The spectrum of Bacillus cereus infections in patients with haematological malignancy

Abstract

Background: Bacillus cereus is a rare but important cause of serious infections in patients with haematological malignancies. Since these infections are rapidly fatal, increased awareness, early recognition and appropriate antibiotic therapy will lead to favourable outcome. AIMS: The aim of this study is to describe the clinical spectrum and laboratory diagnosis of B. cereus infections in patients with haematological malignancies. Study Setting and Design: This is a retrospective observational study on the data from a tertiary care cancer hospital. Methodology: Patients with haematological malignancy having clinical and microbiological evidence of B. cereus infections during 2013–2015 were included in the study. Clinical records were reviewed to assess the type of underlying haematological malignancies, the spectrum of infections caused by B. cereus, risk factors, antibiotic therapy and outcome. Microbiological methods used for isolation and identification of B. cereus as well as their antibiotic susceptibility profile were also reviewed. Results: Seven patients had B. cereus infection during the study period. Four patients (57.1%) had sepsis, two patients (28.6%) had skin infections with cellulitis and one patient (14.3%) had meningitis. All patients with bloodstream infections had severe neutropenia. One patient died of the infection, while others survived with appropriate antibiotic treatment. Conclusion: B. cereus, a common agent producing acute diarrhoeal disease, can cause sepsis, invasive infections and cutaneous infections in patients with neutropenia and cancer. In patients with sepsis associated with gastrointestinal symptoms or in those with a preliminary report of Gram-positive bacilli in blood cultures, empirical antibiotic therapy should include a drug effective against B. cereus.