Exacerbation of bronchiectasis by Pseudomonas monteilii: a case report.

BACKGROUND

Pseudomonas spp are important opportunistic and nosocomial pathogens. One such species is Pseudomonas monteilii (P. monteilii). It has been described as an environmental contaminant and potential pathogen. We identified this organism as the causative agent of an exacerbation of bronchiectasis and an environmental contaminant in our hospital on two separate occasions.

CASE PRESENTATION: P. monteilii was the cause of an exacerbation of bronchiectasis in a 30-year-old HIV negative male. Patient presented with cough with sputum production and exertional dyspnea. The isolate was recovered from a sputum sample in significant counts and definitively identified by Matrix-Assisted Laser Desorption/Ionisation- Time of Flight Mass Spectrometry (MALDI-TOF MS). He was treated with piperacillin-tazobactam and recovered clinically and microbiologically. Another two isolates of the organism were contaminants from the hospital environment. The three isolates were susceptible to all tested antibiotics. Typing by Random amplification of polymorphic DNA (RAPD) found no clonal relationship between them.

CONCLUSIONS

Less common species of Pseudomonas need to be identified accurately. This organism is identified by commonly used phenotypic systems as P. putida which may have contributed to a lower reported prevalence. P. monteilii is a known environmental contaminant and must also be considered as a potential pathogen, particularly in patients with chronic lung disease.