title: Bacteremia caused by Pantoea agglomerans at a medical center in Taiwan, 2000-2010.
abstract: OBJECTIVE
  There are only three case reports of adult patients with spontaneous Pantoea agglomerans bacteremia in the English literature. The aim of this study was to investigate clinical and microbiologic characteristics patients of P agglomerans bacteremia.
  
  
  METHODS
  We studied all adult patients with P agglomerans bacteremia at a medical center from 2000 to 2010. The isolates were identified using two commercial identification systems.
  
  
  RESULTS
  Of the 18 patients identified, 72% (n = 13) had active gastroesophageal disease treated with antacids. Two-thirds of patients had indwelling central lines and advanced cancers. None of the removed catheter tips yielded P agglomerans and line persistence was not associated with adverse outcomes. Initial disease severity was low, hypotension was uncommon and no patient died of bacteremia. Recurrence of bacteremia occurred in one patient with deep-seated infection. 16srRNA gene sequencing identified only half of the isolates as P agglomerans. The remaining nine isolates were Enterobacter species for six, Pantoea ananatis for two, and Exiguobacterium profundum for one. There were no significant differences between the characteristics of the subgroup molecularly identified as P agglomernas and the overall group characteristics. Eleven (61%) of the 18 isolates were susceptible to cefazolin, six (33%) susceptible to fosfomycin (MIC ≤ 64 mg/ml). Two isolates had colistin MICs ≥ 4 mg/ml.
  
  
  CONCLUSIONS
  Bacteremia caused by P agglomerans is associated with gastroesophageal reflux disease and receipt of antacids. 16srRNA gene sequencing should not be used as the sole basis for its identification and we have highlighted the need for another molecular-based technique to conclusively characterize P agglomerans.
authors: Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan.
authors: Aristine
authors: A
authors: Cheng
authors: Chia-Ying
authors: CY
authors: Liu
authors: Hsih-Yeh
authors: HY
authors: Tsai
authors: Meng-Shuian
authors: MS
authors: Hsu
authors: Chia-Jui
authors: CJ
authors: Yang
authors: Yu-Tsung
authors: YT
authors: Huang
authors: Chun-Hsing
authors: CH
authors: Liao
authors: Po-Ren
authors: PR
authors: Hsueh
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000863:Antacids / Q000009:adverse effects / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D004756:Enterobacteriaceae Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D020636:Pantoea / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000863:Antacids