Catheter-related blood stream infection caused by Raoultella ornithinolytica

Abstract

Raoultella spp. representatives are Gram-negative capsulated, nonmotile rods. These bacteria are found in the natural environment: plants, water, soil and insects. R. ornithinolytica is one of the three species of Raoultella. R. ornithinolytica is the only species within the genus which has the ability to produce ornithine decarboxylase. Human infections related to R. ornithinolytica are exceedingly rare. The present case report describes catheter-related blood stream infection caused by R. ornithinolytica and successfully treated with antibiotic therapy.

Emerging role of Raoultella ornithinolytica in human infections: a series of cases and review of the literature

“…As well as the well-known clinical presentations of R. ornithinolytica infections, such as primary or cholangitis bloodstream infection, [3][4][5]7,14,16,18,20,22 catheter-related bloodstream infection, 8,26 biliary tract infection, 3-5 urinary tract infection, 5,15,21 and skin infection, 19,20 cases of respiratory infection including community-and hospital-acquired pneumonia and pleural effusion were also identified in this study, and these have been poorly reported. Boattini et al recently reported three cases of community-acquired pneumonia and three cases of hospital-acquired pneumonia among 25 cases of R. ornithinolytica infection over a 5-year period in six university hospital centres in Lisbon.…”

“…A literature search identified 86 reported cases of R. ornithinolytica (formerly Klebsiella ornithinolytica), [3][4][5][6][7][8][14][15][16][17][18][19][20][21][22][23][24][25][26][27] and half of these cases were reported in 2015. 10,12,[24][25][26] A high rate of hospital-acquired infection was observed in the present study (49%), which may be explained by the high proportion of patients who had undergone invasive procedures (48%) involving, for example, urinary catheters, mechanical ventilation, and port catheters. Physicians should take into consideration the fact that cases of R. ornithinolytica infection acquired in hospital are poorly reported in the literature and should adapt their management of infection control and prevention accordingly.…”

“…21 Among the 86 isolates reported in the literature, 80% were resistant to amoxicillin, 17% to amoxicillin-clavulanic acid, 10% to third-generation cephalosporins, 12% to quinolones, 13% to co-trimoxazole, 15% to piperacillin-tazobactam, 7% to aminosides, and 7% to carbapenems. [3][4][5][6][7][8][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Few of these studies reported cases of R. ornithinolytica infection with isolates resistant to multiple antibiotics, including KPC 14 and NDM-1 strains. 27 In this study, the proportions of isolates resistant to ceftriaxone, quinolones, and aminosides were a little bit lower than reported in the literature (4%, 6%, and 1%, respectively).…”

“…Among the 69 reported cases, the mortality rate of human infections caused by R. ornithinolytica was relatively high (20%). [3][4][5][6]8,[14][15][16][17][18][19][20][22][23][24][25][26] This rate was particularly high in cases of bacteraemia (34-44%). 4,8,14,22,23,25,28 In the study cases, the mortality rate was lower (9%) and included three patients (3%) who died of cancer and six patients (6%) who died of septic shock related to pneumonia (three cases), pleural effusion (one case), skin infection (one case), and cholangitis (one case).…”

Clinical significance of positive Raoultella Ornithinolytica and Staphylococcus hominis cultures in a post lobectomy patient. A case report

“…RO is a rare human infection and only small number of patients have been reported postoperatively. Fewer cases are reported that relate to pulmonary challenged patients [1]. It is observed that the effects of RO are greater and more frequent in immunosuppressed and especially in oncological patients.…”