Clinical characteristics and antimicrobial susceptibility of Bacillus cereus blood stream infections

Abstract

BackgroundBacillus cereus is one of the pathogens causing nosocomial bloodstream infections (BSIs). However, few reports have documented the antimicrobial susceptibility and clinical characteristics of Bacillus cereus BSI and the importance of empirical therapy. The aim of this study was to investigate the clinical characteristics and antimicrobial susceptibility of B. cereus isolates from patients with BSI and to analyze the impact of appropriate empirical therapy on the outcome of patients with B. cereus BSI.MethodsAll adult cases of bacteremia between April 2003 and March 2012 in a teaching hospital in Tokyo, Japan were reviewed retrospectively. Clinical data were collected from the patients’ medical records and charts. Antimicrobial susceptibility testing was performed by broth microdilution method. The patients with B. cereus BSI were divided into an appropriate empirical therapy group and an inappropriate empirical therapy group. The primary outcome was all-cause mortality at 4 weeks after the start of BSI. The secondary outcome was early defervescence within 2 days after starting empirical therapy.ResultsThere were 29 B. cereus bloodstream infection cases. No vancomycin, gentamicin, and imipenem-resistant isolates were found. However, 65.5 % were resistant to clindamycin and 10.3 % were resistant to levofloxacin. The main etiology was venous catheter-related (69 %). All-cause mortality at 4 weeks was not significantly different between the appropriate empirical therapy group (9 cases) and the inappropriate group (20 cases) in this study. However, early defervescence within 2 days after starting empirical therapy was significantly different (p = 0.032).ConclusionsThe BSI of B.cereus is mostly caused by venous catheter-related infections. Appropriate empirical therapy is important to achieve early clinical resolution in B. cereus BSI. Vancomycin is one of the appropriate selections of empirical therapy for B. cereus BSI.

Central Venous Access Device-Related Bacillus Cereus Endocarditis: A Case Report and Review of the Literature

“…According to antimicrobial susceptibility studies, B. cereus appears to be uniformly sensitive to gentamicin, imipenem, and vancomycin. [44][45][46][47][48] In general, three separate trials by Weber et al, 44 Luna et al, 46 and Veysseyre et al 48 report all tested strains (100%; n = 240) susceptible to gentamicin, imipenem, and vancomycin. Most strains were variably resistant to amoxicillin (40%), cefazolin (55%), ceftriaxone (40%), ciprofloxacin (41%), clindamycin (20%), and penicillin (100%).…”

“…In contrast, Kassar et al 40 reported 88% of patients (83 of 93) had a fever (defined as greater than 38.0°C) among 94 episodes of Bacillus species-related bloodstream infections. Additionally, Ikeda et al 47 reported an average white blood cell count of 7,497 cells/µL (reported range of 100-22,200 cells/µL) among 29 patients with B. cereus-related bloodstream infections. Therefore, further evaluations are needed to elucidate clinical characteristics for patients with Bacillus species-related endocarditis.…”

The Liver as Another Possible Target Organ for Bacillus cereus Infection

“…The patient denied previous surgery and recent dental procedures. As far as we know, 100% of Bc isolates are susceptible to vancomycin, and vancomycin is considered optimal for empirical treatment of Bc blood stream infections [2]. Clinical conditions and blood tests progressively improved, and, 5 days after abscess drainage, the patient was discharged with the indication to continue antibiotic treatment with levofloxacin 500 mg/daily for 15 additional days.…”

“…Clinical conditions and blood tests progressively improved, and, 5 days after abscess drainage, the patient was discharged with the indication to continue antibiotic treatment with levofloxacin 500 mg/daily for 15 additional days. Indeed, levofloxacin demonstrated excellent antimicrobial activity against Bc [2], and it was therefore chosen for the oral antibiotic treatment as outpatient. An ultrasonography performed one month after percutaneous drainage and the beginning of antibiotic treatment confirmed complete resolution of both abscesses.…”

Prevalence, antibiotic-resistance properties and enterotoxin gene profile of <i>Bacillus cereus</i> strains isolated from milk-based baby foods

“…Occurrence of antibiotic resistance is a considerable risk factor in treatment of diseases caused by B. cereus. Documented data revealed that B. ceuers strains harbored high levels of resistance against several types of antibiotics and especially tetracycline, β-lactamase, and quinolones [6][7][8].…”