Water-borne Sphingomonas paucimobilis epidemic in an intensive care unit

Meriç, Meliha; Willke, Ayşe; Kolayli, Fetiye; Yavuz, Şadan; Vahaboğlu, Haluk

doi:10.1016/j.jinf.2009.01.007

Cited by 17 publications

(15 citation statements)

References 14 publications

(7 reference statements)

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“…Members of this genus were previously isolated from hospital water sources and associated with urinary tract infections and peritonitis (12,67). Notably, cases of bacteremia have been reported, including one in a hospital in Taiwan (68) and another in a cardiovascular intensive care unit (ICU) in a hospital in Turkey (69). Since these reports are based on nonsequencing methods (e.g., pulsed-field gel electrophoresis and blood cultures), it was not possible to perform a more detailed comparison to the isolates and populations recovered in the present study.…”

Section: Resultsmentioning

confidence: 99%

“…Members of these genera also have the ability to coaggregate with other community members, contributing to effective colonization and expansion of biofilms (84). In view of the frequent occurrence of Sphingomonadaceae in hospital tap water and their high survival in the air of the indoor environment, this group has been identified as a frequent contaminant of medical devices (67,69,76). Although these organisms were less abundant than mycobacteria in shower hose biofilms (see Fig.…”

Section: Discussionmentioning

confidence: 99%

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Biofilms on Hospital Shower Hoses: Characterization and Implications for Nosocomial Infections

Soto-Girón

Rodriguez-R

Luo

et al. 2016

Appl Environ Microbiol

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e Although the source of drinking water (DW) used in hospitals is commonly disinfected, biofilms forming on water pipelines are a refuge for bacteria, including possible pathogens that survive different disinfection strategies. These biofilm communities are only beginning to be explored by culture-independent techniques that circumvent the limitations of conventional monitoring efforts. Hence, theories regarding the frequency of opportunistic pathogens in DW biofilms and how biofilm members withstand high doses of disinfectants and/or chlorine residuals in the water supply remain speculative. The aim of this study was to characterize the composition of microbial communities growing on five hospital shower hoses using both 16S rRNA gene sequencing of bacterial isolates and whole-genome shotgun metagenome sequencing. The resulting data revealed a Mycobacterium-like population, closely related to Mycobacterium rhodesiae and Mycobacterium tusciae, to be the predominant taxon in all five samples, and its nearly complete draft genome sequence was recovered. In contrast, the fraction recovered by culture was mostly affiliated with Proteobacteria, including members of the genera Sphingomonas, Blastomonas, and Porphyrobacter. The biofilm community harbored genes related to disinfectant tolerance (2.34% of the total annotated proteins) and a lower abundance of virulence determinants related to colonization and evasion of the host immune system. Additionally, genes potentially conferring resistance to ␤-lactam, aminoglycoside, amphenicol, and quinolone antibiotics were detected. Collectively, our results underscore the need to understand the microbiome of DW biofilms using metagenomic approaches. This information might lead to more robust management practices that minimize the risks associated with exposure to opportunistic pathogens in hospitals.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Biofilms on Hospital Shower Hoses: Characterization and Implications for Nosocomial Infections

Soto-Girón

Rodriguez-R

Luo

et al. 2016

Appl Environ Microbiol

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“…Several Sphingomonas spp. infections in humans have been reported, mostly limited to sporadic case reports or intra-hospital outbreaks, and mostly related to Sphingomonas paucimobilis [13,15]. To our knowledge, this is the first infectious Sphingomonas faeni outbreak described, and the first Sphingomonas spp.…”

Section: Discussionmentioning

confidence: 92%

“…These low positivity rates may have been found because the samples were directly platecultured but no hemoculture was done, and because of the specific growth conditions cultured in order to detect the presence of B. bacilliformis [1]. Sphingomonas is a strictly aerobic microorganism commonly distributed both in hospitals and the natural environment in soil and water [12][13][14]. Several Sphingomonas spp.…”

Section: Discussionmentioning

confidence: 99%

An unidentified cluster of infection in the Peruvian Amazon region

Cornejo

Gomes

Suárez

et al. 2015

J Infect Dev Ctries

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Introduction: Bartonella bacilliformis is the etiological agent of Carrion’s disease, which is a neglected disease linked to people in low-socioeconomic populations in Andean valleys. An outbreak of B. bacilliformis was reported in a rural area of the Peruvian Amazon region. The aim of this study was to characterize this outbreak using molecular techniques. Methodology: Fifty-three blood samples from patients diagnosed with Carrion’s disease were analyzed by molecular tools, using both a Bartonella-specific polymerase chain reaction (PCR) and an universal PCR, both based on 16S rRNA gene amplification. Additional water samples from the area were also analyzed. Results: Unexpectedly, the samples were positive only when the universal PCR was used. Although environmental contamination cannot be ruled out, the results showed that Sphingomonas faeni was the possible causative agent of this outbreak, and that water was the most feasible infection source. Conclusions: Diagnosis by clinical criteria or microscopy may lead to misdiagnosis. There is a need to include molecular tools in the routine diagnosis of febrile syndromes, including Carrion’s disease.

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“…Clinical infections related to S. paucimobilis include bacteraemia, peritonitis, wound infections, adenitis, diarrhoeal disease, sepsis arthritis, osteomyelitis, and meningitis (8,13,18). Outbreaks have also been attributed to contaminated water sources or contaminated intravenous fluids (10,16,17,27). Bacteraemia is the most common clinical infection caused by S. paucimobilis (8,15,18).…”

Section: Discussionmentioning

confidence: 99%

Detection and Clinical Implications of Biofilm Formation Among Clinical Isolates of Sphingomonas paucimobilis in Turkey

Demiray

Köroğlu

Özbek

et al. 2016

Jundishapur J Microbiol

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Background: Sphingomonas paucimobilis is a non-fermentative bacillus and found widely in nature. It acquires great interest in biofouling by production of biofilm. However, S. paucimobilis as a biofilm producer, is not studied in medical aspect. In this study we aimed to assess the biofilm production as a virulence factor in clinical isolates of S. paucimobilis together with patient demographics, clinical aspects, risk factors, and outcomes. Methods: During 5 year-period, total numbers of 43 S. paucimobilis isolates identified in a clinical microbiology laboratory of an university hospital in Turkey. Thirty-three of the isolates, which were isolated from patients with clinically determined infection, were enrolled in this study. Patients' data were collected retrospectively. VITEK II automated system (bioMérieux, Marcy L'Eoile, France) was used for identification and antimicrobial susceptibility testing. Christiansen tube method was used to determine biofilm formation. Results: All the clinical isolates of S. paucimobilis produced biofilms. Primary bacteraemia (n = 16) was the most common clinical manifestation. Twenty-four of the patients were followed in the intensive care unit. Twenty-two patients had indwelling catheters. Malignancy (n = 11) and diabetes mellitus (n = 10) were the most common concomitant diseases. Tigecycline, carbapenems and aminoglycosides were the most susceptible antimicrobial agents. Degree of biofilm formation was correlated only with blood samples (P = 0.003) in the sample types group and a stay in the intensive care unit (P = 0.002) in the risk factors group. Conclusions: Sphingomonas paucimobilis can cause serious infections, especially in immunocompromised patients with determined risk factors such as indwelling catheters and diabetes mellitus, due to the effects of multiple virulence factors, together with biofilm formation.

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Water-borne Sphingomonas paucimobilis epidemic in an intensive care unit

Cited by 17 publications

References 14 publications

Biofilms on Hospital Shower Hoses: Characterization and Implications for Nosocomial Infections

Biofilms on Hospital Shower Hoses: Characterization and Implications for Nosocomial Infections

An unidentified cluster of infection in the Peruvian Amazon region

Detection and Clinical Implications of Biofilm Formation Among Clinical Isolates of Sphingomonas paucimobilis in Turkey

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