Gordonia bronchialis

@tcd518
This is a quite rare finding, and usually occurs after something like open heart surgery. Here is a summary/compilation of several years of reports:
The results of our study showed that G. bronchialis causes numerous, diverse, and serious infections encompassing pneumonia and osteomyelitis as the most frequent, followed by bacteremia, endocarditis, and peritonitis, etc. Human samples for the isolation of G. bronchialis were collected from sputum, wound tissue, blood, bone, peritoneal and pleural fluid, corpus vitreum, and medical device (pacemaker), while its identification was confirmed using gene sequencing method and/or MALDI-TOF-MS analysis. Sensitivity to antibiotics, such as ciprofloxacin, imipenem, and amikacin was proven in the largest number of cases. Treatment of infection caused by G. bronchialis was primarily based on combined antibiotic therapy, while one anti-infective drug was administered in two patients. The most frequently used antibiotics were vancomycin and ciprofloxacin. All patients underwent hospital treatment and recovered completely after therapy (one without treatment)...
Overall, infections due to G. bronchialis were most often represented among patients associated with cardiac surgical intervention (usually coronary artery bypass grafting) and/or the implantation of prosthetic materials (cardiac pacemaker, indwelling catheters, prosthetic valve, intraocular lens implant, and bioresorbable polymer screw). Out of a total of 28 patients included in our systematic review, only two patients did not undergo surgery or insertion of prosthetic material. No data were available for five patients.

Treatment of infections caused by G. bronchialis was mandatory based on pharmacotherapy in all patients, except one.

A review of the literature related to G. bronchialis infections in humans, clearly shows the difficulties associated with its identification, even today. Gordonia bronchialis was often misidentified as Nocardia, Rhodococcus, or non-tuberculosis mycobacteria...

Gordonia bronchialis infections should be taken seriously, because if not, it can lead to a high degree of resistance to antibiotics. The treatment of G. bronchialis infections should include fluoroquinolones, vancomycin with or without aminoglycosides, and carbapenems. Cotrimoxazole as well as linezolid should be avoided, because in some cases G. bronchialis shows resistance to those antibiotics."
https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1333663/full
I would guess your provider iss going to order antibiotic therapy - have you spoken to them yet?

Hi Sue. No, I haven't spoken to the doctor yet and probably won't until next week because of the holiday. This test result is from one of three sputum samples submitted at the beginning of January; the first sample was negative, the second showed the Gordonia, and the third showed MAC. I can't help but wonder if there's a lab issue here. I haven't had any kind of surgery or invasive medical treatment, just a persistent, wracking cough.

The irony is that I just started the Big 3. Last week I began with 500 mg azithromycin, next week I add 1500mg ethambutol, and the following week I add 600 mg rifampin, all three times a week (Monday, Wednesday, and Friday). Now I wonder if that will change.

Thank you so much for this information. It is very helpful to me and gives me some background when I talk to the doctor. Stay well.

Toni, I hope this is easily resolved. It sounds like you are in the thick of it, and it's always a bit alarming to hear of a new bug revealed in the cultures.
Sue, your research and sharing is always amazing, and so appreciated.

My last sputum culture (late October), came back negative for MAC again (thank you chlofazamine trial and airway clearance!) but did show Gordonia Otitidis. Dr. Winthrop said it was not a concern, "usually due to an environmental contaminant." But around Thanksgiving I began having sinus issues, starting with a one-sided headache that hurt when I coughed. I have not gotten really sick, just stuffiness and drainage, that is especially annoying when, at night, it combines with the stuff coming up from my lungs. I've been managing, more or less, with saline nasal washes and flunisolide nasal drops, but now I'm wondering if the contaminant in my sputum might be from my sinuses. I have an appointment with Dr. W next week and will ask him. It would certainly be nice to clear my head!
All best to all of us.
Anna

Thank you, Anna. I wonder if the G. Otitidis was an early warning sign of a sinus infection?

I don't know how concerned to be about the G. Bronchialis. Reading the article Sue cited above raises the question of how - if at all - it will affect my MAC treatment and what antibiotics my doctor will prescribe. One article I read, https://pmc.ncbi.nlm.nih.gov/articles/PMC3811652/ said that G. Bronchialis takes 6 days to culture, so another question I'll have for my doctor is why it took the lab 42 days to identify it. I would also like to know if the lab did susceptibility testing. So many questions!

Good luck with your appointment with Dr. Winthrop. If you're comfortable with it, would you share if he says anything more about the Gordonia? Best,
Toni

Anna - that's an interesting finding, I believe it is one of the usual causes for "swimmer's ear" which is an outer ear infection. I'm curious about what the doctor will say.

I'll be happy to share anything I learn and increase our group's knowledge base.
And to Sue's comment, I could not find much about it except that it was identified in an ear infection in a woman in Japan. Apparently in a lot more ear infections since then, hence "swimmer's ear."
Anna

Hi all. I just spoke with my pulmonologist, and he said that in my case the Gordonia bronchialis is not a cause for concern; as Sue's research showed, it is a threat to those who are immunocompromised but is otherwise just one more thing to keep an eye on.

This is a relief, because I'd much rather look at pictures of Gordon Setters than G. bronchialis....

🤣Thanks Toni, I needed a laugh today.
Sue

I had my chat with Dr. Winthrop today and asked about the possible connection of Gordonia Otitidis with my sinus issues. He said no, that it's a bug that's around a lot, but doesn't do much to human beings. As it happens, about the time I posted the message above, my head cleared up and I've had much better nights, and less mucus in general. Dr. W said it was likely a virus that went into a bacterial infection and a round of antibiotics would have been helpful, "but you toughed it out." That's always a question for me, when should I call the doctor for help? I don't get fevers easily, or sick enough to stop walking and going on with my life. I'm pretty stoic, by nature, but definitely have times when I feel better and times when I feel worse. I'm just grateful for the better times and grateful that the worse ones aren't too bad.
Anna

“That's always a question for me, when should I call the doctor for help?”

I think a lot of us struggle with that. I sometimes send a note to the team on “MyChart” to get advice. My doc has encouraged that and told me the nurses screening the messages are excellent. It’s a thought if your doc uses a message system.