BUG OF THE QUARTER
Contributed by W. Grant Starrett, M.D.
This article reviews the more obscure organisms which are less commonly isolated in clinical specimens. Please contact me at email@example.com if you come across an isolate that may fit in this category.
Organism: Flavimonas oryzihabitans
Clinical Data: A 42 year-old female with history of uncontrolled type I diabetes mellitus presented to the hospital with lethargy after taking her husband’s pain medicine. After admission she admitted to having lower abdominal pain and subjective fever with shaking chills for several days. Empiric antibiotics were initiated and blood cultures grew gram-negative rods in one of two sets. A subsequent CT scan was remarkable for a thickened loop of bowel in the distal ileum which was attributed to under-distension, although inflammation could not be excluded. Two days later the patient felt well and insisted on going home; the isolate had not yet been identified. She was discharged on ciprofloxacin, and the isolate was eventually identified as Flavimonas oryzihabitans sensitive to ciprofloxacin. Unfortunately the patient did not follow up, but blood cultures eight months later (obtained for unrelated reasons) were negative.
- prosthetic device related infections (eg, line infections, CAPD peritonitis)
- Skin and soft tissue infections
- Post-operative infections
Flavimonas (Pseudomonas) oryzihabitans is an aerobic non-spore-forming gram-negative rod of relatively low virulence, which rarely causes infection. This name was proposed in 1987 after initially being described as a member of the Pseudomonas genus two years earlier. These two genera are now considered synonymous, and the names are used interchangeably in the literature. It is distinguished biochemically from most other clinical pseudomonas isolates by being oxidase negative. Most infections with Flavimonas oryzihabitans occur in patients who are immunocompromised or have prosthetic devices, including central lines and CAPD catheters. Post-operative endophthalmitis and meningitis have also been described.
- Anzai Y, et al. The Phylogeny of the Genera Chryseomonas, Flavimonas, and Pseudomonas Supports Synonymy of These Three Genera. Intern J Syst Bacter. 1997: 249-251.
- Decker C, et al. Flavimonas oryzihabitans (Pseudomonas oryzihabitans; CDC Group Ve-2) Bacteremia in the Immunocompromised Host. Arch Intern Med. 1991;151:603-604.
- Murray, et al. Manual of Clinical Microbiology, 7th edition.