The aim of this systematic review was to determine the causal role of
Erysipelatoclostridium ramosum
in specific invasive
infections in humans, and to assess the clinical outcome of antibiotic therapy
used to treat them. Several electronic databases were systematically searched
for clinical trials, observational studies or individual cases on patients of
any age and gender with a systemic inflammatory response syndrome (SIRS) due to
E. ramosum
isolated from body fluids or tissues in which it
is not normally present. Only reports identifying
E. ramosum
as
the only microorganism isolated from a patient with SIRS were included. This
systematic review included 15 studies reporting 19 individual cases in which
E. ramosum
caused invasive infections in various tissues,
mainly in immunocompromised patients.
E. ramosum
was most often
isolated by blood cultures and identified by specific biochemical tests. Severe
infections caused by
E. ramosum
were in most cases effectively
treated with antibiotics, except in two patients, one of whom died. More than
one isolate of
E. ramosum
exhibited 100% susceptibility to
metronidazole, amoxicillin/clavulanate and piperacillin/tazobactam. On the other
hand, individual resistance of this bacterium to penicillin, ciprofloxacin,
clindamycin, imipenem and ertapenem was reported. This systematic review
confirmed the clinical relevance of
E. ramosum
as a cause of a
number of severe infections mainly in immunocompromised inpatients.
Metronidazole and meropenem appear to be the antibiotics of choice that should
be used in combination or as monotherapy to treat
E. ramosum
infections, depending on the type and severity of the infection.