Rare and Under Reported Causes of Bacteremia: Case Series from a Tertiary Health Care Centre of Northern India

Abstract

With increasing medical interventions, immunosuppressants, hospital stay and antibiotic use; people are finding increased cases of hospital acquired infections. Bacteremia and sepsis are important cause of morbidity and mortality in tertiary health care centres. Majority of bacteremia are caused by the Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp (ESKAPE) pathogens. However, in some cases hospital environment bacteria can cause bacteremia and sepsis, especially in immunocompromised patients. Each bacterium is unique with specific antibiotic susceptibilities. So, accurate identification up to species level is important for management of infections. Automated culture and identification systems like VITEK and Matrix Assisted Laser Desorption Ionization Time of Flight Mass Spectrometry (MALDI-TOF MS) helps a lot in these processes. Here, the authors presents a case series of bacteremia caused by rare bacteria; namely Campylobacter coli, Sphingomonas paucimobilis, Paenibacillus thiaminolyticus and Cuprividus gilardii. All bacteria were grown in bactec culture and identifications were confirmed by MALDI-TOF MS and drug susceptibility testing was done by VITEK-2. All the patients were having co-morbidities and antibiotic history. Patients responded to guided antibiotic therapy. The authors reiterate that increased suspicion of infection by these bacteria, especially in bacteremia cases of patients have co-morbidities (like agammaglobulinemia, end stage renal disease, diabetes mellitus, kidney failure, etc). Latest identification techniques like VITEK and MALDI-TOF MS should be utilised for diagnosis and treatment of these infections.