Version 1: A case series and literature review of infections due to Myroides spp. – Identification of contributing factors and emerging antibiotic susceptibility trends.

Introduction: Infections by Myroides spp. can lead to significant morbidity and mortality, particularly in immunocompromised patients with underlying co-morbidities. Recent reports have highlighted its intrinsic and acquired drug resistance, making it a particularly challenging infectious agent to combat.

Methods: Myroides spp. isolated and reported in clinically significant urine samples were considered for the study. Identification of the organism was done by VITEK 2C, BioMerieux. Antibiotic Susceptibility Testing was done using both manual and automated methods following Clinical and Laboratory Standards Institute (CLSI) guidelines. Existing literature was searched on MEDLINE using PubMed.

Results: We present a series of five catheter associated urinary tract infections (CAUTI) due to M. odoratimimus, with sensitivity to only minocycline. This is the first case from Western India, and the third case in existing literature that shows Myroides sensitivity only to minocycline. Our literature review is the first to systemize possible contributory factors to infection, allowing us to devise a clinically relevant tool that delineates contributory factors and efficacious drugs in Myroides spp. infection.

Conclusion: Myroides spp. infections, earlier considered rare and opportunistic, need cognizance and diagnostic suspicion especially in certain associated conditions.