Rhodococcus equi venous catheter infection: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p><it>Rhodococcus equi </it>is an animal pathogen that was initially isolated from horses and is being increasingly reported as a cause of infection in humans with impaired cellular immunity. However, this pathogen is underestimated as a challenging antagonist and is frequently considered to be a mere contaminant despite the potential for life-threatening infections. Most case reports have occurred in immunocompromised patients who have received organ transplants (for example kidney, heart, bone marrow) or those with human immunodeficiency virus infection. Infections often manifest as pulmonary involvement or soft tissue abscesses. Bacteremia related to <it>R. equi </it>infections of tunneled central venous catheters has rarely been described.</p> <p>Case presentation</p> <p>We report the case of a 63-year-old non-transplant recipient, non-HIV infected Caucasian woman with endometrial carcinoma who developed recurrent bloodstream infections and septic shock due to <it>R. equi </it>and ultimately required the removal of her port catheter, a subcutaneous implantable central venous catheter. We also review the medical literature related to human infections with <it>R. equi</it>.</p> <p>Conclusion</p> <p><it>R. equi </it>should be considered a serious pathogen, not a contaminant, particularly in an immunocompromised patient who presents with a central venous catheter-related bloodstream infection. Counseling patients with central venous catheters who participate in activities involving exposure to domesticated animals is recommended.</p

Immunogenicity of an Electron Beam Inactivated <i>Rhodococcus equi</i> Vaccine in Neonatal Foals

<div><p><i>Rhodococcus equi</i> is an important pathogen of foals that causes severe pneumonia. To date, there is no licensed vaccine effective against <i>R. equi</i> pneumonia of foals. The objectives of our study were to develop an electron beam (eBeam) inactivated vaccine against <i>R. equi</i> and evaluate its immunogenicity. A dose of eBeam irradiation that inactivated replication of <i>R. equi</i> while maintaining outer cell wall integrity was identified. Enteral administration of eBeam inactivated <i>R. equi</i> increased interferon-γ production by peripheral blood mononuclear cells in response to stimulation with virulent <i>R. equi</i> and generated naso-pharyngeal <i>R. equi</i>-specific IgA in newborn foals. Our results indicate that eBeam irradiated <i>R. equi</i> administered enterally produce cell-mediated and upper respiratory mucosal immune responses, in the face of passively transferred maternal antibodies, similar to those produced in response to enteral administration of live organisms (a strategy which previously has been documented to protect foals against intrabronchial infection with virulent <i>R. equi</i>). No evidence of adverse effects was noted among vaccinated foals.</p></div