Journal of Microbiology, Immunology and Infection
Volume 43, Issue 6 , Pages 498-505, December 2010

Clinical and Microbiological Characteristics of Chryseobacterium indologenes Bacteremia

  • Yi-Tsung Lin

      Affiliations

    • Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    • National Yang-Ming University, Taipei, Taiwan
  • ,
  • Yuan-Yu Jeng

      Affiliations

    • Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
  • ,
  • Mei-Lin Lin

      Affiliations

    • Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
  • ,
  • Kwok-Woon Yu

      Affiliations

    • Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    • National Yang-Ming University, Taipei, Taiwan
    • Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
  • ,
  • Fu-Der Wang

      Affiliations

    • Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    • National Yang-Ming University, Taipei, Taiwan
    • Corresponding Author InformationCorresponding author. Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, 201 Section 2, Shih-Pai Road, Taipei, Taiwan
  • ,
  • Cheng-Yi Liu

      Affiliations

    • Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    • National Yang-Ming University, Taipei, Taiwan

Received 11 July 2008; received in revised form 2 February 2009; accepted 30 May 2009.

Article Outline

Background/Purpose

Reports detailing bacteremia caused by Chryseobacterium indologenes remain limited, with most cases reported in Taiwan. The clinical significance of C. indologenes has not been fully established. This retrospective study investigated the clinical features and antimicrobial susceptibility of C. indologenes bacteremia.

Methods

Patients with C. indologenes bacteremia were identified at a medical center/teaching hospital in northern Taiwan between January 1, 2004 and January 31, 2008. Clinical features and the antimicrobial susceptibilities of these patients were analyzed.

Results

Sixteen isolates of C. indologenes from 16 episodes in 16 patients were identified, with all patients having underlying diseases. Two patients (12.5%) had polymicrobial bacteremia. The portal of bacteremia was not determined in most cases. Other clinical syndromes included catheter-related bacteremia, urinary tract infection and peritonitis. The majority of patients had undergone invasive procedures. Other associated conditions included immunosuppression, neutropenia and prolonged use of antibiotics. Only three patients were treated with appropriate antibiotics according to minimum inhibitory concentrations. The susceptibilities of isolates to trimethoprim-sulfamethoxazole (75.0%), levofloxacin (62.5%), piperacillin-tazobactam (50.0%), ciprofloxacin (43.75%) and cefepime (12.5%) were variable and the bacteremia-related mortality rate was 6.25%.

Conclusion

C. indologenes isolates are resistant to multiple antibiotics, with newer fluoroquinolones and trimethoprim-sulfamethoxazole possibly representing the most appropriate antimicrobial agents to treat infections caused by this pathogen. However, the pathogenicity and factors of virulence for C. indologenes remain unclear, with our study revealing favorable outcomes of C. indologenes bacteremia. Epidemiological surveillance of this organism in Taiwan and extensive worldwide surveillance programs are required.

Keywords:  antibacterial agents , bacteremia , Chryseobacterium indologenes

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References 

  1. Vandamme P , Bernardet JF , Segers P , Kersters K , Holmes B . New perspectives in the classification of the flavobacteria: description of Chryseobacterium gen. nov., Bergeyella gen. nov., and Empedobacter nom. rev . Int. J. Syst. Bacteriol . 1994;44:827–831
  2. Yabuuchi E , Hashimoto Y , Ezaki T , Ido Y , Takeuchi N . Genotypic and phenotypic differentiation of Flavobacterium indologenes Yabuuchi et al 1983 from Flavobacterium gleum Holmes et al 1984 . Microbiol Immunol . 1990;34:73–76
  3. Hsueh PR , Hsiue TR , Wu JJ , Teng LJ , Ho SW , Hsieh WC , et al.   Flavobacterium indologenes bacteremia: clinical and microbiological characteristics . Clin Infect Dis . 1996;23:550–555
  4. Hsueh PR , Teng LJ , Ho SW , Hsieh WC , Luh KT . Clinical and microbiological characteristics of Flavobacterium indologenes infections associated with indwelling devices . J Clin Microbiol . 1996;34:1908–1913
  5. Hsueh PR , Teng LJ , Yang PC , Ho SW , Hsieh WC , Luh KT . Increasing incidence of nosocomial Chryseobacterium indologenes infections in Taiwan . Eur J Clin Microbiol Infect Dis . 1997;16:568–574
  6. Green BT , Nolan PE . Cellulitis and bacteraemia due to Chryseobacterium indologenes . J Infect . 2001;42:219–220
  7. Nulens E , Bussels B , Bols A , Gordts B , Van Landuyt HW . Recurrent bacteremia by Chryseobacterium indologenes in an oncology patient with a totally implanted intravascular device . Clin Microbiol Infect . 2001;7:391–393
  8. Lin JT , Wang WS , Yen CC , Liu JH , Chiou TJ , Yang MH , et al.   Chryseobacterium indologenes bacteremia in a bone marrow transplant recipient with chronic graft-versus-host disease . Scand J Infect Dis . 2003;35:882–883
  9. Cascio A , Stassi G , Costa GB , Crisafulli G , Rulli I , Ruggeri C , et al.   Chryseobacterium indologenes bacteraemia in a diabetic child . J Med Microbiol . 2005;54:677–680
  10. Christakis GB , Perlorentzou SP , Chalkiopoulou I , Athanasiou A , Legakis NJ . Chryseobacterium indologenes non-catheter-related bacteremia in a patient with a solid tumor . J Clin Microbiol . 2005;43:2021–2023
  11. Akay M , Gunduz E , Gulbas Z . Catheter-related bacteremia due to Chryseobacterium indologenes in a bone marrow transplant recipient . Bone Marrow Transplant . 2006;37:435–436
  12. Bayraktar MR , Aktas E , Ersoy Y , Cicek A , Durmaz R . Postoperative Chryseobacterium indologenes bloodstream infection caused by contamination of distillate water . Infect Control Hosp Epidemiol . 2007;28:368–369
  13. Pan HJ , Teng LJ , Chen YC , Hsueh PR , Yang PC , Ho SW , et al.   High protease activity of Chryseobacterium indologenes isolates associated with invasive infection . J Microbiol Immunol Infect . 2000;33:223–226
  14. Clinical and Laboratory Standards Institute (CLSI)  . Performance standards for antimicrobial susceptibility testing. 17th informational supplement . Wayne, PA: Clinical and Laboratory Standards Institute; 2007; CLSI document M100-S17.
  15. Chang JC , Hsueh PR , Wu JJ , Ho SW , Hsieh WC , Luh KT . Antimicrobial susceptibility of flavobacteria as determined by agar dilution and disk diffusion methods . Antimicrob Agents Chemother . 1997;41:1301–1306
  16. Fraser SL , Jorgensen JH . Reappraisal of the antimicrobial susceptibilities of Chryseobacterium and Flavobacterium species and methods for reliable susceptibility testing . Antimicrob Agents Chemother . 1997;41:2738–2741
  17. Kirby JT , Sader HS , Walsh TR , Jones RN . Antimicrobial susceptibility and epidemiology of a worldwide collection of Chryseobacterium spp.: report from the SENTRY Antimicrobial Surveillance Program (1997-2001) . J Clin Microbiol . 2004;42:445–448
  18. Marchaim D , Zaidenstein R , Lazarovitch T , Karpuch Y , Ziv T , Weinberger M . Epidemiology of bacteremia episodes in a single center: increase in Gram-negative isolates, antibiotics resistance, and patient age . Eur J Clin Microbiol Infect Dis . 2008;27:1045–1051
  19. Hsueh PR , Chen WH , Luh KT . Relationships between antimicrobial use and antimicrobial resistance in Gram-negative bacteria causing nosocomial infections from 1991-2003 at a university hospital in Taiwan . Int J Antimicrob Agents . 2005;26:463–472

PII: S1684-1182(10)60077-1

doi:10.1016/S1684-1182(10)60077-1

Journal of Microbiology, Immunology and Infection
Volume 43, Issue 6 , Pages 498-505, December 2010