Table 1.
Summary of Sphingobacterium multivorum reports
| Study | Patient characteristics | Comorbidities | Diagnosis | Susceptibility testing results | Treatment and outcome |
|---|---|---|---|---|---|
| Dhawan [8] | 60-year-old man with nausea, vomiting and vague abdominal discomfort for 2 weeks | Alcoholic liver disease, esophageal stricture due to prior suicide attempt by ingesting liquid Drano (a strong alkaline corrosive) | Sepsis due to spontaneous bacterial peritonitis; hospital course complicated with aspiration pneumonia causing acute respiratory failure | Resistant to ampicillin, amikacin, gentamicin, chloramphenicol and cephalosporins; susceptible to tetracycline, carbenicillin, TMP/SMX | Initially treated with ampicillin and gentamicin for 5 days with no improvement, then treated with gentamicin and carbenicillin for 11 days. Full recovery. LOS: 21 days |
| Potvliege [7] | 43-year-old man with chills, fever and myalgias for 1 day | Chronic renal insufficiency on hemodialysis through arteriovenous fistula, bilateral nephrectomy; history of infected arteriovenous fistula | Bacteraemia | Resistant to penicillins, cephalosporins, tobramycin, amikacin, colistin; susceptible to erythromycin, tetracycline, chloramphenicol, vancomycin, gentamicin, sulfonamides, TMP/SMX | Treated with ampicillin (MIC of 8 μg/mL) for 10 days and 1 dose of tobramycin. Full recovery. LOS: no data |
| Freney [4] | 57-year-old man with fever 5 days after starting chemotherapy | Immunoblastic type non-Hodgkin lymphoma treated with chemotherapy complicated by development of bone marrow aplasia | Sepsis in setting of bacteraemia | MICs (mg/L): pefloxacin, 0.5; rifampin, 1; tetracycline, 2; erythromycin, 4; TMP/SMX, 5; chloramphenicol and ceftriaxone, 8; ceftazidime and cefotaxime, 16; carbenicillin and azlocillin, 64; piperacillin and cephalotin, 128; gentamicin, tobramycin, vancomycin, >16; ampicillin, aztreonam and amikacin, >32; fosfomycin, >128 | Treated with a combination of pefloxacin and TMP/SMX. Full recovery. LOS: no data |
| Reina [10] | 20-month-old girl diagnosed with cystic fibrosis at 6 months with fever, cough productive of abundant mucous and respiratory difficulty for 2 days | Cystic fibrosis | Sepsis in setting of acute exacerbation of chronic bronchopathy | Resistant to aztreonam, gentamicin and TMP/SMX; susceptible to carbenicillin, ceftazidime, ceftriaxone, cefuroxime, chloramphenicol, azlocillin, cefotaxime, ticarcillin, ciprofloxacin, imipenem, piperacillin, amikacin | Treated with ceftazidime and amikacin. Full recovery. LOS: no data |
| Areekul [6] | 47-year-old man with fever and chills for 3 months and 10 kg weight loss for 1 month; positive HIV test; cultures from blood and sputum yielded S. multivorum. Patient developed meningitis with negative CSF cultures | Type 2 diabetes; newly diagnosed HIV | Bacteraemia, meningitis, liver failure | Resistant to ampicillin, gentamycin, amikacin, carbenicillin; sensitive to TMP/SMX, chloramphenicol, tetracycline, cefotaxime, ceftazidime, ceftriaxone | Treated initially with gentamycin and ampicillin. Then switched to ceftriaxone and TMP/SMX. Patient died on day 6 of hospitalization |
| Vella [11] | 74-year-old man with 4 days' history of chills, subjective fevers, cough productive of purulent sputum, chest pain; fever, tachypnea, neutrophilia | COPD, history of several hospitalizations due to bronchial infections with Pseudomonas sp. | Sepsis resulting from respiratory infection (authors did specify if pneumonia was present) | Resistant to ceftazidime and aztreonam; intermediate to tobramycin, ticarcillin; susceptible to TMP/SMX, tetracyclines, quinolones, aminoglycosides, β-lactams | Treated initially with ceftazidime and then switched to cefuroxime. Full recovery. LOS: no data |
| Lambiase [9] | Sputum samples obtained from January 2006 to June 2008 from 332 cystic fibrosis patients. S. multivorum was isolated from 3 (2 female, 1 male) patients; 1 was identified as chronically infected by S. multivorum. All patients coinfected by at least 1 other Gram-negative pathogen | Cystic fibrosis, pancreatic insufficiency | Chronic lung infection | Resistant to β-lactams, carbapenems, aminoglycosides; susceptible to TMP/SMX and quinolones | Authors do not specify which therapy was used but mentioned that no subsequent decline in lung function was registered. LOS: no data |
| Grimaldi [3] | 64-year-old woman with leg pain and fever 24 hours after her dog scratched her right leg; patient confused, skin mottled from legs to abdominal wall, right leg was erythematous, edematous and tender to palpation | Morbid obesity (BMI 33.5 kg/m2), coronary artery disease, type 2 diabetes, rheumatoid arthritis treated with long-term intermediate-dose corticosteroids | Septic shock, encephalopathy, acute kidney injury requiring hemodialysis, respiratory failure in setting of necrotizing fasciitis | Resistance to penicillins, cephalosporins, carbapenems, aminoglycosides; susceptible to amoxicillin-clavulanate, ticarcillin-clavulanate, quinolones, TMP/SMX | Treated with amoxicillin-clavulanate for 10 days; patient discharged to rehabilitation unit after 7 weeks; no physical sequelae |
| Nielsen [12] | Report of 3 cases of infections after TRUS-Bx. All received oral prophylaxis with pivmecillinam and amoxicillin/clavulanic acid the night before and 2 hours before TRUS-Bx. Case 1: 79-year-old man hospitalized with fever, chills, malaise 3 days after TRUS-Bx; case 2: 59-year-old man with dysuria and frequent voiding 2 weeks after TRUS-Bx; case 3: 69-year-old-man followed in active surveillance program for low-risk prostate cancer consulted the emergency room 3 days after TRUS-Bx with dysuria and hematuria | Case 1: end-stage renal disease resulting from glomerulonephritis on hemodialysis, benign prostatic hyperplasia, prostate cancer; case 2: benign prostatic hyperplasia; case 3: benign prostatic hyperplasia | Case 1: cystitis and bacteraemia; case 2: cystitis; case 3: cystitis | Cases 1 and 2 had the same antibiogram: resistant to ampicillin, cefuroxime, piperacillin/tazobactam, mecillinam, gentamicin; susceptible to ciprofloxacin and TMP/SMX. Antibiogram not performed for case 3 | Case 1: initially started on piperacillin/tazobactam, ciprofloxacin and discharged after 6 days with oral ciprofloxacin; case 2: did not receive antibiotic treatment; case 3: empiric treatment with trimethoprim for 10 days. All patients recovered |
| This study | 67-year-old African American woman discharged to rehabilitation facility from our institution 4 weeks before, after being treated for hypercapnic hypoxic respiratory failure requiring mechanical ventilation, presented with sudden onset of generalized weakness, light-headedness, shortness of breath and dry cough the morning of admission | Obesity (BMI 38 kg/m2), chronic active smoker, COPD, obstructive sleep apnea, severe pulmonary hypertension, atrial fibrillation, type 2 diabetes, hypertension, dyslipidemia | Septic shock, acute kidney injury in setting of bacteraemia | Resistant to ceftazidime and TMP/SMX; intermediate to meropenem and piperacillin/tazobactam; susceptible to amikacin, cefepime, cefotaxime, ceftriaxone, ciprofloxacin, gentamicin, imipenem, tetracycline | Initially treated with cefepime (4 days) and vancomycin (2 days), then switched to ciprofloxacin for 10 days. Full recovery. LOS: 10 days, 4 in ICU |
BMI, body mass index; COPD, chronic obstructive pulmonary disease; ICU, intensive care unit; LOS, length of stay; TMP/SMX, trimethoprim-sulfamethoxazole; TRUS-Bx, transrectal ultrasound-guided prostate biopsy.