Plesiomonas shigelloides
Gram Stain
- Gram negative bacilli - fermenter
Clinical Significance
This organism is found in a variety of environmental sources including soil and water.
It is associated with both intestinal and extraintestinal infections.
Intestinal infections are more common in summer months and typically self-limited. They may be more severe in immunocompromised individuals. A history of travel to tropical areas or consumption of seafood is common.
Extraintestinal infections are rare and include septicemia, meningitis, skin/soft tissue (cellulitis) and bone/joint infections (septic arthritis/osteomyelitis), endophthalmitis, and cholecystitis.
Infections in immunocompromised individuals may have a fulminant course.
Usual Susceptibility Pattern
This organism produces a variety of beta-lactamases and is typically resistant to ampicillin, 1st/2nd generation cephalosporins, and beta-lactamase inhibitor combinations.
Aminoglycosides have low intrinsic activity and should be considered resistant.
Resistance to tetracyclines is common.
Most strains are susceptible to TMP/SMX and quinolones.
Empiric Therapy |
---|
Diarrhea: |
Treatment not recommended unless symptoms severe or prolonged. |
Severe Diarrhea/Extraintestinal Infections: |
TMP/SMX |
or |
Ciprofloxacin |