. and one Acidaminococcus spp were analyzed. All isolates were identified to the species level with a scores greater than 1.9. The most common species were V. parvula (37 strains), followed by V. dispar (16), V. atypical (16) and V. denticariosi (1). Susceptibilities of the isolates were determined by the E-test methodology. All Veillonella isolates were susceptible to imipenem, whereas high resistance rates were observed for penicillin G, amoxicillin/clavulanate and metronidazole. The proportion of resistant isolates of V. parvula, V. dispar and V. atypica to penicillin was 86 %, 85 % and 100 %, respectively. The resistance to amoxicillin/clavulanate was observed in 28.6 % of V. parvula isolates, 23.1 % of V. dispar isolates and in 6.7 % of V. atypica isolates. Resistance to metronidazole (MIC ≥ 8 µg/ml) of V. parvula, V. dispar and V. atypica was 88.6 %, 53.8 % and 40 %, respectively.

Veillonella clinical Isolates, anaerobic Infections, MALDI-TOF MS, antimicrobial susceptibility, cancer patients

1. Finegold S.M., George W.L. Anaerobic infections in humans. Academic Press, New York, 1989.

2. Davydov М.I., Dmitrieva N.V. Infections in cancer patients. Мoscow: Practical Medicine, 2009. 55–86. [in Russian]

3. Grigorievskaya Z.V. Treatment strategy for nosocomial infections caused by antibiotic-resistant pathogens in cancer patients [Doctoral thesis]. [Moscow]; 2015. 252. [in Russian]

4. Fisher R.G., Denison M.R. Veillonella parvula bacteremia without underlying source. J Clin Microbiol. 1996 Dec; 34 (12): 3235–6.

5. Liu J.W., Wu J.J., Wang L.R., Teng L.J., Huang T.C. Two fatal cases of Veillonella bacteremia. Eur J Clin Microbiol Infect Dis. 1998 Jan; 17 (1): 62–4.

6. Strach M., Siedlar M., Kowalczyk D., Zembala M., Grodzicki T. Sepsis caused by Veillonella parvula infection in a 17-yearold patient with X-linked agammaglobulinemia (Bruton’s disease). J Clin Microbiol. 2006 Jul; 44 (7): 2655–6.

7. Boo T.W., Cryan B., O’Donnell A., Fahy G. Prosthetic valve endocarditis caused Veillonella parvula. J Infect. 2005 Jan; 50 (1): 81–3.

8. Marriott D., Stark D., Harkness J. Veillonella parvula discitis and secondary bacteremia: a rare infection complicating endoscopy and colonoscopy? J Clin Microbiol. 2007 Feb; 45 (2): 672–4.

9. Bhatti M.A., Frank M.O. Veillonella parvula meningitis: case report and review of Veillonella infections. Clin Infect Dis. 2000 Sep; 31 (3): 839–40.

10. Shah A., Panjabi C., Nair V., Chaudhry R., Thukral S.S. Veillonella as a cause of chronic anaerobic pneumonitis. Int J Infect Dis. 2008 Nov; (6): e115–7. doi: 10.1016/j.ijid.2008.03.018.

11. Marchandin H., Teyssier C., de Buochberg M. S., Jean-Pierre H., Carriere C., Jumas-Bilak E. Intra-chromosomal heterogeneity between the four 16S rRNA gene copies in the genus Veillonella: implications for phylogeny and taxonomy. Microbiology. 2003, 149: 1493–1501.

12. Mashima I., Nakazawa F. Identification of Veillonella to be tsuensis in tongue biofilm by using a species-specific primer pair. Anaerobe. 2013 Aug; 22: 77–81. doi: 10.1016/j.anaerobe.2013.04.015

13. Kostrzewa M. MALDI-TOF mass spectrometry in microbiology. Caister Academic Press, 2016. 200.

14. Justesen U.S., Holm A., Knudsen E., Andersen L.B., Jensen T.G., Kemp M., Skov M.N., Gahrn-Hansen B., Møller J.K. Species identification of clinical isolates of anaerobic bacteria: a comparison of two matrix assisted laser desorption ionization-time of flight mass spectrometry systems. J Clin Microbiol. 2011 Dec; 49 (12): 4314–8. doi: 10.1128/JCM.05788-11.

15. Fournier R., Wallet F., Grandbastien B., Dubreuil L., Courcol R., Neut C., Dessein R. Chemical extraction versus direct smear for MALDITOF mass spectrometryidentification of anaerobic bacteria. Anaerobe. 2012, 18: 294–297. doi: 10.1016/j.anaerobe.2012.03.008.

16. Barreau M., Pagnier I., La Scola B. Improving the identification of anaerobes in the clinical microbiology laboratory through MALDITOF mass spectrometry. Anaerobe. 2013 Aug; 22: 123–5. doi: 10.1016/j.anaerobe.2013.04.011.

17. Fedorko D.P., Drake S.K., Stock F., Murray P.R. Identification of clinical isolates of anaerobic bacteria using matrix-assisted laser desorption ionization-time of flight mass spectrometry. Eur J Clin Microbiol Infect Dis. 2012 Sep; 31 (9): 2257–62. doi: 10.1007/s10096-012-1563-4.

18. Schmitt B.H., Cunningham S.A., Dailey A.L., Gustafson D.R., Patel R. Identification of anaerobic bacteria by Bruker Biotyper matrixassisted laser desorption ionizationtime of flight mass spectrometry with on-plate formic acid preparation. J Clin Microbiol. 2013 Mar; 51 (3): 782–6. doi: 10.1128/JCM.02420-12.

19. Veloo A.C., Elgersma P.E., Friedrich A.W., Nagy E., van Winkelhoff A.J. The influence of incubation time, sample preparation and exposure to oxygen on the quality of theMALDI-TOF MS spectrum of anaerobic bacteria. Clin Microbiol Infect. 2014 Dec; 20 (12): O1091–7. doi: 10.1111/1469-0691.12644.

20. Bergey’s Manual of Systematic Bacteriology. Vol. 1. Moscow, 1997. 432. [in Russian]

21. Brook I. Veillonella infections in children. J Clin Microbiol. 1996 May; 34 (5): 1283–5.

22. Reig M., Mir N., Baquero F. Penicillin resistancein Veillonella. Antimicrob Agents Chemother. 1997 May; 41 (5): 1210.

23. Nyfors S., Könönen E., Bryk A., Syrjänen R., Jousimies-Somer H. Age-related frequency of penicillin resistance of oral Veillonella. Diagn Microbiol Infect Dis. 2003 Aug; 46 (4): 279–83.

24. Ready D., Bedi R., Mullany P., Wilson M. Penicillin and amoxicillin resistance in oral Veillonella spp. Int J Antimicrob Agents. 2012 Aug; 40 (2): 188–9. doi: 10.1016/j.ijantimicag.2012.04.007.