Bercholc-Urinowsky IJ, Ugalde-Resano R, Monge-Urrea J

Language: Spanish
References: 17
Page: 283-288
PDF size: 354.05 Kb.

ABSTRACT

Background: Chryseobacterium indologenes is an opportunistic gram-negative bacillus responsible for bloodstream infections in immunocompromised patients and in those with indwelling intravascular devices. Recently, its incidence has increased due to a rise in the use of broad-spectrum antibiotics.
Clinical case:A 3-year-old male patient with acute lymphoblastic leukemia underwent Port-a-Cath placement three months after initial diagnosis. He was hospitalized to receive chemotherapy, without eventualities at home and a normal cellular blood count. When the indwelling catheter was accessed, the patient presented signs of bacteremia, and a catheter-related bacteremia was suspected. Central and peripheral blood cultures were obtained, and meropenem (40mg/kg/dose) and vancomycin (10mg/ kg/dose) were started, and the permanent catheter was removed. Blood cultures grew Chryseobacterium indologenes from both central and peripheral line specimens. He received a twelve-day course of IV meropenem and vancomycin, and later switched to levofloxacin as per antimicrobial susceptibility testing and completed a seven-day course. He markedly improved within 48 hours of starting antibiotics and permanent catheter removal, no further complications. Surveillance blood cultures were negative. He was able to complete his chemotherapy regimen.
Conclusión: C. indologenes is an emerging public health problem due to its frequent resistance to antibiotics routinely used for the empiric treatment of gram-negative bacteremia. The treatment, not yet standardized, can be successful by prompt the removal of indwelling catheters, or try to rescue the device by antimicrobial therapy carefully tailored to susceptibility testing.

REFERENCES

1. Malini A, et al. Nonfermenting gram-negative bacilli infections in a tertiary care hospital in Kolar, Karnataka. J Lab Physicians. 2009;1(2):62-66. doi: 10.4103/0974-2727.59701

2. Chen F, et al. Clinical and epidemiological features of Chryseobacterium indologenes infections: Analysis of 215 cases. J Microbiol Immunol Infec. 2013;46(6):425-32. https://doi. org/10.1016/j.jmii.2012.08.007

3. Chang Y, et al. Identification, epidemiological relatedness, and biofilm formation of clinical Chryseobacterium indologenes isolates from central Taiwan. J Microbiol Immunol Infec. 2015;48(5):559-64. DOI: https://doi.org/10.1016/j. jmii.2014.04.004

4. Carrillo-Esper R, Peña-Pérez CA, Neri-Maldonado R, Flores- Rivera OI, de la Torre-León T, Pérez-Calatayud A, Meza- Márquez JM, Alonso-Martínez D. Sepsis grave secundaria a bacteriemia por Chryseobacterium indologenes. Primer caso reportado en México. Med Int Méx. 2017;31(5): 633-36.

5. Hsueh PR, Teng LJ, Ho SW, Hsieh WC, Luh KT. Clincal and Microbiological Characteristics of Flavobacterium indologenes Infections Associted with Indwelling Devices. J Clin Microbiol. 1996;34(8):1908-13.

6. Robledo JA, López J, Sierra P, Robledo C, Pfaller MA, Jones RN. El programa de vigilancia antimicrobiana SENTRY en Colombia: hallazgos iniciales en tres hospitales de Medellín. Asociación Colombiana de Infectología.1999;3(2):100-7.

7. Gales A, Jones R, Andrade S, Sader H. Antimicrobial susceptibility patterns of unusual nonfermentative gram-negative bacilli isolated from Latin America: report from the SENTRY Antimicrobial Surveillance Program (1997-2002). Mem Inst Oswaldo Cruz. 2005;100(6):571-57. http://dx.doi. org/10.1590/S0074-02762005000600011

8. Kirby J, Sader H, Walsh T, Jones R. Antimicrobial susceptibility and epidemiology of a worldwide collection of Chryseobacterium spp: Report from the SENTRY Antimicrobial Surveillance Program (1997-2001). J Clin Microbiol. 2004;42(1):445-48.

9. Cimmino T, Rolain JM. Whole genome sequencing for deciphering the resistome of Chryseobacterium indologenes, an emerging multidrug-resistant bacterium isolated from a cystic fibrosis patient in Marseille, France. New Microbes New Infections. 2016;12:35-42. doi: 10.1016/j.nmni.2016.03.006

10. Aydin Teke T, Oz F, Metin O, Bayhan G, Gayretli Aydin Z, Oguz M, et al. Chryseobacterium indologenes. Septicemia in an Infant. Case Reports in Infectious Diseases. 2014;2014:1-4. http://dx.doi.org/10.1155/2014/270521

11. Lin Y, et al. Clinical and Microbiological Characteristics of Chryseobacterium indologenes Bacteremia. J Microbiol Immunol Infec. 2010;43(6):498-505. https://doi.org/10.1016/ S1684-1182(10)60077-1

12. Corbella M, Brandolini M, Cambieri P, Decembrino N, Pagani M, Bottazzi A, Muzzi A, Zecca M, Mariani B, Marone P. A catheter-related bloodstream infection caused by Chryseobacterium indologenes successfully treated with antibiotic-lock rescue therapy. New Microbiologica 2017; 4(40): 223-25.

13. Hsueh P, Hsiue T, Wu J, Teng L, Ho S, Hsieh W, et al. Flavobacterium indologenes Bacteremia: Clinical and Mi crobiological Characteristics. Clinical Infectious Diseases. 1996;23(3):550-55.

14. Ozcan N, Dal T, Tekin A,Kelekci S, Can S, Ezin O, Kandemir I, Gul K.. Is Chryseobacterium indologenes a shunt-lover bacterium? A case report and review of the literature. Le Infezioni in Medicina. 2013; (4):312-16.

15. Aykac K, et al. Six cases during 2012–2015 and literature review of Chryseobacterium indologenes infections in pediatric patients. Canadian Journal of Microbiology. 2016;62(10):812- 19. https://doi.org/10.1139/cjm-2015-0800

16. Kodama Y, Nishimura M, Nakashima K. Central intravenous catheter-related bacteremia due to Cryseobacterium indologenes after cord blood transplantation. Rinsho Ketsueki. 2013;54:305-310.

17. Jackson MA, et al. The Use of Systemic and Topical Fluoroquinolones. Pediatrics. 2016;138(5). doi: 10.1542/ peds.2016-2706.