Ochrobactrum anthropi Bacteremia with Variable Clinical Course: Report of Two Cases

@#Ochrobactrum anthropi is a rare nosocomial pathogen that is manifesting itself mostly in immunocompromised patients and those with indwelling catheters. Identification of the microorganism is challenging and the ability to survive in aquatic surroundings have made it a clinically significant pathogen. Furthermore, the clinical picture of O. anthropi infection, is not well described. It may manifest in any form of clinical infections though bacteremia is the most common mode of presentation reported in the limited literature. We report here two cases of O. anthropi bacteremia presenting in an immunocompetent and an immunocompromised host respectively with different clinical manifestation and response. In view of the highly variable presentation of O.anthropi, a high index of suspicion must be given to at risks patients to ensure the timely diagnosis and optimal clinical outcome.

Polymicrobial Keratitis of Pseudomonas aeruginosa, Acinetobacter baumannii, and Ochrobactrum anthropi

PURPOSE: To report polymicrobial keratitis involving Pseudomonas aeruginosa, Acinetobacter baumannii, and Ochrobactrum anthropi. CASE SUMMARY: A 53-year-old female complained of pain and secretion in her right eye, which started 6 weeks before her visit. She applied steroid ointment, which was received from the dermatologist, to her eyelid 7 days prior to her visit but this treatment worsened her symptoms. At the initial visit, the visual acuity of the right eye was light perception, and purulent secretions were observed. Using a slit lamp, severe conjunctival hyperemia, hypopyon, and a ring-shaped central corneal ulcer were observed. The anterior chamber and fundus were not observed due to corneal lesions but ultrasonography showed no intraocular inflammation. Infectious keratitis was suspected and cultured by corneal scraping. During the incubation period, 0.5% moxifloxacin, 2% voriconazole, and 1% cyclopentolate were administered. A total of 400 mg of moxifloxacin and 100 mg of doxycycline were given orally. In the primary culture, Pseudomonas aeruginosa and Acinetobacter baumannii were identified so 5% ceftazidime, which was sensitive for the antibiotic susceptibility results was further instilled. Thereafter, the keratitis improved but the keratitis again worsened while maintaining the topical treatment. A secondary culture was positive for Ochrobactrum anthropi. Treatment with 1.4% gentamicin, which was sensitive for the antibiotic susceptibility test was added and the keratitis improved. A conjunctival flap was performed because of the increased risk of perforation. CONCLUSIONS: We report polymicrobial keratitis involving Pseudomonas aeruginosa, Acinetobacter baumannii, and Ochrobactrum anthropi for the first time in the Republic of Korea.

Presencia de Ochrobactrum anthropi en muestras de semen / Presence of Ochrobactrum Anthropi in Semen Samples

Introducción: El semen es una mezcla compleja de fluidos y células que posee las condiciones adecuadas para albergar microorganismos, especialmente bacterias. Objetivo: Evaluar la presencia de bacterias en el semen de individuos normozoospérmicos asintomáticos para infecciones urogenitales. Métodos: Se realizó una secuenciación estándar posterior a la amplificación por PCR con el uso de los cebadores universales 27F y 1492R para identificación de bacterias, en 10 muestras de semen de voluntarios normozoospérmicos asintomáticos para infecciones urogenitales. Resultados: Se identificó a Ochrobactrum anthropi en 8 de las 10 muestras seminales evaluadas y a Haemophilus paraurethrae o Escherichia coli en los dos restantes. O. anthropi es una bacteria comensal, ampliamente distribuida en la naturaleza, especialmente en las fuentes de agua que, a pesar de su baja virulencia, ocasionalmente causa infecciones en individuos inmunocomprometidos. Conclusión: La alta frecuencia de O. anthropi en las muestras de semen de individuos normozoospérmicos asintomáticos para infecciones urogenitales puede asociarse a procesos de contaminación durante la recolección de la muestra, debido a la amplia distribución de esta bacteria, especialmente en las fuentes de agua(AU)

Introduction: Semen is a complex combination of fluids and cells that can harbor microorganisms, especially bacteria. Objective: To assess the presence of bacteria in semen samples from asymptomatic normozoospermic individuals, for urogenital infections. Methods: Standard sequencing after PCR amplification was performed with the use of the universal primers 27F and 1492R for bacterial identification, in 10 semen samples of asymptomatic normozoospermic volunteers for urogenital infections. Results: Thisidentified Ochrobactrum anthropi in 8 out of 10 samples assessed. In the remaining two samples, we identified Haemophilus paraurethrae and Escherichia coli. O. anthropi is a commensal bacterium, widely spread in nature, especially in water sources that, despite its low virulence, occasionally cause infections in immune compromised individuals. Conclusion: The high frequency of O. anthropi in semen samples from asymptomatic normozoospermic individuals, for urogenital infections can be associated with contamination during the collection of the sample, due to the wide distribution of this bacterium, especially in water sources(AU)

Ochrobactrum anthropi : An unusual pathogen: Are we missing them.

With increasing incidence of immunocompromised patients, many unusual organisms are emerging as pathogens in these patients. Ochrobactrum anthropi is an emerging opportunistic pathogen in immunocompromised patients. Here, we report two cases of neonates who presented with septicemia due to O. anthropi. Both were preterm and low birth weight babies admitted in the Neonatal Intensive Care Unit of our Hospital. One baby manifested with respiratory distress and eventually died. The second baby responded well to treatment and was discharged. The clinical presentation of infections along with microbiological characteristics and clinical significance of the organism are described.

Bacteriemia por Ochrobactrum anthropi en paciente en hemodiálisis por catéter tunelizado permanente: Caso clínico / Catheter associated bacteremia caused by Ochrobactrum anthropi in a patient on hemodialysis: Report of one case

Ochrobactrum anthropi is a rare pathogen in humans that is usually related to infections in inmunocompromised patients or people with indwelling medical devices. There are very few reported cases of O. anthropi bacteremia in patients on hemodialysis. We report a 19-year-old female on hemodialysis through a jugular catheter, with fever and malaise lasting one month. The catheter was withdrawn and Ochrobactrum anthropi was isolated from it and from blood cultures. The patient was successfully treated with levofloxacin.

Prosthetic aortic valve endocarditis due to Ochrobactrum anthropi.

Ochrobactrum anthropi is an emerging pathogen increasingly affecting the immunocompromised host. Only four cases of infective endocarditis have been documented in literature. Therapeutic approach is a rising challenge as it is resistant to most of the currently available beta lactam antibiotics with the exception of carbapenems. We report a case of prosthetic valve endocarditis secondary to Ochrobactrum anthropi infection; the host was temporarily immunocompromised due to disseminated herpes zoster after surgery.

A Case of Continuous Ambulatory Peritoneal Dialysis Related Peritonitis Caused by Ochrobactrum anthropi / 대한신장학회지

Ochrobactrum anthropi is a ubiquitous gram-negative bacillus and currently thought to be an opportunistic pathogen. We experienced a 66-year-old male patient with continuous ambulatory peritoneal dialysis (CAPD)-related peritonitis caused by O. anthropi. Susceptible antibiotic therapy including amikacin and ciprofloxacin improved the patient's clinical status. However, peritoneal effluent showed sustained leukocytosis, thus CAPD catheter was removed. After 2 weeks of temporary hemodialysis, CAPD was successfully restarted with reinsertion of catheter. This is, to our knowledge, the first case of CAPD-related peritonitis caused by O. anthropi in Korea.

A Case of Meropenem-Resistant Ochrobactrum anthropi Bacteremia / 감염과화학요법

Ochrobactrum anthropi is an oxidase-producing, non-lactose-fermenting, gram-negative bacillus that is frequently isolated from the environment including sinks, baths, soil, and hospital water sources. Recently O. anthropi have been reported as an emerging opportunistic pathogen in immunocompromised patients, particularly in those with indwelling venous catheters. Most O. anthropi were highly resistant to beta-lactam antibiotics except carbapenem. We report a case of O. anthropi bacteremia with an unusual pattern of antibiotic resistance compared to previous reports. A 47-year-old woman undergoing camptobell/cisplatin chemotherapy via indwelling venous catheter (chemoport) for stage IV ovarian cancer, had septicemia due to O. anthropi of unknown origin. The isolates were resistant to all beta-lactams and meropenem and susceptible to aminoglycoside, ciprofloxacin, and trimethoprim-sulfamethoxazole. She recovered from sepsis with combination treatment with imipenem and ciprofloxacin for 3 weeks.

A Case of Meropenem-Resistant Ochrobactrum anthropi Bacteremia / 감염과화학요법

Ochrobactrum anthropi is an oxidase-producing, non-lactose-fermenting, gram-negative bacillus that is frequently isolated from the environment including sinks, baths, soil, and hospital water sources. Recently O. anthropi have been reported as an emerging opportunistic pathogen in immunocompromised patients, particularly in those with indwelling venous catheters. Most O. anthropi were highly resistant to beta-lactam antibiotics except carbapenem. We report a case of O. anthropi bacteremia with an unusual pattern of antibiotic resistance compared to previous reports. A 47-year-old woman undergoing camptobell/cisplatin chemotherapy via indwelling venous catheter (chemoport) for stage IV ovarian cancer, had septicemia due to O. anthropi of unknown origin. The isolates were resistant to all beta-lactams and meropenem and susceptible to aminoglycoside, ciprofloxacin, and trimethoprim-sulfamethoxazole. She recovered from sepsis with combination treatment with imipenem and ciprofloxacin for 3 weeks.

Infective Endocarditis due to Ochrobactrum anthropi in a Hemodialysis Patient: A Case Report / 대한신장학회지

Ochrobactrum anthropi is an aerobic, gram-negative, motile, non-lactose-fermenting, oxidase-producing, and urease-positive bacillus. We reported a case of aortic valve endocarditis due to O. anthropi in a hemodialysis patient. To our knowledge, this is the first case of O. anthropi endocarditis in a hemodialysis patient in Korea. The organism was resistant to beta-lactam antibiotics and susceptible to ciprofloxacin, amikacin, trimethoprim-sulfamethoxazole, gentamicin and carbapenem. We treated O. anthropi endocarditis with meropenem for 6 weeks and the patient recovered completely.

A Case of Ochrobactrum anthropi Bacteremia / 병원감염관리

Ochrobactrum anthropi, a rarely encountered organism in humans, is usually associated with infections in immunocompromised hosts and patients with indwelling catheters. We report a case of bacteremia associated with O. anthropi in a 80-year-old male with intrahepatic duct carcinoma. After insertion of biliary stent with endoscopic retrograde cholangiopancreatography, fever and neutrophilic leukocytosis developed in the patient. Blood cultures were performed three times, and O. anthropi was isolated from an aerobic bottle. Although the patient did not receive effective antibiotic treatment, fever and neutrophilic leukocytosis were improved.

Spontaneous Bacterial Peritonitis due to Ochrobactrum anthropi: A Case Report

We report a case of spontaneous bacterial peritonitis from Ochrobactrum anthropi. O. anthropi is recognized as an emerging pathogen in immunocompromised patients. In contrast to most previously described cases, the patient reported here had no indwelling catheter. To our knowledge, no case of O. anthropi spontaneous bacterial peritonitis has been reported in the medical literature until now.

A Case of Ochrobactrum Anthropi Endophthalmitis after Cataract Surgery

PURPOSE: To report a case of Ochrobactrum anthropi endophthalmitis following cataract extraction and intraocular lens implantation. METHODS: A 57-year-old man was refered for evaluation and management of chronic uveitis on his left eye. He had undergone cataract surgery 1 year previously. His visual acuity of left eye was 20/100. The left eye had marked inflammation in anterior chamber and vitreous cavity. We performed pars plana vitrectomy with removal of the intraocular lens and intravitreal antibiotics injection (Amikacin 0.4 mg/0.1 ml). RESULTS: Microbiologic examination of the anterior chamber fluid, intraocular lens disclosed Ochrobactrum anthropi, a gram-negative bacillus. Twelve weeks after vitrectomy, his left corrected visual acuity was 20/25 and anterior segment showed no inflammatory cell.