Kluyvera cryocrescens finger infection: case report and review of eighteen Kluyvera infections in human beings

West, Burton C.; Vijayan, Hemalatha; Shekar, Raja

doi:10.1016/s0732-8893(98)00087-x

Cited by 30 publications

(17 citation statements)

References 16 publications

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“…Only 2 investigators have implicated Kluyvera as a cause of diarrhea [7,20]. The organism has also caused biliary tract infections [8,14,21], post-traumatic urethrorectal fistula [18], and soft-tissue infections [22,23].…”

Section: Discussionmentioning

confidence: 99%

Infections Caused byKluyveraSpecies in Humans

2001

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Kluyvera is a relatively newly described genus in the family Enterobacteriaceae that infrequently causes infections in humans. The organism has been isolated from various clinical specimens, but its significance has not been clearly established. In fact, it has been regarded alternatively as saprophytic, opportunistic, or pathogenic. Since the redefinition of this genus in 1981, case reports of diverse clinical infections occurring under various host conditions have been published. Here we present a critical review of all Kluyvera infections reported in the literature, along with our experience involving 5 additional cases. Most patients received prompt antimicrobial treatment on the basis of susceptibility testing, and overall the clinical outcomes were good. Antimicrobial agents active against most Kluyvera strains include third-generation cephalosporins, fluoroquinolones, and aminoglycosides. In contrast, the resistance to ampicillin, extended-spectrum penicillins, and first- and second-generation cephalosporins is significant. Kluyvera is a potentially virulent pathogen that deserves aggressive treatment designed with an awareness of the organism's antimicrobial resistance patterns.

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Section: Discussionmentioning

confidence: 99%

Infections Caused byKluyveraSpecies in Humans

2001

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“…With so few clinically significant cases reported, it is difficult to detect trends in the accrued data. In a review of clinically significant Kluyvera infections by Sarria et al 5 in 2001, 21 cases with documented evidence of infection [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] were identified in a review of the literature, and the authors reported 5 new cases. One clinically significant infection reported in the series by Fainstein et al 7 was not included in the review by Sarria et al 5 Since that time, a central venous line infection in a pediatric patient, 22 a case of bacteremia in a patient with Crohn disease, 23 a case of acute cholecystitis, 24 and a nosocomial outbreak of 4 cases of K cryocrescens bacteremia on a cardiovascular ward 25 have been reported, for a total of 34 previously reported cases.…”

Section: Discussionmentioning

confidence: 99%

Clinically SignificantKluyveraInfections

Carter¹,

Evans²

2005

Am J Clin Pathol

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To determine the clinical significance of Kluyvera isolates at our institution, we retrospectively analyzed clinical microbiology data from January 1999 to September 2003. We identified 11 isolates classified as Kluyvera ascorbata, 7 of which were considered clinically significant pathogens: 3 cases represented urinary tract infections; 2, bacteremia; 1, a soft tissue infection of the finger; and 1, acute appendicitis with a subsequent intra-abdominal abscess. The age distribution of patients was wide, ranging from 2 months to 73 years. Antimicrobial susceptibility studies of the clinically significant and non-clinically significant Kluyvera isolates showed susceptibility patterns similar to those reported in the medical literature, namely trends of resistance to ampicillin and first- and second-generation cephalosporins. Of the 4 non-clinically significant isolates in our study, 1 was resistant to ciprofloxacin, a finding reported in only 1 other isolate of Kluyvera in the medical literature. Patient outcome after treatment with third-generation cephalosporins and aminoglycosides in the 7 clinically significant cases was good, with no long-term sequelae. The potential virulence of K ascorbata highlights the need for heightened scrutiny of its antimicrobial susceptibility patterns for adequate clinical treatment.

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“…1,2,4 Only 8 pediatric cases of Kluyvera infections have been previously reported in the English language medical literature. 1,2,5 Two of these children had no underlying disease. Severe infections in immunocompetent patients, like in our patient, show that Kluyvera species may have a more pathogenic nature than previously believed.…”

Section: To the Editorsmentioning

confidence: 98%