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Uncommon Pathogens Causing Hospital-Acquired Infections in Postoperative Cardiac Surgical Patients

Bacterial infections are common causes of sepsis in the intensive care units. However, usually a finite number of Gram-negative bacteria cause sepsis (mostly according to the hospital flora). Some organisms such as Escherichia coli, Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus are relatively common. Others such as Stenotrophomonas maltophilia, Chryseobacterium indologenes, Shewanella putrefaciens, Ralstonia pickettii, Providencia, Morganella species, Nocardia, Elizabethkingia, Proteus, and Burkholderia are rare but of immense importance to public health, in view of the high mortality rates these are associated with. Being aware of these organisms, as the cause of hospital-acquired infections, helps in the prevention, treatment, and control of sepsis in the high-risk cardiac surgical patients including in heart transplants. Therefore, a basic understanding of when to suspect these organisms is important for clinical diagnosis and initiating therapeutic options. This review discusses some rarely appearing pathogens in our intensive care unit with respect to the spectrum of infections, and various antibiotics that were effective in managing these bacteria.