1
|
Huang Q, Zhang J, Liao G, Li D. Clinical Characteristics of Abdominal Infections Caused by Raoultella Spp.: A Retrospective Study. Surg Infect (Larchmt) 2024. [PMID: 39193772 DOI: 10.1089/sur.2024.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2024] Open
Abstract
Background: In recent years, Raoultella spp. have attracted clinical attention as a new type of pathogen. The most common of human infection with Raoultella are bacteremia, urinary tract infections, abdominal infections, etc. Abdominal infection is a serious and complex infection problem. However, there have been no systematic reports of abdominal infections caused by Raoultella. The objective of this study was to explore the clinical characteristics of Raoultella abdominal infections and provide a reference for clinical practice. Methods: A review of publications on abdominal infections caused by the genus Raoultella between 2009 and 2024 is carried out. This review studied seven parameters: infection type, number of cases, gender, age, comorbidities, treatment, and outcome, and descriptive statistical methods were used to analyze the results. Results: A total of 40 cases (16 Raoultella ornithinolytica and 24 Raoultella planticola) were analyzed: 20 cases of biliary tract infection, 5 cases of liver infection, and 4 cases of peritonitis. Fever and abdominal pain were the main symptoms, and some patients present with multiple skin flushes, systemic erythema. Of the 40 cases, 92.5% of patients had underlying diseases. Among them, malignant disease, immunodeficiency, and invasive operations increase the risk of infection. On the basis of the drug susceptibility results, the preferred antibiotics are quinolone, third generations of cephalosporins, carbapenems, and aminoglycoside. Last, patients with abdominal infections caused by Raoultella spp. mostly have a good prognosis after early use of sensitive antibiotics. Conclusions: According to existing literature reports, the main type of abdominal infection caused by Raoultella is biliary tract infection, and most patients have other underlying diseases. Malignancy, immune deficiency, and invasive procedures are risk factors for bacterial infections. This review also emphasizes that Raoultella spp. is a rarely found opportunistic pathogen, which can cause a high incidence of healthcare-associated infections after invasive procedures.
Collapse
Affiliation(s)
- Qiuxia Huang
- The Central Hospital of Shaoyang, Shaoyang, China
| | - Jihong Zhang
- The Central Hospital of Shaoyang, Shaoyang, China
| | - Gang Liao
- The Central Hospital of Shaoyang, Shaoyang, China
| | - Daitian Li
- The Central Hospital of Shaoyang, Shaoyang, China
| |
Collapse
|
2
|
Dadana S, Jadav RS, Kondapalli A. COVID-19 Bullous Lung Disease Superinfection by Raoultella planticola. Cureus 2023; 15:e39910. [PMID: 37404396 PMCID: PMC10317198 DOI: 10.7759/cureus.39910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2023] [Indexed: 07/06/2023] Open
Abstract
Bullous lung lesions from coronavirus disease 2019 (COVID-19) pneumonia, causing pneumothorax, are a rare complication, affecting up to 1% of infected patients. Raoultella planticola is an aerobic, gram-negative bacteria known to cause opportunistic infection. We present a rare case of spontaneous pneumothorax from rupture of lung bulla as a late sequela from COVID-19 pneumonia and superinfection of the bulla by R. planticola. Although superinfection of bullous lesions is known, this is the first reported case of R. planticola pneumonia in a patient with COVID-19 lung bullae. COVID-19 patients are at heightened risk for bullous lung lesions and superinfection by opportunistic organisms; thus, they should be followed up closely.
Collapse
Affiliation(s)
- Sriharsha Dadana
- Internal Medicine, Cheyenne Regional Medical Center, Cheyenne, USA
| | | | | |
Collapse
|
3
|
Goggins A, Lykins J, Aston A, Shaw J. Acute cholecystitis secondary to Raoultella ornithinolytica infection, complicated by sepsis, gallbladder perforation, hepatic abscess and bacteraemia. BMJ Case Rep 2022; 15:e250766. [PMID: 36581355 PMCID: PMC9806088 DOI: 10.1136/bcr-2022-250766] [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] [Indexed: 12/31/2022] Open
Abstract
Herein, a case of an immunocompromised patient in his early 70s is discussed who presented with clinical signs and symptoms compatible with sepsis from an intra-abdominal source and who was found to have blood cultures positive for the encapsulated Gram-negative pathogen Raoultella ornithinolytica, with the source of infection determined, via imaging, to be a case of acute cholecystitis complicated by gallbladder perforation, multiple pericholecystic and hepatic abscesses, and persistent bacteraemia. To our knowledge, this represents the first described case of cholecystitis and gallbladder perforation directly attributed to this species, and highlights both the pathogen's capacity to cause severe disease as well as the utility of a multidisciplinary approach to achieve optimal patient outcome.
Collapse
Affiliation(s)
- Alexander Goggins
- Department of Internal Medicine, Virginia Commonwealth University Health System, Richmond, Virginia, USA
| | - Joseph Lykins
- Department of Internal Medicine, Virginia Commonwealth University Health System, Richmond, Virginia, USA
- Emergency Medicine, Virginia Commonwealth University Health System, Richmond, Virginia, USA
| | - Adam Aston
- Department of Internal Medicine, Virginia Commonwealth University Health System, Richmond, Virginia, USA
| | - Jawaid Shaw
- Department of Internal Medicine, Virginia Commonwealth University Health System, Richmond, Virginia, USA
| |
Collapse
|
4
|
A Rare Case of Raoultella planticola and Enterococcus casseliflavus Coinfection. Case Rep Infect Dis 2022; 2022:3377331. [PMID: 35656361 PMCID: PMC9152405 DOI: 10.1155/2022/3377331] [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: 11/04/2021] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 11/21/2022] Open
Abstract
Raoultella planticola, a Gram-negative bacterium, is a nonmotile rod usually found in soil and aquatic environments. It can be found in association with gastrointestinal malignancy. Enterococcus casseliflavus is a rare vancomycin-resistant Enterococcus that is responsible for some bacteremia. Our case describes a unique presentation of colonization with both R. planticola and E. casseliflavus isolated from the biliary stent isolates of a patient with known pancreatic malignancy and concomitant E. casseliflavus bacteremia. This is the first case ever reported of infection with both species.
Collapse
|
5
|
Li Y, Qiu Y, Gao Y, Chen W, Li C, Dai X, Zhang L. Genetic and virulence characteristics of a Raoultella planticola isolate resistant to carbapenem and tigecycline. Sci Rep 2022; 12:3858. [PMID: 35264602 PMCID: PMC8907287 DOI: 10.1038/s41598-022-07778-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/16/2022] [Indexed: 01/29/2023] Open
Abstract
Raoultella planticola is an emerging pathogen causing several infections in humans, and its roles in the propagation of antibiotic resistance genes (ARGs) remain uncharacterized. In this study, a carbapenem and tigecycline-resistant R. planticola isolate was recovered from hospital sewage. It carried nine plasmids, bearing 30 ARGs, including one blaKPC-2 and two blaNDM-1. It also contained a plasmid-borne efflux pump gene cluster, tmexCD1-toprJ, conferring resistance to tigecycline. Analysis of plasmid sequences revealed that both blaNDM-1-carrying plasmids were highly similar to those recovered from humans, reinforcing the close relatedness of environmental and clinical isolates. We also identified that plasmid bearing blaNDM-1 or tmexCD1-toprJ1 was transferable, and can be stabilized in the host bacteria, indicating that the R. planticola isolate has a considerable potential in the dissemination of ARGs. Besides, we found that this isolate could produce biofilm and was virulent in a Galleria mellonella infection model. In conclusion, our study shows the convergence of virulence and multidrug resistance in a R. planticola isolate. This potentially virulent superbug may disseminate into its receiving rivers, and finally to humans through cross-contamination during recreation activities or daily use of water, which poses a risk to public health.
Collapse
Affiliation(s)
- Ying Li
- The School of Basic Medical Science and Public Center of Experimental Technology, Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Yichuan Qiu
- The School of Basic Medical Science and Public Center of Experimental Technology, Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Yan Gao
- The School of Basic Medical Science and Public Center of Experimental Technology, Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Wenbi Chen
- The School of Basic Medical Science and Public Center of Experimental Technology, Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Chengwen Li
- The School of Basic Medical Science and Public Center of Experimental Technology, Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Xiaoyi Dai
- The School of Basic Medical Science and Public Center of Experimental Technology, Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Luhua Zhang
- The School of Basic Medical Science and Public Center of Experimental Technology, Southwest Medical University, Luzhou, 646000, Sichuan Province, China.
| |
Collapse
|
6
|
Blihar D, Phuu P, Kotelnikova S, Johnson E. Bacteremic cholangitis due to Raoultella planticola complicating intrahepatic bile duct stricture 5 years post-laparoscopic cholecystectomy: a case report. J Med Case Rep 2021; 15:152. [PMID: 33823908 PMCID: PMC8025561 DOI: 10.1186/s13256-021-02762-0] [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] [Received: 11/28/2019] [Accepted: 02/25/2021] [Indexed: 11/21/2022] Open
Abstract
Background Raoultella Planticola is a facultative anaerobic, gram-negative, water- and soil-dwelling rod bacterium rarely reported as a cause of human disease. However, the number of reported R. planticola infections is growing, without a concomitant increase in research on the microbe or its pathogenesis. Previous genomic studies demonstrating genetic similarities between R. planticola and Klebsiella pneumoniae suggest that capsule biosynthesis, mucoid phenotype, biofilm production, and lipopolysaccharide (endotoxin) synthesis may all be potential virulence factors of R. planticola. We present a unique case of R. planticola infection of the biliary tract 5 years after biliary surgery in a patient with no previously documented risk factors. We also use in silico techniques to predict virulence factors of R. planticola. Case presentation This case report is the first to discuss a R. planticola infection in the biliary tract of late onset post-surgery (5 years) in a Caucasian patient with no previously documented risk factors. Conclusions An in-depth search of the current literature did not yield other similar cases of R. planticola infections. Moreover, to the best of our knowledge, our case is the first case of R. planticola isolated from post-endoscopic retrograde cholangiopancreatography (ERCP) as part of biliary sepsis not associated with gastroenteritis. The late onset of the infection in our patient and the results of the in silico analysis suggest that R. planticola may have survived exposure to the host immune system through the creation of an intracellular biofilm or in a non-culturable but viable state (NCBV) for the 5-year period. The in silico analysis also suggests that biofilms, enterobactin, and mucoid phenotype may play a role in the pathogenesis of R. planticola. However, further research is needed to illuminate the significance of pili, capsule biosynthesis, and lipopolysaccharide (LPS) in the virulence of R. planticola. Lastly, as our patient did not have any risk factors previously associated with R. planticola, we suggest that biliary tract stricture, cholecystitis, and prior surgery may be possible novel risk factors.
Collapse
Affiliation(s)
- David Blihar
- School of Medicine, St George University, True Blue, St. George, Grenada.
| | - Phenyo Phuu
- School of Medicine, St George University, True Blue, St. George, Grenada
| | | | - Edward Johnson
- School of Medicine, St George University, True Blue, St. George, Grenada
| |
Collapse
|
7
|
Hong G, Yong HJ, Lee D, Kim DH, Kim YS, Park JS, Jee YK. Clinical characteristics and treatment outcomes of patients with pneumonia caused by Raoultella planticola. J Thorac Dis 2020; 12:1305-1311. [PMID: 32395267 PMCID: PMC7212158 DOI: 10.21037/jtd.2020.02.56] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Raoultella planticola, considered to be an environmental organism, is a rare cause of human infections. Although in recent years the frequency of R. planticola infections reported in the literature has increased, few cases of pneumonia caused by R. planticola have been described. Here, we investigate the clinical characteristics, management, and clinical outcomes of pneumonia caused by R. planticola. Methods Consecutive patients with pneumonia caused by R. planticola were included. The medical records of patients with R. planticola pneumonia treated at Dankook University Hospital from January 2011 to December 2017 were collected. Results A total of 11 adult patients with R. planticola pneumonia were diagnosed and treated [10 males and 1 female; median age, 70 years (range: 51-79 years)]; 5 patients had underlying malignant conditions (45.5%). Antibacterial susceptibility testing showed that all isolates of R. planticola were susceptible to cephalosporins, carbapenems, fluoroquinolones, aminoglycosides, and beta-lactams/beta-lactamase inhibitors. Chest imaging revealed consolidation (8/11, 72.7%), ground-glass opacity (5/11, 45.5%), pleural effusion (5/11, 45.5%), and micronodules (3/11, 27.3%). Four patients (36.4%) required mechanical ventilation; three survived but one died of multiple organ dysfunction syndrome (principally pneumonia and septic shock). Conclusions R. planticola pneumonia occurred mainly in patients with underlying risk factors such as malignant disease, cerebral infarction or hemorrhage, and chronic obstructive pulmonary disease. The organism was sensitive to most antibiotics, and the clinical outcomes were favorable after empirical antibiotic therapy.
Collapse
Affiliation(s)
- Goohyeon Hong
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, South Korea
| | - Ho Jin Yong
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, South Korea
| | - Dabee Lee
- Department of Chest Radiology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, South Korea
| | - Doh Hyung Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, South Korea
| | - Youn Seup Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, South Korea
| | - Jae-Suk Park
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, South Korea
| | - Young Koo Jee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, South Korea
| |
Collapse
|
8
|
Al-Sawaf O, Garcia-Borrega J, Vehreschild JJ, Thelen P, Fätkenheuer G, Shimabukuro-Vornhagen A, Kochanek M, Böll B. Pelvic cellulitis caused by Raoultella planticola in a neutropenic patient. J Infect Chemother 2018; 25:298-301. [PMID: 30482700 DOI: 10.1016/j.jiac.2018.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 09/08/2018] [Accepted: 09/25/2018] [Indexed: 11/25/2022]
Abstract
Raoultella planticola is a gram-negative, encapsulated, aerobic bacterium within the Enterobacteriaceae family. It has been primarily described as pathogen in cases with pneumonia and gastrointestinal infections. Here we describe a case of severe pelvic cellulitis in a patient with neutropenia following induction therapy for myeloid sarcoma. The patient experienced a septic shock and was treated successfully with antibiotic therapy. A literature review is provided to put this case in context with previous reports on R. planticola. This report highlights that awareness for uncommon pathogens is crucial in the clinical management of infections in neutropenic patients.
Collapse
Affiliation(s)
- O Al-Sawaf
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; Department I of Internal Medicine, Critical Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - J Garcia-Borrega
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; Department I of Internal Medicine, Critical Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - J J Vehreschild
- Department I of Internal Medicine, Division of Infectious Diseases, University Hospital of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn - Cologne, Cologne, Germany
| | - P Thelen
- Institute for Medical Microbiology, Immunology and Hygiene, University Hospital of Cologne, Cologne, Germany
| | - G Fätkenheuer
- Department I of Internal Medicine, Division of Infectious Diseases, University Hospital of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn - Cologne, Cologne, Germany
| | - A Shimabukuro-Vornhagen
- Department I of Internal Medicine, Critical Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - M Kochanek
- Department I of Internal Medicine, Critical Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - B Böll
- Department I of Internal Medicine, Critical Care Medicine, University Hospital of Cologne, Cologne, Germany.
| |
Collapse
|
9
|
AlSweed A, Alghamdi A, Tufenkeji H, Al-Hajjar S. The first case of Raoultella planticola infective endocarditis in a 4 year old child: A case report and review of literature. Int J Pediatr Adolesc Med 2018; 5:28-30. [PMID: 30805529 PMCID: PMC6363258 DOI: 10.1016/j.ijpam.2017.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 12/24/2017] [Accepted: 12/31/2017] [Indexed: 12/02/2022]
Abstract
Infective endocarditis is a complication of bacteremia that can lead to serious morbidity and even mortality if not appropriately treated, well known organisms commonly lead to this condition in many repeated scenarios so they are usually recognized and treated, but if it was caused by other organisms its detection and treatment can be harder. Raoultella planticola, a low virulent organism used to be part of the Klebsiella species, has been found in many reports to cause multiple human conditions. In this article, a novel case of R. planticola is reported, and the organism was reviewed in many aspects for clinician to be able to recognize this infection and manage it in a more effective way.
Collapse
Affiliation(s)
- Abdulrahman AlSweed
- Department of Pediatrics, Section of Infectious Disease, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | | | | | | |
Collapse
|
10
|
Naganathan G, Amin NK. Raoultella Planticola associated necrotizing appendicitis: A novel case report. Int J Surg Case Rep 2018; 44:38-41. [PMID: 29475169 PMCID: PMC5928031 DOI: 10.1016/j.ijscr.2018.01.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Revised: 01/14/2018] [Accepted: 01/27/2018] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Raoultella Planticola is a gram negative, aerobic, rod bacteria found in water and soil and is rarely reported to cause infections in humans. This case study is the first of its kind in reporting R. planticola appendicitis. PRESENTATION OF CASE We report a case of a woman presenting with a two-day history of increased weakness, fatigue and anorexia, localized pain to the right lower quadrant, and elevated white blood cell count. CT results demonstrated acute uncomplicated appendicitis which was managed via laparoscopic appendectomy. The patient became febrile on the day of the procedure and was found to have R. planticola bacteremia which was treated with amoxicillin-clavulanate. She was discharged on postoperative day two and reported an unremarkable recovery at her five-week follow-up appointment. DISCUSSION R. planticola is a common organism that is rarely, though increasingly, associated with human infection. Interestingly, prior to hospitalization, this patient did not have any risk factors commonly associated with R. planticola infection, such as seafood consumption. However, she may have had gastrointestinal tract colonization with R. planticola prior to onset of appendicitis and appendectomy. Bacteremia likely resulted from micro-perforation of the appendix. CONCLUSION Although infection with R. planticola is typically benign when treated appropriately, this pathogen has homology with Klebsiella species, and has the potential to acquire antimicrobial resistance. The case presented here suggests that R. planticola should be considered as a potential source of bacteremia in inflammatory/infectious gastrointestinal tract diseases even in the absence of typical risk factors.
Collapse
Affiliation(s)
- Gayathri Naganathan
- Michael G Degroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
| | - Nalin Kumar Amin
- Michael G Degroote School of Medicine, McMaster University, Hamilton, Ontario, Canada; Department of General Surgery, St. Joseph's Healthcare, Hamilton, Ontario, Canada
| |
Collapse
|
11
|
Is It Necessary to Specifically Define the Cause of Surgically Treated Biliary Tract Infections? A Rare Case of Raoultella planticola Cholecystitis and Literature Review. Case Rep Infect Dis 2017; 2017:4181582. [PMID: 28555166 PMCID: PMC5438854 DOI: 10.1155/2017/4181582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 02/09/2017] [Accepted: 02/16/2017] [Indexed: 11/18/2022] Open
Abstract
Raoultella planticola is an aquatic and soil organism that does not notoriously cause invasive infections in humans. Infections in the literature are limited only in case reports. We present a very rare case of R. planticola cholecystitis. A 71-year-old female patient with abdominal pain was diagnosed with acute cholecystitis. Patient received intravenous antibiotic treatment, but the treatment failed and the patient underwent an open cholecystectomy. The final pathological result was gangrenous cholecystitis complicated with R. planticola. Eventually, the patient recovered with appropriate antimicrobial therapy. Patients with acute cholecystitis are usually treated without any microbiological sampling and antibiotic treatment is started empirically. To date, there have only been 5 reported biliary system related R. planticola infections in humans. We believe that Raoultella species might be a more frequent agent than usually thought, especially in resistant cholecystitis cases. Resistant strains should be considered as a possible causative organism when the patient’s condition worsened despite proper antimicrobial therapy. It should be considered safe to send microbiological samples for culture and specifically define the causative microorganisms even in the setting of a cholecystectomized patient.
Collapse
|
12
|
Westerveld D, Hussain J, Aljaafareh A, Ataya A. A Rare Case of Raoultella planticola Pneumonia: An Emerging Pathogen. Respir Med Case Rep 2017; 21:69-70. [PMID: 28409111 PMCID: PMC5382143 DOI: 10.1016/j.rmcr.2017.03.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 03/25/2017] [Accepted: 03/27/2017] [Indexed: 11/25/2022] Open
Abstract
Raoultella planticola (R. planticola), considered an environmental organism, is a gram negative, motile, bacillus with phenotypic similarities to the genus Klebsiella. The organism remains a rare cause of human infection with a few cases reported in the literature. However, since its description in 1981 there have been increasing rates of infections caused by R. planticola with reports of conjunctivitis, liver abscess, cholangitis, pancreatitis, and necrotizing fasciitis. More concerning are reports of carbapenemase-producing isolates which have led to the only 2 mortalities associated with R. planticola infections. To our knowledge, we report the third case of R. planticola pneumonia in an immunocompromised patient with no known direct exposure to the reported risk factors.
Collapse
Affiliation(s)
- Donevan Westerveld
- University of Florida College of Medicine, Department of Internal Medicine, USA
| | - Jonathan Hussain
- University of Florida College of Medicine, Department of Internal Medicine, USA
| | - Almotasembellah Aljaafareh
- University of Florida College of Medicine, Division of Pulmonology, Critical Care and Sleep Medicine, USA
| | - Ali Ataya
- University of Florida College of Medicine, Division of Pulmonology, Critical Care and Sleep Medicine, USA
| |
Collapse
|
13
|
Merino Rodríguez E, Rebolledo Olmedo S, Miquel Plaza J. Bacteremia with Raoultella planticola in the setting of acute pancreatitis complicated with acute cholangitis. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2017; 109:479. [PMID: 28229615 DOI: 10.17235/reed.2017.4592/2016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The bacterium Raoultella planticola (R planticola) is a rare pathogen in humans. We report a case of mild acute pancreatitis (MAP) of biliary origin with cholangitis and bacteremia with R planticola in association with pancreatic panniculitis (PP). We present the case report of a 55-year-old woman.
Collapse
|
14
|
Skelton WP, Taylor Z, Hsu J. A rare case of Raoultella planticola urinary tract infection in an immunocompromised patient with multiple myeloma. IDCases 2017; 8:9-11. [PMID: 28271042 PMCID: PMC5328912 DOI: 10.1016/j.idcr.2017.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Accepted: 02/07/2017] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Raoultella planticola is a gram-negative rod associated with soil and aquatic environments that has rarely been associated with human infections. PRESENTATION OF CASE We present the case of a 73 year old female with multiple myeloma and recurrent Clostridium difficile infection who was found to have a urinary tract infection with Raoultella planticola, which has only been reported to cause 29 cases of human infections and 2 cases of urinary tract infections. DISCUSSION AND CONCLUSION Our case and literature review suggest that immunocompromised patients are predisposed to developing Raoultella planticola infection, and that this is a potential emerging pathogen.
Collapse
Affiliation(s)
- William Paul Skelton
- Department of Internal Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610, United States
- Corresponding author.
| | - Zachary Taylor
- Department of Internal Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610, United States
| | - Jack Hsu
- Division of Hematology and Oncology, Department of Internal Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610, United States
| |
Collapse
|
15
|
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.
Collapse
Affiliation(s)
- Alicja Sękowska
- Department of Microbiology, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, M. Skłodowskiej-Curie 9, 85-094, Bydgoszcz, Poland.
| |
Collapse
|
16
|
Pan Z, Liu R, Zhang P, Zhou H, Fu Y, Zhou J. Combination of Tigecycline and Levofloxacin for Successful Treatment of Nosocomial Pneumonia Caused by New Delhi Metallo-β-Lactamase-1-Producing Raoultella planticola. Microb Drug Resist 2016; 23:127-131. [PMID: 27754764 DOI: 10.1089/mdr.2015.0346] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Raoultella planticola is a gram-negative bacterium that rarely causes diseases in humans. Here, we present a case of hospital-acquired pneumonia caused by R. planticola that likely originated in the gastrointestinal tract. To the best of our knowledge, this is the second report describing the detection of the gene New Delhi Metallo-β-lactamase-1 (blaNDM-1) in multidrug-resistant R. planticola. Clinical samples were collected for bacterial culture and antimicrobial susceptibility testing from a patient during hospitalization. The presence of blaNDM-1 was detected by PCR and sequencing. An NDM-1-positive R. planticola was isolated from the sputum and stool of the same patient. Further findings confirmed that blaNDM-1 was located on a plasmid. Isolates from the sputum and stool cultures were identical, suggesting that the R. planticola may have originated in the gastrointestinal tract. The patient completely recovered and was discharged after treatment with tigecycline combined with levofloxacin, for a week. In conclusion, R. planticola is a possibly underestimated pathogen that contributes to the spread of the blaNDM-1 gene. Early and precise identification of this pathogen can lead to better prognosis of the associated infections and an improved approach to controlling the spread of carbapenemase-resistant gram-negative bacteria.
Collapse
Affiliation(s)
- Zhijie Pan
- The First Affiliated Hospital, College of Medicine, Zhejiang University , Hangzhou, China
| | - Rong Liu
- The First Affiliated Hospital, College of Medicine, Zhejiang University , Hangzhou, China
| | - Pei Zhang
- The First Affiliated Hospital, College of Medicine, Zhejiang University , Hangzhou, China
| | - Hua Zhou
- The First Affiliated Hospital, College of Medicine, Zhejiang University , Hangzhou, China
| | - Yiqi Fu
- The First Affiliated Hospital, College of Medicine, Zhejiang University , Hangzhou, China
| | - Jianying Zhou
- The First Affiliated Hospital, College of Medicine, Zhejiang University , Hangzhou, China
| |
Collapse
|
17
|
Sitaula S, Shahrrava A, Al Zoubi M, Malow J. The first case report of Raoultella planticola liver abscess. IDCases 2016; 5:69-71. [PMID: 27516968 PMCID: PMC4975706 DOI: 10.1016/j.idcr.2016.07.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 07/26/2016] [Accepted: 07/26/2016] [Indexed: 11/24/2022] Open
Abstract
Raoultella species are a group of gram-negative, non-motile bacilli commonly isolated from the environment. The group was considered a member of the genus Klebsiella until the late 1990s. Raoultella planticola is a rare cause of human infections. We report the first case of liver abscess caused by this organism. The patient was successfully treated with appropriate antimicrobials combined with operative drainage.
Collapse
Affiliation(s)
- Sujata Sitaula
- Department of Internal Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL, USA
| | - Anahita Shahrrava
- Department of Internal Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL, USA
| | - Moamen Al Zoubi
- Department of Internal Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL, USA
| | - James Malow
- Department of Infectious Disease, Advocate Illinois Masonic Medical Center, Chicago, IL, USA
| |
Collapse
|
18
|
de Campos FPF, Guimarães TB, Lovisolo SM. Fatal pancreatic pseudocyst co-infected by Raoultella planticola: an emerging pathogen. AUTOPSY AND CASE REPORTS 2016; 6:27-31. [PMID: 27547740 PMCID: PMC4982781 DOI: 10.4322/acr.2016.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 04/14/2016] [Indexed: 12/31/2022] Open
Abstract
Raoultella planticola is an aerobic Gram-negative bacterium belonging to the Enterobacteriaceae family. Initially identified in the 1980s, its pathogenic potential was further recognized when the first case of bacteremia was reported. Since then, only a few infections caused by this pathogen have been described. Although considered an opportunistic agent, fatal outcomes are associated with the infection by this pathogen, since it is more prevalent among the patients with immunodeficiency. The authors report the case of a middle-aged man diagnosed with end-stage renal disease and alcoholic pancreatitis, who was admitted to the emergency department with septic shock. Physical examination disclosed peritoneal irritation and a laparotomy was undertaken. Purulent peritonitis was found as well as a retroperitoneal abscess, which was drained. The postoperative period was troublesome, and the patient died. The autopsy showed a ruptured, infected pancreatic cyst and purulent peritonitis, among other findings. The culture of the peritoneal fluid and two blood sample sets were positive for R. planticola. The authors call attention to the importance of this emerging pathogen associated with severe gastrointestinal infections.
Collapse
Affiliation(s)
| | - Tiago Borges Guimarães
- Anatomic Pathology Department - Faculty of Medicine - University of São Paulo, São Paulo/SP - Brazil
| | - Silvana Maria Lovisolo
- Anatomic Pathology Service - Hospital Universitário - University of São Paulo, São Paulo/SP - Brazil
| |
Collapse
|
19
|
Four cases of Raoultella planticola conjunctivitis. Eye (Lond) 2016; 30:632-4. [PMID: 26742869 DOI: 10.1038/eye.2015.260] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Accepted: 10/29/2015] [Indexed: 12/26/2022] Open
Abstract
AIMS This brief report of four cases of conjunctivitis caused by Raoultella planticola provides a description of possibly the first documented cases of this eye infection. METHODS The laboratory database and medical records were used to trace all the R. planticola-positive conjunctival swabs obtained in our institution. Four cases were identified and available relevant information was obtained. RESULTS This organism causes a non-specific purulent conjunctivitis that seems to have a benign course and tends to be responsive to a topical fluoroquinolone. CONCLUSIONS The possibility of atypical organisms must be considered when managing infective conjunctivitis. Conjunctival swabs should be obtained and topical treatment switched when initial empirical therapy fails.
Collapse
|
20
|
Cho YJ, Jung EJ, Seong JS, Woo YM, Jeong BJ, Kang YM, Lee E. A Case of Pneumonia Caused by Raoultella planticola. Tuberc Respir Dis (Seoul) 2015; 79:42-5. [PMID: 26770234 PMCID: PMC4701793 DOI: 10.4046/trd.2016.79.1.42] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 09/18/2015] [Accepted: 10/08/2015] [Indexed: 11/24/2022] Open
Abstract
Raoultella species are gram-negative, non-motile, aerobic bacilli that are primarily considered as environmental bacteria. Raoultella planticola is reportedly a rare cause of human infections. Also, the definite pathological mechanism of Raoultella planticola is currently unknown. We report a case of pneumonia caused by Raoultella planticola.
Collapse
Affiliation(s)
- Young Jun Cho
- Department of Internal Medicine, Seoul Red Cross Hospital, Seoul, Korea
| | - Eun Jung Jung
- Department of Internal Medicine, Seoul Red Cross Hospital, Seoul, Korea
| | - Ji Seok Seong
- Department of Internal Medicine, Seoul Red Cross Hospital, Seoul, Korea
| | - Yong Moon Woo
- Department of Internal Medicine, Seoul Red Cross Hospital, Seoul, Korea
| | - Beom Jin Jeong
- Department of Internal Medicine, Seoul Red Cross Hospital, Seoul, Korea
| | - Yeong Mo Kang
- Department of Internal Medicine, Seoul Red Cross Hospital, Seoul, Korea
| | - Eun Lee
- Department of Internal Medicine, Seoul Red Cross Hospital, Seoul, Korea
| |
Collapse
|
21
|
Kim SW, Kim JE, Hong YA, Ko GJ, Pyo HJ, Kwon YJ. Raoultella planticola peritonitis in a patient on continuous ambulatory peritoneal dialysis. Infection 2015; 43:771-5. [PMID: 25958102 DOI: 10.1007/s15010-015-0788-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 04/25/2015] [Indexed: 11/28/2022]
Abstract
A 65-year-old man on continuous ambulatory peritoneal dialysis was admitted with peritonitis. Empirical antibiotic therapy was initiated, and Raoultella planticola was identified in the peritoneal fluid culture. We treated the patient with intraperitoneally administered ciprofloxacin and ceftazidime according to the antibiotic susceptibility. His condition improved, and he was well treated with a 2-week antibiotic course.
Collapse
Affiliation(s)
- Sun Woo Kim
- Division of Nephrology, Department of Internal Medicine, Korea University, Seoul, South Korea
| | - Ji Eun Kim
- Division of Nephrology, Department of Internal Medicine, Korea University, Seoul, South Korea
| | - Yu Ah Hong
- Division of Nephrology, Department of Internal Medicine, Korea University, Seoul, South Korea
| | - Gang Jee Ko
- Division of Nephrology, Department of Internal Medicine, Korea University, Seoul, South Korea
| | - Heui Jung Pyo
- Division of Nephrology, Department of Internal Medicine, Korea University, Seoul, South Korea
| | - Young Joo Kwon
- Division of Nephrology, Department of Internal Medicine, Korea University, Seoul, South Korea.
| |
Collapse
|
22
|
Wang JT, Wu UI, Lauderdale TLY, Chen MC, Li SY, Hsu LY, Chang SC. Carbapenem-nonsusceptible Enterobacteriaceae in Taiwan. PLoS One 2015; 10:e0121668. [PMID: 25794144 PMCID: PMC4368706 DOI: 10.1371/journal.pone.0121668] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 02/03/2015] [Indexed: 11/18/2022] Open
Abstract
A total of 1135 carbapenem-resistant (nonsusceptible) Enterobacteriaceae (CRE) isolates were recovered between November 2010 and July 2012 (517 from 2010-2011 and 618 from 2012) from 4 hospitals in Taiwan. Carbapenemase-producing Enterobacteriaceae (CPE) comprised 5.0% (57 isolates), including 17 KPC-2 (16 Klebsiella pneumoniae and 1 Escherichia coli), 1 NDM-1 (K. oxytoca), 37 IMP-8 (26 Enterobacter cloacae, 4 Citrobacter freundii, 4 Raoultella planticola, 1 K. pneumoniae, 1 E. coli and 1 K. oxytoca), and 2 VIM-1 (1 E. cloacae, 1 E. coli). The KPC-2-positive K. pneumoniae were highly clonal even in isolates from different hospitals, and all were ST11. IMP-8 positive E. cloacae from the same hospitals showed higher similarity in PFGE pattern than those from different hospitals. A total of 518 CRE isolates (45.6%) were positive for blaESBL, while 704 (62.0%) isolates were blaAmpC-positive, 382 (33.6% overall) of which carried both blaESBL and blaAmpC. CTX-M (414, 80.0%) was the most common blaESBL, while DHA (497, 70.6%) and CMY (157, 22.3%) were the most common blaAmpC. Co-carriage of blaESBL and blaAmpC was detected in 31 (54.4%) and 15 (26.3%) of the 57 CPE, respectively. KPC-2 was the most common carbapenemase detected in K. pneumoniae (2.8%), while IMP-8 was the most common in E. cloacae (9.7%). All KPC-2-positive CRE were resistant to all three tested carbapenems. However, fourteen of the 37 IMP-8-positive CRE were susceptible to both imipenem and meropenem in vitro. Intra- and inter-hospital spread of KPC-2-producing K. pneumoniae and IMP-8-producing E. cloacae likely occurred. Although the prevalence of CPE is still low, careful monitoring is urgently needed. Non-susceptibility to ertapenem might need to be considered as one criterion of definition for CRE in areas where IMP type carbapenemase is prevalent.
Collapse
Affiliation(s)
- Jann-Tay Wang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Un-In Wu
- Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan
| | - Tsai-Ling Yang Lauderdale
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Mei-Chen Chen
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | | | - Le-Yin Hsu
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Shan-Chwen Chang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
- * E-mail:
| |
Collapse
|
23
|
Colangitis y bacteriemia por Raoultella planticola. Med Clin (Barc) 2015; 144:231-2. [DOI: 10.1016/j.medcli.2014.04.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 04/23/2014] [Accepted: 04/24/2014] [Indexed: 11/22/2022]
|
24
|
Low virulence? Clinical characteristics of Raoultella planticola bacteremia. Infection 2014; 42:899-904. [PMID: 25047268 DOI: 10.1007/s15010-014-0664-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Accepted: 07/05/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE Numerous case reports regarding Raoultella planticola infection have accumulated in the literature; however, its significance as a clinical pathogen remains unknown. We performed a retrospective review of R. planticola bacteremia to characterize its clinical features, antimicrobial susceptibility, and patient outcome. METHODS Raoultella planticola bacteremia cases were culled from an electronic database of all bacteremia cases occurring over a 4-year-period. Medical records were retrospectively reviewed and demographic data, clinical findings, presence of underlying disease, results of antimicrobial susceptibility testing, and the antibiotic regimens administered during the treatment were evaluated. RESULTS Raoultella planticola was isolated from blood culture specimens in 20 cases. The majority of these patients had underlying malignant conditions (17 patients, 85%). The most prevalent causes of malignancy were adenocarcinoma involving the gallbladder or bile duct (7 patients) and hematologic malignancies (6 patients). No cases with resistance to carbapenem or third generation cephalosporins were found. All 14 patients with R. planticola as the sole microbial isolate recovered with the use of empirical antibiotics. Of the six patients with polymicrobial infection, three did not recover and subsequently expired. CONCLUSIONS Raoultella planticola bacteremia seemed to occur mainly in immunocompromised patients, and was also frequently found in patients with lesions involving the gallbladder or bile duct. The overall outcome was favorable when R. planticola was treated with administration of empirical antibiotics. Mixed outcomes were found when blood cultures yielded multiple species of microbes.
Collapse
|
25
|
Emerging pathogen: a case and review of Raoultella planticola. Infection 2014; 42:1043-6. [PMID: 24902523 DOI: 10.1007/s15010-014-0638-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 05/19/2014] [Indexed: 10/25/2022]
Abstract
Raoultella planticola has been considered a relatively harmless Gram-negative bacteria, rarely associated with clinical infection. However, in recent years, the frequency at which severe infection by R. planticola and drug-resistant strains are reported in literature has increased. Here, we present one case of acute cholecystitis caused by R. planticola, and review all previously reported cases of the infection in an attempt to identify new trends in biological and clinical features of R. planticola infections.
Collapse
|
26
|
Nada B, Areej M. Raoultella planticola, a central venous line exit site infection. J Taibah Univ Med Sci 2014. [DOI: 10.1016/j.jtumed.2013.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
27
|
A novel case of chronic conjunctivitis in a 58-year-old woman caused by Raoultella. Infection 2014; 42:927-9. [PMID: 24865691 DOI: 10.1007/s15010-014-0624-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 04/11/2014] [Indexed: 11/27/2022]
Abstract
A 58-year-old woman presented to eye emergency with a chronic conjunctivitis which was diagnosed by laboratory microbiological testing to be due to the environmental pathogen Raoultella planticola. The organism was sensitive to Chloramphenicol and the patient made a rapid recovery on these drops. This is the first report of this organism infecting the eye.
Collapse
|
28
|
Kocovski L, Fernandes JR. Acute Fatal Peritonitis: A New Organism for Consideration. Acad Forensic Pathol 2012. [DOI: 10.23907/2012.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A 40-year-old man died suddenly and unexpectedly at home. His comorbid conditions included central diabetes insipidus, obesity, and hypertension. Autopsy revealed acute and chronic pancreatitis with an abscess and associated purulent peritonitis. Peritoneal fluid cultures grew Raoultella planticola and a light growth of Candida albicans. The organism isolated, R. planticola, is a waterborne bacterium with limited previous clinical isolates causing morbidity but no previously described mortality. Vitreous humor analysis demonstrated concomitant acute water intoxication complicating the decedent's diabetes insipidus. Discussion includes a review of the literature with a description of the eight previous cases of human infection with R. planticola, a recently described organism that was previously in the genus Klebsiella. The proposed fatal pathogenesis includes retrograde entry of the organism from the gastrointestinal tract via the pancreatic duct to the pancreas and subsequent peritonitis. This is the first reported fatality caused by this organism.
Collapse
Affiliation(s)
- Linda Kocovski
- Medical Director of the Regional Forensic Pathology Unit Hamilton Health Sciences and Pathology and Molecular Medicine at McMaster University in Hamilton Ontario Canada. Author Afilliations: Hamilton Health Sciences - Forensic Pathology, Hamilton, ON, Canada (LK)
| | - John R. Fernandes
- Medical Director of the Regional Forensic Pathology Unit Hamilton Health Sciences and Pathology and Molecular Medicine at McMaster University in Hamilton Ontario Canada. Author Afilliations: Hamilton Health Sciences - Forensic Pathology, Hamilton, ON, Canada (LK)
| |
Collapse
|
29
|
Hu AY, Leslie KA, Baskette J, Elsayed S. Raoultella planticola bacteraemia. J Med Microbiol 2012; 61:1488-1489. [DOI: 10.1099/jmm.0.041129-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Amy Yichen Hu
- Department of Pharmacy Services, London Health Sciences Centre, London ON, Canada
| | - Kenneth Anderson Leslie
- Department of Surgery, Division of General Surgery, London Health Sciences Centre and University of Western Ontario, London ON, Canada
| | - John Baskette
- Department of Pharmacy Services, London Health Sciences Centre, London ON, Canada
| | - Sameer Elsayed
- Department of Medicine, Division of Infectious Diseases, London Health Sciences Centre, and Departments of Medicine, Microbiology & Immunology, and Pathology, University of Western Ontario, London ON, Canada
| |
Collapse
|