Kluyvera co‐infection in two solid organ transplant recipients: an emerging pathogen or a colonizer bystander?

Abstract

Kluyvera species are opportunistic, gram-negative bacilli in the family Enterobacteriaceae. Ordinarily occurring as a commensal, Kluyvera have been reported to cause serious infections in immunosuppressed and immunocompetent hosts, causing diarrhea, urinary infections, peritonitis, and cholecystitis. We report Kluyvera infections in 2 solid organ transplant recipients. An 18-year-old female with alpha-1 antitrypsin deficiency underwent living donor liver transplantation and presented 6 months later with a liver abscess. The abscess aspirate grew mixed organisms including Kluyvera cryocrescens. A 22-year-old female with renal failure secondary to focal segmental glomerulosclerosis underwent a deceased donor kidney transplant and presented 3 months later with pyelonephritis; the urine culture grew Kluyvera ascorbata. Both patients improved only when their antibiotic coverage was broadened to include Kluyvera. The isolation of Kluyvera as a pathogen in transplant patients emphasizes that this commensal organism may be virulent in this patient population.

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.…”

A Case of a Persistent Postoperative Infection Caused by Multidrug-ResistantKluyvera ascorbatain the Oral and Maxillofacial Region

“…Kluyvera ascorbata is a Gram-negative microorganism belonging to the family of Enterobacteriaceae and was first identified by Farmer et al [1]. Although it infrequently causes infections, it can cause a wide range of infections including acute appendicitis [2]; biliary tract infection [3]; urinary tract infection [4]; bacteremia with neutropenia and fever [5]; bacteremia and severe sepsis [6]; sepsis accompanied with multiorgan dysfunction [7]; hock and pulmonary hemorrhage [8]; enteritis, central venous catheter infections, and peritonitis [9, 10]; solid organ transplant recipient infection [11]; acute cholecystitis [12]; and cholecystitis and bacteremia [13]. However, no K. ascorbata infections have been reported to date in the oral and maxillofacial region.…”