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Open Access Highly Accessed Case report

Enterobacter nimipressuralis as a cause of pseudobacteremia

Dong-Min Kim14, Sook Jin Jang24, Ganesh Prasad Neupane1, Mi-Sun Jang15, Se-Hoon Kwon1, Seok Won Kim3* and Won Yong Kim6

Author Affiliations

1 Division of Infectious Diseases, Department of Internal Medicine, Chosun University, School of Medicine Gwangju City, Republic of Korea

2 Department of Laboratory Medicine, Chosun University, School of Medicine Gwangju City, Republic of Korea

3 Department of Neurosurgery, Chosun University, School of Medicine Gwangju City, Republic of Korea

4 Research Center for Resistant Cells, Chosun University, School of Medicine Gwangju City, Republic of Korea

5 Department of Public Health, Chosun University, School of Medicine, Gwangju City, Republic of Korea

6 Department of Microbiology, Chung-Ang University, College of Medicine, Seoul, Republic of Korea

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BMC Infectious Diseases 2010, 10:315  doi:10.1186/1471-2334-10-315

Published: 29 October 2010

Abstract

Background

The clinical significance of the Enterobacter nimipressuralis as human pathogens remains unclear.

Case presentations

The microbiologic culture monitoring system of sterile body fluids revealed on an episode of Enterobacter cloacae and Enterobacter amnigenus in blood culture results on the same day; the antibiotic sensitivity and MIC were nearly the same for both species. First patient was a healthy woman with postmenopausal syndrome, while second patient with herpes zoster. Both patients had febrile sensations without signs of bacteremia. E. amnigenus was also cultured from the unused package of salined cotton in the container through epidemiologic investigation. The cultured Enterobacter species were all identified as E. nimipressuralis through hsp60 gene sequencing and infrequent-restriction-site PCR (IRS-PCR).

Conclusion

When an unusual microorganisms such as E. nimipressuralis is isolated from blood of a patient with no clinical signs of sepsis, a pseudobacteremia should be suspected. When the antibiogram and MIC test results of bacterial cultures from two or more patients are nearly the same, although the species involved may appear different, it may be necessary to prove that they are the same species through molecular methods. The microbiologic cultures monitoring system will probably help to detect pseudobacteremia and other pseudo infections through reliable and fast identification.