Human Brucella canis infection incidence is unknown. Most identified cases are associated with pet dogs. Contact with pathogenic Brucella spp. can lead to laboratory-acquired infections. We identified a pediatric B. canis case, the source, and other exposed persons. A three-year-old New York City child with fever and dyspnea was hospitalized for 48 hours for bronchiolitis. After her admission blood culture grew B. canis, she was prescribed antimicrobials and recovered. B. canis was isolated from blood of the child's pet dog. Isolates from the child and the dog were genetically similar. The dog originated from an Iowa breeding facility which was quarantined after identification of the puppy's infection. Thirty-one laboratory workers were exposed and subsequently monitored for symptoms; 15 completed post-exposure prophylaxis. This first report strongly suggesting B. canis transmission from a canine to a child in the United States highlights the need for coordinated control policies to minimize human illness.

We report the first case of recurrent intravascular-catheter-related bacteremia in a pediatric hemodialysis patient caused by Delftia acidovorans, previously called Comamonas acidovorans or Pseudomonas acidovorans. The patient had a history of multiple infections of central vascular catheters with other organisms, requiring courses of antibiotics and catheter replacements. Previously reported cases of D. acidovorans infections are reviewed. The isolate appeared to become resistant to cephalosporins after antibiotic treatment, but resistance could not be confirmed with additional testing. In vitro susceptibility testing for cephalosporins is not reliable for this organism. CASE REPORTA 10-year-old girl with renal cortical necrosis and end-stage renal disease was receiving hemodialysis via a Quinton PermCath dual-lumen catheter for 5 years. Over this period, she had a history of 24 episodes of catheter-related infections, requiring multiple courses of antibiotics and catheter replacements. While receiving outpatient dialysis treatment on day 120 of the catheter, she developed a fever of 38°C and chills. There was no erythema, warmth, tenderness, or swelling at the exit site in the femoral area. A blood culture was obtained from the catheter which subsequently grew a Gram-negative rod identified as Delftia acidovorans by MicroScan WalkAway-40 BP combo panel type 34 (Siemens, Munich, Germany). The organism was susceptible to expanded-spectrum and broad-spectrum cephalosporins, aztreonam, carbapenems, piperacillin-tazobactam, ticarcillinclavulanate, and quinolones but resistant to all aminoglycosides, penicillin, and narrow-spectrum cephalosporins and intermediately susceptible to ampicillin-sulbactam. A 14-day course of cefepime was given through the catheter with hemodialysis when microbial identification and susceptibility results were available. The patient remained afebrile. Blood cultures drawn from the catheter before starting antibiotic therapy, 3 days and 7 days after the end of therapy, were negative. The catheter was not removed.Twenty-four days after cefepime was stopped, she became febrile again (38°C), with chills, after hemodialysis. Blood cultures were obtained from the catheter and peripheral vein. Vancomycin and cefepime were started, and she defervesced within 24 h. Staphylococcus epidermidis and D. acidovorans were identified from both specimens. The D. acidovorans isolate was initially not identifiable by MicroScan WalkAway (Siemens, Munich, Germany). Additional testing was done with Vitek and API 20 NE version 6.0 (bioMérieux, Marcy l'Etoile, France). The Vitek reported D. acidovorans with 53% probability, and the API 20 NE version 6.0 reported D. acidovorans as a significant taxon with an unacceptable profile. Finally, it was further characterized with long-chain-fatty-acid analysis by gas chromatography using the MIDI 62 system (Microbial Identification Systems, Newark, DE). The susceptibilities of the second D. acidovorans isolate by MicroScan were now reported as resistant to cefotaxime, cef...

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