Pantoea ananatis as a Cause of Corneal Infiltrate after Rice Husk Injury

Abstract

We report a case of an agricultural worker presenting with corneal infiltrate following ocular injury with a rice husk. On examination, a superficial corneal foreign body was removed and sent for culture, which grew Pantoea ananatis. This is, to our knowledge, the first clinical case report of Pantoea ananatis causing corneal infiltrate. CASE REPORTA 35-year-old male patient complaining of pain and redness in his left eye for 4 days presented to Aravind Eye Hospital, Madurai, a tertiary eye hospital in South India. He gave a history of ocular trauma with a rice husk while working in the agricultural field. On examination, his visual activity was 6/9. The eyelids were normal. Slit-lamp examination revealed a superficial corneal foreign body with minimal infiltrate at the 4 o'clock position. Examination of the anterior chamber showed occasional cells. The foreign body was removed and plated on blood agar medium for microbiological investigation. The patient was treated empirically with topical gatifloxacin (0.3%) and econazole eye drops (0.2%, wt/vol) every 2 h in the affected eye.After 24 h of incubation at 37°C with 5% CO 2 , yellow, pigmented, mucoid colonies grew around the foreign body on the blood agar. The organism was identified as a Pantoea species by using the API Rapid ID 32E (BioMérieux) system database and was further identified to the species level by sequencing the 16S RNA region. Molecular identification of the BLASTn identities resulted in the patient's sample being classified as Pantoea ananatis strain E5 with a 98% sequence coverage.This strain was susceptible to amikacin, gentamicin, tobramycin, chloramphenicol, cefotaxime, cefazolin, ceftazidime, ciprofloxacin, ofloxacin, gatifloxacin, moxifloxacin, and levofloxacin by the Kirby-Bauer disk diffusion method (2, 3). The patient was reevaluated after 1 week, and the ulcer showed signs of healing. Gatifloxacin (0.3%) eye drops were continued for another week.Corneal ulceration is a major cause of visual morbidity and is most commonly caused by various fungal and bacterial species. Trauma with or without an associated foreign body is the leading risk factor in developing countries such as India. A foreign body can carry microorganisms on its surface or in its substance, and approximately 50% of the removed foreign bodies carry bacterial contamination. Bacterial keratitis following corneal trauma is more likely to occur in agricultural or mining settings than in industrial factories. Bacterial keratitis usually begins in the corneal tissue immediately surrounding the foreign body (9, 10, 12). In corneal ulcers, the most commonly isolated organisms from the family Enterobacteriaceae are Enterobacter, Klebsiella, and Proteus species and Escherichia coli (1).The genus Pantoea belongs to the family Enterobacteriaceae, which are Gram-negative aerobic bacilli. Pantoea species are commonly found in soil, water, and food, and when associated with plants, they can function as either pathogens or commensals. Only a limited number of cases of human disease ass...

Infections Caused by Antimicrobial Drug-Resistant Saprophytic Gram-Negative Bacteria in the Environment

“…Three cases of P. agglomerans infections were attributed to (1) Hickman catheter contaminated with water from botanical garden ( 160 ), (2) puncture wound involving date palm tree thorn ( 70 , 167 ), and (3) plant-product splinters ( 70 , 167 ). One case of P. ananatis infection followed an ocular trauma with a rice husk ( 193 ). A case of Serratia fonticola infection resulted from a bear bite ( 258 ) (Table 5 ).…”

Pantoea abscess mimicking sarcoma in a HTLV-1-infected Indigenous Australian man: case report and literature review

“…(72) One case each of endocarditis,(15) prosthetic joint infection, (55) and post-neurosurgical meningitis (73) was also reported, as were four cases of neonatal sepsis. (74,75) Only in 19 patients, all of whom had either SSTI, (37,41,42) septic arthritis, (53,56,58,59) or ocular infection (66,69) was there a history of penetrating plant trauma, indicating that this risk factor is less important than previously assumed. The vast majority (84%) of infections were caused by P. agglomerans , with only four other culprit species reported:P. dispersa , (16,17,25,27,28,72) P. ananatis , (19,21,68) P. calida , (24,73) and P. stewartii .…”

Pantoea abscess mimicking sarcoma in a HTLV‐1‐infected Indigenous Australian man: Case report and literature review

“…One case each of endocarditis, 15 prosthetic joint infection, 55 and post‐neurosurgical meningitis 73 was also reported, as were four cases of neonatal sepsis 74,75 . Only in 19 patients, all of whom had either SSTI, 37,41,42 septic arthritis, 53,56,58,59 or ocular infection 66,69 was there a history of penetrating plant trauma, indicating that this risk factor is less important than previously assumed. The vast majority (84%) of infections were caused by P. agglomerans , with only four other culprit species reported: P. dispersa , 16,17,25,27,28,72 P. ananatis , 19,21,68 P. calida , 24,73 and P. stewartii 18 .…”

“…Sporadic adult and pediatric cases were seen in equal proportions, with immunocompetent patients greatly outnumbering their immunocompromised counterparts. Bacteraemia, 14–36 followed by skin and soft tissue infections (SSTI), 31,32,37–42 were the commonest manifestations of Pantoea infection, but the range of syndromes was wide, including peritonitis, 32,43–52 bone and joint infection, 32,53–60 intra‐abdominal abscess, 61–63 pneumonia, 31,64 urinary tract infection, 31,32 ocular infection, 65–71 and rhinosinusitis 72 . One case each of endocarditis, 15 prosthetic joint infection, 55 and post‐neurosurgical meningitis 73 was also reported, as were four cases of neonatal sepsis 74,75 .…”