Bacillus cereus infection: 57 case patients and a literature review

Objectives. - We aimed to study the characteristics of patients presenting with a Bacillus cereus infection in a university hospital. Methods. - We performed a retrospective analysis of the clinical, biological, and treatment-related data of patients hospitalized in our university hospital between January 1st, 2008 and December 31st, 2012 and diagnosed with a B. cereus infection. We identified a subgroup of patients presenting with bacteremia and looked for risk factors for death within that group of patients. Results. - We included 57 patients in our study; 31 (54.4%) were hospitalized in a medical ward. We identified 24 bacteremia case patients, including 17 patients presenting with bacteremia alone (29.8%). Other frequently observed infection sites were skin infections (16; 28.1%) and bone and joint infections (10; 17.5%). We recorded 9 deaths (11.8%); 2 patients, despite being on an appropriate antibiotic therapy, died from a medical device-related infection that had not been removed. The empirical administration of a beta-lactam antibiotic was significantly associated with death (P = 0.022). Three patients presenting with recurrent bacteremia were identified. The patients only recovered once the infected device had been removed. Conclusion. - B. cereus infections may have various clinical presentations. Prospective data is needed to put forward a consensual treatment approach and guide physicians in choosing the appropriate antibiotic therapy and in removing the infected device. (C) 2015 Elsevier Masson SAS. All rights reserved.