Leptotrichia Bacteremia: 10-Year Retrospective Clinical Analysis and Antimicrobial Susceptibility Profiles

• Published in: Journal of clinical microbiology 2023-02, Vol.61 (2), p.e0173322-e0173322
• Main Authors: Ranganath, Nischal, Shirley, Joshua D, Challener, Douglas W, Stevens, Ryan W, Kind, Dalton R, Comba, Isin Y, Patel, Robin, Schuetz, Audrey N, Shah, Aditya S
• Format: Article
• Language: English
• Subjects: Adult; Anti-Bacterial Agents; Anti-Infective Agents; Bacteremia - microbiology; Bacteriology; Female; Gram-Negative Bacteria; Humans; Leptotrichia; Metronidazole; Microbial Sensitivity Tests; Middle Aged; Piperacillin, Tazobactam Drug Combination; Retrospective Studies; Sepsis
• ISSN: 0095-1137; 1098-660X
• DOI: 10.1128/jcm.01733-22

species are anaerobic, Gram-negative bacilli increasingly recognized as pathogens capable of causing invasive infections such as bloodstream infection (BSI), particularly among immunocompromised patients. However, there is a paucity of data regarding epidemiology, antimicrobial susceptibility, optimal treatment, and clinical outcomes among patients with bacteremia. Patient risk factors, treatment approaches, and outcomes of a retrospective cohort of adult patients with BSI at a tertiary medical center (Mayo Clinic Rochester [MCR]) were evaluated. Concurrently, species, temporal trends, and antimicrobial susceptibility testing (AST) results of isolates submitted to a reference laboratory (Mayo Clinic Laboratories) over the past 10 years were examined. We identified 224 blood culture isolates of species, with 26 isolates from patients treated at MCR. The most frequent species included L. trevisanii (49%), L. buccalis (24%), and L. wadei (16%). species demonstrated >90% susceptibility to penicillin, metronidazole, ertapenem, and piperacillin-tazobactam. However, 96% (74/77) of isolates were resistant to moxifloxacin. For patients treated at MCR, the mean patient age was 55 years (standard deviation [SD], 17), with 9 females (35%), and all were neutropenic at the time of BSI. The primary sources of infection were gastrointestinal (58%), intravascular catheter (35%), and odontogenic (15%). Patients were treated with metronidazole (42%), piperacillin-tazobactam (27%), or carbapenems (19%). The mean duration of treatment was 11 days (SD, 4.5), with a 60-day all-cause mortality of 19% and no microbiologic relapse. species are rare but important causes of BSI in neutropenic patients. Due to evolving antimicrobial susceptibility profiles, a review of AST results is necessary when selecting optimal antimicrobial therapy.