Evaluation of Sphingomonas paucimobilis as an emerging nosocomial pathogen in a teaching hospital in Uttarakhand

Abstract

Background and Objectives: Sphingomonas paucimobilis is an opportunistic pathogen and was rarely encountered in clin- ical specimens previously. This study aimed to investigate the clinical features, associated co-morbidities, and antimicrobial susceptibility patterns of S. paucimobilis infection in a tertiary hospital in Uttarakhand.
 Materials and Methods: S. paucimobilis isolates cultured from various sections of hospital and OPDs were identified and an- alyzed for their antibiograms in the microbiology laboratory for a duration of one year from January 2020 to December 2020. Results: S. paucimobilis was isolated from 49 samples (0.01%) out of 3792 samples processed in VITEK 2 Compact auto- mated ID/AST instrument. The maximum number of isolates were obtained from urine samples (31%), followed by blood (24%). Septicemia (41%), meningitis (17%), lower respiratory tract infections and ventilator associated pneumonia (14%) constituted a major portion of infections caused by this organism. Diabetes mellitus (22%) and steroid usage (16%) were major associated co-morbid conditions. Third and Fourth generation cephalosporins like ceftriaxone (81%) and cefepime (86%) were found to be the most susceptible drugs whereas 61% of isolates were resistant to colistin.
 Conclusion: This organism is an up-and-coming pathogen and should not be simply labeled as a contaminant. Although the organism is not grossly virulent and still might not be associated with serious life-threatening infections; however their evolving resistance patterns and increased spectrum of infections should be seriously taken into account.

Multiple hepatosplenic abscesses in an immunocompetent host

“…2,9 This infection is usually seen in immunocompromised states like malignancies, steroid use, immunodeficiencies, or chronic disease states like diabetes mellitus, chronic kidney disease, or chronic respiratory conditions. [1][2][3][4] According to a retrospective study done by Rohilla in a teaching school in Uttarakhand, diabetes mellitus and steroid use were the most common comorbid conditions in which S. paucimobilis infection was seen. 3 Such patients commonly have a contact history with healthcare facilities.…”

“…[1][2][3][4] According to a retrospective study done by Rohilla in a teaching school in Uttarakhand, diabetes mellitus and steroid use were the most common comorbid conditions in which S. paucimobilis infection was seen. 3 Such patients commonly have a contact history with healthcare facilities. A retrospective study by Ionescu et al showed that at least 43% of patients with bloodstream infections had a hospital-acquired infection and 37% had acquired one from the community.…”

“…Being less virulent, this organism mainly affects individuals with an immunocompromised profile; which includes chronic conditions like diabetes mellitus, chronic kidney disease, chronic respiratory ailments, steroid-using patients with autoimmune diseases, or malignancies. [1][2][3][4] Such patients usually have a history of contact with health care. [1][2][3][4] Though infrequent, Sphingomonas paucimobilis may cause severe infection leading to septicemia, meningitis, septic arthritis, osteomyelitis, visceral abscess, enteritis, and keratitis.…”

“…[1][2][3][4] Such patients usually have a history of contact with health care. [1][2][3][4] Though infrequent, Sphingomonas paucimobilis may cause severe infection leading to septicemia, meningitis, septic arthritis, osteomyelitis, visceral abscess, enteritis, and keratitis. [2][3][4][5] Such cases are seen among both, pediatrics and adults.…”

“…[1][2][3][4] Though infrequent, Sphingomonas paucimobilis may cause severe infection leading to septicemia, meningitis, septic arthritis, osteomyelitis, visceral abscess, enteritis, and keratitis. [2][3][4][5] Such cases are seen among both, pediatrics and adults. 13 We here present a case of splenic and liver abscesses in a young male and more surprisingly in an immunocompetent patient with no contact with health care in the past.…”