Abstract
Wohlfahrtiimonas chitiniclastica are bacteria that cause rare infections, typically associated with the infestation of an open wound with fly larvae. Here, we present a unique case report of the first W. chitiniclastica isolation from a burn wound with accidental myiasis in a 63-year-old homeless man and a literature review focused on human infections caused by these bacteria. So far, 23 cases of infection with W. chitiniclastica have been reported; in 52% of these, larvae were found in the wound area. Most of these cases suffered from chronic non-healing wound infections but none of these were burn injuries. The overall fatality rate associated directly with W. chitiniclastica in these cases was 17%. Infections with parasitic larvae occur in moderate climates (especially in people living in poor conditions); therefore, an infection with rare bacteria associated with accidental myiasis, such as W. chitiniclastica, can be expected to become more common there. Thus, in view of the absence of recommendations regarding the treatment of patients with accidental myiasis and, therefore, the risk of infection with W. chitiniclastica or other rare pathogens, we provide a list of recommendations for the treatment of such patients. The importance of meticulous microbial surveillance using molecular biological methods to facilitate the detection of rare pathogens is emphasized.
Highlights
Wohlfahrtiimonas chitiniclastica was first described in 2008 by Tóth et al [1]
The presence of W. chitiniclastica was associated with fly larvaewith infestation in open wounds; an infection with this bacterium is very rare in wounds; an infection with this bacterium is very rare in humans [2].humans
The overall fatality rate reported in previous studies was 26%; death clearly associated with W. chitiniclastica infection was reported only in 17% of patients
Summary
Wohlfahrtiimonas chitiniclastica was first described in 2008 by Tóth et al [1]. These bacteria are strictly aerobic gram-negative, straight short rods (1.5–2.0 × 0.5–1.0 μm) that are non-motile, non-spore-forming, which grow at pH 5.0–10.5 and temperatures of 28–37 ◦ C, and are capable of causing both local skin/soft tissues infections (SSTIs) and sepsis. There is no report about a W. chitiniclastica infection in a wound [3]. W. chitiniclastica a burn from a wound with accidental myiasis Europe) an wound with accidental myiasis (interestingly in a patient from Central Europe) and reviews views available information on chitiniclastica-caused infections in humans. The wound showed signs of accidental myiasis, redness, and edema unattended. 2. Wound bed preparation with granulation tissue (a,b),ofthe process of split-thickness skin graft transplantation (c). Staphylococcus inaaacid single spot; the systemic therapy with amoxicillin and clavulanic acid continued for days. All skin defects were completely healed, and the patient was discharged spot; the systemic therapy with amoxicillin and clavulanic acid continued for 8 to ou.
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