{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T06:01:14Z","timestamp":1772517674935,"version":"3.50.1"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Phytobacter diazotrophicus<\/jats:italic>\n                      is an emerging opportunistic, Gram-negative bacterium, originally recognized as a nitrogen-fixing, plant-associated organism and increasingly implicated in nosocomial infections. We report the first documented case of bloodstream infection due to\n                      <jats:italic>P<\/jats:italic>\n                      .\n                      <jats:italic>diazotrophicus<\/jats:italic>\n                      in an elderly female breast cancer patient with chemotherapy-induced febrile neutropenia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      A 62-year-old woman with HER2-positive, cT4bN2M0 breast cancer receiving neoadjuvant trastuzumab, carboplatin, and docetaxel presented with fever, headache, profound fatigue, pallor, and retinal hemorrhages. Laboratory evaluation revealed severe pancytopenia, with a platelet count of 5\u202f\u00d7\u202f10\u2079\/L, an absolute neutrophil count of 0.294\u202f\u00d7\u202f10\u2079\/L, a total leukocyte count of 1.05\u202f\u00d7\u202f10\u2079\/L, and a hemoglobin level of 3.7\u202fg\/dL. Blood cultures grew non-lactose-fermented Gram-negative bacilli, initially identified as\n                      <jats:italic>Pantoea<\/jats:italic>\n                      species by the VITEK-2 system; however, 16S rDNA sequencing confirmed the organism as\n                      <jats:italic>Phytobacter<\/jats:italic>\n                      species. The patient was managed with blood component transfusions, filgrastim, and empirical piperacillin\u2013tazobactam. Antimicrobial therapy was stopped on day 8, with recovery of blood counts noted by day 7. Subsequently, chemotherapy was resumed with trastuzumab and single-agent taxane at a reduced dose.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Gram-negative infections caused by phytobacteria are likely underreported with the automated VITEK-2 identification system. This first molecularly confirmed case of\n                      <jats:italic>Phytobacter diazotrophicus<\/jats:italic>\n                      identified by 16S rDNA sequencing in India underscores the need for heightened clinical awareness, prompt and accurate microbiological identification, and vigilance regarding antimicrobial resistance, especially in the immunocompromised population.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1735688","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T05:23:52Z","timestamp":1772515432000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Febrile neutropenia caused by the rare organism Phytobacter: first Case Report from India"],"prefix":"10.3389","volume":"13","author":[{"given":"Anusha Mruthyunjaya","family":"Swamy","sequence":"first","affiliation":[{"name":"Department of Medical Oncology Haematology, All India Institute of Medical Sciences","place":["Rishikesh, Uttarakhand, India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prasenjit","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Haematology, All India Institute of Medical Sciences","place":["Rishikesh, Uttarakhand, India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Indrani","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Haematology, All India Institute of Medical Sciences","place":["Rishikesh, Uttarakhand, India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepak","family":"Sundriyal","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Haematology, All India Institute of Medical Sciences","place":["Rishikesh, Uttarakhand, India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amber","family":"Prasad","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences","place":["Rishikesh, Uttarakhand, India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saugata","family":"Hazra","sequence":"additional","affiliation":[{"name":"Department of Biosciences and Bioengineering, Indian Institute of Technology","place":["Roorkee, Uttarakhand, India"]},{"name":"Centre for Nanotechnology, Indian Institute of Technology","place":["Roorkee, Uttarakhand, India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uttam Kumar","family":"Nath","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Haematology, All India Institute of Medical Sciences","place":["Rishikesh, Uttarakhand, India"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e00147-23","DOI":"10.1128\/msphere.00147-23","article-title":"Emergence of Phytobacter diazotrophicus carrying an IncA\/C2 plasmid harboring blaNDM-1 in Tokyo, Japan","volume":"8","author":"Kubota","year":"2023","journal-title":"mSphere"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1007\/s00203-007-0333-7","article-title":"Diverse endophytic nitrogen-fixing bacteria isolated from wild rice (Oryza rufipogon) and description of Phytobacter diazotrophicus gen. 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