CASE REPORT For reprint orders, please contact: [email protected]
Wohlfahrtiimonas chitiniclastica-associated osteomyelitis: a rare case report Karthika Suryalatha1, Joby John2 & Sabu Thomas*,1
ABSTRACT Wohlfahrtiimonas chitiniclastica is a rare pathogen that was first isolated from a parasitic fly, Wohlfahrtia magnifica. It is a very rare but an emerging human pathogen reported only in Europe and South America. Recently, it is reported to be an egressing zoonotic pathogen from different geographical locations. The present case represents the first report of this pathogen from a patient suffering from osteomyelitis from India and so far no reports are available regarding the W. chitiniclastica associated infections in Asian countries. Clinical awareness of such emerging human pathogens is crucial for the infectious disease containment. Wohlfahrtiimonas chitiniclastica is a rare pathogenic bacterium belonging to the class of Gammaproteobacteria. There are currently only three reports for W. chitiniclastica causing human infections. Septicemia was reported in two patients with very poor sanitation conditions and multiple skin lesions. The first case was reported from a 60-year-old homeless woman with widespread excoriations in southeastern France in 2009 [1] . The second case was a fulminant sepsis reported from a 70-year-old homeless male patient in South America in 2011 [2] . He developed septic shock and died after 5 days from the date of admission to the hospital. They were diagnosed and the causative agent for the infections was found to be W. chitiniclastica. Another case of W. chitiniclastica in soft tissue and bone infection was reported from Estonia, northern Europe [3] . Recently W. chitiniclastica was reported to be zoonotic, which induced bacterial septicemia secondary to wound myiasis in a deer [4] , endocarditis in a dolphin [5] and sepsis in an aquatic fish Pangasius sutchi [6] . Osteomyelitis in humans is commonly associated with Staphylococcus aureus, Group B Streptococci, Pseudomonas aeruginosa and Escherichia coli [7] . Here we present a rare case of W. chitiniclastica associated with osteomyelitis reported from a tertiary care hospital in Kerala, India.
KEYWORDS
• 16S rRNA sequencing • emerging
human pathogen • gammaproteobacterium • osteomyelitis • Wohlfahrtiimonas chitiniclastica
Case presentation A 43-year-old male with diabetes suffering from a deep ulcer with cellulitis progressed to osteomyelitis at plantar aspect of right lower limb was admitted to the Department of Surgery at Govt. Medical College Hospital (Trivandrum, Kerala, India). He is a manual laborer with a history of alcoholism and smoking. He has thickened skin over right lower limb with nonpitting edema for the past 6 years. Later, he developed an ulcer at the plantar aspect of right limb 1 year ago. The ulcer progressed, and the fourth and fifth toes were amputated. He was brought under diabetic control and put on oral antibiotic treatment from a local hospital. Then gangrenous changes developed on the third toe at the right limb over the past 6 months.
Cholera & Biofilm Research Laboratory, Rajiv Gandhi Centre for Biotechnology, Trivandrum 695 014, Kerala, India Department of Surgery, Government Medical College Hospital, Trivandrum 695 011, Kerala, India *Author for correspondence: Tel.: +91 471 252 9521; Fax: +91 471 234 9303; [email protected] 1 2
10.2217/FMB.15.44 © 2015 Future Medicine Ltd
Future Microbiol. (2015) 10(7), 1107–1109
part of
ISSN 1746-0913
1107
Case Report Suryalatha, John & Thomas Routine laboratory test results on admission were as follows: decreased hemoglobin level, 9.7 g/dl (reference range: 13.8–17.2 g/dl); higher levels of leukocyte count, 15,100 cells/μl (reference range: 4.5–11,000/μl); erythrocyte sedimentation rate, 120 mm/h (reference range: 0–19 mm/h); creatinine, 1.7 mg/dl (reference range: 0.5–1.0 mg/dl) and blood urea 50 mg/ dl (reference range: 5–18 mg/dl). Radiographs showed osteomyelitis at the base of the third proximal phalanx and head of the third metatarsal bone. Peripheral pulsations were present at the distal end. No specific interventions were done during nephrological consultation. As the limb was edematous, suspecting the possibility of filarial cellulitis, the patient was advised to take diethyl carbamazine. Amputation of the third toe was also performed. Swabs were obtained from the deep sites of ulcer at the plantar aspect of right foot where soft tissues are degraded and infected bones are exposed. The swab samples were transported in Amies transport medium and were directly plated onto 5% enriched sheep blood agar and MacConkey agar. Colony morphology of this Gram-negative, rod-shaped, nonhemolytic bacterium was entire, convex and smooth as described previously [2] . It was found to be catalase and oxidase positive, and viable at pH 5. Routine tests failed to identify the bacterium with accuracy. Susceptibility to antimicrobial agents was checked by Kirby-Bauer disc diffusion method on Muller Hinton agar [8] and the strain was found to be susceptible to pipera cillin, amoxyclav, imipenem, cefoxitine, ceftazidime, cefepime, ciprofloxacin, gentamycin and co-trimoxazole. The 16SrRNA gene of the test strain was amplified using previously described universal primers [9] . The amplified PCR product was sequenced using Applied BioSystems model 3100 automated DNA sequencing system. The similarity and homology of the 16S rRNA gene sequence was analyzed with the sequences available in the data bank of National Center for Biotechnology Information (NCBI) using BLAST search and was identified as W. chitiniclastica. The sequence identity was again confirmed with 98.89% similarity by using the web-based tool, Ez Taxon [10] . The strain was simultaneously analyzed by matrix-assisted laser desorption ionization–time of flight (MALDITOF) mass spectrometry (MS) and identified as W. chitiniclastica on the BioTyper system [11] .
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Future Microbiol. (2015) 10(7)
Treatment The patient was put on intravenous injection cefoperazone-sulbactam (1.5 g/12 h) and the treatment continued with daily wound dressing. After a week, the wound showed healing tendency and the patient was discharged on 200 mg Cefpodoxime every 12 h orally for 2 weeks with strict diabetic control. Discussion Wohlfahrtiimonas chitiniclastica is a nonfermenting Gram-negative, catalase and oxidase positive, rod-shaped bacterium. This was first isolated from third-stage larvae of the obligate parasitic fly Wohlfahrtia magnifica [12] , which is reported to cause wound myiasis in mammals especially in Europe, Russia and Africa. A rare case of ocular myiasis caused by W. magnifica was reported in a 1.5-year-old child in India [13] . This supports the upcoming prevalence of W. magnifica in India. Wohlfahrtiimonas chitiniclastica has also been successfully isolated from gut of Musca domestica (house flies) [14] . This shows the possible role of common house flies as a vector for this emerging pathogen. The complete genome of a nonclinical strain of W. chitiniclastica was sequenced [15] and the pathogenicity associated with this emerging pathogen has yet to be investigated. The patient lives in a moderate sanitary condition, but near a waste disposal zone and the mode of transmittance of the pathogen is yet to be studied. Conclusion In conclusion, we have reported a rare and emerging pathogen, W. chitiniclastica associated with osteomyelitis from a tertiary care hospital. The present study highlights the emergence of rare pathogens in severe infections and the importance of the proper pathology and polyphasic identification to detect such pathogens. Clinical awareness of such rare pathogens is crucial, as the range of clinical manifestation and geographical distributions are broad. This also throws light on the seriousness of recognizing infections caused by pathogens inhabiting the parasitic flies and to pay attention toward public sanitation. ●●Nucleotide sequence accession number
The obtained sequences for the Wohlfahrtiimonas chitiniclastica SK202 16S rRNA gene has been submitted to GenBank under accession number KM030600.
future science group
Wohlfahrtiimonas chitiniclastica-associated osteomyelitis: a rare case report Acknowledgements We acknowledge M Radhakrishna Pillai, Director of Rajiv Gandhi Centre for Biotechnology, for providing facilities, A Sreekumar, Professor and Head of the Department of Surgery, Government Medical College Hospital, Trivandrum for kindly providing the clinical sample and S Nallapeta, Bruker Daltonics India, Bangalore, for MALDI TOF analysis.
Financial & competing interests disclosure K Suryalatha would like to thank KSCSTE, Govt. of Kerala for the fellowship provided. The authors have no other relevant affiliations or financial involvement with
Case Report
any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.
Ethical conduct of research The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.
EXECUTIVE SUMMARY ●●
Wohlfahrtiimonas chitiniclastica, a rare emerging human pathogen, has been reported to cause infections in patients from Europe and South America.
●●
Here the pathogen is isolated from a diabetic patient suffering from osteomyelitis at the plantar aspect of the right foot.
●●
16S rRNA gene sequencing and MALDI TOF analysis revealed the identity to W. chitiniclastica.
●●
This is the first case report of W. chitiniclastica associated with osteomyelitis from an Asian country.
References 1
2
3
4
5
Rebaudet S, Genot S, Renvoise A, Fournier PE, Stein A. Wohlfahrtiimonas chitiniclastica bacteremia in homeless woman. Emerg. Infect. Dis. 15, 985–987 (2009).
6
RadhaKrishnaReddy M, Mastan M. Wohlfahrtiimonas chitiniclastica fulminant sepsis in Pangasius Sutchi-first report. Turk. J. Fish Aquat. Sci. 13, 753–758 (2013).
7
Sabater L, Ramirez MS, Vay CA. First case of fulminant sepsis due to Wohlfahrtiimonas chitiniclastica. J. Clin. Microbiol. 49, 2333–2335 (2011).
Carek PJ, Dickerson LM, Sack JL. Diagnosis and management of osteomyelitis. Am. Fam. Physician 63(12), 2413–2420 (2001).
8
Koljalg S, Telling K, Huik K et al. First report of Wohlfahrtiimonas chitiniclastica from soft tissue and bone infection at an unusually high northern latitude. Folia Microbiol. (Praha). 60(2), 155–158 (2015).
Hudzicki J. Kirby-Bauer Disk Diffusion Susceptibility Test Protocol. ASM Microbe Library. American Society of Microbiology. www.microbelibrary.org
9
Weisburg WG, Barns SM, Pelletier DA, Lane DJ. 16S ribosomal DNA amplification for phylogenetic study. J. Bacteriol. 173, 697–703 (1991).
Thaiwong T, Kettler NM, Lim A, Dirkse H, Kiupela M. First report of emerging zoonotic pathogen Wohlfahrtiimonas chitiniclastica in the United States. J. Clin. Microbiol. 52(6), 2245–2247 (2014). Diaz-Delgado J, Isabel VA, Lucas D, Marisa A, Manuel A, Antonio F. Endocarditis associated with Wohlfahrtiimonas chitiniclastica in a short-beaked common dolphin (Delphinus delphis). J. Wildl. Dis. 51(1), 283–286 (2015).
future science group
10 Chun J, Lee JH, Jung Y et al.et al. EzTaxon: a
web-based tool for the identification of prokaryotes based on 16S ribosomal RNA gene sequences. Int. J. Syst. Evol. Microbiol. 57(10), 2259–2261 (2007). 11 Clark A E, Kaleta E J, Arora A, Wolk DM.
Matrix-assisted laser desorption ionization– time of flight mass spectrometry: a fundamental shift in the routine practice of clinical microbiology. Clin. Microbiol. Rev. 26(3), 547–603 (2013).
12 Tóth EM, Schumann P, Borsodi AK, Kéki Z,
Kovács AL, Márialigeti K. Wohlfahrtiimonas chitiniclastica gen. nov., sp. nov., a new gammaproteobacterium isolated from Wohlfahrtia magnifica (Diptera: Sarcophagidae). Int. J. Syst. Evol. Microbiol. 58, 976–981 (2008). 13 Maurya RP, Mishra D, Bhushan P, Singh VP,
Singh MK. Orbital myiasis: due to invasion of larvae of flesh fly (Wohlfahrtia magnifica) in a child; rare presentation. Case Rep. Ophthalmol. Med. 2012, 371498 (2012). 14 Gupta AK, Nayduch D, Verma P et al.
Phylogenetic characterization of bacteria in the gut of house flies (Musca domestica L.). FEMS Microbiol. Ecol. 79, 581–593 (2012). 15 Cao M, Chen T, Xu LZ et al. Complete
genome sequence of Wohlfahrtiimonas chitiniclastica strain SH04, isolated from Chrysomya megacephala collected from Xiao-Pudong International Airport in China. Genome Announc. 1(2), e00119–13 (2013).
www.futuremedicine.com
1109
Wohlfahrtiimonas chitiniclastica-associated osteomyelitis: a rare case report Karthika Suryalatha1, Joby John2 & Sabu Thomas*,1
ABSTRACT Wohlfahrtiimonas chitiniclastica is a rare pathogen that was first isolated from a parasitic fly, Wohlfahrtia magnifica. It is a very rare but an emerging human pathogen reported only in Europe and South America. Recently, it is reported to be an egressing zoonotic pathogen from different geographical locations. The present case represents the first report of this pathogen from a patient suffering from osteomyelitis from India and so far no reports are available regarding the W. chitiniclastica associated infections in Asian countries. Clinical awareness of such emerging human pathogens is crucial for the infectious disease containment. Wohlfahrtiimonas chitiniclastica is a rare pathogenic bacterium belonging to the class of Gammaproteobacteria. There are currently only three reports for W. chitiniclastica causing human infections. Septicemia was reported in two patients with very poor sanitation conditions and multiple skin lesions. The first case was reported from a 60-year-old homeless woman with widespread excoriations in southeastern France in 2009 [1] . The second case was a fulminant sepsis reported from a 70-year-old homeless male patient in South America in 2011 [2] . He developed septic shock and died after 5 days from the date of admission to the hospital. They were diagnosed and the causative agent for the infections was found to be W. chitiniclastica. Another case of W. chitiniclastica in soft tissue and bone infection was reported from Estonia, northern Europe [3] . Recently W. chitiniclastica was reported to be zoonotic, which induced bacterial septicemia secondary to wound myiasis in a deer [4] , endocarditis in a dolphin [5] and sepsis in an aquatic fish Pangasius sutchi [6] . Osteomyelitis in humans is commonly associated with Staphylococcus aureus, Group B Streptococci, Pseudomonas aeruginosa and Escherichia coli [7] . Here we present a rare case of W. chitiniclastica associated with osteomyelitis reported from a tertiary care hospital in Kerala, India.
KEYWORDS
• 16S rRNA sequencing • emerging
human pathogen • gammaproteobacterium • osteomyelitis • Wohlfahrtiimonas chitiniclastica
Case presentation A 43-year-old male with diabetes suffering from a deep ulcer with cellulitis progressed to osteomyelitis at plantar aspect of right lower limb was admitted to the Department of Surgery at Govt. Medical College Hospital (Trivandrum, Kerala, India). He is a manual laborer with a history of alcoholism and smoking. He has thickened skin over right lower limb with nonpitting edema for the past 6 years. Later, he developed an ulcer at the plantar aspect of right limb 1 year ago. The ulcer progressed, and the fourth and fifth toes were amputated. He was brought under diabetic control and put on oral antibiotic treatment from a local hospital. Then gangrenous changes developed on the third toe at the right limb over the past 6 months.
Cholera & Biofilm Research Laboratory, Rajiv Gandhi Centre for Biotechnology, Trivandrum 695 014, Kerala, India Department of Surgery, Government Medical College Hospital, Trivandrum 695 011, Kerala, India *Author for correspondence: Tel.: +91 471 252 9521; Fax: +91 471 234 9303; [email protected] 1 2
10.2217/FMB.15.44 © 2015 Future Medicine Ltd
Future Microbiol. (2015) 10(7), 1107–1109
part of
ISSN 1746-0913
1107
Case Report Suryalatha, John & Thomas Routine laboratory test results on admission were as follows: decreased hemoglobin level, 9.7 g/dl (reference range: 13.8–17.2 g/dl); higher levels of leukocyte count, 15,100 cells/μl (reference range: 4.5–11,000/μl); erythrocyte sedimentation rate, 120 mm/h (reference range: 0–19 mm/h); creatinine, 1.7 mg/dl (reference range: 0.5–1.0 mg/dl) and blood urea 50 mg/ dl (reference range: 5–18 mg/dl). Radiographs showed osteomyelitis at the base of the third proximal phalanx and head of the third metatarsal bone. Peripheral pulsations were present at the distal end. No specific interventions were done during nephrological consultation. As the limb was edematous, suspecting the possibility of filarial cellulitis, the patient was advised to take diethyl carbamazine. Amputation of the third toe was also performed. Swabs were obtained from the deep sites of ulcer at the plantar aspect of right foot where soft tissues are degraded and infected bones are exposed. The swab samples were transported in Amies transport medium and were directly plated onto 5% enriched sheep blood agar and MacConkey agar. Colony morphology of this Gram-negative, rod-shaped, nonhemolytic bacterium was entire, convex and smooth as described previously [2] . It was found to be catalase and oxidase positive, and viable at pH 5. Routine tests failed to identify the bacterium with accuracy. Susceptibility to antimicrobial agents was checked by Kirby-Bauer disc diffusion method on Muller Hinton agar [8] and the strain was found to be susceptible to pipera cillin, amoxyclav, imipenem, cefoxitine, ceftazidime, cefepime, ciprofloxacin, gentamycin and co-trimoxazole. The 16SrRNA gene of the test strain was amplified using previously described universal primers [9] . The amplified PCR product was sequenced using Applied BioSystems model 3100 automated DNA sequencing system. The similarity and homology of the 16S rRNA gene sequence was analyzed with the sequences available in the data bank of National Center for Biotechnology Information (NCBI) using BLAST search and was identified as W. chitiniclastica. The sequence identity was again confirmed with 98.89% similarity by using the web-based tool, Ez Taxon [10] . The strain was simultaneously analyzed by matrix-assisted laser desorption ionization–time of flight (MALDITOF) mass spectrometry (MS) and identified as W. chitiniclastica on the BioTyper system [11] .
1108
Future Microbiol. (2015) 10(7)
Treatment The patient was put on intravenous injection cefoperazone-sulbactam (1.5 g/12 h) and the treatment continued with daily wound dressing. After a week, the wound showed healing tendency and the patient was discharged on 200 mg Cefpodoxime every 12 h orally for 2 weeks with strict diabetic control. Discussion Wohlfahrtiimonas chitiniclastica is a nonfermenting Gram-negative, catalase and oxidase positive, rod-shaped bacterium. This was first isolated from third-stage larvae of the obligate parasitic fly Wohlfahrtia magnifica [12] , which is reported to cause wound myiasis in mammals especially in Europe, Russia and Africa. A rare case of ocular myiasis caused by W. magnifica was reported in a 1.5-year-old child in India [13] . This supports the upcoming prevalence of W. magnifica in India. Wohlfahrtiimonas chitiniclastica has also been successfully isolated from gut of Musca domestica (house flies) [14] . This shows the possible role of common house flies as a vector for this emerging pathogen. The complete genome of a nonclinical strain of W. chitiniclastica was sequenced [15] and the pathogenicity associated with this emerging pathogen has yet to be investigated. The patient lives in a moderate sanitary condition, but near a waste disposal zone and the mode of transmittance of the pathogen is yet to be studied. Conclusion In conclusion, we have reported a rare and emerging pathogen, W. chitiniclastica associated with osteomyelitis from a tertiary care hospital. The present study highlights the emergence of rare pathogens in severe infections and the importance of the proper pathology and polyphasic identification to detect such pathogens. Clinical awareness of such rare pathogens is crucial, as the range of clinical manifestation and geographical distributions are broad. This also throws light on the seriousness of recognizing infections caused by pathogens inhabiting the parasitic flies and to pay attention toward public sanitation. ●●Nucleotide sequence accession number
The obtained sequences for the Wohlfahrtiimonas chitiniclastica SK202 16S rRNA gene has been submitted to GenBank under accession number KM030600.
future science group
Wohlfahrtiimonas chitiniclastica-associated osteomyelitis: a rare case report Acknowledgements We acknowledge M Radhakrishna Pillai, Director of Rajiv Gandhi Centre for Biotechnology, for providing facilities, A Sreekumar, Professor and Head of the Department of Surgery, Government Medical College Hospital, Trivandrum for kindly providing the clinical sample and S Nallapeta, Bruker Daltonics India, Bangalore, for MALDI TOF analysis.
Financial & competing interests disclosure K Suryalatha would like to thank KSCSTE, Govt. of Kerala for the fellowship provided. The authors have no other relevant affiliations or financial involvement with
Case Report
any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.
Ethical conduct of research The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.
EXECUTIVE SUMMARY ●●
Wohlfahrtiimonas chitiniclastica, a rare emerging human pathogen, has been reported to cause infections in patients from Europe and South America.
●●
Here the pathogen is isolated from a diabetic patient suffering from osteomyelitis at the plantar aspect of the right foot.
●●
16S rRNA gene sequencing and MALDI TOF analysis revealed the identity to W. chitiniclastica.
●●
This is the first case report of W. chitiniclastica associated with osteomyelitis from an Asian country.
References 1
2
3
4
5
Rebaudet S, Genot S, Renvoise A, Fournier PE, Stein A. Wohlfahrtiimonas chitiniclastica bacteremia in homeless woman. Emerg. Infect. Dis. 15, 985–987 (2009).
6
RadhaKrishnaReddy M, Mastan M. Wohlfahrtiimonas chitiniclastica fulminant sepsis in Pangasius Sutchi-first report. Turk. J. Fish Aquat. Sci. 13, 753–758 (2013).
7
Sabater L, Ramirez MS, Vay CA. First case of fulminant sepsis due to Wohlfahrtiimonas chitiniclastica. J. Clin. Microbiol. 49, 2333–2335 (2011).
Carek PJ, Dickerson LM, Sack JL. Diagnosis and management of osteomyelitis. Am. Fam. Physician 63(12), 2413–2420 (2001).
8
Koljalg S, Telling K, Huik K et al. First report of Wohlfahrtiimonas chitiniclastica from soft tissue and bone infection at an unusually high northern latitude. Folia Microbiol. (Praha). 60(2), 155–158 (2015).
Hudzicki J. Kirby-Bauer Disk Diffusion Susceptibility Test Protocol. ASM Microbe Library. American Society of Microbiology. www.microbelibrary.org
9
Weisburg WG, Barns SM, Pelletier DA, Lane DJ. 16S ribosomal DNA amplification for phylogenetic study. J. Bacteriol. 173, 697–703 (1991).
Thaiwong T, Kettler NM, Lim A, Dirkse H, Kiupela M. First report of emerging zoonotic pathogen Wohlfahrtiimonas chitiniclastica in the United States. J. Clin. Microbiol. 52(6), 2245–2247 (2014). Diaz-Delgado J, Isabel VA, Lucas D, Marisa A, Manuel A, Antonio F. Endocarditis associated with Wohlfahrtiimonas chitiniclastica in a short-beaked common dolphin (Delphinus delphis). J. Wildl. Dis. 51(1), 283–286 (2015).
future science group
10 Chun J, Lee JH, Jung Y et al.et al. EzTaxon: a
web-based tool for the identification of prokaryotes based on 16S ribosomal RNA gene sequences. Int. J. Syst. Evol. Microbiol. 57(10), 2259–2261 (2007). 11 Clark A E, Kaleta E J, Arora A, Wolk DM.
Matrix-assisted laser desorption ionization– time of flight mass spectrometry: a fundamental shift in the routine practice of clinical microbiology. Clin. Microbiol. Rev. 26(3), 547–603 (2013).
12 Tóth EM, Schumann P, Borsodi AK, Kéki Z,
Kovács AL, Márialigeti K. Wohlfahrtiimonas chitiniclastica gen. nov., sp. nov., a new gammaproteobacterium isolated from Wohlfahrtia magnifica (Diptera: Sarcophagidae). Int. J. Syst. Evol. Microbiol. 58, 976–981 (2008). 13 Maurya RP, Mishra D, Bhushan P, Singh VP,
Singh MK. Orbital myiasis: due to invasion of larvae of flesh fly (Wohlfahrtia magnifica) in a child; rare presentation. Case Rep. Ophthalmol. Med. 2012, 371498 (2012). 14 Gupta AK, Nayduch D, Verma P et al.
Phylogenetic characterization of bacteria in the gut of house flies (Musca domestica L.). FEMS Microbiol. Ecol. 79, 581–593 (2012). 15 Cao M, Chen T, Xu LZ et al. Complete
genome sequence of Wohlfahrtiimonas chitiniclastica strain SH04, isolated from Chrysomya megacephala collected from Xiao-Pudong International Airport in China. Genome Announc. 1(2), e00119–13 (2013).
www.futuremedicine.com
1109
