An outbreak of chryseobacterium indologenes bacteremia: Pseudobacteremia of unrecognized sources

[[abstract]]Purpose: Some of the bacteria from blood culture might be due to contamination but others were true infection. The aim of our study is to investigate the distribution and clinical implication of blood-stream infection. Methods: Bacteria yielded from blood culture in a district hospital between February 2013 and November 2014 was enrolled. If the same pathogen yielded from the blood of the same patient repeatedly, then only the first bacteria from blood culture was enrolled. Results: Total 4319 pathogens from blood culture were enrolled as Figure1. The number of aerobic gram-positive cocci was 2169 (50.2%), with most of them was Staphylococcus epidermidis (n = 1395), followed by Staphylococcus aureus (n = 388) and Enterococcus (n = 226). The number of aerobic gram-negative bacilli was 1705 (39.5%) with 1083 was glucose-fermenting and 621 was glucose-non-fermenting. Most of the glucose-fermenting GNB was Escherichia coli (n = 577), Klebsiella pneumoniae (n = 250) and Proteus mirabilis (n = 54). Most of the glucose-non-fermenting GNB was Chryseobacterium indologenes (n = 105), Acinetobacter baumannii (n = 95) and Pseudomonas aeruginosa (n = 82). The number of fungus from blood culture was 173 with most of them was Candida albicans (n = 89), Candida glabrata (n = 37) and Candida tropicalis (n = 28). Because of unusual number of Chryseobacterium from the blood culture result, we did serial of environmental sampling, including hand of doctor and nurse, bedside and disinfectants. However no Chryseobacterium spp. could be yielded from environmental samples. We traced the patients with Chryseobacterium yielded from blood culture but no obvious infection focus was noted. Conclusion: Unusual number of Chryseobacterium from the blood culture result was found but negative in environmental sampling or infection focus survey