Nosocomial infections caused by Sphingomonas paucimobilis: clinical features and microbiological characteristics.

From January 1995 to September 1996, 14 isolates of Sphingomonas paucimobilis, including 11 from clinical specimens from six patients with nosocomial infection and three from environmental sources, were collected. Two of the six patients had intravascular catheter-related bacteremia and one each had bacteremic biliary tract infection, urinary tract infection, ventilator-associated pneumonia, and wound infection. The S. paucimobilis isolates were identified according to biochemical profiles established with use of the API 20NE system and Vitek GNI card and the characteristic cellular fatty acid chromatogram. Ten biotypes, 11 antibiograms (by the Etest), and 12 random amplified polymorphic DNA (RAPD) patterns (by arbitrarily primed polymerase chain reaction) were identified. The identical biotype, antibiogram, and RAPD pattern of the two isolates (one each from blood and bile) from a patient with biliary tract infection indicated the invasiveness of the organism. Two patients with intravascular catheter-related bacteremia had isolates of this organism repeatedly recovered, and these isolates had heterogeneous RAPD patterns. The present study highlights the wide distribution in hospital environments of various clones of S. paucimobilis, which may cause recurrent infections by a single strain or several episodes of infection due to two or more clones of this organism in hospitalized patients.