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Volume 43, Number 6, December 2010

Clinical and Microbiological Characteristics of Chryseobacterium indologenes Bacteremia


Yi-Tsung Lin, Yuan-Yu Jeng, Mei-Lin Lin, Kwok-Woon Yu, Fu-Der Wang, Cheng-Yi Liu


Received: July 11, 2008    Revised: February 2, 2009    Accepted: May 30, 2009   

 

Corresponding author:

Fu-Der Wang, Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital,
201 Section 2, Shih-Pai Road, Taipei, Taiwan. E-mail: fdwang@vghtpe.gov.tw



 

Background and 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.



 

Key words:

antibacterial agents, bacteremia, Chryseobacterium indologenes