Opportunistic Brevundimonas spp infections: experience with three cases

Authors:
Saron Araya, Sridha Gona, Aaron George, Hugo Bonatti

Body of Abstract:
Introduction: Brevundimonas species are aerobic, non-fermenting, Gram-negative bacilli most closely related to Pseudomonas and were initially classified within that genus. Brevundimonas is recognized as genus since 1994 and was associated with bacteremia, pneumonia, and soft tissue infections with <50 cases reported thus far infections. Patients and Methods: Following an index case of a surgical site infection after excision of a skin tumor, in which Brevundimonas spp was isolated, our institutional database was searched for all infections caused by the pathogen during a 4-year period. Results: In total three patients (4 isolates) including the index case with infections due to Brevundimonas spp were identified. There were two men a one woman aged 27.6, 65.1 and 77.9 years. The patient with SSI had a polymicrobial wound infection (Streptococcus constellatus, Serratia marcescens, Bacteroides melaninogenicus) after an excision of a skin tumor. The other two patients had blood stream infections (in one case also Corynebacterium species grew). The 1st patient had been hospitalized with diabetic ketoacidosis. He developed colitis, which was assumed to be the source of the Brevundimoas bacteremia. The 2nd patient suffered from alcoholic liver cirrhosis and had multiple other co-morbidities and was hospitalized with lower leg cellulitis subsequent and Clostridoides difficile colitis, which were discussed as source of his Brevundimoas bacteremia. Both patient with sepsis died, the SSI was successfully managed with debridement and antibiotics. Conclusion: Brevundimonas spp should be added to the ever-expanding spectrum of human pathogens. These infections occur usually in patients with severe medical conditions and are difficult to treat resulting in a high mortality rate.