Isolation of Schineria sp. from a Man

lated from the 1st and 2nd larval stages of Wohlfahrtia magnifica Marialigeti K. Bacteria isolated from the different developmental stages and larval organs of the obligate parasitic fly, Wohlfahrtia magnifica Analysis of the bacterial community inhabiting an aero-bic thermophilic sequencing batch reactor (AT-SBR) treating swine waste. To the Editor: Schineria larvae has been isolated from maggots of the fly Wohlfahrtia magnifica (1), which cause myiasis in animals and people in Eurasia and northern Africa. In industrialized nontropical countries, a range of species in the order Diptera cause facultative myiasis in patients with neglected wounds (2). Since the recent description of S. larvae, Schineria sp. isolates and clones have been detected in diverse environmental and animal sources, but in all cases a relation with flies could be established. We describe a case of bac-teremia due to Schineria sp. in a human patient with myiasis. In July 2005, a 39-year-old homeless man with medical history of polyneuropathy related to alcohol abuse was examined at Montpellier Hospital, Montpellier, France, and found to be in poor general health and to have an abnormal electrocardio-gram, mild fever (38°C), metabolic disorders, increased C-reactive protein (254 mg/L) and fibrinogen (18.23 µmol/L), and a normal leukocyte count (7.8 × 10 9 /L). Removal of his shoes and socks, which he had worn continuously for 2 months, showed advanced maceration of his feet (trench foot) with wounds invaded by maggots. The following organisms were found in wound samples: Proteus mirabilis, Providentia stuartii, group G Streptococcus, Streptococcus sp., and Enterococcus sp. Aerobic blood culture, after 2 days of incubation , was positive for a gram-negative rod, strain ADV1107. 05. Subculture on MacConkey medium showed positive reactions for oxidase, catalase, and gamma-glutamyltransferase. Positive malate reaction with API 20NE system (bioMérieux, Marcy l'Etoile, France) identified the strain as Oligella urethralis, whereas VITEK2 (bioMérieux) with ID-GN card failed to identify the strain. Disk diffusion assay showed the strain to be susceptible to β-lactams, amino-glycosides, fluoroquinolones, tetracy-clines, erythromycin, rifampin, and colistin but resistant to nalidixic acid and fosfomycin. Local therapy of debridement, bandaging, and sulfadi-azin argentic, along with systemic antimicrobial therapy (ofloxacin 400 mg/day plus cefotaxime 6 g/day) for 2 weeks, led to clinical improvement and sterilization of the blood cultures. The local therapy was continued, and ofloxacin (400 mg/day) was prescribed for 15 days while the patient was in a rehabilitation center. In October 2005, the patient was readmitted with the same symptoms. …