Karvar Şinasi, Okumuş Elif, Tutan Kübra Nur, Yeşilyurt Aysun Özel
Alanya Alaaddin Keykubat University Faculty of Medicine, Department of Medical Microbiology, Antalya, Türkiye.
University of Health Sciences, Van Training and Research Hospital, Department of Medical Microbiology, Van, Türkiye.
Diagn Microbiol Infect Dis. 2025 Dec;113(4):117066. doi: 10.1016/j.diagmicrobio.2025.117066. Epub 2025 Aug 14.
Myroides odoratimimus, a non-fermentative Gram-negative bacillus, has increasingly been recognized as a cause of opportunistic healthcare-associated infections, particularly in intensive care units (ICUs). Its intrinsic resistance to multiple antibiotic classes, including carbapenems, aminoglycosides, and polymyxins, presents serious therapeutic challenges. Here, we report a clonal outbreak of urinary M. odoratimimus involving 27 patients over a 7-month period in a tertiary care hospital in Turkey. All patients were hospitalized in ICUs and had indwelling urinary catheters. The isolates were identified using automated systems and confirmed through 16S rRNA gene sequencing. Clonal relatedness was determined by (GTG)₅-PCR, demonstrating genetic identity among all isolates despite their detection in different ICU wards. All strains exhibited a pan-drug-resistant phenotype, showing resistance to every tested antimicrobial, including colistin. The mean duration of hospital stay was 61 days, and the mortality rate was 70.3 %, notably exceeding predicted mortality based on APACHE II scores and the background ICU mortality rate. Environmental cultures were all negative, possibly due to delayed sampling or limitations of conventional detection techniques. This study highlights the ability of M. odoratimimus to cause persistent clonal outbreaks in critical care settings, underscores its clinical significance as a multidrug-resistant pathogen, and emphasizes the need for early microbiological identification, molecular surveillance, and robust infection control strategies.
气味类志贺氏菌是一种非发酵革兰氏阴性杆菌，越来越多地被认为是机会性医疗保健相关感染的病因，尤其是在重症监护病房（ICU）。它对多种抗生素类别的固有耐药性，包括碳青霉烯类、氨基糖苷类和多粘菌素，带来了严重的治疗挑战。在此，我们报告了土耳其一家三级医院在7个月内发生的一起涉及27例患者的泌尿系统气味类志贺氏菌克隆性暴发。所有患者均在ICU住院且留置导尿管。分离株通过自动化系统进行鉴定，并通过16S rRNA基因测序得以确认。通过（GTG）₅-PCR确定克隆相关性，结果显示尽管在不同的ICU病房检测到这些分离株，但它们在基因上是相同的。所有菌株均表现出泛耐药表型，对包括黏菌素在内的每种测试抗菌药物均耐药。平均住院时间为61天，死亡率为70.3%，明显超过基于急性生理与慢性健康状况评分系统（APACHE II）评分预测的死亡率以及ICU的背景死亡率。环境培养均为阴性，可能是由于采样延迟或传统检测技术的局限性。本研究强调了气味类志贺氏菌在重症监护环境中引发持续性克隆性暴发的能力，突显了其作为多重耐药病原体的临床意义，并强调了早期微生物鉴定、分子监测和强有力的感染控制策略的必要性。
