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Sphingomonas paucimobilis infections in children: 24 case reports
Nuri Bayram1, Ilker Devrim, Hurşit Apa
1Department of Pediatric Infectious Diseases, Dr. Behçet Uz Children's Hospital, İzmir, Turkey.
Insights
Sphingomonas paucimobilis infections are increasingly reported in children, affecting both healthy and immunocompromised individuals. Effective treatments include fluoroquinolones, carbapenems, and trimethoprim/sulfamethoxazole, with no fatalities observed.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
- Antimicrobial Resistance
Background:
- Sphingomonas paucimobilis is an opportunistic pathogen increasingly implicated in healthcare-associated infections, particularly in immunocompromised patients.
- While rare, S. paucimobilis infections are being encountered more frequently in clinical settings.
- This study focuses on pediatric cases, evaluating clinical characteristics and antimicrobial susceptibility patterns.
Purpose of the Study:
- To report the clinical features of Sphingomonas paucimobilis infections in pediatric patients.
- To determine the antimicrobial susceptibilities of S. paucimobilis isolates from children.
- To provide insights into the epidemiology and management of S. paucimobilis infections in a pediatric population.
Main Methods:
- Retrospective review of medical records of pediatric patients with positive S. paucimobilis cultures.
- Data collection included patient demographics, infection source (community vs. nosocomial), clinical presentation, and treatment outcomes.
- Antimicrobial susceptibility testing was performed on isolated S. paucimobilis strains.
Main Results:
- Twenty-four pediatric patients were identified with S. paucimobilis infections; median age was 4 years, with 58.3% males.
- Infections were predominantly community-related (54.2%) versus nosocomial (45.8%).
- The most effective antibiotics identified were fluoroquinolones, carbapenems, and trimethoprim/sulfamethoxazole; no attributable fatalities occurred.
Conclusions:
- Sphingomonas paucimobilis can cause infections in both healthy and immunocompromised children.
- Effective antimicrobial agents include fluoroquinolones, carbapenems, and trimethoprim/sulfamethoxazole.
- Despite varied treatments, the low virulence of S. paucimobilis resulted in no deaths in this pediatric cohort.
Abstract:
Sphingomonas paucimobilis is a causative agent of infection in immunocompromised patients, and healthcare-associated infection. Although the infections associated with S.paucimobilis occurs rarely, it has been encountered with increasing frequency in clinical settings. In the current study we reported clinical features of the children with S.paucimobilis infection, and the antimicrobial susceptibilities of the isolated strains among the patients. This study was conducted in Dr. Behçet Uz Children's Hospital, Turkey, during the period of January 2005 and December 2012. The medical records of pediatric patients with positive cultures for S.paucimobilis were reviewed. Sphingomonas paucimobilis isolates were recovered from 24 pediatric patients. The median age was 4 years (ranging from 3 days infant to 15 years) and 58,3% were male. Eight (33,3%) of the patients were under 1 months of age. Among the patients; 13 (54,2%) infections were community related however 11(45.8%) infections were nosocomial infection. The median duration of hospital stay was 7 days (ranging from 4 to 22 days). The most effective antibiotics were fluoroquinolones, carbapenems, and trimethoprim/sulfamethoxazole. This is the first largest study in children to evaluate the clinical features of S. paucimobilis infections. Sphingomonas paucimobilis may cause infections in both previously healthy and immunocompromised children. Although variable antimicrobial regimens were achieved to the patients, there was no attributable fatality due to S.paucimobilis infections due to the low virulence of the bacteria.