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Nosocomial infections caused by Sphingomonas paucimobilis: clinical features and microbiological characteristics
Abstract:
From January 1995 to September 1996, 14 isolates of Sphingomonas paucimobilis, including 11 from clinical specimens from six patients with nosocomial infection and three from environmental sources, were collected. Two of the six patients had intravascular catheter-related bacteremia and one each had bacteremic biliary tract infection, urinary tract infection, ventilator-associated pneumonia, and wound infection. The S. paucimobilis isolates were identified according to biochemical profiles established with use of the API 20NE system and Vitek GNI card and the characteristic cellular fatty acid chromatogram. Ten biotypes, 11 antibiograms (by the Etest), and 12 random amplified polymorphic DNA (RAPD) patterns (by arbitrarily primed polymerase chain reaction) were identified. The identical biotype, antibiogram, and RAPD pattern of the two isolates (one each from blood and bile) from a patient with biliary tract infection indicated the invasiveness of the organism. Two patients with intravascular catheter-related bacteremia had isolates of this organism repeatedly recovered, and these isolates had heterogeneous RAPD patterns. The present study highlights the wide distribution in hospital environments of various clones of S. paucimobilis, which may cause recurrent infections by a single strain or several episodes of infection due to two or more clones of this organism in hospitalized patients.
Insights
Sphingomonas paucimobilis is widespread in hospitals, causing various infections. Different strains can lead to recurrent or multiple infections in patients, highlighting environmental contamination risks.
Area of Science:
- Microbiology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Nosocomial infections pose a significant threat in healthcare settings.
- Sphingomonas paucimobilis is an opportunistic pathogen increasingly recognized for its role in hospital-acquired infections.
- Understanding the genetic diversity and environmental distribution of S. paucimobilis is crucial for infection control.
Purpose of the Study:
- To investigate the genetic diversity and sources of Sphingomonas paucimobilis isolates from clinical and environmental samples.
- To determine the clonal relationships among S. paucimobilis isolates causing nosocomial infections.
- To assess the potential for S. paucimobilis to cause recurrent or multiple infections in hospitalized patients.
Main Methods:
- Collected 14 S. paucimobilis isolates from clinical (n=11) and environmental (n=3) sources between January 1995 and September 1996.
- Identified isolates using API 20NE system, Vitek GNI card, and cellular fatty acid analysis.
- Characterized isolates by biotyping, antibiogram profiling (Etest), and random amplified polymorphic DNA (RAPD) typing.
Main Results:
- Identified 10 biotypes, 11 antibiograms, and 12 RAPD patterns among the isolates.
- Demonstrated identical biotype, antibiogram, and RAPD patterns for isolates from blood and bile in one patient, suggesting invasiveness.
- Observed heterogeneous RAPD patterns in repeatedly recovered isolates from patients with catheter-related bacteremia.
- Highlighted the presence of diverse S. paucimobilis clones in hospital environments.
Conclusions:
- Sphingomonas paucimobilis exhibits significant genetic diversity within hospital environments.
- Various S. paucimobilis clones can cause nosocomial infections, including bacteremia, pneumonia, and wound infections.
- The presence of multiple clones may contribute to recurrent or polymicrobial infections in susceptible patients.