A case of infection by Bifidobacterium breve detected in urine and ascites samples

Abstract

We report an adult case of infection by Bifidobacterium breve. A male in his 40s was admitted to our hospital because of general fatigue with frequent vomiting. He was observed to have an inflammatory response (WBC, 13,600 μ/L; CRP, 29.4 mg/dL) on admission and we speculated that this was due to continuing malnutrition or wasting condition because of low levels of albumin, cholinesterase, and triglyceride. In addition, he was observed to have remarkable electrolyte abnormality (Na, 113 mEq/L; K, 6.1 mEq/L; Cl, 67 mEq/L) and a high level of glucose at 1,203 mg/dL. He presented with purulent urine and turbid ascites, and thus a microbiological test was carried out on both urine and ascites samples. Both samples showed branched Gram-positive rods and the strain that grew was found only in anaerobic culture. The identity of the strain was not revealed by biological methods. The strain was identified as Bifidobacterium breve by mass analysis and 16s rRNA gene sequencing. Urine tests on admission showed leukocytes of more than 100/HPF and a score of bacteria 2+. Therefore, urinary tract infection was suspected and SBT/ABPC 6 g/day was administered. Finally, the general condition of the patient improved daily and he was discharged without symptoms on hospital day 90.