title: Bacillus cereus infection: 57 case patients and a literature review.
abstract: OBJECTIVE
  We aimed to study the characteristics of patients presenting with a Bacillus cereus infection in a university hospital.
  
  
  METHODS
  We performed a retrospective analysis of the clinical, biological, and treatment-related data of patients hospitalized in our university hospital between January 1st, 2008 and December 31st, 2012 and diagnosed with a B. cereus infection. We identified a subgroup of patients presenting with bacteremia and looked for risk factors for death within that group of patients.
  
  
  RESULTS
  We included 57 patients in our study; 31 (54.4%) were hospitalized in a medical ward. We identified 24 bacteremia case patients, including 17 patients presenting with bacteremia alone (29.8%). Other frequently observed infection sites were skin infections (16; 28.1%) and bone and joint infections (10; 17.5%). We recorded 9 deaths (11.8%); 2 patients, despite being on an appropriate antibiotic therapy, died from a medical device-related infection that had not been removed. The empirical administration of a beta-lactam antibiotic was significantly associated with death (P=0.022). Three patients presenting with recurrent bacteremia were identified. The patients only recovered once the infected device had been removed.
  
  
  CONCLUSIONS
  B. cereus infections may have various clinical presentations. Prospective data is needed to put forward a consensual treatment approach and guide physicians in choosing the appropriate antibiotic therapy and in removing the infected device.
authors.affiliation: Service de maladies infectieuses et tropicales, CHU Caremeau, place du Pr R.-Debré, 30029 Nîmes cedex 9, France.
authors.forename: F
authors.initials: F
authors.lastname: Veysseyre
authors.affiliation: Service de maladies infectieuses et tropicales, CHU Caremeau, place du Pr R.-Debré, 30029 Nîmes cedex 9, France.
authors.forename: C
authors.initials: C
authors.lastname: Fourcade
authors.affiliation: Service de microbiologie, CHU Caremeau, 30029 Nîmes, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Lavigne
authors.affiliation: Service de maladies infectieuses et tropicales, CHU Caremeau, place du Pr R.-Debré, 30029 Nîmes cedex 9, France. Electronic address: albert.sotto@chu-nimes.fr.
authors.forename: A
authors.initials: A
authors.lastname: Sotto
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001409:Bacillus cereus; D016470:Bacteremia / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents
keywords: Bacillus cereus; Epidemiology; Infection nosocomiale; Nosocomial infection; Épidémiologie