Myroides spp. are opportunistic environmental Gram-negative bacteria. These affect mostly immunocompromised hosts and generally lead to soft tissue, and
urinary tract infections.
Bacteremia most commonly develop secondary to soft tissue or
catheter related infections and may lead rarely to mortality. Myroides spp. are generally suscetible to
fluoroquinolones,
piperacillin/tazobactam,
trimethoprim/sulfamethoxazole,
carbapenems or
tetracyclines however, pan-resistant isolates and multiple resistance genes have been reported in clinical isolates of Myroides spp. We report a pan-resistant Myroides odoratimimus
bacteremia in a patient with severe
COVID-19 ending with fatality and in this context a review of reported Myroides
bacteremias are also described. In this study, a 64-year old male patient with history of
coronary artery bypass was admitted to ICU with severe
COVID-19 pneumonia accompanied by
pneumomediastinum and
pneumopericardium. Continous
renal replacement therapy and extracorporeal membraneous-oxygenation were initiated due to
acute renal failure and persistent hypercarbia/
hypoxia, respectively. Within four weeks of hospitalization various episodes of
bacteremia developed and multiple
antibiotics were used. On the 5th week of follow-up,
acute phase reactants increased and empirical broad spectrum
antibiotics were initiated. Blood culture revealed Gram-negative rods. The patient became hypotensive and despite maximum medical care he was lost due to
cardiac arrest. M. odoratimimus was identified by MALDI-TOF and the bacterium was pan-resistant. According to Center for Genomic Epidemiology results the strain was identified as M. odoratimimus PR63039 and the genome analysis revealed antibiotic resistance genes associated with resistance to
beta-lactams (bla OXA-347, bla MUS-1, bla EBR-1),
tetracyclines (tetX),
sulfonamides (sul2),
macrolides (ereD), (ermF).