Bacteremia or pseudobacteremia? Review of pseudomonas fluorescens infections

P. fluorescens is an aerobic, Gram-negative bacillus related to Pseudomonas aeruginosa. Like other species of Pseudomonas, the organism is widespread in nature and is found in water, moist soil, and vegetation. Due to its low virulence, P. fluorescens is an infrequent cause of infections except for catheter-related bloodstream infections in cancer patients. From August 1, 2003 to May 31, 2016, Hyogo Emergency Medical Center and the Kobe Red Cross Hospital treated three cases of bloodstream infection caused by P. fluorescens. Were these cases true bacteremia or pseudobacteremia? Would it be a risk to induce nosocomial infection, possibly leading to an infection outbreak? We retrospectively examined these three cases in detail.