Clinical characteristics, antimicrobial susceptibilities, and outcomes of patients with Chr+yseobacterium indologenes bacteremia in an intensive care unit

Ten patients with intensive care unit (ICU)-acquired Chryseobacterium indologenes bacteremia between January 2004 and December 2008 were studied. The primary site of infection was unknown for 80z of the cases. The known primary sites of infection were empyema (10z) and catheter-related bacteremia (10z). Eight patients (80z) had polymicrobial bacteremia, spent more than 21 days in the ICU, and received more than 14 days of broad-spectrum antibiotic therapy prior to the onset of C. indologenes bacteremia. All isolates were 100z susceptible to minocycline and trimethoprim/sulfamethoxazole. Vancomycin, imipenem, piperacillin/tazobactam, ciprofloxacin, and levofloxacin exhibited 0z, 10z, 20z, 30z, and 30z, respectively, susceptibility against this pathogen. All isolates were 100z resistant to ceftazidime, cefepime, meropenem, piperacillin, and amikacin. The 14-day mortality rate was 40z. Our findings suggest that this pathogen should be included among the causes of ICU-acquired bacteremia, especially in patients with a prolonged stay in an ICU or who had received long-term broad-spectrum antibiotic therapy. Extended-spectrum penicillins, third- and fourth-generation cephalosporins, and quinolones had very little or no effect against this pathogen. Therefore, choosing an appropriate antibiotic therapy for this pathogen is very difficult.