Sixty-one years aged woman with diarrheal syndrome after fish consumption abroad attended the Clinic of Infectious Diseases at the University Hospital in Plovdiv. The patient complained of watery stools, mixed with mucus; nausea with vomiting, stomach discomfort and low grade fever. A stool specimen was collected for microbiological examination. The isolate identification was performed using API-20NE (BioMerieux) and automated Vitek 2 system. The biotype detection was based on carbohydrate utilization of sucrose, maltose and arabinose. The antimicrobial susceptibility was determined by disk-diffusion test and minimal inhibitory concentrations.
Shewanella putrifaciens biotype I in pure culture was isolated from patient's stool specimen. It showed good susceptibility to tested antimicrobials except to tetracycline, cefalotin and ciprofloxacin. The latter was included in the therapy together with Enterol, Smecta, aqueussaline and glucose solutions. No increased leukocyte count was observed. However the sedimentation rate was slightly increased and ketones were detected in urine. The patient was dehospitalized in reconvalescence after 4 days with diagnosis acute gastroenteritis.
This case is the first in Europe of proven Shewanella putrifaciens gastroenteritis. With this we aim to focus microbiological and clinical attention towards active looking for Shewanella participation in gastrointestinal infections. Species identification with routine and automated methods is mandatory since these bacteria possess different pathogenic potential and antimicrobial susceptibility.