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Clinical manifestations and prognostic factors of Morganella morganii bacteremia

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Abstract

Although Morganella morganii causes a variety of clinical infections, there are limited studies on M. morganii bacteremia after the year 2000. A total of 109 patients with M. morganii bacteremia at a medical center in Taiwan from 2003 to 2012 were studied. Among them, 30.3 % had polymicrobial bacteremia and 75.2 % had community-acquired infection. The most common underlying diseases were hypertension (62.4 %) and diabetes mellitus (38.5 %). The urinary tract (41.3 %) was the major portal of entry, followed by the hepatobiliary tract (27.5 %), skin and soft tissue (21.1 %), and primary bacteremia (10.1 %). Susceptibility testing of M. morganii isolates showed ubiquitous resistance to first-generation cephalosporins and ampicillin–clavulanate; resistance rates to gentamicin, piperacillin–tazobactam, and ciprofloxacin were 30.3 %, 1.8 %, and 10.1 %, respectively. Overall, the 14-day mortality was 14.7 %. Univariate analysis revealed that elevated blood urea nitrogen (BUN) values [p = 0.0137, odds ratio (OR) 5.26], intensive care unit (ICU) admission (p = 0.011, OR 4.4), and higher Acute Physiology and Chronic Health Evaluation II (APACHE II) scores (p < 0.001, OR 1.62) were significantly associated with mortality. The APACHE II score remained the only significant risk factor for mortality in multivariate analysis (p = 0.0012, OR 1.55). In conclusion, M. morganii bacteremia patients were mostly elderly, with one or more comorbidities. Most of the patients had community-acquired infection via the urinary and hepatobiliary tracts. Furthermore, prognosis can be predicted according to disease severity measured by the APACHE II score.

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All authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Number 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan

    T.-Y. Lin, Y.-S. Yang, Y. Lee, K.-M. Yeh, J.-C. Lin & F.-Y. Chang

  2. Infection Control Office, Tri-Service General Hospital, National Defense Medical Center, Number 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan

    M.-C. Chan

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  1. T.-Y. Lin
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  2. M.-C. Chan
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  3. Y.-S. Yang
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  4. Y. Lee
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  5. K.-M. Yeh
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  6. J.-C. Lin
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  7. F.-Y. Chang
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Correspondence to F.-Y. Chang.

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Lin, TY., Chan, MC., Yang, YS. et al. Clinical manifestations and prognostic factors of Morganella morganii bacteremia. Eur J Clin Microbiol Infect Dis 34, 231–236 (2015). https://doi.org/10.1007/s10096-014-2222-8

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  • DOI: https://doi.org/10.1007/s10096-014-2222-8

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