Bacteremia outbreak due to Pantoea agglomerans in hemodialysis, an infection by an unexpected guest

García, Elena Borrego; Sancho, Andrés Luis Ruiz; Lara, Eva Plaza; Gómez, Lidia Díaz; Ureña, Ana Delgado

doi:10.1016/j.nefroe.2019.11.003

Cited by 6 publications

(7 citation statements)

References 8 publications

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“…As is evident from the flowchart, Pantoea infections are rare, with only 248 cases reported worldwide between 1991 and 2022, 53 of which were outbreak cases stemming from various contaminated environmental sources. [7][8][9][10][11][12][13] Sporadic adult and pediatric cases were seen in equal proportions, with immunocompetent patients greatly outnumbering their immunocompromised counterparts. Bacteraemia, followed by skin and soft tissue infections (SSTI), 31,32,[37][38][39][40][41][42] were the commonest manifestations of Pantoea infection, but the range of syndromes was wide, including peritonitis, 32,[43][44][45][46][47][48][49][50][51][52] bone and joint infection, 32,[53][54][55][56][57][58][59][60] intra-abdominal abscess, [61][62][63] pneumonia, 31,64 urinary tract infection, 31,32 ocular infection, [65][66][67]…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pantoea abscess mimicking sarcoma in a HTLV‐1‐infected Indigenous Australian man: Case report and literature review

Susanto

Dunning

Chew

2023

Clinical Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pantoea abscess mimicking sarcoma in a HTLV‐1‐infected Indigenous Australian man: Case report and literature review

Susanto

Dunning

Chew

2023

Clinical Case Reports

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“…Studies have also reported the effectiveness of aminoglycosides and quinolones in treating this infection 2,23,25,29,37 . Some studies have found carbapenems effective against this infection 24,35 . A recent study found a 2‐day course of cephalosporins followed by a 12‐day therapy with quinolone compelling 33 .…”

Section: Discussionmentioning

confidence: 99%

“…3 Currently, there are limited studies on the occurrence of P. agglomerans infections in the dialysis population, with most focusing on peritonitis in peritoneal dialysis patients. 2,23 To the best of our knowledge, only two published editorial letters have described this unusual infection in the hemodialysis population, with one indicating that hemodialysis circuits and water drains were the sources of contamination 24 and the other pointing to central venous catheters as the predominant source of infection. 3 Due to its rarity, published studies have yet to comprehensively describe the clinical features, laboratory findings, complications, and treatment outcomes of P. agglomerans outbreaks in substantial hemodialysis patients.…”

Section: Introductionmentioning

confidence: 99%

Pantoea agglomerans: A rare infectious outbreak affecting maintenance hemodialysis patients in a tertiary care hospital

Hassan,

Saleem,

Haneef

et al. 2023

Seminars in Dialysis

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BackgroundPantoea agglomerans is an environmental pathogen known to cause infection in immunocompromised individuals, particularly after thorn injuries. However, previous data showed few cases of human disease caused by contaminated medical products such as parenteral nutrition, anesthetic agents, blood, and peritoneal dialysis solutions. Infection in hemodialysis patients is rare. In this study, we presented a detailed account of several hemodialysis patients infected with this contagious pathogen and compared them with noninfected dialysis patients.MethodsWe retrospectively reviewed the hospital records of 105 hemodialysis patients. Seventeen of 105 patients were diagnosed with P. agglomerans infection. We carefully analyzed their entire in‐hospital course.ResultsAmong infected patients, 52.9% were male with a median age of 49 (IQR: 32–66) years. Compared to the noninfected patients, age below 50 years, prior kidney transplantation, prior immunosuppression and antibiotics use, and dialysis via a tunneled vascular catheter were the significant epidemiological features. Despite negative microbiological investigations, we suspect the possible infectious spread via infected central venous catheter was the likely infectious source. Most importantly, all patients responded well to intravenous antibiotics. Only two patients required the removal of the tunneled catheter. Their mortality rate was 0%.ConclusionP. agglomerans infection, although considered rare, is becoming increasingly prevalent among dialysis patients. Its occurrence must be appraised as an infectious outbreak rather than mere contamination. Prompt treatment, source identification, and early implementation of preventive strategies should always be the goal to curtail this infection at an early stage.

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“…In pediatric patients, Pantoea species were deemed to be involved in wound infection following penetrating trauma and catheter-related bacteremia [11], postsurgical meningitis [12], bloodstream infection, sepsis or fatal infections in newborns [12][13][14][15][16][17], and nosocomial outbreaks [18][19][20][21]. In adults, wound infections [22][23][24], septic arthritis [25][26][27][28][29][30][31], prosthetic joint infections [32], osteomyelitis [33], bloodstream infections or sepsis [34][35][36][37][38][39][40][41], peritonitis in patients on peritoneal [42][43][44][45][46][47][48] or hemodialysis [49], eye infections [50][51][52][53], endocarditis [54], infection in a near-term female [55], pneumonia post-lung transplant…”

Section: Introductionmentioning

confidence: 99%

Bloodstream Infections by Pantoea Species: Clinical and Microbiological Findings from a Retrospective Study, Italy, 2018–2023

Casale,

Boattini,

Bianco

et al. 2023

Antibiotics

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(1) Background: The widespread use of MALDI-TOF coupled to mass spectrometry has improved diagnostic accuracy by identifying uncommon bacteria. Among Enterobacterales, Pantoea species have been seen to be implicated in several human infections, but their clinical and microbiological framework is currently based on a few anecdotal reports. (2) Methods: We conducted this five-year (2018–2023) single-center study aimed at investigating the prevalence and clinical and microbiological findings of Pantoea species bloodstream infections. (3) Results: Among the 4996 bloodstream infection Gram-negative isolates collected during the study period, Pantoea species accounted for 0.4% (n = 19) of isolates from 19 different patients, 5 of them being pediatric cases. Among Pantoea species isolates, P. agglomerans was the most frequently detected (45%; n = 9) followed by P. eucrina (30%; n = 6) and P. septica (15%; n = 3). Malignancy (35.7%) in adults and malignancy (40%) and cerebrovascular disease following meconium aspiration (40%) in pediatric patients as comorbidities and shivering and/or fever following parenteral infusion (36.8%) as a symptom/sign of Pantoea species bloodstream infection onset were the most frequently observed clinical features. Among adults, primary bloodstream infection was the most frequent (50%), whereas among pediatric patients, the most commonly identified sources of infection were catheter-related (40%) and the respiratory tract (40%). Overall, Pantoea species bloodstream infection isolates displayed high susceptibility to all the antibiotics except for ampicillin (63.2%), fosfomycin (73.7%), and piperacillin/tazobactam (84.2%). Targeted antibiotic treatment was prescribed as monotherapy for adults (71.4%) and combination therapy for pediatric patients (60%). The most prescribed antibiotic regimens were piperacillin/tazobactam (21.4%) in adults and meropenem- (40%) and aminoglycoside-containing (40%) antibiotics in pediatric patients. The overall 28-day all-cause mortality rate was 5.3% (n = 1). (4) Conclusions: The prevalence and 28-day mortality rate of Pantoea species bloodstream infections were low. The prescription of targeted therapy including broad-spectrum antibiotics could indicate an underestimation of the specific involvement of the Pantoea species in the onset of the disease, warranting further studies defining their pathogenic potential.

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Bacteremia outbreak due to Pantoea agglomerans in hemodialysis, an infection by an unexpected guest

Cited by 6 publications

References 8 publications

Pantoea abscess mimicking sarcoma in a HTLV‐1‐infected Indigenous Australian man: Case report and literature review

Pantoea abscess mimicking sarcoma in a HTLV‐1‐infected Indigenous Australian man: Case report and literature review

Pantoea agglomerans: A rare infectious outbreak affecting maintenance hemodialysis patients in a tertiary care hospital

Bloodstream Infections by Pantoea Species: Clinical and Microbiological Findings from a Retrospective Study, Italy, 2018–2023

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