[A rare cause of nosocomial bacteremia: Sphingomonas paucimobilis]

Abstract

Sphingomonas paucimobilis, is a yellow-pigmented, aerobic, non-fermentative, non-spore-forming, gram-negative bacillus. Infections by S. paucimobilis which is widely found in nature and hospital environments are rarely serious or life threatening. In this report we present a case of hospital acquired bloodstream infection due to S. paucimobilis. The patient had a history of hydrocephalus diagnosed at sixth months of his birth and had experienced two ventriculoperitoneal shunt surgery. He was hospitalized and been treated for bronchopneumonia. On the 47th day of hospitalization, blood cultures (BACTEC, Becton Dickinson, USA) were taken because of a body temperature of 38.5 degrees C. One of the blood cultures was positive for gram-negative rods. After 48 h of incubation, the sub-cultures on blood agar medium yielded pure growth of a yellow, non-fermentative, gram-negative, rod-shaped bacterium. The microorganism was positive for oxidase, and esculin hydrolysis, while negative for urea and nitrate reduction and citrate utilisation. Motility was negative as well. The isolate has been identified as S. paucimobilis by using mini API (bioMerieux, France) system. The antibiotic susceptibility test was also performed with the same system and the strain was found susceptible to ceftazidime, ceftriaxone, cefoperazone, cefepime, cefotaxime, ciprofloxacin, imipenem, piperacillin-tazobactam, aztreonam, amikasin and gentamicin. Treatment with intravenous ceftriaxone (2 x 750 mg/day) was initiated. He responded well to the treatment and discharged on the tenth day. This case was reported to emphasize that S. paucimobilis should be kept in mind as a nosocomial infectious agent and the infections should be treated according to the sensitivity test results.