Miscellaneous gram negative bacteria

HACEK organisms are a group of fastidious, slow-growing, gram-negative bacteria whose growth requires an atmosphere of carbon dioxide. Species belonging to this group include several Haemophilus species, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae. HACEK bacteria normally reside in the oral cavity and have been associated with local infections in the mouth. They are also known to cause severe systemic infections— most often bacterial endocarditis, which can develop on either native or prosthetic valves (Chap. 118).

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Other Gram-Negative Bacteria Achromobacter xylosoxidans A. xylosoxidans (previously Alcaligenes xylosoxidans) is probably part of the endogenous intestinal flora and has been isolated from water sources. Immunocompromised hosts, including patients with cancer and post- chemotherapy neutropenia, cirrhosis, and chronic renal failure, are at increased risk. Nosocomial outbreaks of A. xylosoxidans infection have been attributed to contaminated fluids, and clinical illness has been associated with isolates from many sites, including blood (often in the setting of intravascular devices).

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Chryseobacterium Species (Formerly Flavobacterium) C. meningosepticum is an important cause of nosocomial infections, including outbreaks due to contaminated fluids (e.g., disinfectants and aerosolized antibiotics) and sporadic infections due to indwelling devices, feeding tubes, and other fluid-associated apparatuses. Patients with nosocomial C. meningosepticum infection usually have underlying immunosuppression (e.g., related to malignancy). C.

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Harrison's Internal Medicine Chapter 140. Infections Due to the HACEK Group and Miscellaneous Gram-Negative Bacteria The HACEK Group HACEK organisms are a group of fastidious, slow-growing, gram-negative bacteria whose growth requires an atmosphere of carbon dioxide. Species belonging to this group include several Haemophilus species, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae. HACEK bacteria normally reside in the oral cavity and have been associated with local infections in the mouth.

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Kingella kingae Because of improved microbiologic methodology, isolation of K. kingae is increasingly common. Inoculation of clinical specimens (e.g., synovial fluid) into aerobic blood culture bottles enhances recovery of this organism. In recent series, K. kingae has been the third most common cause of septic arthritis in children

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