Successful Treatment of Pantoea agglomerans Bacteremia Using Oral Antibiotics

Penner, Megan; Romans, Brittany; Tah, Lauren; Argubright, Brianna; Strohmeyer, Matthew

doi:10.1155/2022/6136265

Cited by 7 publications

(6 citation statements)

References 19 publications

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“…Some studies have found carbapenems effective against this infection 24,35 . A recent study found a 2‐day course of cephalosporins followed by a 12‐day therapy with quinolone compelling 33 . In our study, around 94.1% of infected patients had an excellent response to cephalosporins, further emphasizing their role in treating this infection, especially in uncomplicated cases.…”

Section: Discussionsupporting

confidence: 62%

“…24,35 A recent study found a 2-day course of cephalosporins followed by a 12-day therapy with quinolone compelling. 33 In our study, around 94.1% of infected patients had an excellent response to cephalosporins, further emphasizing their role in treating this infection, especially in uncomplicated cases. In contrast, in cases of ongoing sepsis, we suggest catheter removal in combination with carbapenem therapy as the most effective treatment option, as seen from our data.…”

Section: Essential Aspects Percentage (Frequency)supporting

confidence: 55%

“…Prior antibiotic exposure may have disrupted the normal gastrointestinal commensal flora, leading to increased infectious predisposition. Although both our infected and noninfected dialysis patients had a history of GERD and prior antacid exposure, a history of GERD [31][32][33] can also predispose to an increased incidence of this infection. Studies showed that the gastric mucosal injury might have been caused by over-acidification of gastric mucosa in GERD or suppression of protective gastric acidity by antacids that may have played a role in the migration of bacteria across the gastric mucosa to the bloodstream in our patients.…”

Section: Resultsmentioning

confidence: 92%

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Pantoea agglomerans: A rare infectious outbreak affecting maintenance hemodialysis patients in a tertiary care hospital

Hassan,

Saleem,

Haneef

et al. 2023

Seminars in Dialysis

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BackgroundPantoea agglomerans is an environmental pathogen known to cause infection in immunocompromised individuals, particularly after thorn injuries. However, previous data showed few cases of human disease caused by contaminated medical products such as parenteral nutrition, anesthetic agents, blood, and peritoneal dialysis solutions. Infection in hemodialysis patients is rare. In this study, we presented a detailed account of several hemodialysis patients infected with this contagious pathogen and compared them with noninfected dialysis patients.MethodsWe retrospectively reviewed the hospital records of 105 hemodialysis patients. Seventeen of 105 patients were diagnosed with P. agglomerans infection. We carefully analyzed their entire in‐hospital course.ResultsAmong infected patients, 52.9% were male with a median age of 49 (IQR: 32–66) years. Compared to the noninfected patients, age below 50 years, prior kidney transplantation, prior immunosuppression and antibiotics use, and dialysis via a tunneled vascular catheter were the significant epidemiological features. Despite negative microbiological investigations, we suspect the possible infectious spread via infected central venous catheter was the likely infectious source. Most importantly, all patients responded well to intravenous antibiotics. Only two patients required the removal of the tunneled catheter. Their mortality rate was 0%.ConclusionP. agglomerans infection, although considered rare, is becoming increasingly prevalent among dialysis patients. Its occurrence must be appraised as an infectious outbreak rather than mere contamination. Prompt treatment, source identification, and early implementation of preventive strategies should always be the goal to curtail this infection at an early stage.

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Section: Discussionsupporting

confidence: 62%

Section: Essential Aspects Percentage (Frequency)supporting

confidence: 55%

Section: Resultsmentioning

confidence: 92%

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Pantoea agglomerans: A rare infectious outbreak affecting maintenance hemodialysis patients in a tertiary care hospital

Hassan,

Saleem,

Haneef

et al. 2023

Seminars in Dialysis

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“…In pediatric patients, Pantoea species were deemed to be involved in wound infection following penetrating trauma and catheter-related bacteremia [11], postsurgical meningitis [12], bloodstream infection, sepsis or fatal infections in newborns [12][13][14][15][16][17], and nosocomial outbreaks [18][19][20][21]. In adults, wound infections [22][23][24], septic arthritis [25][26][27][28][29][30][31], prosthetic joint infections [32], osteomyelitis [33], bloodstream infections or sepsis [34][35][36][37][38][39][40][41], peritonitis in patients on peritoneal [42][43][44][45][46][47][48] or hemodialysis [49], eye infections [50][51][52][53], endocarditis [54], infection in a near-term female [55], pneumonia post-lung transplant…”

Section: Introductionmentioning

confidence: 99%

Bloodstream Infections by Pantoea Species: Clinical and Microbiological Findings from a Retrospective Study, Italy, 2018–2023

Casale,

Boattini,

Bianco

et al. 2023

Antibiotics

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(1) Background: The widespread use of MALDI-TOF coupled to mass spectrometry has improved diagnostic accuracy by identifying uncommon bacteria. Among Enterobacterales, Pantoea species have been seen to be implicated in several human infections, but their clinical and microbiological framework is currently based on a few anecdotal reports. (2) Methods: We conducted this five-year (2018–2023) single-center study aimed at investigating the prevalence and clinical and microbiological findings of Pantoea species bloodstream infections. (3) Results: Among the 4996 bloodstream infection Gram-negative isolates collected during the study period, Pantoea species accounted for 0.4% (n = 19) of isolates from 19 different patients, 5 of them being pediatric cases. Among Pantoea species isolates, P. agglomerans was the most frequently detected (45%; n = 9) followed by P. eucrina (30%; n = 6) and P. septica (15%; n = 3). Malignancy (35.7%) in adults and malignancy (40%) and cerebrovascular disease following meconium aspiration (40%) in pediatric patients as comorbidities and shivering and/or fever following parenteral infusion (36.8%) as a symptom/sign of Pantoea species bloodstream infection onset were the most frequently observed clinical features. Among adults, primary bloodstream infection was the most frequent (50%), whereas among pediatric patients, the most commonly identified sources of infection were catheter-related (40%) and the respiratory tract (40%). Overall, Pantoea species bloodstream infection isolates displayed high susceptibility to all the antibiotics except for ampicillin (63.2%), fosfomycin (73.7%), and piperacillin/tazobactam (84.2%). Targeted antibiotic treatment was prescribed as monotherapy for adults (71.4%) and combination therapy for pediatric patients (60%). The most prescribed antibiotic regimens were piperacillin/tazobactam (21.4%) in adults and meropenem- (40%) and aminoglycoside-containing (40%) antibiotics in pediatric patients. The overall 28-day all-cause mortality rate was 5.3% (n = 1). (4) Conclusions: The prevalence and 28-day mortality rate of Pantoea species bloodstream infections were low. The prescription of targeted therapy including broad-spectrum antibiotics could indicate an underestimation of the specific involvement of the Pantoea species in the onset of the disease, warranting further studies defining their pathogenic potential.

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“…Dicha paciente tenía antecedentes médicos de reflujo gastrointestinal y uso de metanfetamina y heroína por vía intravenosa; ambos factores asociados a bacteriemia por P. agglomerans, este último factor se asocia con la "fiebre del algodón", una respuesta febril benigna a la producción de endotoxinas por P. agglomerans después de la introducción del algodón en el torrente sanguíneo. (12) Otro caso de infección por P. agglomerans fue reportado en un niño de 4 años inmunocompetente y sin comorbilidades, que consultó por fiebre y marcadores inflamatorios elevados. El urocultivo fue estéril.…”

Section: Introductionunclassified

Infección de vías urinarias por Pantoea Agglomerans

Grey Irula

2023

Rev. Cient. Esc. Univ. Cienc. Salud

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La infección del tracto urinario es especialmente frecuente en mujeres, las bacterias aerobias gram negativas son las responsables del mayor número de casos. Pantoea agglomerans denominado previamente Enterobacter agglomerans es un bacilo anaerobio Gram negativo que pocas veces se ha descrito como patógeno en el ser humano; se han reportado casos de infecciones cutáneas, osteomielitis y sinovitis posterior a trauma con plantas; e infecciones nosocomiales especialmente en pacientes inmunodeprimidos que se han asociado a material médico contaminado, siendo la mayor parte de los casos resistentes a betalactámicos. Se presenta un insólito caso clínico de cistitis por Pantoea agglomerans en una mujer de 30 años, inmunocompetente, sin antecedentes de hospitalización ni instrumentación o sondaje de vía urinaria; fue manejada con esquema alargado de betalactámicos, con respuesta favorable a la antibiótico terapia. El diagnóstico de infección urinaria por P. agglomerans en pacientes inmunocompetentes es inusual, su escaso aislamiento podría relacionarse a la dificultad de identificar esta bacteria en muestras biológicas y la resistencia a antibioticoterapia podría asociarse en los pacientes hospitalizados a la amplia y prolongada administraciónde antibióticos en su estancia hospitalaria. Por ello se recomienda solicitar urocultivo y su respectivo antibiograma en pacientes con infección sintomática del tracto urinario para disponer de información del patógeno aislado y dar un adecuado manejo antimicrobiano contemplando el esquema más adecuado.

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Successful Treatment of Pantoea agglomerans Bacteremia Using Oral Antibiotics

Cited by 7 publications

References 19 publications

Pantoea agglomerans: A rare infectious outbreak affecting maintenance hemodialysis patients in a tertiary care hospital

Pantoea agglomerans: A rare infectious outbreak affecting maintenance hemodialysis patients in a tertiary care hospital

Bloodstream Infections by Pantoea Species: Clinical and Microbiological Findings from a Retrospective Study, Italy, 2018–2023

Infección de vías urinarias por Pantoea Agglomerans

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