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      Extensively drug-resistant Myroides odoratimimus – a case series of urinary tract infections in immunocompromised patients

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          Abstract

          Purpose

          We report an outbreak of urinary tract infections (UTIs) caused by Myroides odoratimimus, which occurred in the largest clinical hospital in western Romania.

          Patients and methods

          From June to August 2017, four strains of M. odoratimimus were isolated from the urine samples of patients hospitalized in the urology, diabetes, and surgery departments. Hospital records of all patients whose urine cultures were positive for M. odoratimimus were reviewed retrospectively. We also reviewed the cases reported in the literature.

          Results

          All UTIs, except one, were hospital-acquired infections. All patients with M. odoratimimus UTIs were immunocompromised. Three patients underwent urinary catheterization with a Foley’s catheter upon admission in the emergency department and one presented for replacement of ureterostomy tubes. All Myroides isolates were resistant to almost all the tested antibiotics. Two patients were successfully treated with tigecycline and one was receiving antimicrobial treatment for another infection at the time of isolation of the microorganism.

          Conclusion

          Although M. odoratimimus is an uncommon pathogen, clinicians should be aware of its ability to cause UTI outbreaks, especially in the immunocompromised population. Due to its multi-drug resistance, it is important to rapidly identify Myroides spp. in order to choose the best treatment regimen.

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          Most cited references30

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          Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America.

          Guidelines for the diagnosis, prevention, and management of persons with catheter-associated urinary tract infection (CA-UTI), both symptomatic and asymptomatic, were prepared by an Expert Panel of the Infectious Diseases Society of America. The evidence-based guidelines encompass diagnostic criteria, strategies to reduce the risk of CA-UTIs, strategies that have not been found to reduce the incidence of urinary infections, and management strategies for patients with catheter-associated asymptomatic bacteriuria or symptomatic urinary tract infection. These guidelines are intended for use by physicians in all medical specialties who perform direct patient care, with an emphasis on the care of patients in hospitals and long-term care facilities.
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            Reclassification of Flavobacterium odoratum (Stutzer 1929) Strains to a New Genus, Myroides, as Myroides odoratus comb. nov. and Myroides odoratimimus sp. nov.

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              Septic shock, pneumonia, and soft tissue infection due to Myroides odoratimimus: report of a case and review of Myroides infections

              The genus Myroides comprises aerobic, yellow-pigmented, non-motile, non-fermenting gram-negative rods formerly classified as Flavobacterium odoratum. Members of the genus are widely distributed in the environment, especially in water, and usually behave as low-grade opportunistic pathogens, having been found to cause urinary tract infection, endocarditis, ventriculitis, and cutaneous infections in severely immunocompromised patients. We report a case of soft tissue infection, septic shock, and pneumonia due to M. odoratimimus in an immunocompetent male. To our knowledge, this is the first description of life-threatening infection caused by this organism in an immunocompetent host. We have also reviewed the medical literature on the genus Myroides.
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                Author and article information

                Journal
                Infect Drug Resist
                Infect Drug Resist
                Infection and Drug Resistance
                Infection and Drug Resistance
                Dove Medical Press
                1178-6973
                2018
                18 May 2018
                : 11
                : 743-749
                Affiliations
                [1 ]Department of Microbiology, “Victor Babeş” University of Medicine and Pharmacy, TimisŞoara, Romania
                [2 ]Clinical Laboratory, “Pius Brînzeu” Emergency Clinical County Hospital, TimisŞoara, Romania
                [3 ]Department of Internal Medicine II, “Victor BabesŞ” University of Medicine and Pharmacy, TimisŞoara, Romania
                [4 ]Diabetes Clinic, “Pius Brînzeu” Emergency Clinical County Hospital, TimisŞoara, Romania
                [5 ]“Victor BabesŞ” University of Medicine and Pharmacy, TimisŞoara, Romania
                [6 ]“Pius Brînzeu” Emergency Clinical County Hospital, TimisŞoara, Romania
                [7 ]Department of Orthopaedics – Traumatology, Urology and Medical Imaging, “Victor BabesŞ” University of Medicine and Pharmacy, TimisŞoara, Romania
                [8 ]Urology Unit, “Pius Brînzeu” Emergency Clinical County Hospital, TimisŞoara, Romania
                Author notes
                Correspondence: Teodora Sorescu, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu 2, Timisoara 300041, Romania, Tel +40 72 451 5424, Fax +40 25 622 0484, Email sorescu.teodora@ 123456umft.ro
                Article
                idr-11-743
                10.2147/IDR.S161069
                5965371
                29849466
                eaa116b8-e489-40ab-84b3-960c2ad93be7
                © 2018 Licker et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Original Research

                Infectious disease & Microbiology
                myroides odoratimimus,urinary tract infection,resistance,outbreak

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