Leclercia adecarboxylata cellulitis in a child with acute lymphoblastic leukemia

Leclercia adecarboxylata in a Patient With Newly Diagnosed Chronic Lymphocytic Leukemia

Leclercia adecarboxylata is a Gram-negative bacillus commonly seen in immunocompromised individuals and often misdiagnosed as Escherichia coli. L. adecarboxylata is an opportunistic pathogen found in aquatic environments. It is a nonfatal infection that has low virulence and endorses susceptibility to many common antibiotics. We report a case of a 53-year-old immunocompromised male who was managed for L. adecarboxylata bacteremia.

Leclercia Adecarboxylata and Pseudomonas Oryzihabitans Infection after Achilles Tendon Repair: A Case Report and Literature Review

Leclercia adecarboxylata and Pseudomonas oryzihabitans are two bacteria rarely seen in human infections. We present an unusual case of a patient who developed a localized infection with these bacteria after repair of a ruptured Achilles tendon. We also present a review of the literature regarding infection with these bacteria within the lower extremity.

Monomicrobial Joint Infection by Leclercia adecarboxylata in an Immunocompetent Patient After Knee Arthroscopy: A Case Report

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.

Fulminant Sepsis Caused by Leclercia adecarboxylata in a Premature Neonate: Case Report and Review of the Literature

Hospital-acquired infections are especially evident in premature infants because of prolonged stays and the need for invasive procedures. Leclercia adecarboxylata is an uncommon emerging Gram-negative bacterium that has been described in catheter and noncatheter-related infections, immunocompromised patients and less frequently affecting healthy subjects. We report a case with a postmortem diagnosis of a 24-week-old premature neonate who died as a complication of nosocomial sepsis related to an infection by L. adecarboxylata. Although the cases of L. adecarboxylata infection in children have been rarely reported, this case appears to be the first in which an infection by L. adecarboxylata is accompanied by focal spontaneous ileal perforation.

Leclercia adecarboxylata catheter-related bacteraemia in an immunocompromised patient

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.

Leclercia adecarboxylata: An Emerging Pathogen Among Pediatric Infections

Leclercia adecarboxylata is a gram-negative bacillus of the Enterobacteriaceae family. It is a rare human pathogen that is often acquired via wound and/or contact with aquatic environment. Although multiple cases of L. adecarboxylata infections are described in the adult population, few have been documented in pediatrics. We will present two cases of L. adecarboxylata infections in the pediatric population. The first is a case of cellulitis in an 11-year-old male patient after a penetrating wound. The second is a first-documented urinary tract infection in a 16-year-old male patient with chronic kidney disease. Both patients were successfully treated with antibiotics and surgical intervention, if necessary. These cases highlight the growing emergence of this bacterium in the pediatric population and the need to become more aware of its threat even in patients who are immunocompetent.

Leclercia adecarboxylata Cholecystitis with Septic Shock in Immunocompetent Patient

L. adecarboxylata is a Gram-negative rod previously named Escherichia adecarboxylata, isolated as normal flora in the gut of animals including human stool. Most reported cases refer to immunocompromised patients with polymicrobial infections and water environments. Here we present a case of 51-year-old immunocompetent female presented with nausea, vomiting, malaise, and subjective fever for few days. On examination, she was drowsy but arousable and oriented to person, place, time, and situation. Her abdomen was tender globally and more tender in the epigastric area. Vitals showed a temperature of 37°C, pulse of 110 beats/min, blood pressure of 75/50 mmHg, and oxygen saturation of 91% on room air. An HIV panel and hepatitis panel were negative. Liver and gallbladder ultrasound was performed, revealing multiple nonmobile stones with shadowing noted within the gallbladder sac, a thickened gallbladder wall, and a moderate amount of pericholecystic fluid. Broad spectrum antibiotics, crystalloid fluids, and vasopressors were initiated. A few hours after admission she developed respiratory failure for which she underwent endotracheal intubation. An ultrasound guided gallbladder drain was performed. Culture of the biliary fluid yielded pure growth of pan-sensitive L. adecarboxylata; antibiotics were narrowed accordingly. The patient was on the maximum doses of vasopressin, norepinephrine, and epinephrine with a blood pressure of 75/45 and a mean arterial pressure of 51. She passed away on the fourth day of admission.

Leclercia adecarboxylata: a case report and literature review of 74 cases demonstrating its pathogenicity in immunocompromised patients

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.

Isolation and characterization of multidrug-resistant Leclercia species from animal clinical case

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.

First report of NDM-1-producing clinical isolate of Leclercia adecarboxylata in Spain

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 bla_NDM-1 gene was located in a conjugative plasmid that also contained the bla_SHV-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.

Leclercia adecarboxylata Musculoskeletal Infection in an Immune Competent Pediatric Patient: An Emerging Pathogen?

Case. An immune competent pediatric patient presented with a persistent lower extremity infection with Leclercia adecarboxylata after a penetrating injury. This case report details the presentation, clinical course, and treatment. Conclusion. Leclercia adecarboxylata has increasing reports in immunosuppressed and adult patients with musculoskeletal infection. This case now indicates that Leclercia adecarboxylata is a potential pathogen in immune competent children in musculoskeletal tissue.

Leclercia adecarboxylata Sepsis and Cerebral Herniation

Leclercia adecarboxylata, a gram-negative bacillus of the Enterobacteriaceae family, is rarely identified as a pathogen in humans. We describe a fatal case of L adecarboxylata sepsis in a child. This is the first reported pediatric death associated with infection due to L adecarboxylata.

Is Leclercia adecarboxylata a new and unfamiliar marine pathogen?

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.

Late-onset Leclercia adecarboxylata sepsis in a premature neonate

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.

Catheter-related bacteremia caused by multidrug-resistant Leclercia adecarboxylata in a patient with breast cancer

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.

Late-onset Leclercia adecarboxylata bacteraemia in a premature infant in the NICU

Late-onset sepsis is a unique entity in the neonatal intensive care unit (NICU), as organisms involved are, by definition, nosocomial. As such, a limited number of microbes are characteristically involved. Leclercia adecarboxylata is a gram-negative bacillus rarely cultured in a clinical context, with the few published cases primarily involving immunocompromised adults. We present an ex-26-week newborn girl who developed late-onset sepsis with Leclercia adecarboxylata bacteraemia in the NICU. The infection was successfully treated with gentamicin and cefotaxime. This is the fifth paediatric report of Leclercia adecarboxylata infection, and the first in a neonate. The case raises the possibility that prior courses of antibiotics may have predisposed this individual to a rare infection essentially limited to immunocompromised individuals.

CONCLUSION

Leclercia adecarboxylata is a rare infection, particularly in immunocompetent individuals. In neonates, the clinical course can be good with timely initiation of appropriate antibiotics.