Human Infections Caused by Organisms of the Bacillus Species

Pearson, Harold E.

doi:10.1093/ajcp/53.4.506

Cited by 72 publications

(21 citation statements)

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“…The prevalence of positive blood cultures for Bacillus spp. ranges from 0.1 to 0.9% of specimens submitted (11). Our study supports reports in the literature that 5 to 10% of patients who have Bacillus spp.…”

Section: Resultssupporting

confidence: 91%

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In vitro susceptibility of Bacillus spp. to selected antimicrobial agents

Weber

Saviteer

Rutala

et al. 1988

Antimicrob Agents Chemother

137

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Although often dismissed as contaminants when isolated from blood cultures, Bacillus spp. are increasingly recognized as capable of causing serious systemic infections. As part of a clinical-microbiological study, 89 strains of Bacillus spp. isolated from clinical blood cultures between 1981 and 1985 had their species determined and were tested for antimicrobial agent susceptibility to 18 antibiotics. Species of isolates were determined by the API 50CH and API 20E systems. Bacillus cereus (54 strains) was the most common species isolated, followed by B. megaterium (13 strains), B. polymyxa (5 strains), B. pumilus (4 strains), B. subtilis (4 strains), B. circulans (3 strains), B. amyloliquefaciens (2 strains), B. licheniformis (1 strain), and Bacillus spp.(3 strains). Microdilution MIC susceptibility tests revealed all B. cereus strains to be susceptible to imipenem, vancomycin, chloramnphenicol, gentamicin, and ciprofloxacin. Non-B. cereus strains were most susceptible to imipenem, vancomycin, LY146032, and ciprofloxacin. Disk susceptibility testing suggested that B. cereus was rarely susceptible to penicillins, semisynthetic penicillins; or cephalosporims with the exception of mezlocillin. In Contrast, many non-B. cereus strains were susceptible to penicillins, semisynthetic penicillins, and cephalosporins, but marked variability was noted among species.Bacillus spp. are ubiquitous in nature and are frequently discounted as contaminants in cultures of clinical material. However, numerous reports have described serious infections including endocarditis, sepsis, meningitis, endophthalmitis, and surgical wound infections as a result of this organism (2, 5, 6, 10, 11, 14, 15, 17, 19; Editorial, Lancet ii:1469

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Section: Resultssupporting

confidence: 91%

“…are ubiquitous in nature and are frequently discounted as contaminants in cultures of clinical material. However, numerous reports have described serious infections including endocarditis, sepsis, meningitis, endophthalmitis, and surgical wound infections as a result of this organism (2,5,6,10,11,14,15,17,19 (8).…”

mentioning

confidence: 99%

In vitro susceptibility of Bacillus spp. to selected antimicrobial agents

Weber

Saviteer

Rutala

et al. 1988

Antimicrob Agents Chemother

137

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“…Five cases associated with indwelling central venous catheters have also been reported (Blue et al, 1995). As noted by previous reviewers, serious infections caused by non-anthracis species of Bacillus often develop post-surgery, in association with trauma or in burn cases, and predisposing conditions include alcoholism and diabetes (Farrar, 1963;Pearson, 1970).…”

Section: Discussionmentioning

confidence: 89%

Combined Bacillus licheniformis and Bacillus subtilis infection in a patient with oesophageal perforation

Jeon

Yang

Kim

et al. 2012

Journal of Medical Microbiology

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Species of the genus Bacillus are a common laboratory contaminant, therefore, isolation of these organisms from blood cultures does not always indicate infection. In fact, except for Bacillus anthracis and Bacillus cereus, most species of the genus Bacillus are not considered human pathogens, especially in immunocompetent individuals. Here, we report an unusual presentation of bacteraemia and mediastinitis due to co-infection with Bacillus subtilis and Bacillus licheniformis, which were identified by 16S RNA gene sequencing, in a patient with an oesophageal perforation. Case ReportA 71-year-old male visited the emergency department with chest pain that was first noticed after swallowing tablets 3 h before admission. The pain progressively worsened and was associated with dyspnoea. On examination, his heart rate was 95 beats min 21 , respiratory rate was 30 breaths min 21 , blood pressure was 130/70 mmHg, body temperature was 36 u C and arterial O 2 saturation was 94 %. His medical history included a mild drinking habit and past pulmonary tuberculosis. He was also taking medicine for chronic obstructive pulmonary disease (COPD). The results of laboratory tests performed on admission were haemoglobin 14.3 g dl 21 , white blood cell (WBC) count 9.76610 9 cells l 21 (73.7 % segmented neutrophils, 15.9 % lymphocytes, 3.1 % monocytes, 6.6 % eosinophils), Creactive protein (CRP) ,0.3 mg dl 21 and creatine kinase myocardial band (CK-MB) 2.2 mmol l 21 . A computed tomography (CT) scan of the chest showed a pleural effusion in the left lower lobe and an oesophageal perforation was suspected. We believe that the tablets were the cause of this. Sputum and blood were cultured and empirical antimicrobial therapy with ceftriaxone, clindamycin, and gentamicin was administered. The next day, the pain continued, the CRP had increased to 12.57 mg dl 21 and his body temperature was 38.4 u C. A chest tube was inserted and blood-tinged fluid was drained. Over time, the CRP increased steadily to 29.53 mg dl 21 . Three sets of blood cultures and culture of the pleural fluid from the chest tube were performed. On day 4, the patient underwent an exploratory thoracotomy. In the mediastinum, pus and inflammatory tissue were observed and the pus was cultured; however, no oesophageal perforation was found. At the end of the operation, a chest tube was inserted and pus-containing fluid was drained.Colonies identified as members of the genus Bacillus were isolated from blood and pleural fluid cultured on days 1 and 2 and subcultures were performed on blood agar. Subsequently, the antimicrobial regimen was changed to moxifloxacin and clindamycin. After hospitalization, the patient had a persistent fever above 38 u C and the CRP remained high at 26.07 mg dl 21 .The subcultures grew various colonies of Gram-positive bacilli and the cultures taken on day 1 grew transparent, spreading colonies (designated colony 1). All three sets of blood cultures taken on day 2 grew two kinds of colonies: transparent, spreading colonies (designated colony 2) and ...

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“…As stated earlier, these organisms are usually regarded as contaminants, but this series is not the first to report their isolation from intravenous catheters or drip sets in a consistent fashion (Cox, 1973). Pearson (1970), reviewing cases in which these organisms might have been true pathogens, included one case of phlebitis. More work is urgently needed to assess the significance of these isolations.…”

Section: Discussionmentioning

confidence: 99%