Carbapenemase-Producing Raoultella Planticola: A Rare Cause of Pneumonia and Bacteremia

Abstract

Raoultella planticola is a gram-negative bacterium of the Enterobacteriaceae family that is usually found in soil, plant and aquatic environments. It is an uncommon human pathogen and has been associated with cases of bacteremia, pneumonia, urinary tract infections, among others. Here, we present the case of an 85-year-old female that developed nosocomial pneumonia and bacteremia caused by Raoultella planticola. Pertinent microbiological studies detected carbapenemase production codified by the blaKPC gene. The patient was successfully treated with ceftazidime/avibactam and polymyxin. Our case illustrates the pathogenic potential of this organism and highlights the importance of phenotypic and genotypic assays for the appropriate identification of carbapenemase production.

Ceftazidime-Avibactam for the Treatment of Serious Gram-Negative Infections with Limited Treatment Options: A Systematic Literature Review

“…Inflammatory markers and abdominal CT scan showed resolution of IAI. The patient was discharged 3 months after hospital admission without clinical signs of IAI Gonzales Zamora 2018 [ 77 ] 85-year-old female, nosocomial pneumonia and bacteraemia; intubated and in ICU; 1st- and 2nd-degree burns and CVVH After 12 days of antibiotic treatment for MRSA pneumonia, developed Enterococcus faecalis bacteraemia, and 3 days later endotracheal aspirates and blood cultures were positive for Raoultella planticola Yes Enterococcus faecalis Raoultella planticola (KPC) Morganella morganii MRSA Dose NR, 2 weeks Follow-up blood cultures were negative, the patient’s respiratory status improved over the following days, and she was transferred to a long-term acute care facility to complete 2 weeks of antibiotic therapy Holyk 2018 [ 78 ] Elderly patient (age/sex NR), intubated with intraventricular haemorrhage and post-neurosurgical meningitis with CRKP identified in BAL fluid and EVD cultures No K. pneumoniae (MDR/CRE) 2.5 g q8h (days 26–29 and 31–52) All repeat cultures after day 31 were negative. Treatment concluded after 21 days of ceftazidime-avibactam and 15 days of intraventricular gentamicin.…”

First Case of Raoultella planticola Urinary Tract Infection Reported in Western Romania

“…The cases of infection in humans caused by this organism were described as bacteremia, pneumonia, cholangitis, abscesses and UTIs [ 7 ]. Most of the patients infected by this pathogen present a degree of immunosuppression and malignancies, and have experiences of chemotherapy, organ transplants, prolonged ICU hospitalization or recent trauma [ 8 ].…”

COVID-19 Bullous Lung Disease Superinfection by Raoultella planticola

“…Cystic lung lesions from coronavirus disease 2019 (COVID-19) pneumonia, causing lung bullae and pneumothorax, are a rare complication, affecting up to 1% of infected patients [1,2]. Raoultella planticola is a gram-negative rod, aerobic, encapsulated bacteria of the Enterobacteriaceae family that is usually found in soil, plant, and aquatic environments [3]. It is a rare human pathogen known to cause opportunistic infections [4,5].…”

“…It is a rare human pathogen known to cause opportunistic infections [4,5]. Previously reported cases of R. planticola-related infections include bacteremia, urinary tract infections, pneumonia, joint infections, and cholecystitis, among others [3,[6][7][8][9]. In recent years, the number of R. planticola-related infections is on the rise, mainly nosocomial infections, and so is antibiotic resistance, as strains of multidrug-resistant carbapenemase-producing organisms are being reported more frequently [3,[10][11][12].…”

“…Previously reported cases of R. planticola-related infections include bacteremia, urinary tract infections, pneumonia, joint infections, and cholecystitis, among others [3,[6][7][8][9]. In recent years, the number of R. planticola-related infections is on the rise, mainly nosocomial infections, and so is antibiotic resistance, as strains of multidrug-resistant carbapenemase-producing organisms are being reported more frequently [3,[10][11][12]. We present a rare case of spontaneous pneumothorax and subcutaneous emphysema from rupture of lung bulla as a late sequela from COVID-19 pneumonia in a patient without needing positive pressure ventilation and superinfection of the bulla by R. planticola.…”