PMC7525056_01
Phylogenetic consensus trees based on nearly full-length 16S rRNA gene sequences (a) or partial gyrB sequences (b) for the patient isolate NML 181027 and two historical NML isolates. Alignment done using Clustal W (default settings) and the neighbour-joining (1000 replicates) algorithm found in mega 6.06. A type strain of 
Wohlfahrtiimonas chitiniclastica
 is used as an unrelated outgroup. Scale infers 0.005 (16S) and 0.1 (gyrB) substitutions per nucleotide position.
acmi-2-078-g001.jpg
PMC7525056_01_acmi-2-078-g001.jpg
F1
Based on this analysis, it was found to cluster closely with two other strains previously submitted to NML Special Bacteriology laboratory (NML95-0259, NML99-0170) and the type strain  I. indica  FFA1T (Fig. 1a, b), with 100 % similarity among sequences over 1450 and 565 bp, respectively. There was also 99.5 % sequence identity with the recently described  I. cameli  type strain UAE-HKU57, but  I. indica  and  I. cameli  isolates could be separated with confidence based on gyrB sequencing: strain NML181020 showed >95.1 % sequence similarity with other  I. indica  strains but <87 % similarity with other  Ignatzschineria  species including  I. cameli  (Fig. 1b).
PMC7525056_02
Patient's left foot, post-admission day 4, after multiple sessions of debridement and maggot removal. Cellulitis has resolved at this point, with some remaining areas of necrotic tissue but no visible maggot. Patient consent was obtained for photography and publication.
acmi-2-078-g002.jpg
PMC7525056_02_acmi-2-078-g002.jpg
F2
By admission day 3, the cellulitis had started to settle, and by admission day 4 there was no further evidence of ongoing maggot infestation (Fig. 2.).