Clinically SignificantKluyveraInfections

Abstract

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.

First Report of an OXA-48- and CTX-M-213-Producing Kluyvera Species Clone Recovered from Patients Admitted in a University Hospital in Madrid, Spain

“…To the best of our knowledge, we report for the first time a Kluyvera species clone harboring an OXA-48-encoding plasmid and also the novel chromosomal CTX-M-213 variant. Kluyvera species have been described as opportunistic etiological microorganisms of adult clinical infections (23,24). Moreover, carbapenemase production has been scarcely reported among these isolates and only in relation to KPC-2 and GES-5 genes (25,26).…”

Acute cholangitis in a patient with Kluyvera cryocrescens bacteremia: A case report and literature review

“…There are a multitude of manifestations of Kluyvera infections reported in the literature (see Table 1). [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] One unique case report from 1998 describes a diabetic patient who developed a finger blister that progressed to tenosynovitis requiring serial debridements and a skin flap. [16] Another report found Kluyvera cryocrescens in a peritoneal cavity abscess in a patient undergoing peritoneal dialysis.…”

“…Originally thought to be benign organisms, there is increasing evidence that Kluyvera species harbor the potential to induce a multitude of pathologies. [1][2][3][4][5] Kluyvera are Gram negative bacilli which can colonize the respiratory, gastrointestinal, and urinary tracts. These organisms are small, motile, and possess peritrichous flagella.…”

Multidrug resistant Kluyvera ascorbata septicemia in an adult patient: a case report

“…Four species are described: K. cryocrescens, K. ascorbata, K. georgiana , and K. cochleae. K. ascobata causes a wide range of infectious diseases in different age groups and of varying severity [1,2,9]. …”

“…Although it causes infections infrequently, it is responsible for causing a wide range of infections including severe sepsis [1,2]. It is believed to be the source of genes encoding CTX-M-type extended spectrum B-lactamases (ESBLs) and it has the ability to transfer these genes to other Enterobacteriacae [3].…”