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Casale R, Boattini M, Bianco G, Comini S, Corcione S, Garazzino S, Silvestro E, De Rosa FG, Cavallo R, Costa C. Bloodstream Infections by Pantoea Species: Clinical and Microbiological Findings from a Retrospective Study, Italy, 2018-2023. Antibiotics (Basel) 2023; 12:1723. [PMID: 38136757 PMCID: PMC10740582 DOI: 10.3390/antibiotics12121723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
(1) Background: The widespread use of MALDI-TOF coupled to mass spectrometry has improved diagnostic accuracy by identifying uncommon bacteria. Among Enterobacterales, Pantoea species have been seen to be implicated in several human infections, but their clinical and microbiological framework is currently based on a few anecdotal reports. (2) Methods: We conducted this five-year (2018-2023) single-center study aimed at investigating the prevalence and clinical and microbiological findings of Pantoea species bloodstream infections. (3) Results: Among the 4996 bloodstream infection Gram-negative isolates collected during the study period, Pantoea species accounted for 0.4% (n = 19) of isolates from 19 different patients, 5 of them being pediatric cases. Among Pantoea species isolates, P. agglomerans was the most frequently detected (45%; n = 9) followed by P. eucrina (30%; n = 6) and P. septica (15%; n = 3). Malignancy (35.7%) in adults and malignancy (40%) and cerebrovascular disease following meconium aspiration (40%) in pediatric patients as comorbidities and shivering and/or fever following parenteral infusion (36.8%) as a symptom/sign of Pantoea species bloodstream infection onset were the most frequently observed clinical features. Among adults, primary bloodstream infection was the most frequent (50%), whereas among pediatric patients, the most commonly identified sources of infection were catheter-related (40%) and the respiratory tract (40%). Overall, Pantoea species bloodstream infection isolates displayed high susceptibility to all the antibiotics except for ampicillin (63.2%), fosfomycin (73.7%), and piperacillin/tazobactam (84.2%). Targeted antibiotic treatment was prescribed as monotherapy for adults (71.4%) and combination therapy for pediatric patients (60%). The most prescribed antibiotic regimens were piperacillin/tazobactam (21.4%) in adults and meropenem- (40%) and aminoglycoside-containing (40%) antibiotics in pediatric patients. The overall 28-day all-cause mortality rate was 5.3% (n = 1). (4) Conclusions: The prevalence and 28-day mortality rate of Pantoea species bloodstream infections were low. The prescription of targeted therapy including broad-spectrum antibiotics could indicate an underestimation of the specific involvement of the Pantoea species in the onset of the disease, warranting further studies defining their pathogenic potential.
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Affiliation(s)
- Roberto Casale
- Microbiology and Virology Unit, University Hospital City of Health and Science of Turin, 10126 Turin, Italy
- Department of Public Health and Paediatrics, University of Turin, 10124 Turin, Italy
| | - Matteo Boattini
- Microbiology and Virology Unit, University Hospital City of Health and Science of Turin, 10126 Turin, Italy
- Department of Public Health and Paediatrics, University of Turin, 10124 Turin, Italy
- Lisbon Academic Medical Centre, 1649-028 Lisbon, Portugal
| | - Gabriele Bianco
- Microbiology and Virology Unit, University Hospital City of Health and Science of Turin, 10126 Turin, Italy
- Department of Public Health and Paediatrics, University of Turin, 10124 Turin, Italy
| | - Sara Comini
- Operative Unit of Clinical Pathology, Carlo Urbani Hospital, 60035 Jesi, Italy
| | - Silvia Corcione
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10124 Turin, Italy
| | - Silvia Garazzino
- Infectious Diseases Unit, Department of Pediatric and Public Health Sciences, Regina Margherita Children’s Hospital, 10126 Turin, Italy
| | - Erika Silvestro
- Infectious Diseases Unit, Department of Pediatric and Public Health Sciences, Regina Margherita Children’s Hospital, 10126 Turin, Italy
| | - Francesco Giuseppe De Rosa
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10124 Turin, Italy
- Unit of Infectious Diseases, Cardinal Massaia Hospital, 14100 Asti, Italy
| | - Rossana Cavallo
- Microbiology and Virology Unit, University Hospital City of Health and Science of Turin, 10126 Turin, Italy
- Department of Public Health and Paediatrics, University of Turin, 10124 Turin, Italy
| | - Cristina Costa
- Microbiology and Virology Unit, University Hospital City of Health and Science of Turin, 10126 Turin, Italy
- Department of Public Health and Paediatrics, University of Turin, 10124 Turin, Italy
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Susanto M, Dunning J, Chew R. Pantoea abscess mimicking sarcoma in a HTLV-1-infected Indigenous Australian man: Case report and literature review. Clin Case Rep 2023; 11:e7351. [PMID: 37215972 PMCID: PMC10196424 DOI: 10.1002/ccr3.7351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/11/2022] [Accepted: 05/02/2023] [Indexed: 05/24/2023] Open
Abstract
Gram-negative bacteria of the genus Pantoea are emerging bacterial causes of diverse sporadic and outbreak-linked infections. Chronic Pantoea abscesses are unusual and may give rise to a differential diagnosis of malignancy. Foreign body retention and host immune defects may be risk factors for such chronic infections.
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Affiliation(s)
- Maja Susanto
- Infectious Diseases UnitRedcliffe HospitalRedcliffeQueenslandAustralia
| | - Jacki Dunning
- Department of SurgeryAlice Springs HospitalAlice SpringsNorthern TerritoryAustralia
| | - Rusheng Chew
- Infectious Diseases UnitAlice Springs HospitalAlice SpringsNorthern TerritoryAustralia
- Faculty of MedicineUniversity of QueenslandBrisbaneQueenslandAustralia
- Centre for Tropical Medicine and Global HealthUniversity of OxfordOxfordUK
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Congenital Nasolacrimal Duct Obstruction Update Study (CUP Study): Paper 4-Infantile Acute Dacryocystitis (InAD)-Presentation, Management, and Outcomes. Ophthalmic Plast Reconstr Surg 2021; 38:270-273. [PMID: 34652315 DOI: 10.1097/iop.0000000000002077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To study the presentation, management, and outcomes of infantile acute dacryocystitis. METHODS Retrospective study of infants diagnosed with acute dacryocystitis over a period from June 2016 to December 2019. Data collected include demographics, clinical history, presenting features, management, complications, and outcomes. Treatment provided was intensive medical care followed by early probing under endoscopic guidance. Further interventions, where needed, were performed based on intraoperative findings during probing. Successful outcomes were defined as resolution of infection, subjective relief from epiphora, and anatomical patency determined by a normal fluorescein dye disappearance test. RESULTS Twenty-seven eyes of 27 infants were analyzed during the study period. The mean age of infants was 3.26 months, and males were more affected than females (male:female 15:12). The mean duration of symptoms was 4.66 weeks, with 96% (26/27) presenting with symptoms of redness, watering, discharge, and swelling. Preseptal cellulitis was seen in 74% (20/27) infants, lacrimal abscess in 67% (18/27) infants, and lacrimal fistula in 37% (10/27). Most infants had complex congenital nasolacrimal duct obstruction (62%, 13/27), of which 7 also had intranasal cysts. One infant successfully underwent endoscopic dacryocystorhinostomy. At a mean follow-up period of 7.95 months, successful outcomes were observed in 90.4% (19/21) infants. The 2 failed cases were complex congenital nasolacrimal duct obstruction with associated sac diverticula and are scheduled for an endoscopic dacryocystorhinostomy. CONCLUSION Infantile acute dacryocystitis is a distinct clinical entity. The outcomes of systemic antibiotics and early probing are excellent.
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A Case of Nosocomial Outbreak of Pantoea agglomerans Related to Parenteral Nutrition Procedures. Healthcare (Basel) 2021; 9:healthcare9060684. [PMID: 34200170 PMCID: PMC8226852 DOI: 10.3390/healthcare9060684] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/01/2021] [Accepted: 06/01/2021] [Indexed: 11/17/2022] Open
Abstract
Pantoea agglomerans is a Gram-negative bacterium that infrequently infects humans. Most reports involving it are about infections in soft tissues or bone/joint infections caused by contamination from soil or penetrating trauma by vegetation, such as thorns and splinters. More frequently, it is found as an opportunistic pathogen in immunocompromised patients. It is not rare to find reports of bacteremia and sepsis from contamination of intravenous fluid, parenteral nutrition, blood products and anesthetic agents-that is, through contamination of medical devices and products. We reported a bacterial infection epidemic occurred in 2011 in a hospital in middle Italy which involved different hospital wards; Pantoea agglomerans was isolated from blood cultures of all infected patients and the source of infection was identified in contaminated parenteral nutrition prepared from the local pharmacy.
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The Role of Bacterial Etiology in the Tear Duct Infections Secondary to Congenital Nasolacrimal Duct Obstructions. J Craniofac Surg 2019; 30:2214-2216. [PMID: 31369500 DOI: 10.1097/scs.0000000000005798] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To define the microbiological features of dacryocystitis in childhood. METHODS Patients with dacryocystitis secondary to CNLDO between 2017 and 2019 in Izmir, Turkey were included in the study. Inclusion criteria of the study were: mucopurulent secretion, being under 4 years old and not having received prior antibiotic treatment. Samples from secretion were cultivated in sheep blood agar, eosin methylene blue, and chocolate agar. Reproduction was checked intermittently. Clinically significant growths were reported. RESULTS Seventy patients with dacryocystitis secondary to CNLDO were included in the study. Sixty percent of patients were female (n = 42) and 40% (n = 28) percent of patients were male. The average age of participants was 2.09 ± 0.68 (1-3) years old. Positive bacterial proliferation results were noted in 20 patients (28.6%). Eighty percent (n = 16) of culture-positive bacterias were gram-negative bacterias and 20% (4) were gram-positive bacterias. Twenty percent of culture-positive bacterias were aerobic and 80% were facultative bacterias. The most common bacteria seen in culture specimen was Haemophilus 40% (Haemophilus haemolyticus [20%] and Haemophilus influenzae [20%]). CONCLUSIONS Gram-negative organisms especially Haemophilus were most prevalent. These findings could be helpful for antibiotic selection.
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Zhang C, Cui Y, Wu Q, Li L. Computed tomography for guidance in the diagnosis and surgical correction of recurrent pediatric acute dacryocystitis. Pediatr Investig 2019; 3:39-44. [PMID: 32851287 PMCID: PMC7331299 DOI: 10.1002/ped4.12115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 01/29/2019] [Indexed: 11/16/2022] Open
Abstract
IMPORTANCE This is the first retrospective study of the effect of computed tomography (CT) in diagnosis and surgical correction of recurrent pediatric acute dacryocystitis (PAD). OBJECTIVE To explore the pathogenesis of recurrent PAD and the impact of CT in guidance of surgical planning. METHODS Medical histories, clinical manifestations, and CT results of 10 patients with recurrent PAD were reviewed. Etiologies and treatment effectiveness were recorded for all patients. RESULTS CT revealed that three patients had congenital dacryocystocele with lacrimal sac cyst, enlargement of the nasolacrimal canal, and intranasal cyst of affected sides. After regression of local inflammation, marsupialization was performed. CT showed that four patients had PAD secondary to congenital nasolacrimal canal dysplasia; these patients exhibited normal upper portions of the nasolacrimal canals, but had stenotic or atretic middle and terminal segments. After improvement of local inflammation, endonasal dacryocystorhinostomy was performed. Three patients had PAD secondary to congenital lacrimal sac diverticulum; after contrast injection, CT showed that the cysts at the lacrimal sac area were filled with contrast, and were connected to the normal lacrimal sac. After the topical infection was controlled, transcutaneous dacryocystorhinostomy was performed in combination with excision of the lacrimal sac diverticulum. No recurrence of PAD was detected at 6-month follow-up. INTERPRETATION Causes of PAD include congenital dacryocystocele, congenital lacrimal sac diverticulum, or congenital nasolacrimal canal dysplasia. Marsupialization with endoscope, endonasal dacryocystorhinostomy, and transcutaneous dacryocystorhinostomy constitute distinct surgeries for PAD treatment. CT provides an important diagnostic function and facilitates selection of specific surgical approaches for recurrent PAD.
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Affiliation(s)
- Chengyue Zhang
- National Key Discipline of PediatricsMinistry of EducationDepartment of OphthalmologyBeijing children's hospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina
| | - Yanhui Cui
- National Key Discipline of PediatricsMinistry of EducationDepartment of OphthalmologyBeijing children's hospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina
| | - Qian Wu
- National Key Discipline of PediatricsMinistry of EducationDepartment of OphthalmologyBeijing children's hospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina
| | - Li Li
- National Key Discipline of PediatricsMinistry of EducationDepartment of OphthalmologyBeijing children's hospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina
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Büyükcam A, Tuncer Ö, Gür D, Sancak B, Ceyhan M, Cengiz AB, Kara A. Clinical and microbiological characteristics of Pantoea agglomerans infection in children. J Infect Public Health 2017; 11:304-309. [PMID: 28780309 DOI: 10.1016/j.jiph.2017.07.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 06/12/2017] [Accepted: 07/09/2017] [Indexed: 10/19/2022] Open
Abstract
Pantoea agglomerans is an environmental Gram-negative bacterium that rarely is responsible for the infections in humans but it is often a causative factor of a number of occupational diseases. This study evaluated the clinical and microbiological characteristics and pathogenicity of P. agglomerans in children. We retrospectively reviewed microbiological test results for all children (1 month old to 18 years old) who were admitted to our pediatric hospital between January 2000 to June 2015 and had positive clinical specimen cultures for P. agglomerans. Isolates were identified using conventional tests and the BBL Crystal E/NF ID or MALDI-TOF MS systems. Antibiotic susceptibilities were evaluated using the Kirby-Bauer disc diffusion method. We identified fifteen positive cultures from 14 patients with confirmed infections. The positive specimens included pus, urine, tracheal aspirate, blood, and central venous line samples that yielded P. agglomerans. The median patient age was 8.8 years (range: 1.5 months to 16.5 years), and all patients had underlying comorbidities. Five patients had medical devices, and two devices were removed. The most common P. agglomerans infections involved wound infections (35.7%), pneumonia (21.4%), and urinary tract infections (21.4%). Three patients had concomitant infections (Enterococcus faecium, Pseudomonas aeruginosa, and Aspergillus fumigatus). Five patients had anemia. Three patients (21.4%) died, and all three had carbapenem-resistant P. agglomerans that was detected after the first week of hospitalization; two cases involved pneumonia, which was ineffectively treated. P. agglomerans infections may be life-threatening, especially in young patients with pneumonia. Hospital-acquired P. agglomerans may have different pathogenicity and clinical features, compared to community-acquired P. agglomerans, although further studies are needed to understand the drug-resistance patterns in this bacterium.
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Affiliation(s)
- Ayşe Büyükcam
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
| | - Özlem Tuncer
- Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
| | - Deniz Gür
- Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
| | - Banu Sancak
- Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
| | - Mehmet Ceyhan
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
| | - Ali B Cengiz
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
| | - Ateş Kara
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
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