The expanding spectrum of human infections caused by Kocuria species: a case report and literature review

Abstract

Although not previously known to cause human infections, Kocuria species have now emerged as human pathogens, mostly in compromised hosts with severe underlying disease. Recently, there has been an increasing incidence of different types of Kocuria infections reported, most likely due to the adoption of better identification methods. Here, we report a case of peritonitis caused by Kocuria rosea in a diabetic nephropathy patient who was on continuous ambulatory peritoneal dialysis. Sepsis and peritonitis caused by K. rosea in our case yielded two identical Kocuria isolates from the peritoneal dialysate fluid within a period of three days. The infection was subsequently resolved by antibiotic treatment and catheter removal. In addition to reporting this case, we herein review the literature concerning the emergence of Kocuria as a significant human pathogen. The majority of cases were device-related, acquired in the hospital or endogenous, and different Kocuria species appear to share a common etiology of peritonitis. The overall disease burden associated with Kocuria appears to be high, and the treatment guidelines for diseases associated with Kocuria have not yet been clearly defined.

Native valve endocarditis caused by Kocuria rosea complicated by peripheral mycotic aneurysm in an elderly host

“…The literature reports a spectrum of cases due to Kocuria causing infective endocarditis, arthritis, central nervous system infections, pneumonia, peritonitis, hepatic abscess, and nosocomial bloodstream infections such as infections associated with indwelling intravenous lines, continuous ambulatory peritoneal dialysis fluids, ventricular shunts, and prosthetic valves in immune-compromised hosts. [3456789] Whereas, our case with severe intravascular infection in an elderly host with no other risk factor is quite rare.…”

Scanning electron microscopy and antibiotic sensitivity of the actinobacterium, Kocuria sediminis DDK6

“…and can be explained by the presence of efflux pumps and a decrease in the cell wall permeability [34][35]and/or lack of targets that can be attacked by the antibiotic [19]. Unlike what expected, no β-lactamase was observed by these strains [32]indicating an alternative mechanism of ampicillin resistance other than production of β-lactamase in Gram-positive bacteria.…”

Emerging Bacterial Infection: Identification and Clinical Significance of Kocuria Species

“…Previous research has highlighted that in the case of non-availability of molecular and advanced laboratory methods, Kocuria  can still be identified and differentiated from Staphylococci  and Micrococci  using morphological, cultural characteristics and differential antibiotic discs. Kocuria spp are sensitive to bacitracin, lysozyme and resistant to nitrofurantoin, furazolidone and lysostaphin [18, 24]. …”

“…Although the patient was healthy before suffering from the infection, a history of surgery to correct congenital heart disease was present [9]. Evaluation of biofilm production by Kocuria spp isolated from a case of peritonitis showed that the strain was negative for biofilm production [18]. Isolation of K. marina showing tolerance to severe alkaline conditions in a 7-year-old patient receiving epoprostenol therapy should be considered as an alarming signal regarding the potential of Kocuria spp in causing both opportunistic and nosocomial infections [29-30].…”