Kocuria rosea Bacteremia in a Sickle Cell Patient: A Case Report

Abstract

Central line-associated bloodstream infections (CLABSI) are a significant risk factor for poor patient outcomes. It is important to correctly diagnose and treat these infections to ensure the best chance of recovery. Kocuria rosea is a novel bacteria that is native to the human flora and has been on the rise as a culprit in recent nosocomial infections. However, due to its characteristics, it is often misclassified by commonly used hospital tests. We present a case of a 55-year-old female with sickle cell disease who developed a K. rosea infection during her hospital course and was effectively diagnosed and treated. This case report aims to bring awareness to this unusual bacteria as a possible cause of inpatient infection and CLABSI. Further research should be conducted to determine the incidence of this bacteria and the best testing to be done for its proper recognition.

Multidrug-Resistant Kocuria rosea and Methicillin-Resistant Staphylococcus aureus Co-Infection in a Nigerian Patient with COVID-19: A Case Report

“…In this study, the isolated K. rosea was highly multi-drug-resistant, with susceptibility only seen to imipenem, meropenem, vancomycin, nitrofurantoin, rifampicin, and tetracycline. Similarly, a recent case report in 2022 showed the isolation of K. rosea from the blood of a sickle cell patient with bacteria [12]; as in our study, the isolated K. rosea was also susceptible to vancomycin and meropenem. The K. rosea in our patient was resistant to all the macrolides and ciprofloxacin, which further substantiates the ineffectiveness of the ceftriaxone and ciprofloxacin used for the management of this patient, even though the MRSA was sensitive to these antibiotics.…”

“…Kocuria infection has been mostly reported in patients with indwelling devices. The infections associated with the presence of indwelling devices has been termed central line-associated or catheter-related bloodstream infections [12][13][14]. These types of infection have been reported to significantly affect patient outcome [12][13][14].…”

“…It is believed that one of the problems that affected the management of this patient was the identification process after blood culture. This is because Kocuria are usually misidentified by phenotypic tests and sometimes ignored as laboratory contaminants [12]. Other reports have also mentioned that identification of Kocuria species using biochemical methods is often difficult due to their similarity to Staphylococci [10,[16][17][18][19].…”

“…This case report presents an interesting case of bacterial co-infection in a COVID-19 patient who was living with diabetes as a comorbidity. The 2 bacteria identified in this case were Methicillin-resistant Staphylococcus aureus (MRSA) and Kocuria rosea ( K. rosea ), which is a gram-positive bacterium and a normal flora of the skin, but capable of causing nosocomial infection, infection in patients with underlying co-morbidities, and causing central line-associated bloodstream infections in catheterized and immunocompromised patients [ 12 ]. The major symptoms associated with Kocuria infection include recurrent sepsis, increased platelets and white blood cell counts, and febrile neutropenia [ 2 , 13 ].…”

“…However, to the best of our knowledge, there are no reports of K. rosea co-infection in COVID-19 cases, even in those with other co-morbidities. This is probably because infections due to Kocuria species are very rare and the bacteria are sometimes misidentified as Staphylococci [ 12 ]. There are, nonetheless, a few reports of this bacteria in the literature, causing or associated with peritonitis, brain abscesses, meningitis, endocarditis, bacteremia/ sepsis, and acute cholecystitis [ 10 , 16 ].…”