Angiostrongylus cantonensis: An optimized cultivation of this parasitic nematode under laboratory conditions
Whether C. hongkongensis belongs to the intestinal fl ora, as do Bifi dobacterium, Eggerthella, Eubacterium, and Lactobacillus spp., remains undetermined. Codony et al. recently investigated by real-time PCR the presence of Catabacteriaceae in 29 water samples in the vicinity of Barcelona, Spain. Four samples were positive, demonstrating presence of this organism in the European environment and its probable enteric origin (4). Because our patient sought treatment with severe infection associated with isolation of other pathogenic bacteria, whether blood infection by C. hongkongensis may be responsible for such a fatal outcome is unknown. Nevertheless, we can exclude sample contamination by this anaerobic bacteria for the 2 following reasons. First, anaerobic contaminants are rare in blood cultures and generally involve Propionibacterium acnes. Furthermore, the rapid growth of the present isolate in blood cultures within 3 days suggested a relatively high bacterial load in the blood sample. Our report confi rms that C. hongkongensis can be found in blood culture associated with gastrointestinal disease and may refl ect intestinal perforation. Identifi cation may be diffi cult. Isolation of motile gram-positive anaerobic bacillus together with catalase positivity should lead to suspicion of C. hongkongensis in clinical laboratories. Full identifi cation of this pathogen requires 16S sequencing. Environmental reports have demonstrated the presence of this organism in human wastewater in Europe, which suggests that it may be universally present as part of the normal human gastrointestinal fl ora.