Chryseobacterium hominis is non-fermenting Gram-negative rod that was first identified as a novel species in 2007. Here, we report the first clinical case of C. hominis bacteremia, which was confirmed by MALDI-TOF MS and 16S rRNA gene sequencing. A 16-year-old boy diagnosed with acute lymphoblastic leukemia was hospitalized for three months. Two sets of blood culture test through a peripherally inserted central catheter (PICC), which was inserted a month ago, was performed when his white blood cell count declined and he had a high fever. Colonies of medium sizes that looked round, mucoid, sticky, and grayish on blood and chocolate agar plates were observed. Identification of bacteria using the VITEK MALDI-TOF MS system (BioMérieux, France) was not successful and the VITEK 2 system (BioMérieux, USA) indicated Sphingomonas paucimobilis, with a questionable level of confidence (92%). However, Microflex LT Biotyper (Bruker Daltonics, Germany) showed C. homins (log score: 1.81) and sequence of 16S rRNA showed a 100% identity with C. hominis. Piperacillin-tazobactam was administered since the isolate was susceptible to piperacillin-tazobactam but C. hominis showed growth in the next four follow-up culture of blood drawn through PICC. The fever subsided only after PICC was changed. The clinical prognosis and antimicrobial susceptibility test of C. hominis should be further studied.
Adolescent ; Agar ; Bacteremia ; Bacteria ; Cacao ; Catheters ; Chryseobacterium ; Fever ; Follow-Up Studies ; Genes, rRNA ; Humans ; Leukocyte Count ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prognosis ; Sphingomonas

Chryseobacterium indologenes (C. indologenes) is a nonmotile, gram-negative bacillus that is widely distributed in nature. Generally considered nonpathogenic, C. indologenes rarely infects humans and is not normally present in the human microflora. C. indologenes infections have been observed in cases of peritoneal dialysis (PD)-associated peritonitis, although the incidence of these infections is low. Although C. indologenes is generally susceptible to trimethoprim-sulfamethoxazole, levofloxacin, ciprofloxacin, piperacillin-tazobactam, and cefepime, no guidelines have been established for the treatment of PD-associated peritonitis. Here we report the first case of PD-associated peritonitis in Korea with C. indologenes identified as the sole etiologic agent. The patient recovered after intraperitoneal antibiotic treatment without the need for Tenckhoff catheter removal.
Bacillus ; Catheters ; Chryseobacterium ; Ciprofloxacin ; Humans ; Incidence ; Korea ; Levofloxacin ; Peritoneal Dialysis ; Peritonitis ; Trimethoprim, Sulfamethoxazole Drug Combination

BACKGROUND: Few reports have documented the clinical characteristics and treatment outcomes of adult patients with Elizabethkingia meningoseptica infection. METHODS: Medical records of patients over 18 years of age and suspected of having an E. meningoseptica infection from March 1, 2006 to February 28, 2013 were reviewed retrospectively. Their clinical characteristics, antimicrobial susceptibility results, and treatment outcomes were analyzed. RESULTS: E. meningoseptica was isolated from 30 patients. Median age was 68.5 years, and infections were more frequent in males (17, 56.7%). The most common isolation source was sputum (23, 76.7%), and pneumonia was the most common condition (21, 70%) after excluding two cases of colonization. This bacterium was most susceptible to minocycline (27, 90%) and fluoroquinolones, including levofloxacin (20, 66.7%) and ciprofloxacin (18, 60%). The mortality rate due directly to E. meningoseptica infection was 20% (6/30), and uncontrolled pneumonia was the only cause of death. After isolating E. meningoseptica, the numbers of patients with pneumonia (9/9, 100% vs. 12/21, 57.1%), history of hemodialysis (5/9, 55.6% vs. 3/21, 14.3%), tracheostomy (8/9, 88.9 vs. 10/21, 47.6%), and median Charlson comorbidity index score (6 [range, 3-9] vs. 4 [range, 0-9]) were significantly higher in non-survivors than those in survivors (p < 0.05, for each). However, only 12 (40%) patients received appropriate antibiotics. CONCLUSIONS: E. meningoseptica infection most commonly presented as pneumonia in adults with severe underlying diseases. Despite the high mortality rate, the rate of appropriate antibiotic use was notably low.
Adult* ; Anti-Bacterial Agents ; Cause of Death ; Chryseobacterium ; Ciprofloxacin ; Colon ; Comorbidity ; Cross Infection ; Fluoroquinolones ; Humans ; Levofloxacin ; Male ; Medical Records ; Minocycline ; Mortality ; Pneumonia ; Renal Dialysis ; Retrospective Studies ; Sputum ; Survivors ; Tertiary Care Centers* ; Tracheostomy

BACKGROUND: Few reports have documented the clinical characteristics and treatment outcomes of adult patients with Elizabethkingia meningoseptica infection. METHODS: Medical records of patients over 18 years of age and suspected of having an E. meningoseptica infection from March 1, 2006 to February 28, 2013 were reviewed retrospectively. Their clinical characteristics, antimicrobial susceptibility results, and treatment outcomes were analyzed. RESULTS: E. meningoseptica was isolated from 30 patients. Median age was 68.5 years, and infections were more frequent in males (17, 56.7%). The most common isolation source was sputum (23, 76.7%), and pneumonia was the most common condition (21, 70%) after excluding two cases of colonization. This bacterium was most susceptible to minocycline (27, 90%) and fluoroquinolones, including levofloxacin (20, 66.7%) and ciprofloxacin (18, 60%). The mortality rate due directly to E. meningoseptica infection was 20% (6/30), and uncontrolled pneumonia was the only cause of death. After isolating E. meningoseptica, the numbers of patients with pneumonia (9/9, 100% vs. 12/21, 57.1%), history of hemodialysis (5/9, 55.6% vs. 3/21, 14.3%), tracheostomy (8/9, 88.9 vs. 10/21, 47.6%), and median Charlson comorbidity index score (6 [range, 3-9] vs. 4 [range, 0-9]) were significantly higher in non-survivors than those in survivors (p < 0.05, for each). However, only 12 (40%) patients received appropriate antibiotics. CONCLUSIONS: E. meningoseptica infection most commonly presented as pneumonia in adults with severe underlying diseases. Despite the high mortality rate, the rate of appropriate antibiotic use was notably low.
Adult ; Anti-Bacterial Agents ; Cause of Death ; Chryseobacterium ; Ciprofloxacin ; Colon ; Comorbidity ; Cross Infection ; Fluoroquinolones ; Humans ; Levofloxacin ; Male ; Medical Records ; Minocycline ; Mortality ; Pneumonia ; Renal Dialysis ; Retrospective Studies ; Sputum ; Survivors ; Tertiary Care Centers ; Tracheostomy

Sphingomonas paucimobilis is an aerobic Gram-negative bacillus found in soil and water. Knowledge regarding the role of this infectious agent is limited because it is rarely isolated from human material. Furthermore, it is an unusual pathogen in cases of peritoneal dialysis (PD)-associated peritonitis. The clinical courses and outcomes of peritonitis caused by S. paucimobilis are variable. Whereas some patients were cured with appropriate antibiotic therapy, others required catheter removal. Cases of PD-associated peritonitis caused by S. paucimobilis have been reported worldwide, and there was a case report of coinfection with S. paucimobilis and Chryseobacterium indologenes in Korea. However, there has been no case caused by S. paucimobilis as a single pathogen. We report a case of PD-associated peritonitis due to S. paucimobilis in which the patient recovered after catheter removal.
Bacillus ; Catheters ; Chryseobacterium ; Coinfection ; Humans ; Korea ; Peritoneal Dialysis ; Peritonitis ; Soil ; Sphingomonas

To report keratitis with Elizabethkingia meningoseptica, which occurred in a healthy patient after wearing contact lenses for 6 months. A 24-year-old male patient visited our hospital with ocular pain. This patient had a history of wearing soft contact lenses for 6 months, about 10 hours per day. At initial presentation, slit lamp examination showed corneal stromal infiltrations and small epithelial defect. Microbiological examinations were performed from corneal scrapings, contact lenses, and the contact lens case and solution. The culture results from contact lenses, contact lens case and solution were all positive for Elizabethkingia meningoseptica. Thus, we could confirm that the direct cause of keratitis was contamination of the contact lenses. The patient was treated with 0.3% gatifloxacin. After treatment, the corneal epithelial defect was completely healed, and a slight residual subepithelial corneal opacity was observed. We diagnosed keratitis with Elizabethkingia meningoseptica in a healthy young male wearing soft contact lenses. We conclude that Elizabethkingia meningoseptica should be considered as a rare but potential pathogen for lens-related keratitis in a healthy host.
*Chryseobacterium ; Contact Lenses, Hydrophilic/*adverse effects/*microbiology ; Flavobacteriaceae Infections/*complications ; Humans ; Keratitis/*etiology/*microbiology ; Male ; Young Adult

To report keratitis with Elizabethkingia meningoseptica, which occurred in a healthy patient after wearing contact lenses for 6 months. A 24-year-old male patient visited our hospital with ocular pain. This patient had a history of wearing soft contact lenses for 6 months, about 10 hours per day. At initial presentation, slit lamp examination showed corneal stromal infiltrations and small epithelial defect. Microbiological examinations were performed from corneal scrapings, contact lenses, and the contact lens case and solution. The culture results from contact lenses, contact lens case and solution were all positive for Elizabethkingia meningoseptica. Thus, we could confirm that the direct cause of keratitis was contamination of the contact lenses. The patient was treated with 0.3% gatifloxacin. After treatment, the corneal epithelial defect was completely healed, and a slight residual subepithelial corneal opacity was observed. We diagnosed keratitis with Elizabethkingia meningoseptica in a healthy young male wearing soft contact lenses. We conclude that Elizabethkingia meningoseptica should be considered as a rare but potential pathogen for lens-related keratitis in a healthy host.
*Chryseobacterium ; Contact Lenses, Hydrophilic/*adverse effects/*microbiology ; Flavobacteriaceae Infections/*complications ; Humans ; Keratitis/*etiology/*microbiology ; Male ; Young Adult

Chryseobacterium meningosepticum is rarely encountered as a pathogen causing peritonitis in peritoneal dialysis (PD) patients. We report a case of peritonitis due to Chryseobacterium meningosepticum, which was treated successfully with intraperitoneal (IP) vancomycin and ciprofloxacin, and without PD catheter removal. Peritonitis was developed in a 53-year-old PD patient on the third hospital day. Although empirical IP treatment with cefazolin and tobramycin was initiated and maintained for 3 days, the fever and signs of peritonitis persisted. Antibiotics were changed to cefoperazone/sulbactam, amikacin, and vancomycin due to clinical deterioration. After 3 days of vancomycin use, leukocyte count in PD fluid was less than 100/mm3 and the patient became asymptomatic. On seventh day after the onset of peritonitis, Chryseobacterium meningosepticum was isolated from initial dialysate sample, and this strain was susceptible to ciprofloxacin, piperacillin, and piperacillin/tazobactam. Accordingly, we changed the antibiotics to ciprofloxacin and vancomycin, which were given for the total of 14 days. Even though Chryseobacterium meningosepticum is an uncommon causative organism of peritonitis in PD patients, this report suggests that vancomycin and ciprofloxacin are effective as empiric therapy, and early suspicion and appropriate antimicrobial therapy are crucial to the successful treatment of peritonitis due to Chryseobacterium meningosepticum without catheter removal.
Amikacin ; Anti-Bacterial Agents ; Catheters ; Cefazolin ; Chryseobacterium ; Ciprofloxacin ; Fever ; Humans ; Leukocyte Count ; Middle Aged ; Peritoneal Dialysis ; Peritonitis ; Piperacillin ; Sprains and Strains ; Tobramycin ; Vancomycin

Chryseobacterium meningosepticum is a ubiquitous Gram-negative rod widely distributed in natural and hospital environments. It mostly causes meningitis in premature and newborn infants. Few such cases have been reported in Korea, and no case of community-acquired pneumonia caused by Chryseobacterium meningosepticum. A 53-year-old man was brought to the emergency department because of severe pneumonia. We report a case of community-acquired pneumonia and sepsis caused by Chryseobacterium meningosepticum.
Chryseobacterium ; Emergencies ; Humans ; Infant, Newborn ; Korea ; Meningitis ; Middle Aged ; Pneumonia ; Sepsis

We report on two premature infants who developed nosocomial infection caused by Chryseobacterium meningosepticum in a neonatal intensive care unit (NICU). One premature infant developed sepsis, meningitis, and hydrocephalus, and was treated successfully with ciprofloxacin plus trimethoprim-sulfamethoxazole combination therapy for 4 weeks and with a ventriculoperitoneal shunt. The other premature infant, who was in a chronically debilitated state, had infection that had colonized only in the respiratory tract but had no clinical signs for 66 days. Extensive environmental surveillance demonstrated that the suction bottle apparatus was the source of infection. We prevented the spread of infection by closing the NICU temporarily, isolating the patients early in their infection, and eradicating the source of infection source.
Chryseobacterium* ; Ciprofloxacin ; Colon ; Cross Infection ; Environmental Monitoring ; Humans ; Hydrocephalus ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal* ; Meningitis ; Respiratory System ; Sepsis ; Suction ; Trimethoprim, Sulfamethoxazole Drug Combination ; Ventriculoperitoneal Shunt