Bloodstream Infections by <i>Pantoea</i> Species: Clinical and Microbiological Findings from a Retrospective Study, Italy, 2018-2023
(1) Background: The widespread use of MALDI-TOF coupled to mass spectrometry has improved diagnostic accuracy by identifying uncommon bacteria. Among Enterobacterales, <i>Pantoea</i> species have been seen to be implicated in several human infections, but their clinical and microbiologic...
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| Main Authors: | , , , , , , , , , |
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MDPI AG,
2023-12-01T00:00:00Z.
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| Summary: | (1) Background: The widespread use of MALDI-TOF coupled to mass spectrometry has improved diagnostic accuracy by identifying uncommon bacteria. Among Enterobacterales, <i>Pantoea</i> species have been seen to be implicated in several human infections, but their clinical and microbiological framework is currently based on a few anecdotal reports. (2) Methods: We conducted this five-year (2018-2023) single-center study aimed at investigating the prevalence and clinical and microbiological findings of <i>Pantoea</i> species bloodstream infections. (3) Results: Among the 4996 bloodstream infection Gram-negative isolates collected during the study period, <i>Pantoea</i> species accounted for 0.4% (n = 19) of isolates from 19 different patients, 5 of them being pediatric cases. Among <i>Pantoea</i> species isolates, <i>P. agglomerans</i> was the most frequently detected (45%; n = 9) followed by <i>P. eucrina</i> (30%; n = 6) and <i>P. septica</i> (15%; n = 3). Malignancy (35.7%) in adults and malignancy (40%) and cerebrovascular disease following meconium aspiration (40%) in pediatric patients as comorbidities and shivering and/or fever following parenteral infusion (36.8%) as a symptom/sign of <i>Pantoea</i> species bloodstream infection onset were the most frequently observed clinical features. Among adults, primary bloodstream infection was the most frequent (50%), whereas among pediatric patients, the most commonly identified sources of infection were catheter-related (40%) and the respiratory tract (40%). Overall, <i>Pantoea</i> species bloodstream infection isolates displayed high susceptibility to all the antibiotics except for ampicillin (63.2%), fosfomycin (73.7%), and piperacillin/tazobactam (84.2%). Targeted antibiotic treatment was prescribed as monotherapy for adults (71.4%) and combination therapy for pediatric patients (60%). The most prescribed antibiotic regimens were piperacillin/tazobactam (21.4%) in adults and meropenem- (40%) and aminoglycoside-containing (40%) antibiotics in pediatric patients. The overall 28-day all-cause mortality rate was 5.3% (n = 1). (4) Conclusions: The prevalence and 28-day mortality rate of <i>Pantoea</i> species bloodstream infections were low. The prescription of targeted therapy including broad-spectrum antibiotics could indicate an underestimation of the specific involvement of the <i>Pantoea</i> species in the onset of the disease, warranting further studies defining their pathogenic potential. |
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| Item Description: | 10.3390/antibiotics12121723 2079-6382 |