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Ioannou P, Alexakis K, Kofteridis DP. Endocarditis in Liver Transplant Recipients: A Systematic Review. J Clin Med 2021; 10:jcm10122660. [PMID: 34208756 PMCID: PMC8235265 DOI: 10.3390/jcm10122660] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 02/06/2023] Open
Abstract
Infective Endocarditis (IE) is associated with significant mortality. Interestingly, IE in patients with liver transplantation has not been adequately described. The aim of this review was to systematically review all published cases of IE in liver transplant recipients and describe their epidemiology, microbiology, clinical characteristics, treatment and outcomes. A systematic review of PubMed, Scopus and Cochrane Library (through 2 January 2021) for studies providing epidemiological, clinical, microbiological, treatment data and outcomes of IE in liver transplant recipients was conducted. A total of 39 studies, containing data for 62 patients, were included in the analysis. The most common causative pathogens were gram-positive microorganisms in 69.4%, fungi in 25.8%, and gram-negative microorganisms in 9.7% of cases, while in 9.3% IE was culture-negative. The aortic valve was the most commonly infected valve followed by mitral, tricuspid and the pulmonary valve. Aminoglycosides, vancomycin and aminopenicillins were the most commonly used antimicrobials, and surgical management was performed in half of the cases. Clinical cure was noted in 57.4%, while overall mortality was 43.5%. To conclude, this systematic review thoroughly describes IE in liver transplant recipients and provides information on epidemiology, clinical presentation, treatment and outcomes.
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Lekhniuk N, Fesenko U, Pidhirnyi Y, Sękowska A, Korniychuk O, Konechnyi Y. Raoultella terrigena: Current state of knowledge, after two recently identified clinical cases in Eastern Europe. Clin Case Rep 2021; 9:e04089. [PMID: 34026135 PMCID: PMC8123537 DOI: 10.1002/ccr3.4089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 03/10/2021] [Accepted: 03/14/2021] [Indexed: 11/06/2022] Open
Abstract
Raoultella terrigena is a rarely found opportunistic pathogen that can cause healthcare-associated infections with high mortality. It is important to differentiate it from Klebsiella species.
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Affiliation(s)
- Nadiia Lekhniuk
- Department of Genetics and BiotechnologyIvan Franko National University of LvivLvivUkraine
| | - Ulbolgan Fesenko
- Department of Anesthesiology and Intensive CareDanylo Halytsky Lviv National Medical UniversityLvivUkraine
| | - Yaroslav Pidhirnyi
- Department of Anesthesiology and Intensive CareDanylo Halytsky Lviv National Medical UniversityLvivUkraine
| | - Alicja Sękowska
- Department of MicrobiologyLudwik Rydygier Collegium MedicumNicolaus Copernicus UniversityBydgoszczPoland
| | - Olena Korniychuk
- Department of MicrobiologyDanylo Halytsky Lviv National Medical UniversityLvivUkraine
| | - Yulian Konechnyi
- Department of MicrobiologyDanylo Halytsky Lviv National Medical UniversityLvivUkraine
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Mal PB, Sarfaraz S, Herekar F, Ambreen R. Clinical manifestation and outcomes of multi-drug resistant (MDR) Raoultella terrigena infection - A case series at Indus Health Network, Karachi, Pakistan. IDCases 2019; 18:e00628. [PMID: 31485415 PMCID: PMC6717099 DOI: 10.1016/j.idcr.2019.e00628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 08/18/2019] [Accepted: 08/18/2019] [Indexed: 11/30/2022] Open
Abstract
Background and objectives There is paucity of literature available on Raoultella terrigena infection. Microbiological identification of Raoultella terrigena is difficult and isolates are frequently misidentified as Klebsiella species. This series of 3 cases with Raoultella terrigena septicemia provides a description of the pitfalls and challenges in the diagnosis and management of the highly resistant strains isolated and to the best of our knowledge, is the first report from Pakistan. Methods The medical records of 3 cases of R. terrigena reported in the hospital over two months were reviewed retrospectively to record all relevant clinical information. Organism was identified by using Analytical profile index (API) 20 E with 90–95% successful identification and the sensitivity testing was performed by disc diffusion method. Results This organism caused fulminant sepsis in case 2 resulting in mortality and complicated urinary tract infection in the third, while in case 1 it preceded the fatal candidemia. All three patients were females who had multiple co-morbid and had a history of protracted hospital stay and antibiotic usage elsewhere before being shifted to our hospital. The isolates were resistant to all beta lactams and were even colistin resistant in two patients, creating challenges and suboptimal response for effective antibiotic therapy. Conclusions The purpose of this case series is to highlight the highly drug resistant profile of this organism and the fulminant infection it can cause, which if spreads in our hospitals due to breaches in infection control practices, can pose risk as a deadly and untreatable nosocomial infection.
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Affiliation(s)
| | - Samreen Sarfaraz
- Department of Infectious Disease, The Indus Hospital, Karachi, Pakistan
| | - Fivzia Herekar
- Department of Internal Medicine, The Indus Hospital, Karachi, Pakistan
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Complete Whole-Genome Sequences of Two Raoultella terrigena Strains, NCTC 13097 and NCTC 13098, Isolated from Human Cases. Microbiol Resour Announc 2019; 8:8/27/e00239-19. [PMID: 31270187 PMCID: PMC6606901 DOI: 10.1128/mra.00239-19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Raoultella terrigena is a bacterial species associated with soil and aquatic environments; however, sporadic cases of opportunistic disease in humans have been reported. Here, we report the first two complete genome sequences from clinical strains isolated from human sources that have been deposited in the National Collection of Type Cultures (NCTC). Raoultella terrigena is a bacterial species associated with soil and aquatic environments; however, sporadic cases of opportunistic disease in humans have been reported. Here, we report the first two complete genome sequences from clinical strains isolated from human sources that have been deposited in the National Collection of Type Cultures (NCTC).
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Sękowska A. Raoultella spp.-clinical significance, infections and susceptibility to antibiotics. Folia Microbiol (Praha) 2017; 62:221-227. [PMID: 28063019 DOI: 10.1007/s12223-016-0490-7] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 12/29/2016] [Indexed: 12/11/2022]
Abstract
The genus Raoultella belongs to the family of Enterobacteriaceae. Raoultella spp. are Gram-negative, aerobic, non-motile rods. This genus can be distinguished from the genus Klebsiella, in that genus use histamine as the only source of carbon in the medium. Also, Raoultella grow at 4 °C and do not produce gas from lactose at 44.5 °C. Raoultella sp. is known to inhabit natural environments (water, soil, plants). The reservoir of Raoultella is the gastrointestinal tract and upper respiratory tract. Raoultella spp. are opportunistic bacteria, which usually cause infections of the biliary tract, pneumonia and bacteraemia in oncologic and with lower immunity patients. Raoultella planticola and Raoultella ornithinolytica are the most frequently encountered human pathogens among the genus Raoultella. In this review, the current knowledge on Raoultella infections is summarized.
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Affiliation(s)
- Alicja Sękowska
- Department of Microbiology, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, M. Skłodowskiej-Curie 9, 85-094, Bydgoszcz, Poland.
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Identification of Raoultella terrigena as a Rare Causative Agent of Subungual Abscess Based on 16S rRNA and Housekeeping Gene Sequencing. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2016; 2016:3879635. [PMID: 27379169 PMCID: PMC4917704 DOI: 10.1155/2016/3879635] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 04/28/2016] [Accepted: 05/15/2016] [Indexed: 11/18/2022]
Abstract
A 63-year-old-man was admitted to our hospital with severe subungual abscess. Bacteria were isolated from pus samples, and an inconsistent identification was shown by VITEK 2 system and MALDI-TOF mass spectrometry as Raoultella planticola and Raoultella terrigena, respectively. Molecular identification by 16S rRNA sequencing suggested that the isolate is R. terrigena, and this was further demonstrated by sequencing three housekeeping genes (rpoB, gyrA, and parC) with phylogenetic analysis. To our knowledge, this is the first report of subungual abscess caused by R. terrigena, a rare case of human infection due to soil bacterium. Our study highlights the technique importance on this pathogen identification.
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Boattini M, Almeida A, Cardoso C, Cruz CS, Machado C, Vesza Z, Tosatto V, Maia D, Cardoso S, Pinto M, Moura RB, Garcia T, Guerreiro AS. Infections on the rise: Raoultella spp., clinical and microbiological findings from a retrospective study, 2010-2014. Infect Dis (Lond) 2015; 48:87-91. [PMID: 26357998 DOI: 10.3109/23744235.2015.1082619] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We performed a retrospective analysis of clinical and laboratory data over 5 years in a tertiary centre to assess clinical and microbiological characteristics of patients with Raoultella spp. infection. Raoultella spp. were deemed responsible for clinical infections in 57 patients (R. planticola, n = 32 and R. ornithinolytica, n = 25). The most prevalent diagnoses for R. planticola were cystitis (50%; n = 16) followed by bacteraemia and pneumonia (9.4%; n = 3); for R. ornithinolytica, cystitis (36%; n = 9) followed by pneumonia (24%; n = 6). Immunodeficiency was present in 18 patients (56.3%) with R. planticola and in 16 patients (64%) with R. ornithinolytica infection. Of these, 55.6% and 37.5% had diabetes and 27.8% and 18.% were solid organ transplant recipients, respectively. All isolates were sensitive to third-generation cephalosporins, fluoroquinolones and aminoglycosides. Mortality of infections with R. planticola (n = 5; 15.6%) was higher than for R. ornithinolytica (n = 2; 8.0%), but the difference was not statistically significant.
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Affiliation(s)
- Matteo Boattini
- a Internal Medicine Department, Hospital Santa Marta , Centro Hospitalar de Lisboa Central , Lisboa , Portugal.,b NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria , 130,1169-056, Lisboa , Portugal
| | - André Almeida
- a Internal Medicine Department, Hospital Santa Marta , Centro Hospitalar de Lisboa Central , Lisboa , Portugal.,b NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria , 130,1169-056, Lisboa , Portugal
| | - Catarina Cardoso
- a Internal Medicine Department, Hospital Santa Marta , Centro Hospitalar de Lisboa Central , Lisboa , Portugal
| | - Cristiano Silva Cruz
- a Internal Medicine Department, Hospital Santa Marta , Centro Hospitalar de Lisboa Central , Lisboa , Portugal
| | - Catarina Machado
- a Internal Medicine Department, Hospital Santa Marta , Centro Hospitalar de Lisboa Central , Lisboa , Portugal
| | - Zsófia Vesza
- a Internal Medicine Department, Hospital Santa Marta , Centro Hospitalar de Lisboa Central , Lisboa , Portugal
| | - Valentina Tosatto
- a Internal Medicine Department, Hospital Santa Marta , Centro Hospitalar de Lisboa Central , Lisboa , Portugal
| | - Dionísio Maia
- c Pneumology Department, Hospital Santa Marta , Centro Hospitalar de Lisboa Centra , Lisboa , Portugal
| | - Sara Cardoso
- d Infectious Diseases Department, Hospital Curry Cabral , Centro Hospitalar de Lisboa Central , Lisboa , Portugal
| | - Margarida Pinto
- e Microbiology Department, Hospital Dona Estefania , Centro Hospitalar de Lisboa Central , Lisboa , Portugal
| | - Rita Barata Moura
- a Internal Medicine Department, Hospital Santa Marta , Centro Hospitalar de Lisboa Central , Lisboa , Portugal.,b NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria , 130,1169-056, Lisboa , Portugal
| | - Teresa Garcia
- a Internal Medicine Department, Hospital Santa Marta , Centro Hospitalar de Lisboa Central , Lisboa , Portugal.,b NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria , 130,1169-056, Lisboa , Portugal
| | - António Sousa Guerreiro
- a Internal Medicine Department, Hospital Santa Marta , Centro Hospitalar de Lisboa Central , Lisboa , Portugal.,b NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria , 130,1169-056, Lisboa , Portugal
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Avcıoğlu NH, Bilkay IS. Comparative assessment of five clinical Klebsiella isolates in terms of antibiotic resistance and plasmid profiles / Beş farklı klinik Klebsiella türünün antibiyotik dirençliliği ile plazmid profillerinin karşılaştırmalı olarak değerlendirilmesi. ACTA ACUST UNITED AC 2015. [DOI: 10.1515/tjb-2015-0032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractObjective: This study is firstly aimed to biotype and to investigate the antibiotic resistance profiles of Klebsiella strains which were isolated from clinical materials. Also plasmid profile types of Klebsiella species were investigated and the results were compared with each other.Methods: Klebsiella strains were biotyped by BBL Enterotube II and the antibiotic resistance was tested by Kirby Bauer disc diffusion method. In order to analyse Klebsiella strains genotypically, plasmid DNA’s of them were isolated and generated plasmid profile types determined by Dice coefficients of similarity.Results: According to biotyping, Klebsiella strains were distributed to five different species (K. pneumoniae, K. ornithinolytica, K. oxytoca, K. terrigena, K. rhinoscleromatis). As well as K. pneumoniae (37.33%) was the most isolated strain, K. terrigena (8.95%) which is not found to be investigated as much as other strains in the literature, was also observed. Additionally, it is determined that Klebsiella strains were resistant to at least one and at most seven antibiotics. With a similarity coefficient of 84%, it was observed that five different Klebsiella species displayed 17 different plasmid profile types. Among these profiles, P1 (52.23%) was the most observed type which exhibits >10 kbp plasmid DNA band and this profile was isolated from all strains.Conclusion: Finally, it is observed that antibiotic resistance can be due to the plasmid or chromosomal sources and different strains of the same genus may exhibit the same plasmid profile because of the plasmid transformation from one strain to another.
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George S, Varghese J, Chandrasekhar S, Perumalla R, Reddy MS, Jayanthi V, Rela M. Gram-negative bacteria causing infective endocarditis: Rare cardiac complication after liver transplantation. World J Hepatol 2013; 5:296-297. [PMID: 23717742 PMCID: PMC3664289 DOI: 10.4254/wjh.v5.i5.296] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 05/02/2013] [Accepted: 05/08/2013] [Indexed: 02/06/2023] Open
Abstract
Bacterial endocarditis is a rare complication amongst solid organ transplant recipients and is often linked to bacteremia. Majority of these recipients do not have underlying valvular heart disease or congenital valvular abnormalities. Staphylococoocusaureus and Enterococcus species are the most commonly isolated organisms. There are very few reports of gram-negative bacteria causing endocarditis in liver transplant recipients. We report a 51-year-old male, a liver transplant recipient, who developed bacterial endocarditis of the mitral valve due to extended spectrum of betalactamase producing strain of Escherichia coli and was managed successfully with antibiotics.
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