title: Ventilator-associated pneumonia caused byChryseobacterium indologenes: a rare infant case and review of the literature.
abstract: BACKGROUND
  Chryseobacterium indologenesis an uncommon organism that has been documented to cause a variety of invasive infections mostly in hospitalized patients with severe underlying diseases.
  
  
  METHODS
  A three-month-old female infant born at term by caesarean section with meningomyelocele and congenital diaphragmatic hernia had two surgeries for the repair of meningomyelocele and diaphragmatic hernia on her 3rd and 14th day, respectively. On the 3rd month of her life, she deteriorated clinically with fever, leukocytosis and increase of acute-phase reactants. Gas exchange condition became worse than it was before. Respiratory secretions, oxygen requirements and ventilator demand increased. Chest X-ray showed bilateral pulmonary infiltrates. Bacteriological blood, urine and cerebrospinal fluid culture test results were negative.C. indologeneswas isolated from tracheobronchial secretion sample obtained by endotracheal aspiration. Although susceptible to ciprofloxacin (MIC:0.5 gr/L), levofloxacin and piperacillin-tazobactam, the isolate was resistant to meropenem, imipenem and colistin. She was treated with ciprofloxacin successfully. Her fever resolved and gas exchange condition improved after 72 h of the treatment. The antibiotic treatment was given for a course of 14 days.
  
  
  CONCLUSIONS
  Chryseobacterium indologenesmay emerge as a potential pathogen in infants with the factors such as invasive equipment, having underlying diseases and prolonged hospitalization.
authors: Department of Pediatrics and Division of Pediatric Infectious Diseases Medical School, Marmara University, Istanbul, Turkey ; T.C. Sağlık Bakanlığı-Marmara Üniversitesi Pendik Eğitim ve Araştırma Hastanesi, Fevzi Çakmak Mah. Mimar Sinan Cad. Üstkaynarca, Pendik, Istanbul, Turkey.
authors: Serkan
authors: 0000-0002-3329-1866
authors: S
authors: Atıcı
authors: Department of Pediatrics and Division of Neonatology, Medical School, Marmara University, Istanbul, Turkey.
authors: Zeynep Alp
authors: ZA
authors: Ünkar
authors: Department of Microbiology, Medical School, Marmara University, Istanbul, Turkey.
authors: Kübra
authors: K
authors: Erdem
authors: Department of Pediatrics and Division of Pediatric Infectious Diseases Medical School, Marmara University, Istanbul, Turkey.
authors: Eda Kepenekli
authors: EK
authors: Kadayifci
authors: Department of Pediatrics and Division of Pediatric Infectious Diseases Medical School, Marmara University, Istanbul, Turkey.
authors: Ayşe
authors: A
authors: Karaaslan
authors: Department of Pediatrics and Division of Neonatology, Medical School, Marmara University, Istanbul, Turkey.
authors: Aslı Çınar
authors: AÇ
authors: Memişoğlu
authors: Department of Pediatrics and Division of Pediatric Infectious Diseases Medical School, Marmara University, Istanbul, Turkey.
authors: Ahmet
authors: A
authors: Soysal
authors: Department of Microbiology, Medical School, Marmara University, Istanbul, Turkey.
authors: Nurver Ülger
authors: NÜ
authors: Toprak
authors: Department of Microbiology, Medical School, Marmara University, Istanbul, Turkey.
authors: Güner
authors: G
authors: Söyletir
authors: Department of Pediatrics and Division of Neonatology, Medical School, Marmara University, Istanbul, Turkey.
authors: Eren
authors: E
authors: Özek
authors: Department of Pediatrics and Division of Pediatric Infectious Diseases Medical School, Marmara University, Istanbul, Turkey.
authors: Mustafa
authors: M
authors: Bakır
keywords: Chryseobacterium indologenes; Infant case; Ventilator-associated pneumonia