Unusual Severe Extra-Intestinal Manifestations of a Common Enteric Pathogen- Spp.

INTRODUCTION

spp. are halophilic, Gram-negative bacilli. They are widely distributed in the soil and aquatic environment and have been associated with various extra-intestinal infections, such as skin and soft-tissue infections, meningitis, bacteraemia etc. The most common species associated with extra-intestinal infection is .

AIM

To get the overview of clinical presentations, underlying predisposing factors associated with the extra-intestinal infections caused by species and their antimicrobial susceptibility pattern.

MATERIALS AND METHODS

Extra-intestinal cases of spp. admitted during December 2015 to October 2016 in the tertiary care hospital of South Karnataka coastal region were analysed retrospectively. The isolates were identified by Matrix Assisted Laser Desorption Ionization Time-of-Flight (MALDI-TOF) VITEKMS and antimicrobial susceptibility testing was performed by VITEK2 system (bioMérieux, Inc., Durham, NC) respectively. Clinical manifestations and management of the cases were noted from the clinical records. Clinical and microbiological findings presented as mean±standard deviation, frequency and percentage.

RESULTS

We included 26 cases in this study, from whom spp. were isolated alone or with another microorganism. Most widespread infection was Skin and Soft Tissue Infection (SSTI) (24, 92.3%). In 50% (12/24) cases, SSTI developed due to trauma. In 45.8% (11/24), underlying co-morbid conditions were present. The common site of infection was lower extremities (16/24, 66.7%) and 62.5% (15/24) of them presented with severe gangrene of the affected site. Other than SSTI, we encountered with two cases of keratitis and cholangitis respectively. were frequently isolated species (23/26, 88.5%). The analysis of antimicrobial susceptibility showed, 13% isolates were Multidrug Resistant (MDR). Carbapenem resistance was also noted.

CONCLUSION

We had isolated spp. from different extra-intestinal sites. Most common extra-intestinal manifestation by this organism was post-traumatic wound infection. Clinical spectrum of this infection confused the clinician with other organisms like group B , spp. etc., and mislead them in empirical management. Finally with the microbiological support all the cases were treated either conservatively or in combination with surgical debridement or amputation depending on the situation.