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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.
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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
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2
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Salgado JFM, Premkrishnan BNV, Oliveira EL, Vettath VK, Goh FG, Hou X, Drautz-Moses DI, Cai Y, Schuster SC, Junqueira ACM. The dynamics of the midgut microbiome in Aedes aegypti during digestion reveal putative symbionts. PNAS NEXUS 2024; 3:pgae317. [PMID: 39157462 PMCID: PMC11327924 DOI: 10.1093/pnasnexus/pgae317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 07/02/2024] [Indexed: 08/20/2024]
Abstract
Blood-feeding is crucial for the reproductive cycle of the mosquito Aedes aegypti, as well as for the transmission of arboviruses to hosts. It is postulated that blood meals may influence the mosquito microbiome but shifts in microbial diversity and function during digestion remain elusive. We used whole-genome shotgun metagenomics to monitor the midgut microbiome in 60 individual females of A. aegypti throughout digestion, after 12, 24, and 48 h following blood or sugar meals. Additionally, ten individual larvae were sequenced, showing microbiomes dominated by Microbacterium sp. The high metagenomic coverage allowed for microbial assignments at the species taxonomic level, also providing functional profiling. Females in the post-digestive period and larvae displayed low microbiome diversities. A striking proliferation of Enterobacterales was observed during digestion in blood-fed mosquitoes. The compositional shift was concomitant with enrichment in genes associated with carbohydrate and protein metabolism, as well as virulence factors for antimicrobial resistance and scavenging. The bacterium Elizabethkingia anophelis (Flavobacteriales), a known human pathogen, was the dominant species at the end of blood digestion. Phylogenomics suggests that its association with hematophagous mosquitoes occurred several times. We consider evidence of mutually beneficial host-microbe interactions raised from this association, potentially pivotal for the mosquito's resistance to arbovirus infection. After digestion, the observed shifts in blood-fed females' midguts shifted to a sugar-fed-like microbial profile. This study provides insights into how the microbiome of A. aegypti is modulated to fulfil digestive roles following blood meals, emphasizing proliferation of potential symbionts in response to the dynamic midgut environment.
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Affiliation(s)
- João Felipe M Salgado
- RG Insect Microbiology and Symbiosis, Max Planck Institute for Terrestrial Microbiology, Karl-von-Frisch str. 10, Marburg 35043, Germany
- Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, 373 Avenida Carlos Chagas Filho, Rio de Janeiro, RJ 21941-902, Brazil
| | - Balakrishnan N V Premkrishnan
- Singapore Center for Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, 60 Nanyang Drive, Singapore 637551, Singapore
| | - Elaine L Oliveira
- Singapore Center for Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, 60 Nanyang Drive, Singapore 637551, Singapore
| | - Vineeth Kodengil Vettath
- Singapore Center for Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, 60 Nanyang Drive, Singapore 637551, Singapore
| | - Feng Guang Goh
- Temasek Life Sciences Laboratory, National University of Singapore, 1 Research Link, Singapore 117604, Singapore
- Department of Biological Sciences, National University of Singapore, 16 Science Drive 4, Block S3, #05-01, Singapore 117558, Singapore
| | - Xinjun Hou
- Temasek Life Sciences Laboratory, National University of Singapore, 1 Research Link, Singapore 117604, Singapore
- Department of Biological Sciences, National University of Singapore, 16 Science Drive 4, Block S3, #05-01, Singapore 117558, Singapore
| | - Daniela I Drautz-Moses
- Singapore Center for Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, 60 Nanyang Drive, Singapore 637551, Singapore
| | - Yu Cai
- Temasek Life Sciences Laboratory, National University of Singapore, 1 Research Link, Singapore 117604, Singapore
- Department of Biological Sciences, National University of Singapore, 16 Science Drive 4, Block S3, #05-01, Singapore 117558, Singapore
| | - Stephan C Schuster
- Singapore Center for Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, 60 Nanyang Drive, Singapore 637551, Singapore
| | - Ana Carolina M Junqueira
- Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, 373 Avenida Carlos Chagas Filho, Rio de Janeiro, RJ 21941-902, Brazil
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3
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Huang Q, Zhang J, Liao G. Abdominal abscess caused by Raoultella ornithinolytica secondary to postoperative gastric fistula: case report and review of literature. BMC Infect Dis 2024; 24:363. [PMID: 38553710 PMCID: PMC10981363 DOI: 10.1186/s12879-024-09234-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/18/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND In recent years, Raoultella ornithinolytica (R. ornithinolytica) have attracted clinical attention as a new type of pathogen. A wide range of infections with these germs is reported, and commonly found in urinary tract infections, respiratory infections, and bacteremia. CASE PRESENTATION We report the case of an elderly woman with liver abscess, choledocholithiasis and cholangitis, who developed gastric fistula and abdominal abscess after underwent choledocholithotomy, and R. ornithinolytica were isolated from the abdominal drainage fluid. The patient was treated with meropenem and levofloxacin and had a good outcome. CONCLUSIONS To the best of our knowledge, case of isolating R. ornithinolytica from a patient with non-viscerally abdominal abscess was extremely rare. We share a case of a woman with non-viscerally abdominal abscess secondary to postoperative gastric fistula, R. ornithinolytica was isolated from the patient's pus, and the pathogenic bacteria may originate from the gastrointestinal tract. Based on this case, We should be cautious that invasive treatment may greatly increase the probability of infection with this pathogenic bacterium.
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Affiliation(s)
- Qiuxia Huang
- The Central Hospital of Shaoyang, Shaoyang, Hunan, China.
| | - Jihong Zhang
- The Central Hospital of Shaoyang, Shaoyang, Hunan, China
| | - Gang Liao
- The Central Hospital of Shaoyang, Shaoyang, Hunan, China.
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4
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Kitagawa S, Tsushima Y, Ishikawa S. Acute Obstructive Suppurative Pancreatic Ductitis Caused by Raoultella planticola: An Emerging Pathogen. Pancreas 2022; 51:e118-e119. [PMID: 37099795 DOI: 10.1097/mpa.0000000000002158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Affiliation(s)
- Sho Kitagawa
- Department of Gastroenterology, Sapporo Kosei General Hospital, Sapporo, Japan
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Overton-Hennessy ZC, Devane AM, Fiester S, Schammel N, Schammel C, Fulcher JW. Ruptured Splenic Artery Pseudoaneurysm Causing Hemorrhage Into a Pancreatic Pseudocyst. Am J Forensic Med Pathol 2022; 43:76-80. [PMID: 34510054 DOI: 10.1097/paf.0000000000000717] [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: 11/25/2022]
Abstract
ABSTRACT This case report describes fatal exsanguination due to splenic artery hemorrhage into a pancreatic pseudocyst with cystogastrostomy in a 46-year-old woman. The decedent had a complicated medical history including necrotizing pancreatitis, giant pseudocyst formation after cystogastrostomy procedure, and coiling of a hemorrhagic splenic artery. While hospitalized, she underwent embolization of a ruptured splenic artery pseudoaneurysm. Weeks later, she went into hemorrhagic shock and was ultimately pronounced at the hospital. Doctors suspected an upper gastrointestinal (GI) bleed as the cause of death; however, the patient was too unstable to undergo interventional radiology at the time.At autopsy, the pancreas was hemorrhagic and included a 15 × 15 × 15-cm pseudocyst, which contained a metallic stent from a cystogastrostomy. This case describes a unique co-occurrence of numerous common complications of chronic pancreatitis. There are multiple ways by which pancreatitis can cause upper and lower GI bleeds. In this case, the presence of a cystogastrostomy stent allowed for a ruptured pseudoaneurysm to hemorrhage through the pancreatic pseudocyst and into the stomach and duodenum, mimicking the presentation of a more common upper GI bleed. The pseudocyst then ruptured causing abdominal hemorrhage. The passage of hemorrhage through a cystogastrostomy stent is not described in other literature.
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Affiliation(s)
| | | | | | | | | | - James W Fulcher
- From the Volusia County Medical Examiner's Office, Daytona Beach, FL
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6
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Hajjar R, Schwenter F, Su SH, Gasse MC, Sebajang H. Community-acquired infection to Raoultella ornithinolytica presenting as appendicitis and shock in a healthy individual. J Surg Case Rep 2018; 2018:rjy097. [PMID: 29780575 PMCID: PMC5952952 DOI: 10.1093/jscr/rjy097] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 04/27/2018] [Indexed: 01/07/2023] Open
Abstract
Raoultella ornithinolytica and Raoultella planticola are histamine-producing bacteria that are usually found in fish and water. They are associated with scombroid syndrome that presents with vomiting and flushing. A wide range of infections with these germs is reported, but mainly in fragile hospitalized patients with multiple comorbidities. We report the case of a 54-year-old healthy patient who presented with 24-hours abdominal pain, vomiting, flushing and shock. The abdominal examination showed guarding in the right lower quadrant (RLQ), and the abdominal CT scan images showed a thickened terminal ileum and a distended appendix. The patient underwent a surgical exploration revealing a normal terminal ileum but an inflamed appendicular base. Raoultella ornithinolytica was found in blood cultures and in the liquid retrieved from the RLQ. To the best of our knowledge, this is the first report of a severe life-threatening intra-abdominal presentation due to a community-acquired R. ornithinolytica infection.
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Affiliation(s)
- Roy Hajjar
- Université de Montréal, Programme de Chirurgie Générale, Centre Hospitalier de l'Université de Montréal (CHUM), Service de Chirurgie Oncologique, Hôpital Notre-Dame, Montréal, Québec, Canada H2L 4M1
| | - Frank Schwenter
- Centre Hospitalier de l'Université de Montréal (CHUM), Service de Chirurgie Oncologique, Hôpital Hôtel-Dieu, Montréal, Québec, Canada H2W 1T8
| | - Shih-Hann Su
- Centre Hospitalier de l'Université de Montréal (CHUM), Département de microbiologie médicale et infectiologie, Hôpital Notre-Dame, Montréal, Québec, Canada H2L 4M1
| | - Marie-Christine Gasse
- Centre Hospitalier de l'Université de Montréal (CHUM), Service de Chirurgie Oncologique, Hôpital Hôtel-Dieu, Montréal, Québec, Canada H2W 1T8
| | - Herawaty Sebajang
- Centre Hospitalier de l'Université de Montréal (CHUM), Service de Chirurgie Oncologique, Hôpital Notre-Dame, Montréal, Québec, Canada H2L 4M1
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Abstract
The patient was an 81-year-old man who was found to have bacteremia due to Raoultella planticola, which might have entered the circulation through the bile duct during the passing of a gallbladder stone. In the present case, we screened for malignancies because most cases of R. planticola bacteremia occur after trauma, invasive procedures, or in patients with malignancy (70.6%). Early gastric cancer was detected. Although the association between R. planticola bacteremia and malignancy remains speculative in the present case, it may be useful to scrutinize similar cases involving low-virulence bacteremia for possible malignancies or immune conditions.
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Affiliation(s)
- Shotaro Yamamoto
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical University, Japan
- Division of Internal Medicine, Jinsekikogen Town Hospital, Japan
| | - Katsuya Nagatani
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical University, Japan
| | - Takeo Sato
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical University, Japan
| | - Takeyoshi Ajima
- Division of Internal Medicine, Jinsekikogen Town Hospital, Japan
| | - Seiji Minota
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical University, Japan
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8
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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.
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Affiliation(s)
- Abdulrahman AlSweed
- Department of Pediatrics, Section of Infectious Disease, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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9
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Yoshida N, Tsuchida Y. Palm atheroma infection caused by Raoultella planticola. BMJ Case Rep 2017; 2017:bcr-2017-222541. [PMID: 29103013 DOI: 10.1136/bcr-2017-222541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Naoki Yoshida
- Department of Orthopedic Trauma Surgery, Shonankamakura General Hospital, Kanagawa, Japan
| | - Yoshihiko Tsuchida
- Department of Orthopedic Trauma Surgery, Shonankamakura General Hospital, Kanagawa, Japan
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10
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Subedi R, Dean R, Li W, Dhamoon A. A novel case of Raoultella planticola osteomyelitis and epidural abscess. BMJ Case Rep 2017; 2017:bcr-2017-220329. [PMID: 28705846 DOI: 10.1136/bcr-2017-220329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A spinal epidural abscess is the collection of pus in the epidural space, and is a potentially life-threatening condition that requires early detection and prompt management. Almost two-thirds of cases are caused by Staphylococcus aureus, followed by Gram-negative bacilli which account for approximately 16% of cases. Raoultella planticola is an emerging pathogen, and is an extremely rare cause of invasive infection in humans. It has been reported to cause urinary tract infections, pneumonia, bacteraemia, cholangitis, cholecystitis, conjunctivitis and soft tissue infections. We report the first case, to our knowledge, of R. planticola osteomyelitis and spinal epidural abscess.
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Affiliation(s)
- Rogin Subedi
- Department of Medicine, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Ryan Dean
- Department of Medicine, SUNY Upstate Medical University, Syracuse, New York, USA
| | - William Li
- Department of Medicine, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Amit Dhamoon
- Department of Medicine, SUNY Upstate Medical University, Syracuse, New York, USA
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Bonnet E, Julia F, Giordano G, Lourtet-Hascoet J. Joint infection due to Raoultella planticola: first report. Infection 2017; 45:703-704. [PMID: 28337666 DOI: 10.1007/s15010-017-1006-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 03/08/2017] [Indexed: 11/24/2022]
Abstract
The genus Raoultella has been separated from the genus Klebsiella in 2001. Two main species are responsible for human infections: R. ornithinolytica and R. planticola. The most frequent infections due to R. planticola include cystitis, pneumonia and bacteremia (mostly in immunocompromised hosts). To date, no joint or bone infection has been reported. We describe the first case of septic arthritis due to R. planticola following an arthroscopy with intra-articular injection of corticosteroids. Evolution was favorable after arthroscopic lavage and antibiotic therapy with quinolones. Raoultella planticola has been described rarely in human infection. It is mainly deemed responsible for cystitis, pneumonia and bacteremia (mostly in immunocompromised hosts) [1-3]. To our knowledge no case of bone or joint infection has been reported. We described here the first case of infective arthritis due to R. planticola involving a native knee joint following synovectomy and intra-articular injection of corticosteroids during arthroscopy.
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Affiliation(s)
- E Bonnet
- Hôpital Joseph Ducuing, Toulouse, France.
| | - F Julia
- Clinique Toulouse Lautrec, Albi, France
| | - G Giordano
- Hôpital Joseph Ducuing, Toulouse, France
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