A Rare Cause of Bacteremia in a Pediatric Patient with Down Syndrome: Sphingomonas Paucimobilis

Abstract

Sphingomonas paucimobilis, is a yellow-pigmented, aerobic, non fermentative, gram negative motile bacillus. S. paucimobilis which is widely found in nature and hospital environments rarely cause serious or life threatening infections. In this report, a case of hospital acquired bloodstream infection due to S. paucimobilis in a patient with Down syndrome who was on treatment for presumed pneumonia is presented.A one year-old child patient who was a known case of Down syndrome and had previously experienced cardiac surgery was hospitalized and treated for pneumonia. On the 12th day of hospitalization, blood cultures were taken because of a high body temperature. One of the blood cultures was positive for gram-negative rods. After 48 hour of incubation, the sub-cultures on blood agar medium yielded pure growth of a yellow, non-fermentative, gram-negative, rod-shaped bacterium. The microorganism was positive for oxidase, and esculin hydrolysis, while negative for urea and nitrate reduction, citrate utilisation and motility. The isolate had been identified as S. paucimobilis by using Vitek 2 system. The antibiotic susceptibility test was also performed with the same system and the strain was found to be susceptible to piperacillin-tazobactam and other antibiotics. Treatment with intravenous piperacilin-tazobactam (150 mg/kg/day) was initiated. He responded well to the treatment and was discharged after 10 days. This case is reported to emphasize that S. paucimobilis should be kept in mind as a nosocomial infectious agent in patients with Down syndrome and immunosuppressive patients and the infections should be treated according to the sensitivity test results.

Epizootiological characteristics of viable bacteria and fungi in indoor air from porcine, chicken, or bovine husbandry confinement buildings

“…Exposure to high levels of endotoxins has been reported to influence immune responses towards Th2-type immune response [1832]. In addition, Gram-negative bacteria are commonly associated with hospital acquired infections in humans [11262842], indicating greater risk to immune compromised subjects. It is also important to note that the majority of microorganisms identified from most farms are linked to nosocomial infections in humans that usually involve antibiotic-resistant microorganisms.…”

Incidence and molecular characterization of multidrug resistance in Gram‐negative bacteria of clinical importance from pharmaceutical wastewaters in South‐western Nigeria

“…Our study detected that this bacterium was resistant to piperacillin, piperacillin/tazobactam, cefotaxime, imipenem, ciprofloxacin, moxifloxacin, and aztreonam, although it has been reported that the susceptibility to third‐generation cephalosporins and fluoroquinolones is variable (Al‐Halawani et al, ; Hsueh et al, ). Other studies reported that S. paucimobilis was resistant to amikacin, ceftazidime, and fluoroquinolones (Toh et al, ), resistant to cefoxitin and ceftazidime (Özdemir et al, ), and to cefotaxime and amikacin (Cheong et al, ). As there are no definitive guidelines for antimicrobial therapy for this bacterial infections, treatment is done with individualized antibiotic therapy according to the in vitro susceptibility profile of clinical isolates (Özdemir et al, ; Pratama et al, ; Toh et al, ).…”

“…and to cefotaxime and amikacin (Cheong et al, 2008). As there are no definitive guidelines for antimicrobial therapy for this bacterial infections, treatment is done with individualized antibiotic therapy according to the in vitro susceptibility profile of clinical isolates (Özdemir et al, 2011;Pratama et al, 2016;Toh et al, 2011). Some studies recommended fluoroquinolones, third-generation cephalosporins, and carbapenems as excellent drugs of choice as initial therapy for S. paucimobilis infection (Hsueh et al,.…”

Otomastoiditis caused by Sphingomonas paucimobilis: case report and literature review

“…It was believed that S. paucimobilis was the only specimen of clinical importance; however, recently Sphingomonas mucosissima and Sphingomonas adhesiva also have been related to human infection 2 , 3. These bacilli are ubiquitous in nature (especially in water and soil) and in nosocomial environments causing mild-to-severe community and nosocomial illnesses 1 , 4…”