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First clinical case of VIM-1-producing Leclercia adecarboxylata: A case report and literature review. MEDICINE IN MICROECOLOGY 2022. [DOI: 10.1016/j.medmic.2022.100075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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2
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Tan R, Yu JQ, Wang J, Zheng RQ. Leclercia adecarboxylata infective endocarditis in a man with mitral stenosis: A case report and review of the literature. World J Clin Cases 2022; 10:10670-10680. [PMID: 36312476 PMCID: PMC9602224 DOI: 10.12998/wjcc.v10.i29.10670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/11/2022] [Accepted: 08/30/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Infective endocarditis (IE) is a rare disease with a high mortality rate. Leclercia adecarboxylata (L. adecarboxylata) is a movable Gram-negative bacillus of enterobacteriaceae, and it can rarely be a pathogen which often affects immunodeficient patients. There are about three cases of immunocompetent patients with monomicrobial L. adecarboxylata infection. There are only three reported cases of IE caused by L. adecarboxylata in the world. The mitral valve is often affected in IE, and the prognosis for IE with mitral valve lesions is often poor.
CASE SUMMARY A 51-year-old man was found to have moderate to severe mitral stenosis on echocardiography. He came to our Cardiothoracic Surgery Department for surgical management. A diastolic murmur was heard on auscultation of the heart in the mitral region. On the second day of hospitalisation, he presented with slurred speech, reduced muscle strength in the left limb, and acute cerebral infarction on cranial computed tomography. Surgical treatment was decided to postpone. On the ninth day of admission, the patient developed a sudden high fever and shock and was transferred to the Cardiac Intensive Care Unit, where echocardiogram revealed an anterior mitral valve leaflet vegetation. After empirical anti-infective treatment with vancomycin (1g q12h), an emergency valve replacement was performed. Bacterial culture identified L. adecarboxylata. Anti-infective treatment with piperacillin-tazobactam (4.5g q8h) was added for 4 wk. Follow-up echocardiography showed normal bioprosthetic valve function after mitral valve replacement.
CONCLUSION We report the first case of L. adecarboxylata IE in China, and clinicians should pay attention to this pathogen.
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Affiliation(s)
- Rui Tan
- Department of Critical Care Medicine, Northern Jiangsu People’s Hospital, Yangzhou 225001, Jiangsu Province, China
| | - Jiang-Quan Yu
- Department of Critical Care Medicine, Northern Jiangsu People’s Hospital, Yangzhou 225001, Jiangsu Province, China
| | - Jing Wang
- Department of Critical Care Medicine, Northern Jiangsu People’s Hospital, Yangzhou 225001, Jiangsu Province, China
| | - Rui-Qiang Zheng
- Department of Critical Care Medicine, Northern Jiangsu People’s Hospital, Yangzhou 225001, Jiangsu Province, China
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Householder NA, Harris CS, Kugler KM, Oakes DA, Powell SE. Monomicrobial Joint Infection by Leclercia adecarboxylata in an Immunocompetent Patient After Knee Arthroscopy: A Case Report. JBJS Case Connect 2022; 12:01709767-202209000-00010. [PMID: 35833641 DOI: 10.2106/jbjs.cc.22.00016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
CASE A 54-year-old immunocompetent man presented to the office with severe right knee pain and swelling 27 days after knee arthroscopy. Additional diagnostics identified a monomicrobial infection of the right knee joint by the bacterium Leclercia adecarboxylata, which was later confirmed by repeated aspiration of the joint and culture of the aspirated fluid. CONCLUSION This case report details a postoperative monomicrobial infection with L. adecarboxylata after a knee arthroscopy in an immunocompetent host. Although infection by this bacterium is rare, this case demonstrates the possibility of L. adecarboxylata infection in the knee joint after orthopaedic surgery.
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Affiliation(s)
| | | | | | - Daniel A Oakes
- Department of Orthopaedic Surgery, USC Keck School of Medicine, Los Angeles, California
| | - Scott E Powell
- Department of Orthopaedic Surgery, USC Keck School of Medicine, Los Angeles, California
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4
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Harper H, Logan J, Kubat R, Jones M. Leclercia adecarboxylata catheter-related bacteraemia in an immunocompromised patient. BMJ Case Rep 2022; 15:e247496. [PMID: 35332006 PMCID: PMC8948387 DOI: 10.1136/bcr-2021-247496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 06/14/2023] Open
Abstract
A 34-year-old man on active chemotherapy was hospitalised with fever, chills and rigours after power-washing a pig pen on a farm. His blood cultures grew Leclercia adecarboxylata, a gram-negative rod in the Enterobacteriaceae family, which has been isolated from a variety of environments including soil, surface water, as well as in the gastrointestinal flora of farm animals. The likely source of infection was his tunnelled central venous catheter exposed to water contaminated by faeces when he was washing the pig pen. While there have been several cases reported of catheter-related L. adecarboxylata bacteraemia, to our knowledge there are very few reports of infection spread in this manner.
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Affiliation(s)
- Haleigh Harper
- University of Kansas School of Medicine, Kansas City, Kansas, USA
| | - John Logan
- Internal Medicine, The University of Kansas Health System, Kansas City, Kansas, USA
| | - Ryan Kubat
- Internal Medicine, Division of Infectious Disease, The University of Kansas Health System, Kansas City, Kansas, USA
| | - Matthew Jones
- Internal Medicine, The University of Kansas Health System, Kansas City, Kansas, USA
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5
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Arasu R, Ewe YH, Sundaram A, Foley DA, Campbell AJ, Fletcher TRW, Palasanthiran P, Suzuki A. Two cases of Leclercia adecarboxylata septic arthritis in immunocompetent paediatric patients. Access Microbiol 2022; 4:000325. [PMID: 35355870 PMCID: PMC8941959 DOI: 10.1099/acmi.0.000325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 12/09/2021] [Indexed: 11/18/2022] Open
Abstract
Leclercia adecarboxylata
is a rare cause of septic arthritis in children, and has intrinsic resistance to common antibiotics. We describe two cases of
L. adecarboxylata
septic arthritis in children that required re-presentation to hospital with prolonged treatment, and highlight the importance of considering
L. adecarboxylata
as a potential cause of infection among children with penetrating injuries and associated environmental exposure.
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Affiliation(s)
- Ramesh Arasu
- School of Medicine, University of Western Australia, Nedlands, Western Australia, Australia
| | - Yean Hsiang Ewe
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
- Infectious Diseases, Perth Children’s Hospital, 15 Hospital Avenue, Nedlands 6009, Western Australia, Australia
| | - Abavasankar Sundaram
- Department of Orthopaedic Surgery, Bunbury Regional Hospital, Bussell Highway, Bunbury 6230, Australia
| | - David Anthony Foley
- Infectious Diseases, Perth Children’s Hospital, 15 Hospital Avenue, Nedlands 6009, Western Australia, Australia
| | - Anita Jane Campbell
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
- Infectious Diseases, Perth Children’s Hospital, 15 Hospital Avenue, Nedlands 6009, Western Australia, Australia
| | | | - Pamela Palasanthiran
- School of Women’s and Child Health, University of New South Wales, Kensington, Sydney 2052, New South Wales, Australia
- Department of Immunology and Infectious Diseases, Sydney Children’s Hospital Network, High Street, Randwick 2031, New South Wales, Australia
| | - Arnold Suzuki
- Department of Orthopaedic Surgery, Sydney Children’s Hospital, High Street, Randwick 2031, New South Wales, Australia
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Aarab A, Saddari A, Noussaiba B, Ayyad A, Messaoudi S, Amrani R, Benaissa E, Ben Lahlou Y, Maleb A, Elouennass M. Leclercia adecarboxylata invasive infection in a patient with Hirschsprung disease: A case report. Ann Med Surg (Lond) 2021; 71:102927. [PMID: 34691449 PMCID: PMC8517714 DOI: 10.1016/j.amsu.2021.102927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 01/04/2023] Open
Abstract
Introduction Leclercia adecarboxylata is a ubiquitous aerobic, motile, gram-negative bacilli. The human gastro-intestinal tract is known to harbor this rarely opportunistic microorganism. We describe a rare case of invasive infection with a gastrointestinal starting point due to L. adecarboxylata in a patient with Hirschsprung disease. Case report It is about a newborn female who was admitted on the 3rd day of life to the neonatal intensive care unit for intestinal obstruction. On the 9th day of life, while managing the neonatal obstruction, the patient developed febrile peaks. Cytobacteriological examination of cerebrospinal fluid, blood cultures and culture of umbilical vein catheter allowed the exclusive isolation of Leclercia adecarboxylata. It was producing extended spectrum beta-lactamase and was treated with intravenous imipenem. After favourable evolution, the patient was transferred to the pediatric surgery department. There, she was diagnosed with Hirschsprung disease. Discussion Knowledge of the route of transmission of L. adecarboxylata is limited and the possible source of the infection is unclear. However, the authors describe three hypotheses of contamination of our propositus. In our patient, one or more of these routes of contamination would be possible. Indeed, bacteremia could occur as a result of a bacterial translocation across the mucosal barrier of the colon altered by Hirschsprung disease, antibiotic use and feeding practices. Conclusion Infection with L. adecarboxylata revealed a wide range of infection. It has only recently been acknowledged as an emerging pathogen. Further studies of the pathogenesis and risk factors are required. Leclercia adecarboxylata is Gram-negative bacillus as a member of the Enterobacteriaceae family. Infection with this rarely pathogenic microorganism has been limited to a small number of case reports. Of these, only few reports implicate the gastrointestinal tract as the focus of infection. Bacteremia could occur as a result of a bacterial translocation across the mucosal barrier of the colon altered by Hirschsprung disease, antibiotic use and feeding practices. As the number of L. adecarboxylata infections continues to expand so does our insight into its pathogenicity and role in human clinical infections. Further studies of the pathogenesis and risk factors are required.
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Affiliation(s)
- Adnane Aarab
- Laboratory of Microbiology, Mohammed VI University Hospital / Faculty of Medicine and Pharmacy (University Mohammed the First), Oujda, Morocco
| | - Abderrazak Saddari
- Laboratory of Microbiology, Mohammed VI University Hospital / Faculty of Medicine and Pharmacy (University Mohammed the First), Oujda, Morocco
| | - Benhamza Noussaiba
- Laboratory of Microbiology, Mohammed VI University Hospital / Faculty of Medicine and Pharmacy (University Mohammed the First), Oujda, Morocco
| | - Anass Ayyad
- Department of Neonatology Intensive Care Unit, Mohammed VI University Hospital, Oujda, Morocco.,Research Laboratory for Maternal, Child and Mental Health, Faculty of Medicine and Pharmacy (University Mohammed the First), Oujda, Morocco
| | - Sahar Messaoudi
- Department of Neonatology Intensive Care Unit, Mohammed VI University Hospital, Oujda, Morocco.,Research Laboratory for Maternal, Child and Mental Health, Faculty of Medicine and Pharmacy (University Mohammed the First), Oujda, Morocco
| | - Rim Amrani
- Department of Neonatology Intensive Care Unit, Mohammed VI University Hospital, Oujda, Morocco.,Research Laboratory for Maternal, Child and Mental Health, Faculty of Medicine and Pharmacy (University Mohammed the First), Oujda, Morocco
| | - Elmostapha Benaissa
- Department of Bacteriology, Mohammed V Teaching Military Hospital, Rabat, Morocco.,Epidemiology and Bacterial Resistance Research Team/BIO-INOVA Centre, Faculty of Medicine and Pharmacy (University Mohammed V), Rabat, Morocco
| | - Yassine Ben Lahlou
- Department of Bacteriology, Mohammed V Teaching Military Hospital, Rabat, Morocco.,Epidemiology and Bacterial Resistance Research Team/BIO-INOVA Centre, Faculty of Medicine and Pharmacy (University Mohammed V), Rabat, Morocco
| | - Adil Maleb
- Laboratory of Microbiology, Mohammed VI University Hospital / Faculty of Medicine and Pharmacy (University Mohammed the First), Oujda, Morocco.,Research Team "Cell Biology and Pharmacology Applied to Health Sciences". Faculty of Medicine and Pharmacy (University Mohammed the First), Oujda, Morocco
| | - Mostafa Elouennass
- Department of Bacteriology, Mohammed V Teaching Military Hospital, Rabat, Morocco.,Epidemiology and Bacterial Resistance Research Team/BIO-INOVA Centre, Faculty of Medicine and Pharmacy (University Mohammed V), Rabat, Morocco
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7
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Sng ECY, Goh KCM, Tan SH, Tan AL, Oh HML. Leclercia adecarboxylata bacteraemia: Clinical features and antibiotic
susceptibilities in 2 hospitals in Singapore. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2021. [DOI: 10.47102/annals-acadmedsg.202195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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8
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Shaikhain T, Al-Husayni F, Al-Fawaz S, Alghamdi EM, Al-Amri A, Alfares M. Leclercia adecarboxylata Bacteremia without a Focus in a Non-Immunosuppressed Patient. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e929537. [PMID: 33782375 PMCID: PMC8019838 DOI: 10.12659/ajcr.929537] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Leclercia adecarboxylata is a gram-negative rod, which is normally found in water and food. It is an emerging pathogen that affects immunocompromised patients, including patients with hematological malignancies or those receiving chemotherapy. Generally, L. adecarboxylata is considered a low-virulence pathogen with an excellent susceptibility profile, but some strains may be resistant to multiple antibiotics, such as b-lactams. Moreover, L. adecarboxylata is usually isolated as a part of polymicrobial cultures in immunocompetent individuals, but there have been cases where it was the only isolate. CASE REPORT A 74-year-old woman who was non-immunosuppressed and had multiple comorbidities was admitted with acute decompensated heart failure due to pneumonia. She was treated with multiple courses of antibiotics including amoxicillin-clavulanate and ciprofloxacin for pneumonia, but her infection worsened, and she had cardiopulmonary arrest. After resuscitation, she was stable for several days but suddenly became confused and hypotensive. The septic screen showed L. adecarboxylata bacteremia without a clear source, which was treated successfully with meropenem for 14 days. After the meropenem course, the patient developed diarrhea and was found to have severe Clostridium difficile infection. She did not respond to oral vancomycin and intravenous metronidazole and died. CONCLUSIONS This case illustrated an infection in a non-immunosuppressed individual by an organism that is considered an opportunistic pathogen, mainly affecting immunocompromised patients. The patient's blood culture grew L. adecarboxylata, which was sensitive to all antibiotics but resolved with meropenem treatment. Owing to increasing L. adecarboxylata infections, we recommend further studies to understand the organism's pathogenesis, risk factors, and resistance pattern.
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Affiliation(s)
- Talal Shaikhain
- Department of Internal Medicine, National Guard Hospital, Jeddah, Saudi Arabia
| | - Faisal Al-Husayni
- Department of Internal Medicine, National Guard Hospital, Jeddah, Saudi Arabia.,Department of Internal Medicine, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Sarah Al-Fawaz
- Department of Internal Medicine, National Guard Hospital, Jeddah, Saudi Arabia
| | - Erada M Alghamdi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Abdulfattah Al-Amri
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,Department of Microbiology, National Guard Hospital, Jeddah, Saudi Arabia.,Department of Microbiology, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Mona Alfares
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,Department of Infectious Diseases, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.,Department of Infectious Diseases, National Guard Hospital, Jeddah, Saudi Arabia
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9
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Gómez-Arroyo B, González-Donapetry P, Rico-Nieto A, Falces-Romero I. Leclercia adecarboxylata isolates in a tertiary-care hospital: A propos of the first case of prosthetic joint infection. Enferm Infecc Microbiol Clin 2020; 38:503-505. [DOI: 10.1016/j.eimc.2020.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 02/20/2020] [Accepted: 02/25/2020] [Indexed: 11/29/2022]
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10
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Kaushik M, Mittal A, Tirador K, Ibrahim H, Drake S. Leclercia Adecarboxylata Causing Necrotizing Fasciitis in an Immunocompetent Athlete Injecting Illicit Testosterone Supplements. Cureus 2020; 12:e11196. [PMID: 33269127 PMCID: PMC7703988 DOI: 10.7759/cureus.11196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Leclercia adecarboxylata (L. adecarboxylata) is an uncommon and often misdiagnosed cause of multiple infection types including skin and soft tissue, cholecystitis, and septicemia. It commonly afflicts immunocompromised hosts or individuals who experience trauma in aquatic environments. We present a case where this bacteria causes necrotizing fasciitis as a consequence of injecting street bought testosterone supplements. This patient was treated successfully with excisional debridement of the wound as well as a one week course of Linezolid and Bactrim.
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Affiliation(s)
- Milan Kaushik
- Internal Medicine, Wayne State University School of Medicine, Detroit, USA
| | - Aayush Mittal
- Internal Medicine, Wayne State University School of Medicine, Detroit, USA
| | - Kathleen Tirador
- Internal Medicine, Wayne State University School of Medicine, Detroit, USA
| | - Hanan Ibrahim
- Internal Medicine, Henry Ford Health System, Detroit, USA
| | - Sean Drake
- Internal Medicine, Henry Ford Health System, Detroit, USA
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11
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Catheter-Related ESBL-Producing Leclercia adecarboxylata Septicemia in Hemodialysis Patient: An Emerging Pathogen? Case Rep Infect Dis 2020; 2020:7403152. [PMID: 32089912 PMCID: PMC6996699 DOI: 10.1155/2020/7403152] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 01/06/2020] [Indexed: 12/22/2022] Open
Abstract
We report a multidrug-resistant strain of Leclercia adecarboxylata which was responsible for a catheter-related bacteremia, in a 50-year-old female with an end-stage renal disease on hemodialysis. The isolated strain was an extended beta-lactamase producer. Based on a literature review of L. adecarboxylata, there have been only two reports of extended beta-lactamase producer strains. To our knowledge, this is the first case reported in Saudi Arabia.
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12
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Mayfield CK, Haglin JM, Konda SR, Tejwani NC, Egol KA. Post-operative Orthopedic Infection with Monomicrobial Leclercia adecarboxylata: A Case Report and Review of the Literature. JBJS Case Connect 2019; 9:e0297. [PMID: 31343997 DOI: 10.2106/jbjs.cc.18.00297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
CASE An 65-year-old immunocompetent female developed a Leclercia adecarboxylata infection following the repair of closed olecranon fracture. L. adecarboxylata is associated with polymicrobial infections, infections in immunocompromised patients and penetrating or open wounds. Following speciation, intravenous ceftriaxone was started. Two weeks later, the patient presented with leukopenia and neutropenia. Per infectious disease recommendations, the patient was switched to intravenous ertapenem with resolution of both infection and neutropenia. The olecranon fracture went on to heal fully. CONCLUSIONS This case describes a rare postoperative monomicrobial infection with L. adecarboxylata in an immunocompetent host following musculoskeletal trauma and identifies L. adecarboxylata as a potential emerging hospital-acquired pathogen following orthopedic surgery.
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Affiliation(s)
| | | | - Sanjit R Konda
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York City, New York
| | - Nirmal C Tejwani
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York City, New York
| | - Kenneth A Egol
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York City, New York
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13
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Spiegelhauer MR, Andersen PF, Frandsen TH, Nordestgaard RLM, Andersen LP. Leclercia adecarboxylata: a case report and literature review of 74 cases demonstrating its pathogenicity in immunocompromised patients. Infect Dis (Lond) 2018; 51:179-188. [PMID: 30488747 DOI: 10.1080/23744235.2018.1536830] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Leclercia adecarboxylata is a Gram-negative bacterium belonging to the family Enterobacteriaceae. It has been described as an emerging human pathogen with the potential to cause severe infection in immunocompromised patients. The aim of this study was to describe a clinical case of infection with L. adecarboxylata and give a review of previous reports on infection. We report the presence of L. adecarboxylata in a patient initially admitted to our hospital for a lung transplant. She had diarrhoea, urinary tract infection and pneumonia caused by L. adecarboxylata. The isolate was resistant to trimethoprim-sulfamethoxazole and susceptible to 15 other antibiotics tested. The literature search for previous reports of infection with L. adecarboxylata resulted in 61 publications describing 74 cases. Bacteremia and wound infections were most often described, and only a few cases were fatal. L. adecarboxylata was most often found as a monomicrobial infection in immunocompromised patients, and as part of a polymicrobial infection in immunocompetent patients. The previously described isolates showed a high susceptibility to antibiotics, and treatment was efficient in most cases. Due to similarities in metabolic products, L. adecarboxylata might have been mistaken as Escherichia spp., but with new identification methods such as MALDI-TOF MS, it is possible to obtain a certain identification.
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Affiliation(s)
- Malene Roed Spiegelhauer
- a Department of Clinical Microbiology , Copenhagen University Hospital (Rigshospitalet) , Copenhagen , Denmark
| | - Peter Fruergaard Andersen
- b Department of Cardiothoracic Surgery , Copenhagen University Hospital (Rigshospitalet) , Copenhagen , Denmark
| | - Tove Havnhøj Frandsen
- a Department of Clinical Microbiology , Copenhagen University Hospital (Rigshospitalet) , Copenhagen , Denmark
| | | | - Leif Percival Andersen
- a Department of Clinical Microbiology , Copenhagen University Hospital (Rigshospitalet) , Copenhagen , Denmark
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14
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Choudhary M, Choudhary BK, Bhoyar S, Kale SB, Chaudhari SP, Bera BC, Jain A, Barbuddhe SB. Isolation and characterization of multidrug-resistant Leclercia species from animal clinical case. Lett Appl Microbiol 2017; 66:44-48. [PMID: 29063630 DOI: 10.1111/lam.12811] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 10/17/2017] [Accepted: 10/17/2017] [Indexed: 01/28/2023]
Abstract
Leclercia adecarboxylata, a Gram-negative bacillus of family Enterobacteriaceae, is an uncommonly identified pathogen isolated from environmental and clinical specimens. Most of the human infections are polymicrobial and commonly occur in immunocompromised hosts, although nosocomial infections in immunocompetent hosts have been documented. Here, we describe the case of isolation of Leclercia species as polymicrobial infection from bovine suffering from respiratory distress in Chhattisgarh state of India. The isolates were identified by their phenotypes, 16S rDNA sequencing and MALDI-TOF-MS. The isolate was found to be resistant to aminoglycosides and fluoroquinolone antibiotics and intermediate resistant to cephalosporins and evidenced for uncertain clinical relevance and could act as hidden source of public health hazard. SIGNIFICANCE AND IMPACT OF THE STUDY Leclercia adecarboxylata is a rarely reported human pathogen. We report here the case from bovine suffering from respiratory distress; the sample yielded Leclercia species as polymicrobial culture. The isolate was found to be multidrug resistant and evidenced for uncertain clinical relevance and could act as hidden source of public health hazard. The limited literature available on this organism is reviewed, and the potential implications of findings are discussed. To the best of our knowledge, this is the first report of isolation and characterization of multidrug-resistant Leclercia species from animal clinical case from India.
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Affiliation(s)
- M Choudhary
- ICAR-National Institute of Biotic Stress Management, Raipur, India
| | - B K Choudhary
- ICAR-National Institute of Biotic Stress Management, Raipur, India
| | - S Bhoyar
- Centre for Zoonoses, Department of Veterinary Public Health, Nagpur Veterinary College, Maharashtra Animal and Fishery Sciences University, Nagpur, India
| | - S B Kale
- Centre for Zoonoses, Department of Veterinary Public Health, Nagpur Veterinary College, Maharashtra Animal and Fishery Sciences University, Nagpur, India
| | - S P Chaudhari
- Centre for Zoonoses, Department of Veterinary Public Health, Nagpur Veterinary College, Maharashtra Animal and Fishery Sciences University, Nagpur, India
| | - B C Bera
- ICAR- National Centre for Veterinary Type Cultures, National Research Centre on Equines, Hisar, India
| | - A Jain
- Livestock Development Department, Mohala, Rajnandgaon, 491 666, India
| | - S B Barbuddhe
- ICAR-National Institute of Biotic Stress Management, Raipur, India
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15
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Riazzo C, López-Cerero L, Rojo-Martín MD, Hoyos-Mallecot Y, Fernández-Cuenca F, Martín-Ruíz JL, Pascual-Hernández Á, Naas T, Navarro-Marí JM. First report of NDM-1-producing clinical isolate of Leclercia adecarboxylata in Spain. Diagn Microbiol Infect Dis 2017; 88:268-270. [PMID: 28506721 DOI: 10.1016/j.diagmicrobio.2017.04.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 04/24/2017] [Accepted: 04/26/2017] [Indexed: 01/18/2023]
Abstract
We describe the case of NDM-1-producing Leclercia adecarboxylata recovered from the clinical sample of a patient hospitalized for a trauma-related injury to his foot. The isolate was resistant to all beta-lactams, quinolones, trimetroprim-sulfametoxazol, gentamicin and tobramicyn. The blaNDM-1 gene was located in a conjugative plasmid that also contained the blaSHV-12 gene and was preceded by a disrupted insertion sequence of ISAba125. The plasmid belongs to the incompatibility group X3, which is known to be an important vector for NDM-1 dissemination in China. This is the first reported case of NDM-1L. adecarboxylata in our country and evidences that species of uncertain clinical relevance can act as hidden sources of clinically important resistance determinants.
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Affiliation(s)
- Cristina Riazzo
- Department of Microbiology, Virgen de las Nieves University Hospital-ibs, Granada, Spain.
| | - Lorena López-Cerero
- Department of Microbiology, Virgen Macarena University Hospital, Seville, Spain
| | | | - Yannick Hoyos-Mallecot
- Bacteriology-Hygiene unit, Assistance Publique/Hôpitaux de Paris (AP-PH), Bicêtre Hospital, Le Kremlin-Bicêtre, France; Associated French National Reference Center for Antibiotic Resistance: Carbapenemase-producing Enterobacteriaceae, Le Kremlin-Bicêtre, France; EA7361 "Structure, dynamic, function and expression of broad spectrum β-lactamases", Université Paris-Sud, Université Paris-Saclay, LabEx LERMIT, Faculty of Medicine, Le Kremlin-Bicêtre, France
| | | | - Jose Luis Martín-Ruíz
- Department of Preventive Medicine, Virgen de las Nieves University Hospital, Granada, Spain
| | | | - Thierry Naas
- Bacteriology-Hygiene unit, Assistance Publique/Hôpitaux de Paris (AP-PH), Bicêtre Hospital, Le Kremlin-Bicêtre, France; Associated French National Reference Center for Antibiotic Resistance: Carbapenemase-producing Enterobacteriaceae, Le Kremlin-Bicêtre, France; EA7361 "Structure, dynamic, function and expression of broad spectrum β-lactamases", Université Paris-Sud, Université Paris-Saclay, LabEx LERMIT, Faculty of Medicine, Le Kremlin-Bicêtre, France; Joint Research Unit EERA «Evolution and Ecology of Resistance to Antibiotics», Institut Pasteur - APHP - Université Paris Sud, Paris, France
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16
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Sun F, Zhou D, Sun Q, Luo W, Tong Y, Zhang D, Wang Q, Feng W, Chen W, Fan Y, Xia P. Genetic characterization of two fully sequenced multi-drug resistant plasmids pP10164-2 and pP10164-3 from Leclercia adecarboxylata. Sci Rep 2016; 6:33982. [PMID: 27658354 PMCID: PMC5034289 DOI: 10.1038/srep33982] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 09/06/2016] [Indexed: 02/04/2023] Open
Abstract
We previously reported the complete sequence of the resistance plasmid pP10164-NDM, harboring blaNDM (conferring carbapenem resistance) and bleMBL (conferring bleomycin resistance), which is recovered from a clinical Leclercia adecarboxylata isolate P10164 from China. This follow-up work disclosed that there were still two multidrug-resistant (MDR) plasmids pP10164-2 and pP10164-3 coexisting in this strain. pP10164-2 and pP10164-3 were completely sequenced and shown to carry a wealth of resistance genes, which encoded the resistance to at least 10 classes of antibiotics (β-lactams. macrolides, quinolones, aminoglycosides, tetracyclines, amphenicols, quaternary ammonium compounds, sulphonamides, trimethoprim, and rifampicin) and 7 kinds of heavy mental (mercury, silver, copper, nickel, chromate, arsenic, and tellurium). All of these antibiotic resistance genes are associated with mobile elements such as transposons, integrons, and insertion sequence-based transposable units, constituting a total of three novel MDR regions, two in pP10164-2 and the other one in pP10164-3. Coexistence of three resistance plasmids pP10164-NDM, pP10164-2 and pP10164-3 makes L. adecarboxylata P10164 tend to become extensively drug-resistant.
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Affiliation(s)
- Fengjun Sun
- Department of Pharmacy, Southwest Hospital, the Third Military Medical University, Chongqing 400038, China
| | - Dongsheng Zhou
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
| | - Qiang Sun
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
| | - Wenbo Luo
- Department of Pharmacy, Southwest Hospital, the Third Military Medical University, Chongqing 400038, China.,State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
| | - Yigang Tong
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
| | - Defu Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China.,College of Food Science and Project Engineering, Bohai University, Jinzhou 121013, China
| | - Qian Wang
- Department of Pharmacy, Southwest Hospital, the Third Military Medical University, Chongqing 400038, China
| | - Wei Feng
- Department of Pharmacy, Southwest Hospital, the Third Military Medical University, Chongqing 400038, China
| | - Weijun Chen
- Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing, 100029, China
| | - Yahan Fan
- Transfusion Department, Southwest Hospital, the Third Military Medical University, Chongqing 400038, China
| | - Peiyuan Xia
- Department of Pharmacy, Southwest Hospital, the Third Military Medical University, Chongqing 400038, China
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17
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Prakash MR, Ravikumar R, Patra N, Indiradevi B. Hospital-acquired pneumonia due to Leclercia adecarboxylata in a neurosurgical centre. J Postgrad Med 2016; 61:123-5. [PMID: 25766348 PMCID: PMC4943433 DOI: 10.4103/0022-3859.153108] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Leclercia adecarboxylata, a gram-negative bacillus of the Enterobacteriaceae family, is an uncommonly identified human pathogen. The organism has been reported worldwide and isolated from various environmental sources. Most human infections are polymicrobial and commonly occur in immunocompromised hosts, although nosocomial infections in immunocompetent hosts have been documented. We describe three case reports of L. adecarboxylata isolation from cases of hospital acquired pneumonia admitted to a tertiary care center for neurosurgical care.
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Affiliation(s)
| | - R Ravikumar
- Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
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18
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Anuradha M. Leclercia adecarboxylata isolation: case reports and review. J Clin Diagn Res 2014; 8:DD03-4. [PMID: 25653951 PMCID: PMC4316257 DOI: 10.7860/jcdr/2014/9763.5260] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 11/10/2014] [Indexed: 11/24/2022]
Abstract
Leclercia adecarboxylata is usually isolated as a part of polymicrobial cultures in immunocompetent patients, and as a pure culture in immunocompromised persons. Although generally sensitive to most antibiotics, there are reports of resistant strains. Two case reports of L. adecarboxylata isolation in the lab in pure culture in immunocompetent persons are presented here, L. adecarboxylata being isolated from a vaginal swab in the first case and from a gluteal abscess in the second case. Both the isolates were sensitive to most of the antibiotics tested.
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Affiliation(s)
- Mokkapati Anuradha
- Associate Professor, Department of Microbiology, Apollo Institute of Medical Sciences and Research, Jubilee Hills, Hyderabad, India
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19
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Leclercia adecarboxylata Bacteremia in a Patient with Ulcerative Colitis. Case Rep Gastrointest Med 2014; 2014:457687. [PMID: 25405041 PMCID: PMC4227368 DOI: 10.1155/2014/457687] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 10/13/2014] [Indexed: 12/22/2022] Open
Abstract
Patients with inflammatory bowel disease (IBD) are a high risk population for bacteremia. Derangement in the mucosal architecture of the gastrointestinal (GI) tract and frequent endoscopic interventions in immunocompromised individuals are considered primary causes. Isolation of opportunistic microorganisms from the bloodstream of IBD patients has been increasingly reported in recent years. Leclercia adecarboxylata is a ubiquitous, aerobic, motile, gram-negative bacillus. The human GI tract is known to harbor this rarely pathogenic microorganism. There are only a few case reports of bacteremia with this microorganism; the majority are either polymicrobial or associated with immunocompromised patients. We describe a case of monomicrobial L. adecarboxylata bacteremia in a 43-year-old female who presented with bloody diarrhea. Colonoscopy revealed diffuse colonic mucosal inflammation with numerous ulcers, and histopathology revealed crypt abscesses. Following an episode of rectal bleeding, two sets of blood cultures grew L. adecarboxylata, which was treated with intravenous ceftriaxone. After a complicated hospital course, she was eventually diagnosed with ulcerative colitis and enteropathic arthritis, treated with intravenous methylprednisolone, mesalamine, and infliximab which resulted in resolution of her symptoms. In our previously immunocompetent patient, derangement of the gut mucosal barrier was the likely cause of bacteremia, yet performing endoscopic intervention may have contributed to bacterial translocation.
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20
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Abstract
Leclercia adecarboxylata infection is rarely reported in the context of human infections. In the scant cases reported in the literature, it usually involves individuals who are immunocompromised with infections of a polymicrobial nature. Recently, data have begun to accumulate suggesting that L. adecarboxylata is a pathogen associated with water environments. We review the literature regarding L. adecarboxylata infections and present a case of cellulitis and soft-tissue infection in the foot of a healthy surfer.
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21
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Jean SS, Lee WS, Bai KJ, Lam C, Hsu CW, Chen RJ, Hsueh PR. Leclercia adecarboxylata bacteremia in a patient with long-term use of nonsteroidal anti-inflammatory drugs. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2013; 49:452-4. [PMID: 24183991 DOI: 10.1016/j.jmii.2013.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 09/10/2013] [Indexed: 01/04/2023]
Abstract
Leclercia adecarboxylata, a ubiquitous Gram-negative bacillus, is generally viewed as an opportunistic pathogen because it is rarely cultured from clinical samples. Although rare, bacteremia due to L. adecarboxylata tends to occur in immunocompromised hosts and patients with systemic comorbidities. Only one case of bacteremia due to L. adecarboxylata has been reported in a previously healthy patient. We describe a male patient with an active peptic ulcer who developed L. adecarboxylata bacteremia after a long-term use of nonsteroidal anti-inflammatory drugs. The abdomen is believed to have been the most probable portal of entry. After appropriate medical management, the patient recovered without sequela.
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Affiliation(s)
- Shio-Shin Jean
- Department of Emergency Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Wen-Sen Lee
- Division of Infectious Diseases, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Kuan-Jen Bai
- Department of Pulmonary and Critical Care Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Carlos Lam
- Department of Emergency Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chin-Wang Hsu
- Department of Emergency and Critical Medicine, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan
| | - Ray-Jade Chen
- Departments of Emergency and Critical Care Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Po-Ren Hsueh
- Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
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22
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Nelson MU, Maksimova Y, Schulz V, Bizzarro MJ, Gallagher PG. Late-onset Leclercia adecarboxylata sepsis in a premature neonate. J Perinatol 2013; 33:740-2. [PMID: 23986093 DOI: 10.1038/jp.2013.34] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 02/15/2013] [Indexed: 12/22/2022]
Abstract
The epidemiology, etiology and outcome of neonatal sepsis are changing over time. While monitoring longitudinal trends in neonatal sepsis in our institution, we encountered a case of late-onset neonatal sepsis due to Leclercia adecarboxylata. A Gram-negative rod previously not encountered in the clinical setting, L. adecarboxylata has recently emerged as a human pathogen, primarily in immunosuppressed patients. This report describes the clinical and laboratory features of this case of late-onset L. adecarboxylata sepsis, and reviews significant features of infection associated with this emerging pathogen.
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Affiliation(s)
- M U Nelson
- Division of Perinatal Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06520, USA
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23
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De Mauri A, Chiarinotti D, Andreoni S, Molinari GL, Conti N, De Leo M. Leclercia adecarboxylata and catheter-related bacteraemia: review of the literature and outcome with regard to catheters and patients. J Med Microbiol 2013; 62:1620-1623. [PMID: 23882033 DOI: 10.1099/jmm.0.059535-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Infection is a common complication in patients carrying a central venous catheter (CVC) and is associated with increased morbidity and mortality. Leclercia adecarboxylata is an unusual but emerging pathogen in healthy and immunocompromised patients. We report a case of L. adecarboxylata bacteraemia in a patient with a haemodialysis tunnelled CVC. In accordance with the susceptibility to the tested antimicrobials, a long-course treatment with intravenous gentamicin plus amoxicillin-clavulanic acid and gentamicin-lock therapy was adopted. The patient had a full recovery and the catheter was not removed. We also performed a systematic PubMed/Medline and Scopus review of peer-reviewed English papers on L. adecarboxylata infections, focusing on bacteraemia in patients with different types of CVCs. Moreover, we suggest a treatment algorithm to preserve the patient and maintain the CVC.
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Affiliation(s)
- Andreana De Mauri
- Nephrology and Dialysis Unit, University Hospital 'Maggiore della Carità', Novara, Italy
| | - Doriana Chiarinotti
- Nephrology and Dialysis Unit, University Hospital 'Maggiore della Carità', Novara, Italy
| | - Stefano Andreoni
- Microbiology and Virology Laboratory, University Hospital 'Maggiore della Carità', Novara, Italy
| | - Gian Lorenzo Molinari
- Microbiology and Virology Laboratory, University Hospital 'Maggiore della Carità', Novara, Italy
| | - Novella Conti
- Nephrology and Dialysis Unit, University Hospital 'Maggiore della Carità', Novara, Italy
| | - Martino De Leo
- Nephrology and Dialysis Unit, University Hospital 'Maggiore della Carità', Novara, Italy
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24
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Tam V, Nayak S. Isolation of Leclercia adecarboxylata from a wound infection after exposure to hurricane-related floodwater. BMJ Case Rep 2012; 2012:bcr-2012-007298. [PMID: 23109419 DOI: 10.1136/bcr-2012-007298] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A man in his early 80s presented to our emergency department with painless redness and swelling in his right leg. One week prior, he cleaned up floodwater in his basement after Hurricane Irene passed the Mid-Atlantic region of the USA in August 2011. Physical examination included large purple bullae and raised concern for necrotising fasciitis. Wound culture revealed a polymicrobial infection including Leclercia adecarboxylata.
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Affiliation(s)
- Vernissia Tam
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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25
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Catheter-related bacteremia caused by multidrug-resistant Leclercia adecarboxylata in a patient with breast cancer. J Clin Microbiol 2012; 50:3129-32. [PMID: 22760051 DOI: 10.1128/jcm.00948-12] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report a multidrug-resistant strain of Leclercia adecarboxylata responsible for catheter-related bacteremia in a 47-year-old female with breast cancer. The isolated strain was resistant to several β-lactams, aminoglycosides, and folate pathway inhibitors and harbored bla(TEM-1) and bla(CTX-M) group 1 and intl1 genes (dfrA12-orfF-aadA2) as genetic determinants for resistance. Based on a review of the L. adecarboxylata literature, there have been only 4 reports of antibiotic-resistant strains. To our knowledge, this is the first report of an L. adecarboxylata strain with simultaneous resistance to β-lactams, aminoglycosides, and sulfonamides.
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