Urinary Catheter Colonization by Multidrug-ResistantCedecea neteriin Patient with Benign Prostatic Hyperplasia

Abstract

Cedecea neteri, a member of the Enterobacteriaceae family, has only been identified as a human pathogen in a few previous clinical cases, thus complicating assessment of this organism's pathogenicity and medical relevance. Documented infections attributed to C. neteri primarily involved bacteremia in severely immunocompromised patients. We report a rare case of urinary catheter colonization by a multidrug-resistant C. neteri strain in a patient of advanced age with benign prostatic hyperplasia and other chronic comorbidities. This C. neteri isolate was resistant or intermediate to second-generation cephalosporins, penicillins, and certain β-lactamase inhibitor/β-lactam combinations. Analysis of whole genome sequence information for a representative C. neteri strain indicated the presence of multiple open reading frames with sequence similarity to β-lactamases, including a chromosome-encoded AmpC β-lactamase and metallo-β-lactamases, consistent with the resistance phenotype of this bacterium. The presence of an AmpR homolog suggests that the C. neteriampC may be inducible in response to β-lactam exposure. Molecular insights into antibiotic resistance traits of this emerging opportunistic pathogen will be important for administering adequate antibiotic treatment to ensure favorable patient outcomes.

Comparative genomic insights into Yersinia hibernica – a commonly misidentified Yersinia enterocolitica-like organism

“… C. neteri is a rare isolate from immunocompromised human clinical cases [40] while Pantoea are plant pathogens that cause rare opportunistic infections in humans [41]. The PSI-2 of P.…”

Expanding spectrum of opportunistic Cedecea infections: Current clinical status and multidrug resistance

“…During hospitalization, the patient's white blood cell (WBC) count became elevated, and urinalysis from the Foley catheter demonstrated a cloudy appearance, 3+ leukocyte esterase, 4 + WBC clumps, and 2+ bacteria. Urine culture results exclusively revealed C. neteri, but the catheter colonization was likely detected before a urinary tract infection could be established, since the patient remained afebrile (Ginn et al, 2018).…”

“…In most cases, infections attributed to Cedecea have occurred in immunocompromised patients with underlying medical conditions such as uncontrolled diabetes mellitus (Bae and Sureka, 1981;Dalamaga et al, 2008a,b), chronic kidney disease (Peretz et al, 2013), renal or liver transplantation (Davis and Wall, 2006;Mawardi et al, 2010), chronic obstructive pulmonary disease (COPD) (Perkins et al, 1986;Hong et al, 2015), and various malignancies (Abate et al, 2011;Akinosoglou et al, 2012;Lopez et al, 2013;Biswal et al, 2015). Cedecea species have also been isolated from venous and urinary access catheters (Ginn et al, 2018;Perkins et al, 1986;Abate et al, 2011). The clinical cases summarized in Table 1 indicate the opportunistic nature of Cedecea pathogenesis, underscoring the importance of aggressive management of these bacterial infections in immunocompromised populations.…”

“…The only reported pediatric case of C. neteri involved peritonitis in a male preterm neonate who developed the infection after his colon perforated due to necrotizing enterocolitis (Arishi et al, 2017). In the only other C. neteri case reported to date, a male patient of advanced age with significant multiple comorbidities was hospitalized for a generalized skin rash (Ginn et al, 2018). This patient was on long-term Foley catheterization due to progression of benign prostatic hyperplasia.…”

Diversity and susceptibility pattern of medically important bacteria isolated from intestinal tract of Hemidactylus frenatus in Ilishan-Remo, Ogun State

“…Among the species reported in this study, Cedecea has less prevalence. However, it is an opportunistic pathogen commonly isolated from immunocompromised patients and has been linked to infections such as bacteremia, scrotal abscess, chronic renal, and heart diseases, pneumonia [41][42][43][44][45]. The first case fatality due to Cedecea lapagei infection was reported in a 52-year-old Mexican who developed septic shock and multiple organ failure [46].…”