From the Research
Pantoea species infections should be treated with empiric therapy including third-generation cephalosporins, fluoroquinolones, or carbapenems until susceptibility testing guides definitive treatment, as these bacteria can cause severe opportunistic infections in humans, particularly in immunocompromised patients, neonates, and those with indwelling medical devices. The most clinically relevant species include Pantoea agglomerans, Pantoea dispersa, and Pantoea ananatis, which are commonly found in soil, water, and plant surfaces, and can cause infections through traumatic inoculation with contaminated plant material, such as thorns or splinters, leading to wound infections, septic arthritis, or osteomyelitis 1. Key points to consider in the management of Pantoea infections include:
- Proper wound cleaning and debridement are essential components of management for localized infections
- The bacteria's ability to form biofilms on medical devices may complicate treatment in healthcare-associated infections, sometimes necessitating device removal alongside antibiotic therapy
- Most strains remain susceptible to multiple antibiotics, though resistance patterns can vary, as seen in a study where Pantoea species bloodstream infection isolates displayed high susceptibility to all the antibiotics except for ampicillin, fosfomycin, and piperacillin/tazobactam 1
- Early institution of appropriate antibiotic therapy against this organism could be lifesaving, particularly in newborn infants and the neonatal intensive care unit (NICU) setting, where prematurity and the associated relative immunocompromised state are major risk factors for hospital-acquired infections due to Pantoea 2. It is critical for healthcare providers to understand the clinical spectrum of Pantoea infections and to be aware of the potential for these bacteria to cause severe infections in vulnerable populations, as highlighted in a recent study on bloodstream infections by Pantoea species, which found a low prevalence and 28-day mortality rate, but emphasized the importance of targeted therapy and proper management 1.