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\title{Nosocomial infection of extensively drug-resistant Myroides odoratimimus
in a Turkish hospital}



\author[1]{Unsal Savci}%
\author[1]{Baris Eser}%
\author[2]{Mustafa Sungur}%
\author[1]{Mustafa Sahin}%
\author[3]{Nezahat Kosar}%
\author[4]{Djursun  KARASARTOVA}%
\author[5]{Ayse Semra GURESER}%
\author[6]{Aysegul Taylan-Ozkan}%
\author[7]{Selahattin Caliskan}%
\author[8]{Serap Suzuk Yildiz}%
\author[9]{Fatma  Bayrakdar}%
\author[8]{Yasemin Numanglu Cevik}%
\author[10]{Coskun Kaya}%
\author[11]{Derya Yapar}%
\author[12]{Ozlem Akdogan}%
\affil[1]{Hitit University}%
\affil[2]{Eskişehir State Hospital}%
\affil[3]{ Hitit University, Turkey }%
\affil[4]{Hitit Universitesi}%
\affil[5]{Hitit University, Faculty of Medicine}%
\affil[6]{Hitit University, Turkey }%
\affil[7]{Reyap Hospital, Department of Urology}%
\affil[8]{Public Health Institutions of Turkey}%
\affil[9]{ Public Health Institutions of Turkey, Ankara, Turkey.}%
\affil[10]{Eskisehir City Hospital, Department of Urology}%
\affil[11]{Hitit University Faculty of Medicine,Turkey.}%
\affil[12]{ Hitit University Faculty of Medicine,Turkey.}%


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  \date{May 04, 2024}


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\begin{abstract}
Objectives: Myroides spp. is an environmental pathogen and causes
disease in immunocompromised patients. In this study, we report an
outbreak of urinary tract infections caused by M. odoratimimus in a
university hospital in Turkey. Methods: A total of 25 M. odoratimimus
strains isolated from the clinical samples of 20 patients in our
intensive care units and clinics were included in the study. Phenotypic
and genotypic identification of isolates was performed using
conventional methods, VITEK\selectlanguage{ngerman}®-2 automated identification system, Matrix
Assisted Laser Desorption/Ionisation-Time of Flight Mass Spectrometry
and 16S-RNA Microbial Diagnosis methods. In addition, Repetitive
Extragenic Palindromic Elements (REP) PCR Assay method was applied for
molecular epidemiological analysis. Results: All cases were diagnosed
with nosocomial urinary tract infection, except for one case diagnosed
with nosocomial bacteraemia. One of the M. odoratimimus isolates was
sensitive to piperacillin/tazobactam (MIC: \selectlanguage{english}[?]4 \selectlanguage{greek}µ\selectlanguage{english}g/ml) and one isolate was
moderately sensitive to cefepime (MIC: 16 \selectlanguage{greek}µ\selectlanguage{english}g/ml). Other M. odoratimimus
isolates were resistant to the tested antibiotics of beta lactams,
monobactams, carbapenems, aminoglycosides, fluoroquinolones and
sulphonamides. When 10 isolates were evaluated with the REP PCR method,
DNA finger print similarities were visually determined and there was a
similar DNA pattern among them. Myroides source was not detected in
environmental samples. Conclusion: Clinicians should consider that
Myroides spp. isolates with multiple and broad-spectrum drug resistance
may be a serious nosocomial pathogen like Pseudomonas aeruginosa or
Acinetobacter baumannii. In order to choose the best treatment regimen,
this atypical pathogen needs to be quickly identified and antibiotic
susceptibility tests performed.%
\end{abstract}%



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