Peritonitis by Leclercia adecarboxylata in a patient with continuous ambulatory peritoneal dialysis: the first case report from India

Ghosh, Rajesh; Misra, Richa; Prasad, Kashi Nath; Prasad, Narayan

doi:10.18203/2320-6012.ijrms20160818

Cited by 3 publications

(4 citation statements)

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“…After the screening, the remaining 12 publications fulfilled the eligibility criteria and were included in this review. Of these, 11 were case reports, and 1 was a case series [3,[9][10][11][12][13][14][15][16][17][18][19]. Twelve cases of peritonitis due to L. adecarboxylata in PD patients have been reported so far in the literature in all languages, to which we contributed a new case, bringing the total to 13.…”

Section: Resultsmentioning

confidence: 99%

“…A suggestion to remove the Tenckhoff catheter in peritonitis caused by L. adecarboxylata cannot yet be established, but some evidence suggests removal was necessary in a few cases [ 16 , 18 ]. However, the ability of L. adecarboxylata to produce a biofilm is unknown, although the association of L. adecarboxylata with catheter-related septicemia, particularly tunneled central venous catheters, is reported to be increased [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

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Leclercia adecarboxylata in Peritoneal Dialysis Patients: A Systematic Review

et al. 2023

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Background: Leclercia adecarboxylata is a Gram-negative bacillus that can rarely cause infections in humans. We recently treated a case of peritonitis due to L. adecarboxylata in a peritoneal dialysis (PD) pediatric patient, and we systematically reviewed all the relevant reported cases in the literature. Methods: We searched the PubMed and Scopus databases, and we reviewed 13 such cases (2 children, 11 adults) that were reported, including our patient. Results: The mean (±SE) age was 53.2 ± 22.5 years, with a male-to-female ratio of approximately 1:1.6. Their mean vintage period on PD prior to L. adecarboxylata peritonitis was 37.5 ± 25.3 months. The VITEK card was the identification diagnostic tool in most cases (63%). The antimicrobial agent that was most frequently used was ceftazidime, which was implemented in 50% of cases as initial therapy, either as a monotherapy or combination therapy; in only two patients (15.3%) was the Tenkhoff catheter removed. The median duration of treatment was 18 days (range of 10–21 days), and all 13 patients that were reviewed were healed. Conclusions: Physicians should be aware that L. adecarboxylata is noted to rarely cause peritonitis in PD patients; however, this pathogen seems to be sensitive to most antimicrobial agents and can result in a favorable outcome with the selection of appropriate treatment.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Leclercia adecarboxylata in Peritoneal Dialysis Patients: A Systematic Review

et al. 2023

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“…Knowledge of the route of transmission of L. adecarboxylata is limited, and the possible sources of infection are unknown. In the available case reports, L. adecarboxylata can be isolated from specimens including blood, wound pus, faeces, urine, gallbladder, peri-ciliary and ciliary abscesses, synovial fluid, peritoneal fluid from peritoneal dialysis, sputum, cerebrospinal fluid, and catheters[ 79 , 80 ]. A few cases with diabetes as the only risk factor have L. adecarboxylata infection of the skin and soft tissues[ 81 , 82 ].…”

Section: Discussionmentioning

confidence: 99%

Leclercia adecarboxylata infective endocarditis in a man with mitral stenosis: A case report and review of the literature

Tan¹,

Yu²,

Wang³

et al. 2022

World J Clin Cases

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BACKGROUND Infective endocarditis (IE) is a rare disease with a high mortality rate. Leclercia adecarboxylata ( L. adecarboxylata ) is a movable Gram-negative bacillus of enterobacteriaceae, and it can rarely be a pathogen which often affects immunodeficient patients. There are about three cases of immunocompetent patients with monomicrobial L. adecarboxylata infection. There are only three reported cases of IE caused by L. adecarboxylata in the world. The mitral valve is often affected in IE, and the prognosis for IE with mitral valve lesions is often poor. CASE SUMMARY A 51-year-old man was found to have moderate to severe mitral stenosis on echocardiography. He came to our Cardiothoracic Surgery Department for surgical management. A diastolic murmur was heard on auscultation of the heart in the mitral region. On the second day of hospitalisation, he presented with slurred speech, reduced muscle strength in the left limb, and acute cerebral infarction on cranial computed tomography. Surgical treatment was decided to postpone. On the ninth day of admission, the patient developed a sudden high fever and shock and was transferred to the Cardiac Intensive Care Unit, where echocardiogram revealed an anterior mitral valve leaflet vegetation. After empirical anti-infective treatment with vancomycin (1g q12h), an emergency valve replacement was performed. Bacterial culture identified L. adecarboxylata . Anti-infective treatment with piperacillin-tazobactam (4.5g q8h) was added for 4 wk. Follow-up echocardiography showed normal bioprosthetic valve function after mitral valve replacement. CONCLUSION We report the first case of L. adecarboxylata IE in China, and clinicians should pay attention to this pathogen.

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“…In case reports and series, L. adecarboxylata was isolated from a large variety of specimens, including wounds, feces, urine, gallbladder, peritonsillar and periovarian abscesses, synovial fluid, peritoneal fluid in peritoneal dialysis, nosocomial pneumonia, and bacteremia [ 17 – 19 ]. L. adecarboxylata is an uncommon pathogen and is usually isolated as a part of poly-microbial wound cultures; it is postulated that it needs other bacteria to facilitate infection [ 13 , 17 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Leclercia adecarboxylata Bacteremia without a Focus in a Non-Immunosuppressed Patient

et al. 2021

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Patient: Female, 74-year-old Final Diagnosis: Leclercia adecarboxylata bacteremia Symptoms: Cough • fever • shock • shortness of breath Medication: — Clinical Procedure: — Specialty: Infectious Diseases • Microbiology and Virology Objective: Rare disease Background: Leclercia adecarboxylata is a gram-negative rod, which is normally found in water and food. It is an emerging pathogen that affects immunocompromised patients, including patients with hematological malignancies or those receiving chemotherapy. Generally, L. adecarboxylata is considered a low-virulence pathogen with an excellent susceptibility profile, but some strains may be resistant to multiple antibiotics, such as β-lactams. Moreover, L. adecarboxylata is usually isolated as a part of polymicrobial cultures in immunocompetent individuals, but there have been cases where it was the only isolate. Case Report: A 74-year-old woman who was non-immunosuppressed and had multiple comorbidities was admitted with acute decompensated heart failure due to pneumonia. She was treated with multiple courses of antibiotics including amoxicillin-clavulanate and ciprofloxacin for pneumonia, but her infection worsened, and she had cardiopulmonary arrest. After resuscitation, she was stable for several days but suddenly became confused and hypotensive. The septic screen showed L. adecarboxylata bacteremia without a clear source, which was treated successfully with meropenem for 14 days. After the meropenem course, the patient developed diarrhea and was found to have severe Clostridium difficile infection. She did not respond to oral vancomycin and intravenous metronidazole and died. Conclusions: This case illustrated an infection in a non-immunosuppressed individual by an organism that is considered an opportunistic pathogen, mainly affecting immunocompromised patients. The patient’s blood culture grew L. adecarboxylata , which was sensitive to all antibiotics but resolved with meropenem treatment. Owing to increasing L. adecarboxylata infections, we recommend further studies to understand the organism’s pathogenesis, risk factors, and resistance pattern.

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Peritonitis by Leclercia adecarboxylata in a patient with continuous ambulatory peritoneal dialysis: the first case report from India

Cited by 3 publications

References 13 publications

Leclercia adecarboxylata in Peritoneal Dialysis Patients: A Systematic Review

Leclercia adecarboxylata in Peritoneal Dialysis Patients: A Systematic Review

Leclercia adecarboxylata infective endocarditis in a man with mitral stenosis: A case report and review of the literature

Leclercia adecarboxylata Bacteremia without a Focus in a Non-Immunosuppressed Patient

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