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Sphingobacterium multivorum is a Gram-negative bacterium previously classified as a Flavibacterium. It produces non lactose fermenting colonies and is capable of producing oxidase and catalase enzymes. It is found ubiquitously in the environment and has been isolated from food, plants, soil, and aquatic environments, including hospital water supplies. Only a few cases of clinical infections caused by Sphingobacterium multivorum have been reported. Most cases of infection have been demonstrated in immunosuppressed patients. This case report presents the case of a 23-year-old immunocompetent woman with pituitary macroadenoma haemorrhage who developed Sphingobacterium meningitis following neurosurgery and subsequently died from cardiac arrest. [ABSTRACT FROM AUTHOR]

Chryseobacterium spp., is non motile, non fermenter, Gram Negative Bacillus (GNB) showing enzymatic activity of catalase, oxidase, and indole production. Chryseobacterium spp. are found widely in the soil and aquatic milieu. It is also capable of surviving in chlorinated water, which can be attributed to the spread of infection in hospital settings hosting profusely immunosuppressed individuals. Newer diagnostic modalities like Matrix-Assisted Laser Desorption Ionisation-Time Of Flight-Mass Spectrometry (MALDI-TOF-MS) and Vitek-2 facilitate early identification and treatment can alleviate the infections caused by them. Present series discusses three cases of Chryseobacterium indologenes (C. indologenes) Urinary Tract Infection (UTI) Case 1-was a 61-year-old hypertensive and diabetic male patient diagnosed with renal failure with pyelonephritis. Case 2- was a female patient of 64-year-old with left upper ureteric calculus. Case 3-was a 31-year-old male patient having left mid ureteric calculus. All the patients were catheterised with a urinary catheter and developed UTI by C. indologenes. C. indologenes infection in UTI patients is uncommon but these cases of complicated UTIs demonstrate C. indologenes as a potential cause of UTI in hospitalised patients using invasive equipment like urinary catheters. As the organism was Multidrug-Resistant (MDR), appropriate antibiotic treatment and accurate identification can alleviate infection by this organism. [ABSTRACT FROM AUTHOR]

Pseudomonas mendocina is a Gram negative bacillus, belonging to the Pseudomonadaceae family. It was first isolated in 1970 from soil and water of Mendoza region in Argentina. Although, it rarely causes infection, 21 cases of infections ranging from infective endocarditis, bacteraemia, meningitis, soft tissue infections and urinary tract infections are reported worldwide mostly among patients with underlying co-morbidities. This report is the first case of pyogenic meningitis due to Pseudomonas mendocina reported from a 1600 bedded teaching hospital in Northern India and second case of Pseudomonas mendocina infection from the Indian subcontinent. The presented case was of a 31-year-old female who was diagnosed for pituitary macroadenoma on Magnetic Resonance Imaging (MRI). She underwent endoscopic endonasal trans-sphenoidal excision of the tumour after two months of diagnosing the tumour following which she developed meningitis. On two consecutive aerobic bacterial culture and identification by Matrix-Assisted Laser Desorption/Ionisation-Time of Flight-Mass Spectrometry (MALDI-TOF-MS), growth of Pseudomonas mendocina was observed. After Antibiotic Sensitivity Testing (AST) the patient was started on Piperacillin-tazobactam and Amoxicillin-clavulanic acid which lead to alleviate her symptoms of meningitis and was discharged after 27 days of hospital stay. [ABSTRACT FROM AUTHOR]

Achromobacter xylosoxidans subspecies denitrificans flourishes in presence of oxygen, commonly isolated from aquatic milieu. It is rarely implicated as the causative agent of endocarditis. It is not known to cause virulent infections in patients but causes severe infections in immunosuppressed patients with underlying co-morbidities. Present report is first case of Achromobacter xylosoxidans prosthetic valve endocarditis from India. This case report accounts for a 47-year-old man, suffering from Rheumatic Heart Disease (RHD), who presented to the cardiology emergency with chief complaints of remitting type high-grade fever for years years followed by persistent fever for 10 days. On echocardiography and positively flagged BACTEC blood culture reports was diagnosed as a case of Achromobacter xylosoxidans subspecies denitrificans bacteraemia and prosthetic aortic valve endocarditis. Antibiotics were started according to the susceptibility testing but the patient could not complete the course of treatment as he developed dyspnoea and cardiac arrest following which he could not be resuscitated. [ABSTRACT FROM AUTHOR]

Patients undergoing chemotherapy for any malignant disease are at a higher risk of developing central line related blood stream infection, as a result of lack of proper care of the central line used for giving chemotherapy. Here, a case of sepsis by an unusual pathogen Delftia acidovorans is shown in a 29-year-old female patient undergoing chemotherapy for breast cancer with no other related co-morbidities and family history. On investigation, elevated procalcitonin showed presence of bacterial sepsis. Despite of empirical antimicrobial therapy, the patient showed features of continued sepsis. Blood specimens were taken and sent as paired sets of BACTEC blood culture bottles. This was identified as Delftia acidovorans which is rarely known to cause central line related blood stream infection and has a ubiquitous presence and cause infection mostly in immunocompromised patients. Empirical therapy was continued in the patient but could not be revived because of sudden episode of bradycardia. This report highlights the significance of appropriate diagnosis and treatment of such rare pathogen as a causative pathogen for sepsis. In this report, authors also emphasise the need of education of patients and healthcare providers for proper care of any chemoport inserted to avoid incidence of central line associated blood stream infection. [ABSTRACT FROM AUTHOR]