Abstract
Background:
Tissierella praeacuta (TP), previously known as Clostridium hastiforme, is a rare and potentially underreported pathogen. TP may cause a variety of infections, including the potential as an important pathogen of intra-abdominal infections (IAIs). Still little data on this anaerobic gram-positive rod are available.
Patients and Methods:
The institutional database was searched for TP infections during a 4-year period. Isolation and identification of the pathogen were done according to standard guidelines, including those for anaerobic culture.
Results:
A total of 21 patients, including 11 males and 10 females, with a median age of 63.8 (range 35.8–90) years with infections because of TP (24 isolates) were identified. There were eight IAIs, 12 soft tissue infections, and 1 pleural empyema; two patients had bacteremia. In 19 cases, microscopy was done revealing white blood cells in 79%, gram-positive cocci in 53%, gram-negative rods in 47%, and gram-positive rods in 32%. Final cultures grew TP monoculture in 38%; in 62%, TP was part of a mixed flora. Twenty-four co-pathogens were identified, including gram-positive cocci (13), gram-negative rods (9), and gram-positive rods (2). Treatment consisted of antibiotic agents, including beta-lactams, clindamycin, or metronidazole, and surgery or interventional drainage for the majority of cases. Outcomes were generally favorable with 19 of the 21 patients surviving.
Conclusions:
This is a first large series of infections because of the emerging pathogen TP from a rural area. TP mainly causes purulent infections requiring surgical intervention. The series emphasizes the importance of anaerobic cultures in surgical specimens.
Get full access to this article
View all access options for this article.