Clinical and Microbiological Features of <i>Shewanella</i> Bacteremia in Patients with Hepatobiliary Disease

Abstract

Objective Shewanella bacteremia is an uncommon but potentially fatal disease. Although hepatobiliary diseases have been proposed to be risk factors for various Shewanella infections, little is known about the features of Shewanella bacteremia in patients with hepatobiliary diseases. This study aims to characterize the presentation and risk factors of Shewanella bacteremia in patients with hepatobiliary diseases. Methods We retrospectively investigated the clinical features, microbiology and outcomes of patients with Shewanella bacteremia who were admitted to a tertiary medical center between January 2001 and December 2010. All isolates were confirmed to the species level using 16S rRNA sequencing analyses. The English language medical literature was searched for previously published reports. Results Fifty-nine cases of Shewanella bacteremia, including nine at the hospital, were identified, 28 (47.4%) of which involved underlying hepatobiliary diseases, representing an important risk factor. In 12 of the 28 cases, the infections involved the hepatobiliary system; with a tendency towards an Asian origin. In our case series of nine patients, Shewanella haliotis was isolated in five patients. The majority of our patients lived in coastal areas, consumed seafood regularly and developed bacteremia during the summer season. Conclusion It is recommended that the possibility for Shewanella infection be considered in patients with bacteremia and also underlying hepatobiliary diseases, particularly if patients present with hepatobiliary infections, a history of seafood, or development of the disease during the summer.

Skin and Soft Tissue Infections due to Shewanella algae – An Emerging Pathogen

“…The sensitivity findings of our study are in complete agreement with those reported by other investigators [7,15,16]. There are reports of multidrug resistance in Shewanella [10,12,22].…”

“…Available data suggest that Shewanella species are susceptible to aminoglycosides, quinolones, extended-spectrum cephalosporins, ß-lactamase inhibitor combinations and carbapenems [4,7]. However recent epidemiological data showed an increasing frequency of drug resistance especially to piperacillin-tazobactam and imipenem and was attributed to the presence of derepressed ambler class D beta-lactamases in them [6,14,19,20].…”

“…Hence MIC values for above antibiotics were interpreted using CLSI approved standard M100-S23 [5] categories for other Non-Enterobacteriaceae in accordance with previous studies [6,7] and as per the standards recommended by US Food and Drug Administration for ampicillin/sulbactam [8].…”

The Phantom Menace for Patients with Hepatobiliary Diseases: <i>Shewanella haliotis</i>, Often Misidentified as <i>Shewanella algae</i> in Biochemical Tests and MALDI-TOF Analysis

“…Since S. algae was added to the database of commercial identification systems a decade ago, this species has been easily differentiated from S. putrefaciens. S. algae causes a wide range of infections, including otitis media, cholecystitis, cholangitis, liver abscess, bacteremia, nonhealing ulcer, gastroenteritis, osteomyelitis, cellulitis, pneumonia, peritonitis, and septicemia, similar to V. vulnificus (9)(10)(11)(12)(13)(14). In 2007, S. haliotis was first isolated from the gut microflora of abalone by Kim et al (6).…”

“…As the Clinical and Laboratory Standards Institute (CLSI) has not provided the minimal inhibitory concentration (MIC) interpretative standards for Shewanella spp., we applied CLSI-approved standard M100-S22 (9). As only 2 Shewanella spp., S. putrefaciens and S. algae, were registered in the database of the VITEK 2 system, additional identification by using 16S rRNA gene sequence analysis (Macrogen, Seoul, Korea) and MALDI-TOF MS (bioM áerieux Inc.) with the database V2 released in November 2012 were performed.…”