RESUMEN
Kluyvera is a relatively new genus, belonging to family Enterobacteriaceae. This organism colonizes mainly respiratory and gastrointestinal tract. It has also been reported from various environmental sources. Due to a rise in immune-compromised states and ease of identification using automated methods rare organisms are now being reported with their role as potential opportunistic pathogens. Meticulous detailed identification and reporting of pathogens like Klyuvera to differentiate it from other members of Enterobacteriaceae can lead to solving the pathogenic importance of such organisms. We report a case of bilateral gluteal abscess due to Kluyvera cryocrescens in an obese diabetic adult male.
RESUMEN
La Kluyvera cryocrescens es una enterobacteria gram negativa que se ha aislado del esputo, orina, secreción biliar, líquido peritoneal y sangre en los seres humanos, raramente es causa de infección clínicamente significativa. Sin embargo hay varios casos descritos en la bibliografía, donde se ha manifestado con cuadros de sepsis severa y choque séptico, algunos con adecuada respuesta a diferentes terapias antibióticas. Se presenta un caso de sepsis severa, debido a bacteriemia por Kluyvera cryocrescens, en un masculino de 73 años, y se describe su diagnóstico, tratamiento y evolución. El paciente desarrolló la infección durante su estadía hospitalaria y recibió tratamiento 10 días con cefalosporinas de tercera generación, logrando una adecuada resolución de su cuadro.
Kluyvera cryocrescens is a gram-negative enterobacteria that has been isolated from sputum, urine, bile secretion, peritoneal fluid and blood in humans, but rarely causes clinically significant infections. However, there are several cases described in the literature that have presented with symptoms of severe sepsis and septic shock, some with adequate response to different antibiotic therapies. A case of severe sepsis due to Kluyvera cryocrescens bacteremia is described in a 73 year old male, regarding his diagnosis, treatment and outcome. He develops the infection while hospitalized and received a 10 day course of a third generation cephalosporin achieving adequate resolution of the infection.
Asunto(s)
Humanos , Masculino , Adulto , Bacteriemia , Cefalosporinas , Infección Hospitalaria , Bacterias Gramnegativas , Kluyvera , Sepsis , Choque SépticoRESUMEN
OBJECTIVE To study the antimicrobial susceptibility,classification and distribution of the ?-lactamases produced by Kluyvera cryocrescens.METHODS To detect the ?-lactamases produced by 17 strains of K.cryocrescens with a multi-disk test [synergy test,and antagonized test for the inducible AmpC ?-lactamases(IABLs)],AmpC ?-lactamases(ABLs)phenotype test and extended-spectrum ?-lactamases(ESBLs) confirment test,and the susceptibility of antimicrobial agents.RESULTS The resistant rate to AMP,GEN,CFZ and SXT was 100.0%,88.2%,88.2% and 88.2%,respectively,and that to IMP,CIP and AMK was 0.0%,35.3%,and 47.1%,respectively;all of 17 strains produced the ?-lactamases(100.0%),two strains produced penicillinases(11.8%),six strains produced broad-spectrum ?-lactamases(35.3%) and nine strains produced ESBLs(52.9%),1 strain produced ABLs,and 1 strain produced ESBLs+high product ABLs,all did not produce carbapenem-hydrolyzing ?-lactamases(CHBLs).CONCLUSIONS The resistant rate of K.cryocrescens is very high,all multi-resistant.The resistant rate of K.cryocrescens to AMP,GEN,CFZ and SXT is high,but to IMP,CIP and AMK is lower.The rate of ?-lactamases produced by the 17 strains of K.cryocrescens is very high,four classes of ?-lactamases are produced by five types,mainly BSBLs and ESBLs,without CHBLs.