We report a case of catheter-related bacteremia associated with Roseomonas mucosa isolated from an immunocompromised pediatric patient with a history of multiple episodes of urinary tract infection and bacteremia.
CASE REPORTAn 18-year-old male presented to the UCLA Emergency Department with a 2-day history of fever, malaise, and decreased activity level and was admitted to the UCLA Medical Center for suspected catheter-related sepsis. The patient had a past medical history that included pseudoobstruction, status postcolectomy, chronic total parenteral nutrition dependence, and G-tube placement. In addition to having multiple incidences of urinary tract infections with Morganella species and Enterococcus species, the patient has also had multiple episodes of bacteremia in the past 2 years with Methylobacterium mesophilicum, Acinetobacter lwoffii, Delftia acidovorans, and another unidentified Gram-negative bacillus. The patient's last admission to the UCLA Medical Center was 9 months ago for Broviac catheter-related bacteremia with Delftia acidovorans and the unidentified Gram-negative bacillus. For these past infections, the patient was treated with extended-spectrum cephalosporins, gentamicin, and ciprofloxacin. Blood samples were collected for culture, and the patient was empirically treated with vancomycin and ceftriaxone.Two sets of BactT/Alert aerobic and anaerobic blood culture bottles were drawn from the Broviac catheter line within a 24-hour period. Bacterial growth was detected in one aerobic bottle on day 4 of incubation, using the BacT/Alert (bioMérieux, Marcy l'Etoile, France). Gram-negative coccobacilli were detected on Gram stains, and the organism was subcultured to MacConkey agar, blood agar, and chocolate agar and incubated at 35°C in 5% CO 2 . Growth on blood agar and chocolate agar revealed slightly pink, mucoid colonies; no growth was observed on MacConkey agar. The organism was further subcultured to Sabouraud dextrose (SAB) agar, which grew prominent pink mucoid colonies after 24 h incubation (Fig.