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      Methicillin-Resistant Staphylococcus schleiferi Subspecies coagulans Infection in a Patient With Hepatocellular Carcinoma

      case-report

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          Abstract

          To our knowledge and literature search, Staphylococcus schleiferi subspecies coagulans infection in human beings has rarely been described in the medical literature. Furthermore, we believe that this is a first detailed case report of methicillin-resistant Staphylococcus schleiferi subspecies coagulans infection in a patient with hepatocellular carcinoma. Because of the possible association of Staphylococcus schleiferi infection and immunosuppression, any isolates of this bacterium in human beings should be presumed to be pathogenic, unless proven otherwise.

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          Staphylococcus schleiferi subsp. coagulans subsp. nov., isolated from the external auditory meatus of dogs with external ear otitis.

          T Mitsuoka, E. Takahashi, S Igimi (1990)
          A new subspecies, Staphylococcus schleiferi subsp. coagulans, was isolated from the external auditory meatus of dogs suffering from external ear otitis and is described on the basis of studies of 21 strains. Phenotypic studies showed that these strains are more closely related to Staphylococcus intermedius than to other staphylococci, but DNA hybridization studies indicated that they are closely related to Staphylococcus schleiferi N850274T. On the basis of biochemical distinctiveness (positive test tube coagulase test and different carbohydrate reactions) and the etiological importance (frequent isolation from otitis specimens from dogs) of these strains, we propose to classify them as a subspecies of S. schleiferi. The strains of this new subspecies are coagulase tube test, beta-hemolysin, and heat-stable nuclease positive but clumping factor negative. A simple scheme for the differentiation of S. schleiferi subsp. coagulans from the other coagulase-positive staphylococci is presented. The type strain is GA211 (= JCM 7470).
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            Case of Staphylococcus schleiferi subspecies coagulans endocarditis and metastatic infection in an immune compromised host.

            S. Alvarez, Kristopher Irizarry, Peter J Cawley … (2007)
            Staphylococcus schleiferi subspecies coagulans is a relatively recently described organism with limited human pathogenicity. Described case reports of infection are primarily limited to canine external otitis with only one reported case of human involvement, localized to a surgical wound infection. Similarities in phenotypic and microbiological characteristics between S. schleiferi subsp. coagulans and S. aureus have resulted in frequent mistakes using common methods of identification. We describe the first case of disseminated human infection with this species, definitively identified using DNA sequencing, and successfully treated with conventional therapy.
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              Clotting activity in Staphylococcus schleiferi subspecies from human patients.

              F. Vandenesch, T Greenland, Y Benito … (1994)
              Staphylococcus schleiferi subsp. schleiferi is a coagulase-negative staphylococcus, usually present as a contaminant in human specimens. A near relative, S. schleiferi subsp. coagulans, possesses coagulase activity but has not been reported from humans. We here describe three isolates of pseudocoagulase-positive S. schleiferi subsp. schleiferi and one isolate of S. schleiferi subsp. coagulans from human patients. The pseudocoagulase from the S. schleiferi subsp. schleiferi isolates differs from S. aureus staphylocoagulase by being sensitive to a combination of protease inhibitors (aprotinin, N-ethylmaleimide, and heparin). These isolates could all easily be confused with S. aureus in a typical clinical laboratory, since they all possess a heat-stable DNase and promote clotting formation. Moreover, S. schleiferi subsp. coagulans produces protein A, and S. schleiferi subsp. schleiferi expresses a clumping factor (fibrinogen affinity factor). Southern blot hybridization with an S. aureus coa-specific probe revealed no sequence related to the coa gene in any of the S. schleiferi isolates, and their riboprobe profiles and biochemical characteristics were typical of S. schleiferi subspecies, not of S. aureus. This study demonstrates that both subspecies of S. schleiferi can promote clotting of rabbit plasma in the standard tube test for coagulase.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Investig Med High Impact Case Rep
                Journal ID (iso-abbrev): J Investig Med High Impact Case Rep
                Journal ID (publisher-id): HIC
                Journal ID (hwp): sphic
                Title: Journal of Investigative Medicine High Impact Case Reports
                Publisher: SAGE Publications (Sage CA: Los Angeles, CA )
                ISSN (Electronic): 2324-7096
                Publication date (Electronic): 26 September 2016
                Publication date Collection: Jul-Sep 2016
                Volume: 4
                Issue: 3
                Electronic Location Identifier: 2324709616671148
                Affiliations
                [1 ]Department of Internal Medicine, Interfaith Medical Center, New York, NY, USA
                [2 ]Department of Microbiology and Pathology, Interfaith Medical Center, New York, NY, USA
                [3 ]Division of Oncology, Interfaith Medical Center, New York, NY, USA
                Author notes
                [*]Thein Swe, Department of Internal Medicine, Interfaith Medical Center, 1545 Atlantic Ave, New York, NY 11213, USA. Email: mglay2004@ 123456gmail.com
                Article
                Publisher ID: 10.1177_2324709616671148
                DOI: 10.1177/2324709616671148
                PMC ID: 5040195
                SO-VID: 7ef1ae9c-d870-42b2-bbb0-8982348db096
                Copyright © © 2016 American Federation for Medical Research
                License:

                This article is distributed under the terms of the Creative Commons Attribution 3.0 License ( http://www.creativecommons.org/licenses/by/3.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Date received : 16 August 2016
                Date revision received : 3 September 2016
                Date accepted : 4 September 2016
                Categories
                Subject: Case Report
                Custom metadata
                cover-date July-September 2016

                Keywords: hepatocellular carcinoma,staphylococcus schleiferi subspecies coagulans,methicillin resistant
                Data availability:
                Keywords: hepatocellular carcinoma, staphylococcus schleiferi subspecies coagulans, methicillin resistant

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