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Published on: July 22, 2017
Agrobacterium infections in humans: experience at one hospital and review
M Hulse1, S Johnson, P Ferrieri
1Department of Pediatrics, University of Minnesota Hospital and Clinic, Minneapolis 55455.
Abstract:
Agrobacteria are noted primarily for their phytopathogenicity and when isolated from human clinical specimens are often considered contaminants or organisms of low pathogenicity. We report six cases at one hospital over a 6 1/2-year period in which infection was accompanied by a compatible clinical syndrome and review 19 cases reported in the literature. Fourteen of the 25 combined cases involved central venous catheter-associated infections. Six cases involved peritonitis, five of which occurred in patients undergoing continuous ambulatory peritoneal dialysis. Additional infections included two non-catheter-associated bacteremias, one prosthetic valve endocarditis, and two urinary tract infections. Most infections were community acquired, and restriction enzyme analysis of Agrobacterium isolates from eight patients at one hospital revealed unique patterns in each case without evidence for clonal dissemination of these strains. Agrobacterium isolates may be resistant to multiple antibiotics, and optimal therapy has not yet been determined. Agrobacteria should be recognized as opportunistic pathogens in the immunocompromised host, particularly in those with indwelling plastic catheters.
Insights
Agrobacteria, typically plant pathogens, can cause serious infections in humans, especially in immunocompromised patients with catheters. These opportunistic infections, often linked to central venous catheters and peritonitis, require further study for effective treatment.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Clinical Medicine
Background:
- Agrobacteria are primarily known as plant pathogens.
- They are often dismissed as contaminants or low-pathogenicity organisms in human clinical settings.
- This study investigates the clinical significance of Agrobacteria in human infections.
Purpose of the Study:
- To highlight Agrobacteria as potential opportunistic pathogens in humans.
- To characterize the clinical syndromes associated with Agrobacteria infections.
- To review reported cases and present new findings.
Main Methods:
- Case series reporting six new cases.
- Literature review of 19 previously reported cases.
- Restriction enzyme analysis of Agrobacterium isolates from eight patients.
Main Results:
- A total of 25 cases were analyzed, with 14 involving central venous catheter-associated infections.
- Six cases of peritonitis were identified, primarily in patients undergoing peritoneal dialysis.
- Infections were mostly community-acquired, with unique strain patterns suggesting no clonal spread.
Conclusions:
- Agrobacteria can cause significant opportunistic infections in immunocompromised hosts, particularly those with indwelling catheters.
- Central venous catheter-associated infections and peritonitis are notable manifestations.
- Further research is needed to determine optimal therapeutic strategies due to potential antibiotic resistance.
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