Clinical Features of Patients with Invasive Eikenella corrodens Infections and Microbiological Characteristics of the Causative Isolates

Abstract

Clinical features of 43 cases of invasive Eikenella corrodens infections diagnosed at National Taiwan University Hospital during a 6-year period (1993-1998) were analyzed. The clinical syndromes included head and neck infection (56%), pulmonary infection (23%), intra-abdominal infection (14%), cutaneous infection (5%), skeletal infection (2%), endocarditis (2%), and pelvic abscess (2%). Nearly two-thirds of the patients (63%) had pre-existing diseases. Malignancy (35%), especially of the head and neck, was the most common underlying illness. More than half of the patients (56%) had associated factors predisposing to invasive Eikenella corrodens infection. Polymicrobial infections occurred in 28 (65%) patients, with two-thirds of the concurrent isolates being streptococci (66%). Five cases were fatal, with four deaths directly attributable to invasive Eikenella corrodens infection. Antimicrobial susceptibility testing and molecular typing were performed on 23 preserved Eikenella corrodens isolates. Antimicrobial susceptibility testing showed that Eikenella corrodens isolates were susceptible to penicillin, amoxicillin, cefoxitin, cefotaxime, cefepime, ciprofloxacin, and imipenem. The isolates were resistant to clindamycin, metronidazole, cephalothin, and cefuroxime. None of the 23 isolates produced beta-lactamase. Random amplified polymorphic DNA patterns of the 23 isolates were different, suggesting that different clones of Eikenella corrodens caused these infections.

Facial bite wounds: management update

“…However, whether the presence of b-lactamase positive anaerobic bacteria is an important consideration in antibiotic selection for simple prophylaxis remains to be determined 46,105 . b-Lactamase activity has also been reported for E. corrodens 55 and P. multocida 79 , but these bacteria generally remain susceptible to penicillin 54, 93,97,98 .…”

“…Clindamycin is currently recommended, but only in combination with either ciprofloxacin or (for children) trimethoprimsulfamethoxazole 41,98 , to compensate for its poor activity against E. corrodens 85,93 and almost all Pasteurella isolates 52 . Ciprofloxacin has limited activity against streptococci and certain anaerobic species typically encountered in human and animal bite wounds 53,54 .…”

“…In addition, except for cefoxitin and related agents, cephalosporins as a whole have limited activity against anaerobes 42 . Cefuroxime axetil is currently recommended as an alternative to amoxicillin-clavulanate for cat bite wounds 41 because of its good coverage of P. multocida 51 ; still it is largely inactive against E. corrodens 51, 93 .…”

Thigh abscess caused by Eikenella corrodens and Streptococcus intermedius: A case report

“…In addition, she had no intrauterine device, which was associated with pelvic abscess. 3 Therefore, the source of the organism remains unknown in this case.…”

“…1 Although E. corrodens infections have been reported globally, no clinical cases were presented in the literatures of China Mainland probably due to the ignorance of such infections. The commonest infections associated with E. corrodens are human bite wounds, 2 head and neck infections, 3 and respiratory tract infections. 1 Thigh abscess, as a rare infection caused by the organism, was described at an insulin injection site in an adolescent with insulindependent diabetes mellitus caused by E. corrodens alone.…”