Chryseobacterium indologenes infection in small for gestational age (sga) neonate: a case report

C. indologenes is a widespread bacteria in the environment, primarily in soil and water. Chryseobacterium indologenes is an aerobic, non-motile, catalase, oxidase & indole positive and non-glucose fermenting Gram negative bacillus. It can survive in chlorine-treated municipal water supplies & can colonize the sink basins and tap waters of the hospitals. Contamination of the medical devices containing water (respirators, intubation tubes, humidifiers, incubators for newborns, etc.) in hospital settings may lead to serious infections. Typically, C. indologenes causes major health care-associated infections such as pneumonia, empyema, pyelonephritis, cystitis, peritonitis, septicemia, meningitis. Though C. indologens is not a part of normal microbial flora it is rarely reported as a pathogen. Management of C. indologenes infection in neonates is not adequately documented due to underreporting, particularly in India. Because of its intrinsic resistance and the less availability of data from the literature, the effective empirical treatment of C. indologenes is challenging. We present an uncommon case of bacteremia caused by C. indologenes in a late preterm SGA newborn having moderate respiratory distress syndrome with thrombocytopenia who was successfully treated. Multidrug resistant C. indologenes should be considered a health-care associated pathogen in neonates receiving treatments involving invasive equipment use and long-term antibiotic therapy.