Acute cholangitis caused by coinfection with zoonotic pathogens of Gallibacterium anatis and Enterococcus cecorum: A case report

Abstract

Background: Gallibacterium anatis and Enterococcus cecorum are considered to be emerging infectious pathogens in poultry, particularly in the European Union. These bacteria are isolated on rare occasions from immunocompromised hosts and cause opportunistic infections associated with the ingestion of contaminated food. Here, we report the first case of G. anatis and E. cecorum coinfection in an immunocompetent host and clarify the genomic characteristics of these bacteria.

Case presentation: A 78-year-old Japanese man diagnosed with acute cholangitis as a result of a common bile duct stone was hospitalized in 2021. He was treated with endoscopic papillary large-balloon dilation and antibiotics. His blood culture was positive for G. anatis and E. cecorum. Whole-genome sequencing identified that our isolate of G. anatis belongs to a highly virulent biovar haemolytica strain and our isolate of E. cecorum had multidrug resistance genes, which have commonly been found in U.S. strains.

Conclusion: A common bile duct stone that impairs bile flow is a risk factor for G. anatis and E. cecorum infection in an immunocompetent host. This report indicates the need for further surveillance of G. anatis and E. cecorum in animals as well as for investigation of their pathogenesis in humans.

Keywords: Cholangitis; E. cecorum; G. anatis; WGS.