Table 1. Characteristics of Shewanella spp. infections in Gran Canaria between 2000 and 2016.
| Case | Date | Origin | Isolate | Co-isolate | Age (years) | Sex | Exposure to seawater | Sample | Underlying condition | Clinical findings | Treatment | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 27/10/00 | C | S. putrefaciens | N | 57 | M | NS | Ear swab | AHT, DM | Severe external otitis | NS | Favourable |
| 2 | 19/02/01 | C | S. putrefaciens | N | 68 | M | NS | Blood | AHT, DM, dyslipidaemia, IC (bypass) | Fever while hospitalized at Neurology department | NS | Favourable |
| 3 | 27/05/03 | NSC | S. putrefaciens | E. coli | 70 | M | NS | SST (abscess) | Colon carcinoma, AHT, DM, IC (bypass surgery) | Rectal bleeding, diarrhoea, nausea, epigastric pain, surgical wound infection | NS | NS |
| 4 | 01/12/03 | NSC | S. putrefaciens | N | 56 | F | NS | Blood | AHT, IC, DM, vascular disease (2 stents) | Fever while hospitalized at Cardiology department | Gentamicin+ceftriaxone | Favourable |
| 5 | 06/03/04 | C | S. putrefaciens | Acinetobacter haemolyticus | 32 | F | NS | Blood | Severe asthma, hiatal hernia, gastroesophageal reflux, obesity, hypercholesterolaemia | Fever while hospitalized | Levofloxacin | Favourable |
| 6 | 23/03/04 | C | S. putrefaciens | N | 64 | M | NS | Blood | Lung cancer (lobectomy, 2001), DM, asthma | Pericardial effusion and pericarditis, hospitalized at Cardiology department | NS | Favourable |
| 7 | 10/02/05 | C | S. putrefaciens | N | 80 | F | NS | Blood | Colon and cervix carcinoma, cholecystectomy, pancreatic mass of unknown origin | Nausea, vomiting, fever, abdominal pain; hospitalized at Oncology department | Antibiotics (NS) | Favourable |
| 8 | 28/08/06 | NSC | S. putrefaciens | N | 67 | F | NS | Blood | DM, chronic renal failure (renal transplant), AHT, IC | Sepsis that required intensive care | Antibiotics (NS) | Death (unrelated to infection) |
| 9 | 29/06/07 | C | S. putrefaciens | Staphylococcus aureus | 20 | M | Y (patera) | SST (abscess) | Septic shock, renal failure, rhabdomyolysis | Hypothermia after patera sinking; septic shock, cellulitis in inferior limbs; malodorous purulent ulcer in a finger | Antibiotics (NS) | Surgical debridement of the lesions; amputation of the finger; otherwise favourable |
| 10 | 21/08/07 | C | S. putrefaciens | N | 25 | M | Y (patera) | SST (cutaneous wound swab) | – | Necrosis of the left foot (dorsal); multiple wounds on the left thigh | Piperacillin/tazobactam+doxycycline, followed by cefazolin+cephalexin | Surgical debridement of the lesions; amputation of several fingers and skin graft; slow recovery, otherwise favourable |
| 11 | 13/08/08 | C | S. putrefaciens | N | 74 | M | NS | Blood | AHT, colon carcinoma, liver and lung metastases, cholecystectomy | Sepsis of abdominal origin; high fever, vomiting, diarrhoea, unconsciousness, dehydration | Piperacillin/tazobactam+levofloxacin | Favourable |
| 12 | 04/09/08 | C | S. algae | N | 21 | M | Y (patera) | SST (ulcer) | Septic shock, renal failure, rhabdomyolysis | Multiple dermal erosions in the legs | Linezolid | Favourable |
| 13 | 05/09/08 | C | S. algae | Bacteroides thetaiotaomicron | 24 | M | Y (patera) | SST (phlyctena) | – | Dehydration, rhabdomyolysis, contusions in the legs | Ceftazidime+doxycycline | Debridement, skin graft, amputation of one phalanx and two fingers; slow recovery, favourable |
| 14 | 09/09/08 | C | S. algae | A. salmonicida | 20 | M | Y (patera) | SST (cutaneous biopsy) | – | Vomiting and diarrhoea after ingestion of seawater; anorexia (6 days), fever, dehydration, cutaneous excoriations, tumefaction, cellulitis in left leg with phlyctenas | Imipenem+ceftazidime+ doxycycline+clindamycin | Debridements, amputation of several fingers; slow recovery, favourable |
| 15 | 15/09/08 | C | S. putrefaciens | N | 20 | M | Y (patera) | SST (wound) | General health deterioration | Right knee arthritis | Cefotaxime+amoxicillin/clavulanic acid | Favourable |
| 16 | 09/12/08 | C | S. algae | Staphylococcus aureus, Morganella morganii | 20 | M | Y (patera) | SST (wound) | – | Pain and tumefaction in the right arm and leg; necrotic phalanx (4th finger, right hand) | Antibiotics (NS) | Amputation of the necrotic finger; otherwise favourable |
| 17 | 20/08/10 | C | S. algae | N | 72 | M | NS | SST (exudate from catheter site) | Chronic renal disease, renal transplant (1999), peritoneal dialysis catheter (2010), multiple myeloma, osteoporosis | Exudate around the dialysis catheter insertion area; slight infection | NS | Favourable |
| 18 | 04/09/10 | C | S. putrefaciens | N | 70 | M | NS | Blood | AHT, auricular fibrillation, myocardial infarction (1996), 2 stents | Fever | NS | Favourable |
| 19 | 14/03/11 | C | S. algae | N | 70 | M | NS* | SST (abscess) | AHT, dyslipidaemia, chronic liver disease, alcoholism | Traumatic wound in the left parieto-occipital region with necrotic, malodorous areas; fever | Ciprofloxacin+vancomycin+ amoxicillin/clavulanic acid | Favourable |
| 20 | 05/10/11 | NSC | S. algae | N | 87 | M | NS | Bronchial aspirate | DM, Parkinson’s disease, AHT, peritonitis with colostomy, bacteraemia (Pseudomonas aeruginosa XDR, 2011) | Complicated acute cholecystitis; accumulation of secretions in both lungs | NS | NS |
| 21 | 06/06/12 | C | S. algae | N | 50 | M | NS | SST (gluteal abscess) | Crohn’s disease with ileostomy and proctocolectomy, intermittent jaundice, hypertriglyceridaemia, DVT; treatment with infliximab since 2009 | Gluteal abscess after a fall; perineal sinus | NS | Torpid but favourable |
| 22 | 23/05/13 | NSC | S. algae | K. oxytoca, E. coli, Bacteroides fragilis | 73 | F | NS | Peritoneal lesion | AHT, biliary fistula, adenocarcinoma of the ampulla of Vater | Abdominal drain infection; gastrostomy | Metronidazole+other antibiotics (NS) | Favourable |
| 23 | 02/06/14 | C | S. putrefaciens | K. oxytoca | 40 | F | NS | Peritoneal lesion | Chronic renal failure | Acute peritonitis in patient with peritoneal dialysis; fever | NS | Favourable |
| 24 | 07/08/14 | C | S. putrefaciens | Enterococcus casseliflavus, Bacteroides uniformis | 81 | F | NS | Bile | Dyslipidaemia, DM, sphincter incontinence, senile dementia | Abdominal pain; faecal vomiting; constipation; sepsis from peripheric insertion central catheter | Ciprofloxacin+fluconazole | Favourable |
| 25 | 12/08/14 | C | S. algae | N | 43 | M | Y | SST (wound) | Polytrauma after impact with a zodiac’s helix (thorax, abdomen, pelvis and right arm) | Wound infection in the right arm | Meropenem+linezolid (empirical); changed to ciprofloxacin after antibiogram | Favourable |
| 26 | 25/02/15 | C | S. algae | K. oxytoca, Finegoldia magna | 36 | M | NS | SST (surgical wound) | Smoker, dyslipidaemia | Infection and necrosis signs in the palmar and radial regions of the right-hand thumb after car outrage | Amoxicillin/clavulanic acid at the Emergency Unit; after surgery – ciprofloxacin+trimethoprim/sulfamethoxazole | Favourable |
| 27 | 11/08/15 | C | S. algae | Staphylococcus aureus | 67 | M | NS | SST (ulcer) | Smoker, AHT, IC | Dry necrosis in feet, leg and thigh; superinfected pretibial vascular ulcer | Meropenem | Supracondylar amputation; otherwise favourable |
| 28 | 17/09/15 | C | S. algae | Staphylococcus aureus, B. fragilis, Clostridium perfringens | 23 | M | Y (patera) | SST (wound) | – | Left-leg ulcers | NS | NS |
| 29 | 21/09/15 | C | S. algae | E. coli, M. morganii | 15 | M | Y (patera) | SST (ulcer) | Slight dehydration, rhabdomyolysis, patera foot; past infection by cytomegalovirus and hepatitis B; papulo-pustular lesions in the inferior limbs | Burn in the lower right limb with phlyctenas; fever, tumefaction | Imipenem+daptomycin+ clindamycin; changed to levofloxacin+ceftriaxone after antibiogram | Favourable |
| 30 | 18/05/16 | NSC | S. algae | N | 60 | F | NS | SST (surgical wound) | Obesity, smoker, diverticular disease, Arnold–Chiari malformation, waiting for abdominal surgery | Desloughing, malodorous wound with necrotic signs; no fever, stable. | Piperacillin/tazobactam | Favourable |
| 31 | 07/07/16 | C | S. algae | Staphylococcus aureus | 68 | M | NS | SST (abscess) | DM, arrhythmia; diabetic foot; left leg amputated (infra-condylar) | Pain, cyanosis and necrosis in right foot | Amoxicillin/clavulanic acid+metronidazole | Infra-condylar amputation of right leg; otherwise favourable |
AHT, Arterial hypertension; C, community; DM, diabetes mellitus; DVT, deep venous thrombosis; F, female; IC, ischaemic cardiomyopathy; M, male; N, no; NS, not stated; NSC, nosocomial; SST, skin and soft tissue; XDR, extensively drug resistant; Y, Yes.
*The patient was not exposed to seawater directly, but to sand from a local park.