Nosocomial Sepsis Triggered by Pluralibacter gergoviae in a Pediatric Intensive Care Unit: A Case Report and Literature Review

Abstract

Pluralibacter gergoviae is a rare opportunistic gram-negative Bacillus in humans and exhibits resistance to preservatives in cosmetic products. In this case report, we present nosocomial P. gergoviae sepsis that developed through contamination from a cleaning product in a previously healthy child without known chronic diseases, during pediatric intensive care unit care. Contamination with the same microorganism was detected even in unused samples of the cleaning product, leading to a recall of these items. This report highlights the case of hospital-acquired P. gergoviae sepsis to emphasize the importance of adherence to antiseptic protocols by health care workers, as well as the necessity for medical materials used in treatment and patient care to be produced and stored in compliance with appropriate regulations.

Keywords

Pluralibacter gergoviae - hospital-acquired infections - pediatric sepsis - nosocomial pathogens - contamination control

Informed Consent

Informed consent was provided by the legal representative.

Publication History

Received: 30 May 2024

Accepted: 26 September 2024

Article published online:
04 November 2024

• References

• 1 Ganeswire R, Thong KL, Puthucheary SD. Nosocomial outbreak of Enterobacter gergoviae bacteraemia in a neonatal intensive care unit. J Hosp Infect 2003; 53 (04) 292-296
• 2 Satlin MJ, Jenkins SG, Chen L. et al. Septic shock caused by Klebsiella pneumoniae carbapenemase-producing Enterobacter gergoviae in a neutropenic patient with leukemia. J Clin Microbiol 2013; 51 (08) 2794-2796
• 3 Brenner DJ, Richard C, Steigerwalt AG, Asbury MA, Mandel M. Enterobacter gergoviae sp. nov.: a new species of Enterobacteriaceae found in clinical specimens and the environment. Int J Syst Bacteriol 1980; 30 (01) 1-6
• 4 Cheng Y, Chen M. Extended-spectrum beta-lactamases in clinical isolates of Enterobacter gergoviae and Escherichia coli in China. Antimicrob Agents Chemother 1994; 38 (12) 2838-2842
• 5 Weiss ZF, Hoffmann M, Seetharaman S. et al. Nosocomial Pluralibacter gergoviae isolates expressing NDM and KPC carbapenemases characterized using whole-genome sequencing. Antimicrob Agents Chemother 2022; 66 (10) e0109322
• 6 Davin-Regli A, Chollet R, Bredin J, Chevalier J, Lepine F, Pagès JM. Enterobacter gergoviae and the prevalence of efflux in parabens resistance. J Antimicrob Chemother 2006; 57 (04) 757-760
• 7 Freire MP, de Oliveira Garcia D, Cury AP. et al. Outbreak of IMP-producing carbapenem-resistant Enterobacter gergoviae among kidney transplant recipients. J Antimicrob Chemother 2016; 71 (09) 2577-2585
• 8 Rashid AMA, Lim CTS. Enterobacter gergoviae peritonitis in a patient on chronic ambulatory peritoneal dialysis-first reported case. Malaysian J Med Health Sci 2017; 13: 67-69
• 9 Khashei R, Edalati Sarvestani F, Malekzadegan Y, Motamedifar M. The first report of Enterobacter gergoviae carrying bla _NDM-1 in Iran. Iran J Basic Med Sci 2020; 23 (09) 1184-1190
• 10 Deshpande LM, Rhomberg PR, Sader HS, Jones RN. Emergence of serine carbapenemases (KPC and SME) among clinical strains of Enterobacteriaceae isolated in the United States Medical Centers: report from the MYSTIC Program (1999-2005). Diagn Microbiol Infect Dis 2006; 56 (04) 367-372
• 11 Almeida ACS, de Castro KKA, Fehlberg LCC, Gales AC, Vilela MA, de Morais MMC. Carbapenem-resistant Enterobacter gergoviae harbouring blaKPC-2 in Brazil. Int J Antimicrob Agents 2014; 44 (04) 369-370
• 12 Hidron AI, Edwards JR, Patel J. et al; National Healthcare Safety Network Team, Participating National Healthcare Safety Network Facilities. NHSN annual update: antimicrobial-resistant pathogens associated with healthcare-associated infections: annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007. Infect Control Hosp Epidemiol 2008; 29 (11) 996-1011
• 13 Périamé M, Pagès JM, Davin-Regli A. Enterobacter gergoviae adaptation to preservatives commonly used in cosmetic industry. Int J Cosmet Sci 2014; 36 (04) 386-395
• 14 Valkova N, Lépine F, Bollet C, Dupont M, Villemur R. prbA, a gene coding for an esterase hydrolyzing parabens in Enterobacter cloacae and Enterobacter gergoviae strains. J Bacteriol 2002; 184 (18) 5011-5017
• 15 Diekema DJ, Pfaller MA, Jones RN. et al. Survey of bloodstream infections due to gram-negative bacilli: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, and Latin America for the SENTRY Antimicrobial Surveillance Program, 1997. Clin Infect Dis 1999; 29 (03) 595-607
• 16 Stock I, Wiedemann B. Natural antibiotic susceptibility of Enterobacter amnigenus, Enterobacter cancerogenus, Enterobacter gergoviae and Enterobacter sakazakii strains. Clin Microbiol Infect 2002; 8 (09) 564-578
• 17 Cantón R, Oliver A, Coque TM, Varela MdelC, Pérez-Díaz JC, Baquero F. Epidemiology of extended-spectrum β-lactamase-producing Enterobacter isolates in a Spanish hospital during a 12-year period. J Clin Microbiol 2002; 40 (04) 1237-1243
• 18 Ho PL, Shek RH, Chow KH. et al. Detection and characterization of extended-spectrum β-lactamases among bloodstream isolates of Enterobacter spp. in Hong Kong, 2000-2002. J Antimicrob Chemother 2005; 55 (03) 326-332
• 19 Simons WJ, Lee TJ. Aztreonam in the treatment of bone and joint infections caused by gram-negative bacilli. Rev Infect Dis 1985; 7 (Suppl. 04) S783-S788
• 20 Chen K-J, Yang K-J, Sun C-C, Yeung L. Traumatic endophthalmitis caused by Enterococcus raffinosus and Enterobacter gergoviae . J Med Microbiol 2009; 58 (Pt 4): 526-528
• 21 Jie TTZ, Junnarkar SP, Shelat VG. Pluralibacter georgoviae causing acute cholecystitis with perforation. Surg Infect (Larchmt) 2021; 22 (03) 353-353
• 22 Sánchez FM, Albo Castaño MI, Arbol Linde F, Casallo Blanco S, Durán Pérez-Navarro A. Lower respiratory tract infection due to Enterobacter gergoviae . Med Interna 2005; 22 (11) 553-554
• 23 Cone L, Tormay AF, Midha NK. Enterobacter gergoviae bacteremia due to a cholangitis: a case report. Antimicrobics Infect Dis Newsletter 1996; 15 (05) 32-34
• 24 Kesieme EB, Kesieme CN, Akpede GO. et al. Tension pneumatocele due to Enterobacter gergoviae pneumonia: a case report. Case Rep Med 2012; 2012: 808630