Catheter-Related ESBL-Producing <i>Leclercia adecarboxylata</i> Septicemia in Hemodialysis Patient: An Emerging Pathogen?

Alosaimi, Roaa S; Kaaki, M

doi:10.1155/2020/7403152

Cited by 14 publications

(26 citation statements)

References 14 publications

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“…In our study, a recent exposition to an aquatic environment was identified in one patient (professional swimmer presenting with corneal abscess with keratitis), such as few cases in medical literature [9]. Until now, this bacterium was considered a low-virulence pathogen with uncertain pathogenicity in human infections [6,9,10]. In our 8 samples, L. adecarboxylata was considered as a clinically significant pathogen based on clinical presentations, except for 2 episodes (one patient with VAP and the second with UTI) when clinicians considered it as an asymptomatic carriage or colonization and they have been mistreated.…”

Section: Discussionmentioning

confidence: 84%

Leclercia adecarboxylata as Emerging Pathogen in Human Infections: Clinical Features and Antimicrobial Susceptibility Testing

et al. 2021

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(1) Background: Leclercia adecarboxylata (L. adecarboxylata) is a gram-negative bacillus of the Enterobacteriaceae family, which is uncommonly isolated from clinical specimens. L. adecarboxylata is considered as an aquatic opportunistic pathogen and most of the human infections are polymicrobial and usually occur in immunocompromised hosts. (2) Methods: In this retrospective study, we included all L. adecarboxylata strains since the introduction of MALDI-TOF MS in the Microbiology Department of Nord Franche-Comté Hospital, France (from 1 March 2015 to 31 July 2019). We studied demographic characteristics, comorbidities, characteristics of the current infection and outcome as well as antimicrobial susceptibility testing in all isolates. (3) Results: A total of 8 samples were identified (in 6 patients (4M/2F), with a recurrent L. adecarboxylata infection in 2 patients). The patients’ mean age was 66.2 years (range: 19–84). All patients were considered as immunocompetent, except a peritoneal dialysis patient with kidney transplantation. An exposition to an aquatic environment was identified in one patient. The most prevalent clinical feature was catheter-associated male urinary tract infection (in 3 cases) followed by ventilator-associated pneumonia (in 2 cases). One of 6 patients presented L. adecarboxylata bacteremia. L. adecarboxylata was part of a polymicrobial infection in 4 patients. The isolates showed a high susceptibility to all tested antibiotics, except one strain, which was resistant to fosfomycin. All patients with L. adecarboxylata infection were treated with antibiotics with a favorable outcome. (4) Conclusion: This study confirms the pathogenicity of L. adecarboxylata, even in immunocompetent patients, with a high susceptibility to antibiotics.

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Section: Discussionmentioning

confidence: 84%

Leclercia adecarboxylata as Emerging Pathogen in Human Infections: Clinical Features and Antimicrobial Susceptibility Testing

et al. 2021

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“…Similarly to other published reports, the overwhelming majority of isolates were susceptible to tested antibiotics in both mentioned studies. Nevertheless, ESBL or AmpCproducing isolates, resistant isolates to cefotaxime, ceftazidime and cefepime were described, in addition to an blaNDM-1-producing strain isolated from a male patient, suffering an open ankle fracture and crush injury to his left foot [31,32]. Comparably to other Gram-negative gut bacteria, the emergence and spread of multidrug-resistant strains is to expected [33].…”

Section: Discussionmentioning

confidence: 99%

Leclercia adecarboxylata as an emerging pathogen in human infections: a 13-year retrospective analysis in Southern Hungary

Gajdács

Ábrók

Lázár

et al. 2020

J Infect Dev Ctries

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Introduction: The clinical role of Leclercia adecarboxylata as an opportunistic pathogen in the context of human infections have been highlighted by multiple published case reports, describing these bacteria as novel or emerging pathogens. Methodology: The study included L. adecarboxylata isolates and laboratory data collected, corresponding to a 13-year time period (between 1 January 2005 and 31 December 2017). Presumptively identified L. adecarboxylata isolates were re-identified using VITEK 2 Compact ID/AST and MALDI-TOF MS analysis. Results: n = 34 isolates were verified by VITEK 2 system and MALDI-TOF. The fosfomycin-agar and CPS Elite agar were effective in the phenotypic differentiation of the isolates. N = 18 (52.9%) of L. adecarboxylata was considered as clinically significant pathogens (based on the clinical signs and symptoms), while n = 16 (47.1%) were considered as contaminants. These pathogens were isolated from wound/abscess samples (n = 9), urine samples (n = 6) and blood cultures (n = 3). 31 out of 34 isolates (91.2%) were pan-sensitive (i.e. wild type) to the tested antibiotics. The median age of affected patients was 57 years (range: 12-80 years), 11 out of 18 patients (61.1%) presented with underlying immunosuppression at the time of isolation. Conclusions: Based on the finding of this study, the actual (published) frequency of L. adecarboxylata infections needs to be re-evaluated as the risk of misidentification (and reporting the isolate as a pan-sensitive Escherichia coli) is high. Additional reporting of cases, both from a microbiological and clinical standpoint, could help clinicians develop a better understanding of the potential of this organism as a pathogen.

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“…First discovered in 1962 as “Escherichia Adecarboxylata (E.coli),” this pathogen was described as a motile, gram-negative, oxidase-negative bacterium that shared many similar biochemical properties with Escherichia Coli [ 2 ]. Due to advancement in microbiology identification capabilities, there have been an increasing number of L. adecarboxylata infections diagnosed, primarily as an opportunistic pathogen.…”

Section: Discussionmentioning

confidence: 99%

Leclercia Adecarboxylata Causing Necrotizing Fasciitis in an Immunocompetent Athlete Injecting Illicit Testosterone Supplements

Kaushik¹,

Mittal²,

Tirador³

et al. 2020

Cureus

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Leclercia adecarboxylata (L. adecarboxylata) is an uncommon and often misdiagnosed cause of multiple infection types including skin and soft tissue, cholecystitis, and septicemia. It commonly afflicts immunocompromised hosts or individuals who experience trauma in aquatic environments. We present a case where this bacteria causes necrotizing fasciitis as a consequence of injecting street bought testosterone supplements. This patient was treated successfully with excisional debridement of the wound as well as a one week course of Linezolid and Bactrim.

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Catheter-Related ESBL-Producing Leclercia adecarboxylata Septicemia in Hemodialysis Patient: An Emerging Pathogen?

Cited by 14 publications

References 14 publications

Leclercia adecarboxylata as Emerging Pathogen in Human Infections: Clinical Features and Antimicrobial Susceptibility Testing

Leclercia adecarboxylata as Emerging Pathogen in Human Infections: Clinical Features and Antimicrobial Susceptibility Testing

Leclercia adecarboxylata as an emerging pathogen in human infections: a 13-year retrospective analysis in Southern Hungary

Leclercia Adecarboxylata Causing Necrotizing Fasciitis in an Immunocompetent Athlete Injecting Illicit Testosterone Supplements

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