Sphingomonas paucimobilis bloodstream infection is a predominantly community-onset disease with significant lethality

Background: Small case series and reports suggest that Sphingomonas paucimobilis is predominantly a cause of nosocomial bloodstream infections (BSI) with very low associated mortality. Our objective was to describe the epidemiology and outcome of Sphingomonas species BSI in a large Australian population. Methods: We included all residents of Queensland, Australia, with BSI because of Sphingomonas species identified within the publicly funded system from 2000 to 2019. Results: A total of 282 incident episodes of Sphingomonas species BSI were identified for an age- and sex-adjusted incidence of 3.2 per million population annually. Incidence rates were highest in the tropical regions of the state. Most (94%) of the isolates were confirmed as Sphingomonas paucimobilis . In addition, 77% of the infections were community-onset, of which 48% were community-associated, and 30% were healthcare-associated. The very young, the old, and male patients were at the highest risk. Patients with community-associated disease were, on average, younger, had fewer co-morbidities, and were less likely to have polymicrobial infections. At least 1 co-morbidity was identified in 62% of patients, with malignancy, diabetes, and lung disease most prevalent. The overall all-cause 30-day case-fatality rate was 6%. Conclusion: Sphingomonas paucimobilis BSI is a predominantly community-onset disease associated with a significant risk of death. (C) 2022 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

Automated summary

This study describes the epidemiology and outcome of Sphingomonas species bloodstream infections (BSI) in an Australian population. The findings suggest that this infection primarily occurs in the community and is associated with a significant risk of death.