Chromobacterium violaceum septicemia

Partial genomic characterization of Chromobacterium piscinae from India reveals multi drug resistance

Species of genus Chromobacterium have been isolated from diverse geographical settings, which exhibits significant metabolic flexibility as well as biotechnological and pathogenic properties. This study describes the isolation, characterization, draft assembly, and detailed sequence analysis of Chromobacterium piscinae strain W1B-CG-NIBSM isolated from water samples from multi use community pond. The organism was characterized by biochemical tests, Matrix Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry (MALDI TOF-MS) and partial genome sequencing. The partial genomic data of Chromobacterium pisciane isolate W1B NIBSM strain was submitted to GenBank with Bio project number PRJNA803347 and accession no CP092474. An integrated genome analysis of Chromobacterium piscinae has been accomplished with PATRIC which indicates good quality genome. DNA sequencing using the illumina HiSeq 4000 system generated total length of 4,155,481 bp with 63 contig with G + C content is 62.69%. This partial genome contains 4,126 protein-coding sequences (CDS), 27 repeats region and 78 transfer RNA (tRNA) genes as well as 3 ribosomal RNA (rRNA) genes. The genomic annotation of Chromobacterium W1B depicts 2,925 proteins with functional assignments and 1201 hypothetical proteins. A repertoire of specialty genes implicated in antibiotic resistance (45 genes), drug target (6 genes), Transporter (3 genes) and virulence factor (10 genes). The genomic analysis reveals the adaptability, displays metabolic varied pathways and shows specific structural complex and various virulence factors which makes this strain multi drug resistant. The isolate was found to be highly resistant to β-lactam antibiotics whereas it showed sensitivity towards aminoglycosides and fluoroquinolone antibiotics. Hence, the recovery of Chromobacterium piscinae from community pond evidenced for uncertain hidden source of public health hazard. To the best of authors knowledge this is first report of isolation and genomic description of C. piscinae from India.

Chromobacterium violaceum: A Review of an Unexpected Scourge

Chromobacterium violaceum is a common environmental bacterium that rarely causes disease in humans but has a high fatality rate if it does. Due to the rarity of the cases, clinicians are often unaware of the rapid progression of C. violaceum infection and its unexpected antibiotic resistance pattern, which contribute to the failure of patient management. Our review provides the clinical characteristics, possible sources of exposure, and comorbidities and determines factors associated with survival. We gathered information on 132 cases of C. violaceum causing disease in humans published between 1953 and 2020. Patients were predominantly male with a median age of 17.5, interquartile range (IQR) of 5.0-40.0 years, and a third of them were known to have immune deficiencies or comorbidities. Portals of entry were mainly through a wound in the leg and feet (28.0%), the torso (8.5%), or hands and arms (6.8%). It is not uncommon to acquire infection through unintended contact with contaminated water or dust through the mouth or inhalation. The median incubation period is 4.0 days (IQR 2.0-8.0 days) with a duration of clinical course of 17.5 days (IQR 8.0-30.8 days). The high rate of positive blood cultures (56.1%) and abscesses in internal organs (36.4%) shows the significant severity of this disease. Sepsis and Bacteremia were related to mortality with a risk ratio (RR) of 5.20 (95% CI, 0.831-32.58) and 2.14 (95% CI, 1.05-4.36), respectively. Appropriate antibiotic use prevented death at a RR 0.33 (95% CI, 0.21-0.52). Most patients who recovered and survived were treated with aminoglycosides, fluoroquinolones and carbapenems. This review shows the malignant nature of C. violaceum infection and the need for clinicians to be aware and provide prompt source management for patients. Appropriate empiric and targeted antibiotic regiment guided by susceptibility test results is of vital importance.

Chromobacterium violaceum- induced sepsis and multiorgan dysfunction, resembling melioidosis in an elderly diabetic patient: A case report with review of literature

An elderly diabetic farmer presented with chronic nonhealing ulcer over the left foot, multiple liver abscesses, and right-sided pleural effusion. The patient developed septicemia and multiorgan failure. The pus grew pigment producing Chromobacterium violaceum. He was treated successfully with ciprofloxacin for a total duration of 15 days. This case is reported for its rare clinical presentation and resemblance with melioidosis. Of the 200 C. violaceum cases reported across the globe, this is the 14^th case from India and the oldest in the literature.

A rare nonfatal presentation of disseminated Chromobacterium violaceum sepsis

We present a case of disseminated Chromobacterium violaceum sepsis with multiple liver and splenic abscesses presenting with skin lesions and cardiogenic shock, and later diagnosed to have chronic granulomatous disease. The patient was treated with prolonged antimicrobial therapy, after which she recovered and remained asymptomatic on follow-up.

Neonatal septicaemia in Calabar, Nigeria

A three-year survey of neonatal septicaemia (363 bacteriologically proven cases) in the University of Calabar Teaching Hospital, Calabar, has demonstrated that the dominant blood isolate was Staphylococcus aureus (53%) followed by unclassified Coliforms (20%), an unexpected Chromobacterium violaceum (5%). The incidence of neonatal septicaemia was 54.9 per 1000 live births for inborn infants. The predominant organisms were largely susceptible to gentamicin, ceftriazone and cefuroxime with a mortality rate of 19% with most (60.9%) of the fatalities being due to Gram-negative organisms.