Gordonia sputi -associated bloodstream infection in a renal transplant patient with chronic indwelling central venous catheter: a case report and literature review
Bibliographic record
Abstract
Introduction: Although rare, human infections caused by Gordonia spp. have been reported especially within the immunocompromised population and those with long-term indwelling devices. We report a case of Gordonia spp. bacteremia in a renal transplant patient and present a literature review on microbiologic identification methods of this organism. Case Presentation: A 62-year-old female renal transplant recipient admitted to hospital with a 2-month history of dry cough and fevers occurring weekly when receiving electrolyte replacement infusions via Groshong line. Over two weeks, blood cultures on multiple occasions repeatedly isolated a Gram-positive bacillus in aerobic bottle only, initially reported as Rhodococcus spp. by local microbiology laboratory. Chest computed tomography (CT) showed multiple ground-glass lung opacities suggestive of septic pulmonary emboli. As central line-associated blood stream infection was suspected, empiric antibiotics were initiated and the Groshong line was removed. The Gram-positive bacillus was later confirmed by reference laboratory as Gordonia sputi via 16S-rRNA sequencing. Vancomycin and ciprofloxacin for duration of six weeks was completed as targeted antimicrobial therapy. After treatment, she remained symptom-free with marked improvement on repeat CT chest imaging. Conclusion: This case illustrates the challenges surrounding identification of Gordonia spp. and other aerobic actinomycetes.16S-rRNA gene sequencing may be a preferred identification method, especially when initial workup of a weakly acid-fast organism fails to identify or shows discrepant results using traditional diagnostic modalities.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".