Pleural effusion due to Chryseobacterium indologenes: Case report and review of literature

Abstract

Chryseobacterium indologenes is found ubiquitously in the environment; it rarely causes human disease. Hence, we report a case of C. indologenes-associated pleural effusion in a patient with aortic dissection. Postoperatively, the patient developed massive right-sided pleural effusion with underlying consolidated lung. Culture of the pleural fluid yielded pure growth of C. indologenes which was susceptible to cotrimoxazole, minocycline, and tigecycline. Therapy was modified; tigecycline and cotrimoxazole were started following which the patient showed improvement, and subsequent cultures of the pleural fluid were sterile. This report promotes awareness of this organism as an emerging pathogen in lung infections and emphasizes the importance of targeted therapy.

Chryseobacterium indologenes, an Emerging Bacteria: A Case Report and Review of Literature

“…Chryseobacterium indologenes is a nonmotile, Gram negative bacilli that is intrinsically resistant to aminoglycosides, first-generation cephalosporins, aminopenicillins, and aztreonam [12]. The increase in clinical usage of colistin and tigecycline against emerging carbapenem-resistant pathogens has been associated with significant problems in the critical care setting [3,9].…”

Whole genome sequencing of the multidrug-resistant Chryseobacterium indologenes isolated from a patient in Brazil

“…However, the following antibiotics were not included in the MDR classification: amikacin and gentamicin (aminoglycosides); ampicillin and ampicillin-sulbactam (aminopenicillins); imipenem, meropenem, and ertapenen (carbapenems). This was because C. indologenes is intrinsically resistant to these antibiotics ( 18 , 19 , 66 , 67 ).…”

“…Considering the pediatric population can present significant morbidity and immune dysfunction, we postulate that the relevance of C. indologenes isolated from clinical samples of infants can be challenging since novel molecular and phenotypic tests are providing rapid and accurate identification of many bacterial species, including glucose non-fermenting gram-negative bacilli (78, 79) such as C. indologenes. Chryseobacterium indologenes often exhibit resistance to a wide variety of broad-spectrum antibiotics, including aminoglycosides, tetracyclines, chloramphenicol, macrolides, clindamycin, and teicoplanin; extended-spectrum penicillins; and first-, second-and third-generation cephalosporin, aztreonam, ticarcillin-clavulanate and the carbapenems (19,23,80). According to our phenotypic results, our C. indologenes strain was resistant to most of these antibiotics.…”

“…Chryseobacterium indologenes often exhibit resistance to a wide variety of broad-spectrum antibiotics, including aminoglycosides, tetracyclines, chloramphenicol, macrolides, clindamycin, and teicoplanin; extended-spectrum penicillins; and first-, second- and third-generation cephalosporin, aztreonam, ticarcillin-clavulanate and the carbapenems ( 19 , 23 , 80 ). According to our phenotypic results, our C. indologenes strain was resistant to most of these antibiotics.…”

“…Although the clinical significance and pathogenicity of C. indologenes are not well established (17,18), C. indologenes is known to be naturally resistant to a wide variety of antibiotics including not only aminoglycosides, tetracyclines, chloramphenicol, macrolides, aminopenicillins, clindamycin, teicoplanin but also first-generation cephalosporins, aztreonam, ticarcillin-clavulanate, and carbapenems (10,(19)(20)(21). The most potent drugs reported against C. indologenes are quinolones (gatifloxacin and levofloxacin), minocycline, and trimethoprimsulfamethoxazole (18,22,23); however, many studies show an alarming trend in resistance to those antibiotics (3,9,24).…”