Pseudomonas otitidis bacteremia in an immunocompromised patient with cellulitis: case report and literature review

Pseudomonas otitidis belongs to the genus Pseudomonas and causes various infections, including ear, skin, and soft tissue infections. P. otitidis has a unique susceptibility profile, being susceptible to penicillins and cephalosporins but resistant to carbapenems, due to the production of the metall...

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Bibliographic Details
Published in:	BMC infectious diseases Vol. 23; no. 1; p. 883
Main Authors:	Mori, Takeo, Yoshizawa, Sadako, Yamada, Kageto, Sato, Takahiro, Sasaki, Masakazu, Nakamura, Yusuke, Gen, Ukyo, Murakami, Hinako, Kashiwagi, Katsuhito, Maeda, Tadashi, Miyazaki, Taito, Yamaguchi, Tetsuo, Urita, Yoshihisa, Ishii, Yoshikazu, Tateda, Kazuhiro
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 18-12-2023 BioMed Central BMC
Subjects:	Antibacterial agents Antibiotics Antimicrobial agents Bacteremia Bacterial infections Beta lactamases Blood Blood culture Cancer Carbapenems Care and treatment Case Report Case reports Cefepime Cell culture Cellulitis Cephalosporins Chemotherapy Complications and side effects Dosage and administration Edema Gram-negative bacilli Health aspects Identification Immunocompromised host Immunocompromised hosts Immunocompromised patient Infections Ionization Levofloxacin Literature reviews Mass spectrometry Mass spectroscopy Medical examination Meropenem Metallo-β-lactamase Metallography Multiple myeloma Neutropenia Pathogens Patients Penicillin POM-1 Prevention Pseudomonas Pseudomonas aeruginosa Pseudomonas otitidis Risk factors Soft tissues Type 2 diabetes Japan United States > US Case report Cellulitis Pseudomonas otitidis Bacteremia Immunocompromised patient POM-1
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Summary:	Pseudomonas otitidis belongs to the genus Pseudomonas and causes various infections, including ear, skin, and soft tissue infections. P. otitidis has a unique susceptibility profile, being susceptible to penicillins and cephalosporins but resistant to carbapenems, due to the production of the metallo-β-lactamase called POM-1. This revealed genetic similarities with Pseudomonas aeruginosa, which can sometimes lead to misidentification. We report the case of a 70-year-old Japanese male who developed cellulitis and bacteremia during chemotherapy for multiple myeloma. He was initially treated with meropenem, but blood culture later revealed gram-negative bacilli identified as P. otitidis using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Carbapenem resistance was predicted from previous reports; therefore, we switched to dual therapy with levofloxacin and cefepime, and favorable treatment results were obtained. This is the first reported case of P. otitidis cellulitis and bacteremia in an immunocompromised patient. Carbapenems are typically used in immunocompromised patients and P. otitidis is often resistant to it. However, its biochemical properties are similar to those of Pseudomonas aeruginosa; therefore, its accurate identification is critical. In the present study, we rapidly identified P. otitidis using MALDI-TOF MS and switched from carbapenems to an appropriate antimicrobial therapy, resulting in a successful outcome.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Review-3 content type line 23 ObjectType-Feature-5 ObjectType-Article-4 ObjectType-Report-1
ISSN:	1471-2334 1471-2334
DOI:	10.1186/s12879-023-08919-0