Acetobacter cibinongensis Bacteremia in Human

Acetobacter cibinongensis Bacteremia in Human To the Editor: The genus Acetobacter belongs to the group of acetic acid bacteria that oxidize alcohols or sugars incompletely, leading to the accumulation of acetic acid. Acetic acid bacteria are of great industrial interest because of their use to produce vinegar from spirits, wine, beer, and cider in temperate regions of Europe, the Americas, and Japan. Several species seem to be associated with tropical climates. In Southeast Asia, Acetobacter spp. have been found in fermented foods such as tea fungus beverage, palm vinegar, palm wine, nata de coco, and pickles (1). A. cibinongensis is mainly found in tropical fruits and fl owers (2). We describe a case of human infection with a member of the genus Acetobacter. The patient was an HIV-seronegative, 40-year-old man who for 1 year had been receiving chronic hemodialysis for end-stage renal failure. He had a history of intravenous drug use, and continued use was suspected. In February 2005, when admitted for a routine dialysis session, he had fever (38°C) and bronchitis and was receiving empiric treatment with amoxicillin (2 g/day). His respiratory status improved slightly, but fever persisted after 48 hours. On his right forearm, he had a large infl ammatory skin lesion that followed the course of an arteriovenous fi stula, suggestive of staphylococcal infection. Treatment was switched to pristinamycin (2 g/ day for 4 days). The patient's leukocyte count was within normal limits, but his C-reactive protein level was elevated (50 mg/L). Two blood samples were drawn, 1 through a subclavian catheter implanted in 2004 and the other through the arteriovenous fi stula. After 4 days, a gram-variable polymorphic rod, named nîmes373