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Volume 45, Number 6, December 2012

Brevundimonas vesicularis bacteremia resistant to trimethoprim-sulfamethoxazole and ceftazidime in a tertiary hospital in southern Taiwan


Chun-Cheng Zhang, Hui-Jine Hsu, Chien-Ming Li


Received: April 30, 2011    Revised: June 30, 2011    Accepted: August 31, 2011   

 

Corresponding author:
  • Division of Infectious Diseases, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
  • Corresponding Author InformationCorresponding author. Division of Infectious Diseases, Department of Internal Medicine, Chi Mei Medical Center, 901 Chung Hwa Road, Yong Kang District, Tainan City 710, Taiwan.


 

Background and purpose: 

Over the past 20 years, Brevundimonas vesicularis has rarely been reported as a pathogen causing human infection. The clinical manifestations of B. vesicularis bacteremia and its susceptibility to antibiotics has not been characterized.



 

Methods:

A retrospective study was conducted between 2006 and 2009 in a tertiary-care hospital in southern Taiwan.



 

Results:

A total of 22 cases of B. vesicularis bacteremia were identified during the study with 86% being community-acquired primary bloodstream infections. Of the 22 patients, 15 (68%) presented with fever, fewer comorbidities, shorter hospital stays, lower mean creatinine levels (1.10 mg/dL vs. 1.74 mg/dL), lower aspartate aminotransferase levels (29.1 IU/L vs. 79.0 IU/L), and lower alanine aminotransferase levels (16.4 IU/L vs. 67.0 IU/L) when compared to afebrile patients. Among the bacterial isolates, 90.9% were susceptible to cefpirome, imipenem and piperacillin/tazobactam while 86.4% were susceptible to gentamicin, amikacin and ciprofloxacin. However, 63.6% of the bacterial isolates were susceptible to ceftazidime, and only 59.1% were susceptible to trimethoprim-sulfamethoxazole (TMP-SMX). The 30-day mortality rate from all causes was 4.5%.



 

Conclusion:

B. vesicularis is able to cause community-acquired and low-mortality primary bloodstream infections. The resistance of B. vesicularis to trimethoprim-sulfamethoxazole and ceftazidime limits the choice of available antibiotics for treatment.



 

Key words:

Antibiotic susceptibilityBacteremiaBrevundimonas vesicularisFeverLength of hospital stay