Morganella morganii Infections in a Greek University Hospital

Abstract

Background Morganella morganii is an unusual opportunistic pathogen causing often health care–associated infections mostly in patients with underlying comorbidities. Except for bacteremia, few studies on other types of infections caused by this organism are available. Methods The characteristics and outcome of any type of M. morganii infection treated at the University Hospital of Heraklion, Crete, Greece, between January 2013 and December 2018 were retrospectively studied. Results A total of 90 patients (57.8% men; mean age ± SD, 67.8 ± 21.1 years) with M. morganii infections were identified. The patients were hospitalized in medical (52.2%), surgical (25.6%), and pediatric department (4.4%), and in the intensive care unit (10%). Only 7 (7.8%) were outpatients. The most frequent were urinary tract (34.5%), and skin and soft tissues infections (33.3%). Of all cases included, 58.9% were health care-associated, whereas in 66.7%, the infection was polymicrobial. Most patients (82.2%) had at least 1 underlying comorbidity. The clinical isolates of M. morganii exhibited high susceptibility rates to carbapenems (100%), amikacin (98.9%), cefepime (94.4%), piperacillin/tazobactam (93.3%), and third-generation cephalosporins and aztreonam (90% each). The empirical treatment given was appropriate for 90% of the 82 patients with available data. Οverall and M. morganii infection–related mortality rates were 10% and 7.8%, respectively. Conclusions Although M. morganii infections are infrequently encountered in healthy individuals, they should be considered in inpatients with underlying comorbidities. The urinary tract, and the skin and soft tissues are the most frequently affected sites, whereas polymicrobial infections are very common. Appropriate antimicrobial treatment is associated with favorable prognosis.