Clinical Microbiology and Infection 24 (2018) 856e857

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Clinical Microbiology and Infection

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Picture of a Microorganism

Acinetobacter ursingii masquerading as Gram-positive cocci

Ka Lip Chew*, Kean Lee Chew
Department of Laboratory Medicine, National University Hospital, Singapore

a r t i c l e i n f o

Article history:
Received 10 April 2018
Received in revised form A 47-year-old woman with acute myeloid leukaemia was
16 April 2018 admitted electively for chemotherapy. Post-chemotherapy, she
Accepted 17 April 2018
developed fever (38 C) and tachycardia, without localizing
Available online 24 April 2018
symptoms of infection. Blood cultures flagged positive; and
Editor: F. Allerberger Gram-positive cocci, mostly in pairs, were seen in a Gram-stained
smear from the aerobic blood culture bottle (Fig. 1). The Gram
Keywords: smear was repeated twice more with the same results. However,
Acinetobacter
the culture grew pure Acinetobacter ursingii, as identified by
Acinetobacter ursingii
Acute myeloid leukaemia Bruker MALDI Biotyper (Bruker Daltonics, Bremen, Germany). No
Bacteraemia Gram-positive bacteria were detected on the agar plates after
Gram stain 5 days of incubation. A repeated Gram smear from the original
Immunocompromised host
aerobic blood culture bottle revealed only Gram-negative coc-
cobacilli (Fig. 2). Acinetobacter spp. may retain the Crystal violet

Fig. 1. Initial Gram stain appearing as Gram-positive cocci.

* Corresponding author. K.L. Chew, Department of Laboratory Medicine, National University Hospital, 5, Lower Kent Ridge Road, 119074, Singapore.
E-mail address: ka_lip_chew@nuhs.edu.sg (K.L. Chew).

https://doi.org/10.1016/j.cmi.2018.04.016
1198-743X/© 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
 K.L. Chew, K.L. Chew / Clinical Microbiology and Infection 24 (2018) 856e857 857

Fig. 2. Repeated Gram stain revealing only Gram-negative coccobacilli.

stain and appear as a Gram-positive organism. Although this is Transparency declaration

uncommon, patients with serious infections may not receive
appropriate therapy in such cases if antibiotics are narrowed The authors have no conflicts of interest to declare.
down based on the Gram stain alone. The patient was treated
with meropenem when the initial Gram stain was reported and Funding
the discrepant result did not have an impact on her antibiotic
regimen or clinical care. No external funding was received.