Evaluation of Sphingomonas paucimobilis as an emerging nosocomial pathogen in a teaching hospital in Uttarakhand
Abstract
Background and Objectives: Sphingomonas paucimobilis is an opportunistic pathogen and was rarely encountered in clinical specimens previously. This study aimed to investigate the clinical features, associated co-morbidities, and antimicrobial susceptibility patterns of S. paucimobilis infection in a tertiary hospital in Uttarakhand.
Materials and Methods: S. paucimobilis isolates cultured from various sections of hospital and OPDs were identified and analyzed for their antibiograms in the microbiology laboratory for a duration of one year from January 2020 to December 2020.
Results: S. paucimobilis was isolated from 49 samples (0.01%) out of 3792 samples processed in VITEK 2 Compact automated ID/AST instrument. The maximum number of isolates were obtained from urine samples (31%), followed by blood (24%). Septicemia (41%), meningitis (17%), lower respiratory tract infections and ventilator associated pneumonia (14%) constituted a major portion of infections caused by this organism. Diabetes mellitus (22%) and steroid usage (16%) were major associated co-morbid conditions. Third and Fourth generation cephalosporins like ceftriaxone (81%) and cefepime (86%) were found to be the most susceptible drugs whereas 61% of isolates were resistant to colistin.
Conclusion: This organism is an up-and-coming pathogen and should not be simply labeled as a contaminant. Although the organism is not grossly virulent and still might not be associated with serious life-threatening infections; however their evolving resistance patterns and increased spectrum of infections should be seriously taken into account.
2. Goker T, Aşik RZ, Muhammet Bahadir Yilmaz, Çelik I, Tekiner A, Sphingomonas Paucimobilis: a rare infectious agent found in cerebrospinal fluid. J Korean Neurosurg Soc 2017; 60: 481-483.
3. Bayram N, Devrim L, Apa H, Gulfidan G, Turkyilmaz HN, Guynay L. Spingomonas paucimobilis infection in children: 24 case reports. Mediterr J Hematol Infect Dis 2013; 5(1): e2013040.
4. Ryan MP, Adley CC. Sphingomonas paucimobilis: a persistent gram negative nosocomial infectious organism. J Hosp Infect 2010; 75: 153-157.
5. Lin JN, Lai CH, Chen YH, Lin HL, Huang CK, Chen WF, et al. Sphingomonas paucimobilis bacteremia in humans: 16case reports and a literature review. J Microbiol Immunol Infect 2010; 43: 35-42.
6. Walayat S, Malik A, Hussain N, Lynch T. Sphingomonas paucimobilis presenting as acute phlebitis: a case report. IDCases 2017; 11: 6-8.
7. Hardjo Lugito NP, Cucunawangsih, Kurniawan A. A lethal case of Sphingomonas paucimobilis bacteremia in an immunocompromised patient. Case Rep Infect Dis 2016; 2016: 3294639.
8. Gursoy S, Yasar KK, Sari ND, Kuvat N, Ozturk S (2018) Sphingomonas paucimobilis bacteremia in a hemodialysis patient and literature review. Int J Crit Care Emerg Med 2018; 4: 041.
9. Dsouza A, Mallepally AR, Marathe NA, Das K, Mohaptra B. A rare case of Sphingomonas paucimobilis spondylodiscitis managed surgically. J Orthop Case Rep 202l; 11: 91-96.
10. Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing. 30th ed. CLSI supplement M100-S30. Wayne, PA: Clinical and Laboratory Standards Institute; 2020.
11. Demir T, Dadali M. Recurrent complicated urinary tract infection due to rare pathogen Sphingomonas paucimobilis: contamination or real deal? Infez Med 2016; 24: 241-244.
12. Lin JN, Lai CH, Chen YH, Lin HL, Huang CK, Chen WF, et al. Sphingomonas paucimobilis bacteremia in humans: 16 case reports and a literature review. J Microbiol Immunol Infect 2010; 43: 35-42.
13. Puca E, Harxhi A, Mehmeti J, Rroji A, Huti G, Jata B, et al. Sphingomonas paucimobilis from blood stream infection to spondylodiscitis. Clin Microbiol 2015; 4(3): e1000203.
14. Toh HS, Tay HT, Kuar WK, Weng TC, Tang HJ, Tan CK. Risk factors associated with Sphingomonas paucimobilis infection. J Microbiol Immunol Infect 2011; 44: 289-295.
15. Mehmood H, Khan N, Ullah S, Ullah A, Marwat A. A rare case of Sphingomonas paucimobilis meningitis in the absence of cerebrospinal fluid pleocytosis. J Investig Med High Impact Case Rep 2018; 6: 2324709618756424.
16. Tai ML, Velayuthan RD. Sphingomonas paucimobilis: an unusual cause of meningitis-case report. Neurol Med Chir (Tokyo) 2014; 54: 337-340.
17. Cheong HS, Wi YM, Moon SY, Kang CI, Son JS, Ko KS, et al. Clinical features and treatment outcomes of infections caused by Sphingomonas paucimobilis. Infect Control Hosp Epidemiol 2008; 29: 990-992.
18. Dervisoglu E, Meric M, Kalender B, Sengul E. Sphingomonas paucimobilis peritonitis: a case report and literature review. Perit Dial Int 2008; 28: 547-550.
19. Jeon CY, Furuya EY, Smaldone A, Larson EL. Post-admission glucose levels are associated with healthcare-associated bloodstream infections and pneumonia in hospitalized patients with diabetes. J Diabetes Complications 2012; 26: 517-521.
20. Titmarsh GJ, McMullin MF, McShane CM, Clarke M, Engels EA, Anderson LA. Community-acquired infections and their association with myeloid malignancies. Cancer Epidemiol 2014; 38: 56-61.
21. Özdemir M, Pekcan S, Demircili ME, Taşbent FE, Feyzioğlu B, Pirinç Ş, et al. A rare cause of bacteremia in a pediatric patient with Down syndrome: Sphingomonas paucimobilis. Int J Med Sci 2011; 8: 537-539.
22. Agyepong N, Govinden U, Owusu-Ofori A, Essack SY. Multidrug-resistant gram-negative bacterial infections in a teaching hospital in Ghana. Antimicrob Resist Infect Control 2018; 7: 37.
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Issue | Vol 13 No 5 (2021) | |
Section | Original Article(s) | |
DOI | https://doi.org/10.18502/ijm.v13i5.7425 | |
Keywords | ||
Sphingomonas; Nosocomial; paucimobilis; Septicemia; Antimicrobial; Steroid |
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