AUTHOR=Ng Wincy Wing-Sze , Shum Hoi-Ping , To Kelvin Kai-Wang , Sridhar Siddharth 

TITLE=Emerging Infections Due to Shewanella spp.: A Case Series of 128 Cases Over 10 Years

JOURNAL=Frontiers in Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.850938

DOI=10.3389/fmed.2022.850938

ISSN=2296-858X

ABSTRACT=<sec><title>Background</title><p><italic>Shewanella</italic> species are emerging pathogens that can cause severe hepatobiliary, skin and soft tissue, gastrointestinal, respiratory infections, and bacteremia. Here we reported the largest case series of infections caused by <italic>Shewanella</italic> species.</p></sec><sec><title>Aim</title><p>To identify the clinical features and risk factors predisposing to <italic>Shewanella</italic> infections. To evaluate resistance pattern of <italic>Shewanella</italic> species and appropriateness of antibiotic use in the study cohort.</p></sec><sec><title>Methods</title><p>Patients admitted to a regional hospital in Hong Kong with <italic>Shewanella</italic> species infection from April 1, 2010 to December 31, 2020 were included. Demographics, antibiotics, microbiology, and outcomes were retrospectively analyzed.</p></sec><sec><title>Findings</title><p>Over the 10 years, we identified 128 patients with <italic>Shewanella</italic> species infection. 61.7% were male with a median age of 78 (IQR 65–87). Important underlying diseases included hepatobiliary diseases (63.3%), malignancy (26.6%), chronic kidney disease or end-stage renal failure (25.8%), and diabetes mellitus (22.7%). Hepatobiliary infections (60.4%) were the most common clinical manifestation. Majority (92.2%) were infected with <italic>Shewanella algae</italic>, while 7.8% were infected with <italic>Shewanella putrefaciens</italic>. The identified organisms were usually susceptible to ceftazidime (98.7%), gentamicin (97.4%), cefoperazone-sulbactam (93.5%) and ciprofloxacin (90.3%). Imipenem-susceptible strains were only present in 76.6% of isolates.</p></sec><sec><title>Conclusion</title><p>This largest case series suggested that <italic>Shewanella</italic> infections are commonly associated with underlying comorbidities, especially with hepatobiliary diseases and malignancy. Although <italic>Shewanella species</italic> remained largely susceptible to third and fourth generation cephalosporins and aminoglycosides, carbapenem resistance has been on a significant rise.</p></sec>