Myroides odoratimimus urinary tract infection in an immunocompromised patient: an emerging multidrug-resistant micro-organism

Abstract

BackgroundMyroides spp. are common environmental organisms and they can be isolated predominantly in water, soil, food and in sewage treatment plants. In the last two decades, an increasing number of infections such as urinary tract infections and skin and soft tissue infections, caused by these microorganisms has been reported. Selection of appropriate antibiotic therapy to treat the infections caused by Myroides spp. is difficult due to the production of a biofilm and the organism’s intrinsic resistance to many antibiotic classes.Case presentationWe report the case of a 69-year-old immunocompromised patient who presented with repeated episodes of macroscopic haematuria, from Northern Italy.A midstream urine sample cultured a Gram negative rod in significant amounts (> 105 colony-forming units (cfu)/mL), which was identified as Myroides odoratimimus. The patient was successfully treated with trimethoprim/sulfamethoxazole after antibiotic susceptibility testing confirmed its activity.ConclusionThis case underlines the emergence of multidrug resistant Myroides spp. which are ubiquitous in the environment and it demands that clinicians should be more mindful about the role played by atypical pathogens, which may harbour or express multidrug resistant characteristics, in immunocompromised patients or where there is a failure of empiric antimicrobial therapy.

Association ofMyroides odoratimimusin immunocompromized piglets with post weaning multisystemic wasting syndrome

“…The phenotypic attributes of M . odoratimimus isolates reported were similar to findings reported earlier (Dharne et al ; Elantamilan et al ; Lorenzin et al ).…”

“…Therefore, the infection was considered due to Myroides spp. The phenotypic attributes of M. odoratimimus isolates reported were similar to findings reported earlier (Dharne et al 2008;Elantamilan et al 2015;Lorenzin et al 2018).…”

<p>A Confirmed Catheter-Related Blood Stream Infection (CRBSI) in an Immunocompetent Patient Due to <em>Myroides odoratimimus</em>: Case Report and Literature Review</p>

“…Myroides infections include cellulitis, urinary tract infection (UTI), bacteremia, necrotizing fasciitis, pneumonia, pericarditis endocarditis, ventriculitis, acalculous cholecystitis, urosepsis, empyema and canaliculitis as well as nosocomial outbreaks. 8,12,13,19 Myroides odoratus and Myroides odoratimimus are the two main species of the genus to cause corresponding infections. Myroides odoratus strains are associated with septic soft tissue infections, whereas Myroides odoratimimus is described in cases of urinary infections, 20 but not absolutely.…”

“…31 There are some infection cases reported in these hosts. 8,11,14,16,31,32 Those infected with the organisms often have underlying diseases such as diabetes mellitus, cirrhosis, chronic obstructive pulmonary disease, renal failure, chemotherapy, immunosuppression for transplantation and prolonged corticosteroid therapy, 3,30 which may damage the body's immunity and make human susceptible to Myroides infections. However, immunocompetent hosts can also be infected although rarely reported.…”

Myroides: An Emerging Pathogen Causing Urinary Tract Infections in Hospitalized Patients

“…to form biofilms. 24 Myroides spp. display strong adherence profiles, with a preference for adherence at lower temperatures.…”