First Report of Ignatzschineria indica Infection in Greece and Review of the Literature

Background: Ignatzschineria species are rare emerging human pathogens that are typically associated with myiasis. Methods: We report the first case of Ignatzschineria indica bacteraemia in Greece in a male patient presenting with maggot-infested wounds of the thorax, shoulders, and arms. The isolate was identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), and antimicrobial susceptibility testing was performed according to EUCAST guidance. A review of the published literature on I. indica bacteraemia was also conducted. Results: The patient was diagnosed with bacteraemia caused by a multisusceptible I. indica isolate and was successfully treated with antibiotic therapy, resulting in complete recovery. This represents the first reported case of I. indica infection in Greece. Review of the literature showed that most published I. indica isolates were susceptible to a broad range of antimicrobial agents, and all reported patients survived, although some required limb amputation because of severe underlying soft tissue disease. Conclusions: Ignatzschineria indica infection should be considered in patients with neglected, maggot-infested wounds. Increased awareness of this emerging pathogen, together with the use of modern microbiological identification methods, may improve recognition of these uncommon infections. Socio-economic inequalities and the changing distribution of insect vectors due to climate change may contribute to the occurrence of such infections.