Bacteremia due to Staphylococcus cohnii ssp. urealyticus caused by infected pressure ulcer
case report and review of the literature
Keywords:
Staphylococcal infections, Pressure ulcer, Bacteremia, Dementia, Community-acquired infectionsAbstract
CONTEXT: Coagulase-negative staphylococci are common colonizers of the human skin and have become increasingly recognized as agents of clinically significant nosocomial infections. CASE REPORT: The case of a 79-year-old male patient with multi-infarct dementia who presented systemic inflammatory response syndrome is reported. This was attributed to bacteremia due to Staphylococcus cohnii ssp. urealyticus, which was grown on blood cultures originating from an infected pressure ulcer. The few cases of Staphylococcus cohnii infection reported in the literature consist of bacteremia relating to catheters, surgical prostheses, acute cholecystitis, brain abscess, endocarditis, pneumonia, urinary tract infection and septic arthritis, generally presenting a multiresistant profile, with nearly 90% resistance to methicillin. CONCLUSIONS: The reported case is, to our knowledge, the first case of true bacteremia due to Staphylococcus cohnii subsp. urealyticus caused by an infected pressure ulcer. It shows that this species may be underdiagnosed and should be considered in the differential diagnosis for communityacquired skin infections.
Downloads
References
Richards MJ, Edwards JR, Culver DH, Gaynes RP. Nosocomial infections in medical intensive care units in the United States. National Nosocomial Infections Surveillance System. Crit Care Med. 1999;27(5):887-92.
Wisplinghoff H, Bischoff T, Tallent SM, et al. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis. 2004;39(3):309-17.
Kirchhoff LV, Sheagren JN. Epidemiology and clinical significance of blood cultures positive for coagulase-negative staphylococcus. Infect Control. 1985;6(12):479-86.
Sader HS, Sampaio JL, Zoccoli C, Jones RN. Results of the 1997 SENTRY Antimicrobial Surveillance Program in Three Brazilian Medical Centers. Braz J Infect Dis. 1999;3(2):63-79.
Pfaller MA, Herwaldt LA. Laboratory, clinical, and epidemiological aspects of coagulase-negative staphylococci. Clin Microbiol Rev. 1988;1(3):281-99.
Drozenová J, Petrás P. [Characteristics of coagulase-negative staphylococci isolated from hemocultures]. Epidemiol Mikrobiol Imunol. 2000;49(2):51-8.
de Allori MC, Jure MA, Romero C, de Castillo ME. Antimicrobial resistance and production of biofilms in clinical isolates of coagulase- negative Staphylococcus strains. Biol Pharm Bull. 2006;29(8):1592-6.
Koksal F,Yasar H, Samasti M. Antibiotic resistance patterns of coagulase- negative staphylococcus strains isolated from blood cultures of septicemic patients in Turkey. Microbiol Res. 2009;164(4):404-10.
Del’Alamo L, Cereda RF, Tosin I, Miranda EA, Sader HS. Antimicrobial susceptibility of coagulase-negative staphylococci and characterization of isolates with reduced susceptibility to glycopeptides. Diagn Microbiol Infect Dis. 1999;34(3):185-91.
Petinaki E, Kanellopoulou M, Damani A, et al. Linezolid-resistant Staphylococcus cohnii, Greece. Emerg Infect Dis. 2009;15(1):116-8.