Kluyvera intermedia bacteremia with septic shock: A case report

Inoue, Tomohiro; Hadano, Yoshiro; Koga, Hitoshi; Tamehiro, Kazuhito; Sagara, Syuichirou; Tokuda, Yuuji; Urabe, Syougo; Mukasa, Kohta; Onitsuka, Kouhei; Higuchi, Masahiro; Sudo, Toshiki; Mabe, Takaaki; Toyama, Kiyosiro; Ichikawa, Aoi; Hisaka, Syunsuke; Moriya, Tomoka; Yamamoto, Masaaki

doi:10.1016/j.idcr.2023.e01765

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…Alfreijat described a case of UTI and severe sepsis secondary to K. ascorbata that was complicated by cardiac arrhythmia pretty similar to our case; however, the patient did not require vasopressors [4]. Inoue et al described a case of UTI secondary to K. intermedia with bacteremia and septic shock [5]. There have been no reported cases resembling our case, of complicated UTI with septic shock attributed to K. ascorbata.…”

Section: Discussionsupporting

confidence: 74%

Kluyvera ascorbata: An Unusual Cause of Septic Shock in a Patient With Urothelial Cancer

Akiki,

Ali,

Jamil

et al. 2023

Cureus

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Kluyvera ascorbata is a gram-negative bacillus which is a rare cause of clinically significant infections in humans. We report a rare case of K. ascorbata infection causing septic shock in a patient with a history of urothelial cancer. After the antimicrobial susceptibility testing, the patient was successfully treated with ceftriaxone. Recognition of the disease-producing potential of this rare pathogen with prompt initiation of effective antimicrobial coverage is paramount for appropriate management in the adult immunocompromised population. To our knowledge, this is the first case report of septic shock secondary to K. ascorbata urinary tract infection.

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Section: Discussionsupporting

confidence: 74%

Kluyvera ascorbata: An Unusual Cause of Septic Shock in a Patient With Urothelial Cancer

Akiki,

Ali,

Jamil

et al. 2023

Cureus

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Misidentification and misreporting of antibiotic resistance in Kluyvera bacteremia by blood culture molecular identification panels

Vatterrodt,

Lee,

et al. 2024

Microbiol Spectr

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The use of molecular identification panels has advanced the diagnosis for blood stream infections with fast turnaround time and high accuracy. Yet, this technology cannot completely replace conventional blood culture and standardized antibiotic susceptibility testing (AST) given its limitations and occasional false results. Here we present two cases of bacteremia caused by Kluyvera . Its identification and antibiotic resistance were at least partially mispresented by blood culture molecular identification panels on ePlex, Verigene, and Biofire. The detection of CTX-M resistance marker did not align with the susceptibility to the third generation cephalosporins among a wide range of antibiotics for this organism. Conventional extended-spectrum beta-lactamase (ESBL) testing was used to confirm the absence of ESBL. Caution should be taken when managing cases with CTX-M or ESBL detection in blood culture caused by uncommon pathogens. Conventional culture with microbial identification and standardized AST should continue to be the gold standard for routine patient care. IMPORTANCE This is the first report that highlights the limitations of blood culture molecular identification panels on identifying Kluyvera and its associated antibiotic resistance patterns. Both the false identification and overreporting of antibiotic resistance could mislead the treatment for bacteremia caused by this pathogen. Patient isolation could have been avoided due to the lack of extended-spectrum beta-lactamase (ESBL) activity of the organism. This report emphasizes the importance of confirming rapid identification and antibiotic resistance by molecular technologies with standardized methods. It also provides insight into the development of new diagnostic panels.

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<i>Kluyvera georgiana</i> Bacteremia Due to Acute Cholangitis: A Report of the First Known Case and a Literature Review

Endo,

Kanai,

Nishio

et al. 2024

Intern. Med.

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We herein present the first known case of bacteremia caused by Kluyvera georgiana in a 67-year-old female undergoing chemotherapy for recurrent pancreatic cancer. The patient underwent choledochojejunotomy and thereafter developed ascending cholangitis. The diagnosis of K. georgiana was confirmed using matrixassisted laser desorption/ionization time-of-flight mass spectrometry. A literature review of Kluyvera spp. infections indicated potential risk factors including an underlying malignancy and immunosuppression. Although Kluyvera spp. infections are typically sensitive to antibiotics, multidrug resistance is possible. This case highlights the importance of the early diagnosis and treatment of K. georgiana and its associated risk factors.

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Kluyvera intermedia bacteremia with septic shock: A case report

Cited by 3 publications

References 5 publications

Kluyvera ascorbata: An Unusual Cause of Septic Shock in a Patient With Urothelial Cancer

Kluyvera ascorbata: An Unusual Cause of Septic Shock in a Patient With Urothelial Cancer

Misidentification and misreporting of antibiotic resistance in Kluyvera bacteremia by blood culture molecular identification panels

<i>Kluyvera georgiana</i> Bacteremia Due to Acute Cholangitis: A Report of the First Known Case and a Literature Review

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