Myroides odoratimimus urinary tract infection in an immunocompromised patient: an emerging multidrug-resistant micro-organism

Antimicrob Resist Infect Control. 2018 Aug 6:7:96. doi: 10.1186/s13756-018-0391-4. eCollection 2018.

Abstract

Background: Myroides spp. are common environmental organisms and they can be isolated predominantly in water, soil, food and in sewage treatment plants. In the last two decades, an increasing number of infections such as urinary tract infections and skin and soft tissue infections, caused by these microorganisms has been reported. Selection of appropriate antibiotic therapy to treat the infections caused by Myroides spp. is difficult due to the production of a biofilm and the organism's intrinsic resistance to many antibiotic classes.

Case presentation: We report the case of a 69-year-old immunocompromised patient who presented with repeated episodes of macroscopic haematuria, from Northern Italy.A midstream urine sample cultured a Gram negative rod in significant amounts (> 105 colony-forming units (cfu)/mL), which was identified as Myroides odoratimimus. The patient was successfully treated with trimethoprim/sulfamethoxazole after antibiotic susceptibility testing confirmed its activity.

Conclusion: This case underlines the emergence of multidrug resistant Myroides spp. which are ubiquitous in the environment and it demands that clinicians should be more mindful about the role played by atypical pathogens, which may harbour or express multidrug resistant characteristics, in immunocompromised patients or where there is a failure of empiric antimicrobial therapy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / administration & dosage*
  • Drug Resistance, Multiple, Bacterial*
  • Flavobacteriaceae / drug effects*
  • Flavobacteriaceae / genetics
  • Flavobacteriaceae / isolation & purification*
  • Flavobacteriaceae / physiology
  • Flavobacteriaceae Infections / drug therapy
  • Flavobacteriaceae Infections / immunology
  • Flavobacteriaceae Infections / microbiology*
  • Humans
  • Immunocompromised Host
  • Male
  • Microbial Sensitivity Tests
  • Sulfamethoxazole / administration & dosage
  • Trimethoprim / administration & dosage
  • Urinary Tract Infections / drug therapy
  • Urinary Tract Infections / immunology
  • Urinary Tract Infections / microbiology*

Substances

  • Anti-Bacterial Agents
  • Trimethoprim
  • Sulfamethoxazole