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Case Reports
. 2025 Jan 6;25(1):32.
doi: 10.1186/s12879-025-10440-5.

A Japanese man with community-onset carbapenem-resistant Stutzerimonas nitrititolerans bacteremia and a sacral pressure ulcer: a case report

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Case Reports

A Japanese man with community-onset carbapenem-resistant Stutzerimonas nitrititolerans bacteremia and a sacral pressure ulcer: a case report

Kohei Hasegawa et al. BMC Infect Dis. .

Abstract

Background: Stutzerimonas is a recently proposed genus comprising strains formerly classified as Pseudomonas stutzeri. The genus includes at least 16 identified species. Stutzerimonas nitrititolerans, previously known as Pseudomonas nitrititolerans, was initially isolated from a bioreactor. Only one case of human infection has been reported to date, and its pathogenicity remains unknown.

Case presentation: We present a case of community-acquired S. nitrititolerans bacteremia in a 77-year-old Japanese man with a sacral pressure ulcer. On admission for cerebral infarction, empirical ampicillin/sulbactam was administered because of an infected sacral pressure ulcer. Blood cultures revealed Gram-negative bacilli. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry was unable to identify the species, but 16 S ribosomal RNA gene sequencing identified the isolate NR5426 as S. nitrititolerans. Despite negative results for common carbapenem-resistance genes, the strain showed possible metallo-beta-lactamase production. The patient was treated with piperacillin/tazobactam and recovered.

Conclusions: This case confirms that S. nitrititolerans can cause infection in humans and highlights the antimicrobial susceptibility profile and the treatment strategy for infections caused by this rare bacterium. Further studies are required to determine its resistance mechanisms and the clinical implications.

Keywords: Stutzerimonas nitrititolerans bacteremia; 16S rRNA sequencing; Non-fermenting Gram-negative bacilli.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Written informed consent was obtained from our patient for publication of this case report and accompanying images in an open access online publication. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
(A Gram-stained sample of the blood culture showing thin, curved, Gram-negative bacilli (× 1000). (B, C) Rough whitish sheeted colonies on 5% sheep blood agar (B), and rough small colonies on desoxycholate-hydrogen sulfide-lactose agar (C)
Fig. 2
Fig. 2
Phylogenetic tree derived of the 16 S rDNA sequences. The tree was constructed using the neighbor-joining method and nucleotide substitution rate (Knuc) values. The numbers on the tree represent bootstrap values for the branch points, with only values above 50% shown

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