From the Research
The finding of Micrococcus in a bone marrow biopsy is most likely a contaminant rather than a true infection, and its significance should be interpreted with caution, considering the potential for misidentification with other life-threatening bacteria, as reported in a study published in 2020 1. When found in bone marrow samples, Micrococcus species typically represent contamination during the collection or processing of the specimen, as they are part of the normal skin flora and rarely cause serious infections in immunocompetent individuals.
- No specific treatment is required if the patient is asymptomatic and there are no other clinical signs of infection.
- However, if the patient is immunocompromised or shows signs of systemic infection, empiric antibiotic therapy with vancomycin (1g IV every 12 hours for adults) should be considered while awaiting further clinical correlation and additional cultures.
- In rare cases where true Micrococcus infection is confirmed, treatment typically involves beta-lactam antibiotics or vancomycin for 10-14 days, depending on the severity of infection.
- Micrococcus is generally susceptible to many antibiotics, but resistance patterns should be checked through sensitivity testing, as some species may be misidentified with other bacteria, such as Kytococcus schroeteri, which has a different drug susceptibility profile 1. The distinction between contamination and true infection is crucial and should be made based on clinical presentation, repeated cultures, and the patient's immune status.
- It is essential to consider the potential for complications associated with bone marrow biopsy, such as bleeding, fracture, or facet joint injury, especially in procedures with improper tracts 2.
- Additionally, the possibility of invasive fungal infections, such as Candida parapsilosis, should be considered in febrile patients, regardless of their immune status, and fungal cultures should be included in the diagnostic workup 3.