Clostridium tertium in Neutropenic Patients: Case Series at a Cancer Institute.

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Clostridium tertium in Neutropenic Patients: Case Series at a Cancer Institute.

Int J Infect Dis. 2016 Aug 26;

Authors: Shah S, Hankenson J, Pabbathi S, Greene J, Nanjappa S

Abstract
OBJECTIVE: Clostridium tertium is considered an uncommon pathogen in humans, but is a cause of bacteremia in patients with underlying hematologic malignancy and neutropenia. We present a case series highlighting our 10 year experience at a NCI designated cancer center of C. tertium as a cause of bacteremia in this population.
METHODS: Institutional review board approval was obtained prior to the start of the study. We reviewed all cases of C. tertium bacteremia at H. Lee Moffitt Cancer Center and Research Institute from 2005 to 2015. The study population was identified by positive blood cultures obtained from the microbiology laboratory over the same period of time.
RESULTS: Seven patients were found to have C. tertium bacteremia, with a temperature of>101°F at the time of diagnosis and severe neutropenia. All patients had a history of hematologic malignancy, five having AML and two having MDS. All of the patient's blood cultures cleared within ≤ 3 days of antibiotic therapy.
CONCLUSIONS: The unusual susceptibility pattern of C. tertium, with resistance to beta-lactams and clindamycin, likely explains its presence in immunosuppressed patients. Vancomycin remains the drug of choice. The pathogen continues to have a low virulence and a low mortality when treated appropriately.

PMID: 27575937 [PubMed - as supplied by publisher]