Bacteremia caused by Comamonas kerstersii in a patient with acute perforated appendicitis and localized peritonitis: case report and literature review

Abstract

Comamonas kerstersii (C. kerstersii) is a Gram-negative bacterium that was initially thought to be non-pathogenic to humans and is abundant in the environment. In recent years, with the availability of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) that enable fast and accurate bacterial identification, there have been increasing number of reports of human infections caused by C. kerstersii, indicating that this organism has emerged as human pathogen. In fact, most clinical isolates of C. kerstersii are recovered from peritoneal liquid, and bacteremia has been infrequently reported. Here, we report a case of bacteremia caused by C. kerstersii in a 28-year-old male patient with acute perforated appendicitis and localized peritonitis and present a comprehensive review of C. kerstersii infections in pathogenic diagnosis and clinical treatment as well as prognosis, thus providing a better understanding of C. kerstersii-related infections.

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“…The low resistance of Enterobacteriaceae species to Sulfonamide, that does target Gram-negative bacteria, could potentially be explained by trends in prescribing practices where newer antibiotics are favored over older ones like Sulfonamide 31 , and consequently species that are less exposed to Sulfonamide also carry less resistance to it. Interestingly, even though the two species outside of the Enterobacteriaceae family have similar amount of resistances, S. maltophilia is known to cause numerous infections 32-33 , while reports of infections due to C. kerstersii have been rare in the past decade 34-39 . This phenomenon might be explained by related species being susceptible and subsequently developing resistances to the same drugs, even if those drugs are meant to target other closely related species.…”