Tetracycline resistance determinants in Mycobacterium and Streptomyces species.

Two of seven tetracycline-resistant (Tcr) Mycobacterium fortuitum group isolates and six Tcr clinical Streptomyces
isolates carried gram-positive Tcr determinants (Tet K and Tet L) and Streptomyces resistance determinants (Otr A,
Otr B, and Otr C). This represents the first documentation of the acquisition by mycobacteria of determinants coding
for antibiotic resistance and suggests the potential for the spread of antibiotic resistance determinants within
mycobacterial species.
Antimicrob Agents Chemother. 1994 June; 38(6): 1408–1412.

Streptomyces thermovulgaris bacteremia in Crohn's disease patient.(Letters)(Letter to the Editor)

To the Editor: Invasive infections with Streptomyces spp. are rare; in reference to two cases reported in Emerging
Infectious Diseases (1,2), we describe here the first documented case of bacteremia with Streptomyces
thermovulgaris. An 81-year-old woman was admitted to the emergency room of Diakonessenhuis, Utrecht, the
Netherlands, with severe abdominal pain in the right lower quadrant and feculent vomitus. The patient had a history of
Crohn's disease, for which she had undergone resection of the ileum and cecum, and was receiving high-dose
corticosteroid therapy (prednisone 25 mg daily). The patient also had steroid-induced osteoporosis and an internal
pacemaker. On admission, the patient had a temperature of 35.6[degrees]C, a leukocyte count of 8.4 x [10.sup.9]/L
with 30% bandforms, and a C-reactive protein level of 18 mg/L. Moreover, the patient had severe metabolic acidosis
and was hemodynamically unstable, suggesting septic shock subsequent to a presumed bowel perforation.

Streptomyces Pneumonia in a Patient with Human Immunodeficiency Virus Infection: Case Report and
Review of the Literature on Invasive Streptomyces Infections

Streptomyces species are most widely known for their production of antimicrobial substances and, apart from
mycetoma, have rarely been reported as a cause of infection. We describe a patient with early human
immunodeficiency virus infection who presented with fever, cough, and nodular pulmonary infiltrates. Open lung
biopsy revealed necrotic tissue and a sulfur granule; aerobic bacterial cultures yielded Streptomyces species. The
patient was treated successfully with clarithromycin for 6 months. We review the clinical presentation and treatment of
invasive streptomyces infections.

Clinical Infectious Diseases 1998;27:93–6

Catheter-Related Bacteremia due to Streptomyces in a Patient Receiving Holistic Infusions

Streptomyces species are rare causes of invasive infection in humans. We report the first documented case of a
catheter-associated bacteremia due to Streptomyces. The most likely source of infection was unlicensed, injectable
holistic preparations that the patient had received. We review reported cases of invasive infections caused by
Streptomyces and comment on the potential infectious complications of parenteral holistic treatments.

Emerg Infect Dis 7(6), 2001. © 2001 Centers for Disease Control and Prevention (CDC)