cefepime and Flavobacteriaceae-Infections

Chryseobacterium meningosepticum is an uncommon pathogen causing adult bacterial meningitis. Herein, we report the case history of one 21-year-old woman with this uncommon central nervous system infection. A diagnosis of adult C. meningosepticum meningitis can only be confirmed by a positive cerebrospinal fluid (CSF) culture. The patient had insulin-dependent diabetes mellitus as the underlying condition associated with this infection. The clinical presentations were fever, headache, consciousness disturbance, and seizure. CSF analysis revealed a purulent inflammatory reaction. After a 21-day course of intravenous cefepime (6 g/day) treatment, this patient was discharged in a state of complete recovery.

Topics: Adult; Anti-Bacterial Agents; Cefepime; Cephalosporins; Chryseobacterium; Female; Flavobacteriaceae Infections; Humans; Meningitis, Bacterial

Topics: Aged, 80 and over; Amino Acid Substitution; Anti-Bacterial Agents; beta-Lactamases; Brazil; Cefepime; Ceftazidime; Chromosomes, Bacterial; Chryseobacterium; Ciprofloxacin; Cross Infection; Drug Resistance, Multiple, Bacterial; Female; Flavobacteriaceae Infections; Gene Expression; Humans; Microbial Sensitivity Tests; Middle Aged; Models, Molecular; Phylogeny; Plasmids; Point Mutation; Protein Structure, Secondary; Tigecycline

To report a case of Chryseobacterium indologenes ventilator-associated pneumonia (VAP) in a critically ill trauma patient.. This report describes a 66-year-old critically ill trauma patient who developed VAP, which was caused by C indologenes. The patient was injured in a riding lawn mower accident that trapped him underwater in a pond. The patient required surgery for intra-abdominal injuries and was mechanically ventilated in the trauma intensive care unit. On hospital day 5, the patient developed signs and symptoms of VAP. A diagnosis of C indologenes VAP was confirmed based on a quantitative culture from a bronchoscopic bronchoalveolar lavage. The patient's infection was successfully treated with moxifloxacin for 2 days followed by cefepime for 7 days.. Formally known as Flavobacterium indologenes, C indologenes is a Gram-negative bacillus normally found in plants, soil, foodstuffs, and fresh and marine water sources. Recently, worldwide reports of C indologenes infections in humans have been increasing, though reports from the United States are still rare. Bacteremia and pneumonia are the most commonly reported infections, and most patients are immunocompromised. The current case differs from most previous reports because this patient was in the United States and did not have any traditional immunocompromised states (eg, transplant, cancer, HIV/AIDS, or corticosteroid use).. This case report demonstrates that C indologenes can cause VAP in a trauma ICU patient.

Topics: Aged; Anti-Bacterial Agents; Aza Compounds; Cefepime; Cephalosporins; Chryseobacterium; Critical Illness; Flavobacteriaceae Infections; Fluoroquinolones; Humans; Intensive Care Units; Male; Moxifloxacin; Pneumonia, Ventilator-Associated; Quinolines; Radiography; Wounds and Injuries

Chryseobacterium species are a rare cause of human disease and are usually associated with indwelling devices or altered immune status. This is the first case to our knowledge, of Chryseobacterium indologenes bacteremia in a previously healthy infant. Chryseobacteria are pathogens resistant to the usual empiric treatments for neonatal or infantile septicemia.

Topics: Anti-Bacterial Agents; Bacteremia; Cefepime; Cephalosporins; Chryseobacterium; Female; Flavobacteriaceae Infections; Humans; Infant; Microbial Sensitivity Tests; Treatment Outcome

A new natural IND-type metallo-beta-lactamase variant, IND-5, was identified in a clinical isolate of Chryseobacterium indologenes. IND-5 shared 92.8% and 92.4% amino acid homology with IND-1 and IND-3, respectively. Purified enzyme (pI = 8.8, M(r) = 25,000) was able to hydrolyze penicillins, some narrow- and expanded-spectrum cephalosporins, and carbapenems but not monobactams.

Topics: Amino Acid Sequence; Anti-Bacterial Agents; beta-Lactam Resistance; beta-Lactamases; Carbapenems; Cephalosporins; Chryseobacterium; Flavobacteriaceae Infections; Humans; Kinetics; Microbial Sensitivity Tests; Molecular Sequence Data; Penicillins; Sequence Analysis, DNA