Extensively drug-resistant Myroides odoratimimus – a case series of urinary tract infections in immunocompromised patients

Abstract

Extensively drug-resistant Myroides odoratimimus – A case series of urinary tract infections in immunocompromised patients Monica Licker,1,2 Teodora Sorescu,3,4 Maria Rus,5,6 Natalia Cirlea,6 Florin Horhat,1 Cristiana Jurescu,5,6 Mircea Botoca,7,8 Alin Cumpănas,7,8 Romulus Timar,3,4 Delia Muntean1,2 1Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 2Clinical Laboratory, “Pius Brînzeu” Emergency Clinical County Hospital, Timisoara, Romania; 3Department of Internal Medicine II, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 4Diabetes Clinic, “Pius Brînzeu” Emergency Clinical County Hospital, Timisoara, Romania; 5“Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 6“Pius Brînzeu” Emergency Clinical County Hospital, Timisoara, Romania; 7Department of Orthopaedics – Traumatology, Urology and Medical Imaging, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 8Urology Unit, “Pius Brînzeu” Emergency Clinical County Hospital, Timisoara, Romania Purpose: We report an outbreak of urinary tract infections (UTIs) caused by Myroides odoratimimus, which occurred in the largest clinical hospital in western Romania. Patients and methods: From June to August 2017, four strains of M. odoratimimus were isolated from the urine samples of patients hospitalized in the urology, diabetes, and surgery departments. Hospital records of all patients whose urine cultures were positive for M. ­odoratimimus were reviewed retrospectively. We also reviewed the cases reported in the literature. Results: All UTIs, except one, were hospital-acquired infections. All patients with M. odoratimimus UTIs were immunocompromised. Three patients underwent urinary catheterization with a Foley’s catheter upon admission in the emergency department and one presented for replacement of ureterostomy tubes. All Myroides isolates were resistant to almost all the tested antibiotics. Two patients were successfully treated with tigecycline and one was receiving antimicrobial treatment for another infection at the time of isolation of the microorganism. Conclusion: Although M. odoratimimus is an uncommon pathogen, clinicians should be aware of its ability to cause UTI outbreaks, especially in the immunocompromised population. Due to its multi-drug resistance, it is important to rapidly identify Myroides spp. in order to choose the best treatment regimen. Keywords: Myroides odoratimimus, urinary tract infection, resistance, outbreak