Sphingomonas paucimobilis Infection over an Eight-Year Period

Abstract

Introduction: Sphingomonas paucimobilis, a yellow-pigmented, aerobic, glucose nonfermenting, Gram-negative bacillus, is a rare cause of human infection. The bacterium is commonly observed in land and water habitats. S. paucimobilis, which can cause sepsis, pneumonia, catheter-related infections, and soft tissue infections, is considered a much more significant pathogen today compared to previous years. Because it has been isolated more often as the responsible pathogen in hospital infections and has taken a weightier role in infections than before, it has been suggested that this bacteria should be considered substantially. Materials and Methods: Patient files from all patients applying to the Diyarbakir Training and Research Hospital between 2005 and 2012 were reviewed retrospectively, and those with a record of S. paucimobilis growth were considered in the study. Conventional methods were used throughout bacterial isolation. Gram staining was performed in colonies in which bacterial growth was identified in blood and eosin-methylene blue (EMB) agars. In the Gram staining, as gram-negative bacilli were seen, BBL Crystal Enteric/Nonfermenter manual identification kit (Becton Dickinson, USA) and Vitek 2 (bioMérieux, France) identification system were used for the identification and antibiogram of the microorganisms that were determined to have negative motion, oxidase and catalase tests. Results: During this eight-year period, 83 S. paucimobilis infections were identified, and when the cases were distributed by clinical samples, it was demonstrated that 38.5% were from sputum, 32.5% from urine, 3.6% from cerebrospinal fluid (CSF), 14.4% from blood, 2.4% from the ear, and 4.8% from wounds. Among the clinical samples, it was found that the most intensive growth was in sputum samples, and these cases were treated in the Department of Pulmonary Diseases as outpatients and/or hospitalized patients. While all patients with S. paucimobilis growth observed in their wound samples were treated in burn units, patients with growth in their urine samples were treated in the Intensive Care Unit (ICU) and Internal Medicine, Infectious Diseases and Neurology wards. It was confirmed that 9.6% of the patients were treated in the wards or outpatient clinics of Internal Medicine, 33.8% in the ICU, 4.8% in the burn unit, 10.8% in Neurology, 20.5% in Infectious Diseases, and 20.5% in Pulmonary Diseases/Thoracic Surgery. As for the gender distribution of S. paucimobilis cases, 49 (59%) were female and 34 (41%) were male. As the susceptibility patterns of the patients were studied, it was seen that this microorganism, which is usually considerably susceptible, was susceptible to amoxicillin, trimethoprim/sulfamethoxazole, cefazolin, cefixime, cephalothin, cefuroxime, cefoperazone, meropenem, and levofloxacin, and was resistant to cefepime (10.8%), ampicillin/sulbactam (8.4%), gentamicin (19.2%), ceftazidime (18%), cefotaxime (2.4%), ceftriaxone (1.2%), imipenem (9.6%), amikacin (25.3%), piperacillin/tazobactam (10.8%), ciprofloxacin (9.6%), and amoxicillin/clavulanate (2.4%). It was determined that the highest resistance was to amikacin. Conclusion: S. paucimobilis may cause serious infections in both previously healthy and immunocompromised patients.

Keywords

• Sphingomonas paucimobilis
• hospital
• infection