ABSTRACT
Leclercia adecarboxylata is a Gram-negative bacterium belonging to the Enterobacteriaceae family. To our knowledge, this is the first report of a carbapenem-resistant L. adecarboxylata strain isolated from a healthy newborn. The L. adecarboxylata strain isolated in this study carried four plasmids that may serve as reservoirs for antibiotic resistance genes. Plasmids 2 and 4 did not harbor any antimicrobial resistance genes. Plasmid 3 is a novel plasmid containing three resistance genes. The bla IMP gene harbored in the strain was most similar to bla IMP-79 at the nucleotide level, with a similarity of 99.4% (737/741). This case highlights the importance of considering L. adecarboxylata as a potential cause of infections in children.
Subject(s)
Infant, Newborn , Child , Humans , Female , Enterobacteriaceae Infections/microbiology , Enterobacteriaceae/genetics , Anti-Bacterial Agents/therapeutic use , PlasmidsABSTRACT
Las infecciones causadas por Leclercia adecarboxylata (L. adecarboxylata) son raramente reportadas en la literatura. Se trata de una enterobacteria anaerobia Gram-negativa que presenta distribución universal y, si bien suele ser parte de infecciones polimicrobianas, existen reportes crecientes de infecciones únicamente por este germen en pacientes inmunocomprometidos.Se reporta el caso de un paciente masculino de 8 años con leucemia linfoblástica aguda, que presentó una colonización de catéter por L. adecarboxylata, en el que se realizó tratamiento sin extracción del dispositivo, con evolución favorable
Infections caused by Leclercia adecarboxylata are rarely reported. It is an anaerobic Gram-negative enterobacteria with universal distribution, and although it is mostly found in polymicrobial infections, monomicrobial infections caused by this bacteria, especially in immunocompromised hosts, have been recently reported.We present the case of an 8-year-old patient, with acute lymphoid leukemia, that suffered a catheter colonization by L. adecarboxylata. He received antibiotic treatment without removal of the device with complete resolution of infectio
Subject(s)
Humans , Male , Child , Enterobacteriaceae , Catheter-Related Infections , Leukemia, Lymphoid , Immunocompromised HostABSTRACT
Leclercia adecarboxylata is a member of the Enterobacteriaceae family that has been isolated from several environmental and animal specimens, however it rarely causes diseases in human beings. It has natural resistance to several antibiotics, and has shown the ability to harbor and produce enzymes capable of hydrolyzing most of the antibiotics used in daily clinical practice, making its treatment a challenge when a strain with such characteristics causes disease. Here we report the first known case of infection by Leclercia adecarboxylata after a trauma with plant material, in a 69-year-old male patient, with poorly controlled Diabetes Mellitus type 2.
Leclercia adecarboxylata es un miembro de la familia Enterobacteriaceae que ha sido aislada tanto de muestras de animales como medioambientales, sin embargo raramente produce enfermedad en seres humanos. Tiene resistencia natural a varios antibióticos y se ha encontrado que tiene enzimas capaces de hidrolizar la mayoría de los antibióticos utilizados en la práctica clínica, lo cual hace un verdadero tratar una infección por este microorganismo en humanos. Aquí reportamos el primer caso de infección por Leclercia adecarboxylata luego de un trauma con material vegetal, en un paciente de 69 años y con una diabetes tipo 2, mal controlada.
Subject(s)
Humans , Male , Aged , Soft Tissue Infections , Enterobacteriaceae , Gram-Negative Aerobic Rods and Cocci , Diabetes Mellitus, Type 2 , Literature , Anti-Bacterial AgentsABSTRACT
PURPOSE: To report a case of corneal ulcer caused by Leclercia adecarboxylata in an immunocompetent patient. CASE SUMMARY: A previously healthy 43-year-old female presented with right ocular pain and was referred to our clinic under the impression of corneal abrasion and secondary infection. The patient was treated at a local clinic for 3 days using artificial tears, therapeutic contact lens, topical antibiotics, and anti-inflammatory eye drops but showed no improvement. Gram staining, bacterial and fungal cultures and antibiotic sensitivity test were performed from a corneal scrape. The cultures revealed growth of Leclercia adecarboxylata. The patient was treated with moxifloxacin and ofloxacin eye drops. After 2 weeks of treatment, the infection resolved without remaining scars. CONCLUSIONS: Reportedly, Leclercia adecarboxylata affects humans only as an opportunistic pathogen or part of polymicrobial infections. However, in the present case, Leclercia adecarboxylata was isolated as a single pathogen in an immunocompetent patient which is the first clinical report of this microorganism found in an ocular sample. Therefore, if antibiotic-susceptible gram-negative bacilli are found in opthalmologic samples, the above bacteria should be considerd in the diagnosis.
Subject(s)
Adult , Female , Humans , Anti-Bacterial Agents , Bacteria , Cicatrix , Coinfection , Corneal Ulcer , Diagnosis , Enterobacteriaceae , Ofloxacin , Ophthalmic SolutionsABSTRACT
Leclercia adecarboxylata is a facultative gram negative bacillus of the Enterobacteriaceae family. It has been previously reported as a rarely isolated opportunistic pathogen, mainly in the form of mixed infection with other organisms. We report two cases of independent infection by L. adecarboxylata. One strain of L. adecarboxylata was isolated from Baker's cyst in an immunocompetent patient and the other strain from dialysate in a patient on continuous ambulatory peritoneal dialysis.
Subject(s)
Humans , Bacillus , Coinfection , Enterobacteriaceae , Peritoneal Dialysis, Continuous Ambulatory , Popliteal Cyst , Sprains and StrainsABSTRACT
Leclercia adecarboxylata is a facultative gram negative bacillus of the Enterobacteriaceae family. It has been previously reported as a rarely isolated opportunistic pathogen, mainly in the form of mixed infection with other organisms. We report two cases of independent infection by L. adecarboxylata. One strain of L. adecarboxylata was isolated from Baker's cyst in an immunocompetent patient and the other strain from dialysate in a patient on continuous ambulatory peritoneal dialysis.
Subject(s)
Humans , Bacillus , Coinfection , Enterobacteriaceae , Peritoneal Dialysis, Continuous Ambulatory , Popliteal Cyst , Sprains and StrainsABSTRACT
BACKGROUND: During a 1-month period in 2005 , a series of 4 Leclercia adecarboxylata and 8 Pseudomonas aeruginosa bacteremias were reported from patients admitted to the emergency room. METHODS: An outbreak of L. adecarboxylata and P. aeruginosa bacteremia that occurred from February to March 2005 was investigated. The infection control nurse reviewed medical records and observed the procedures of blood cultures at the clinical microbiology laboratory. Specimens were obtained for investigational cultures from alcohol sponge, tray, sink, water of sink, saline cotton, microscope, computer, and telephone. RESULTS: L. adecarboxylata was isolated from 4 patients and P. aeruginosa from 8 patients during a 1-month period. Observation of the culture procedure revealed that saline cotton was used to prevent betadin skin discoloration. The culture of the saline solution yielded a heavy growth of P. aeruginosa, which was not isolated from any other specimens. CONCLUSIONS: This was a pseudoepidemic caused by contaminated saline cotton. The use of the saline cotton was stopped, and during the follow-up period of 3 months, no additional L. adecarboxylata or P. aeruginosa bacteremia were reported.
Subject(s)
Humans , Bacteremia , Emergency Service, Hospital , Enterobacteriaceae , Follow-Up Studies , Infection Control , Medical Records , Porifera , Pseudomonas aeruginosa , Skin , Sodium Chloride , Telephone , WaterABSTRACT
Leclercia adecarboxylata and Escherichia hermannii are motile, gram-negative facultative anaerobic bacilli which have rarely been isolated from environmental and clinical specimens. Although several cases of L. adecarboxylata or E. hermannii infections have been reported, a confirmed case of Hickman catheter-associated bacteremia has, to our knowledge, never been reported. A 69-year old woman completed her fourth schedule of chemotherapy for the treatment of leiomyosarcoma and was discharged without complication. However, she suffered from fever and chills for three weeks soon after the completion of chemotherapy and visited the emergency department. A Hickman catheter was promptly removed and the catheter tip was submitted to semiquantitative culture, as well as three sets of blood cultures from three different peripheral veins. Mixed growth of L. adecarboxylata and E. hermannii was isolated from Hickman catheter tip culture and all three sets of blood cultures.
Subject(s)
Aged , Female , Humans , Appointments and Schedules , Bacteremia , Catheters , Chills , Drug Therapy , Emergency Service, Hospital , Enterobacteriaceae , Escherichia , Fever , Leiomyosarcoma , VeinsABSTRACT
A 60-year-old male with continuous ambulatory peritoneal dialysis was admitted because of abdominal discomfort and turbid dialysate. He had a history of chronic renal failure due to diabetic nephropathy. His WBC count of perpheral blood was 8,500/mm3 (neutrophil 92%), and that of dialysate was 1,400/mm3 (polymorphonuclear leukocyte 69%, lymphocyte 31%). Pure growth of Leclercia adecarboxylata was isolated from dialysate. The L. adecarboxylata isolate was susceptible to ampicillin, ampicillin/sulbactam, cephalothin, cefoperazone, cefoxitin, cefotaxime, ceftazidime, aztreonam, imipenem, gentamicin, tobramycin, amikacin, tetracycline, trimethoprim- sulfamethoxazole and ciprofloxacin. Cephalothin & amikacin were added into dialysate, and his clinical symptoms and turbidity of dialysate were resolved. L. adecarboxylata has been rarely isolated from clinical specimens. To our knowledge, this is the first report of L. adecarboxylata isolated from clinical specimen in Korea. On review of the world literature, we found only 7 cases of L. adecarboxylata infections. This microorganism has been isolated from lower extremity wounds and sputum as part of a mixed flora in 3 cases and 1 case, respectively, but it was the only microorganism isolated from cultures of blood in 3 cases. These 3 patients with bacteremia due to L. adecarboxylata had severe underlying diseases, and clinical symptoms were developed after invasive procedures. All of the L. adecarboxylata isolates from clinical specimens were susceptible to antimicrobial agents tested, and the responses to antibiotic therapy were excellent. It is difficult to identify this organism because its biochemical reactions are similar to those of Escherichia coli, therefore careful identification is required. And additional studies are necessary to determine the pathogenic potential and route of infection of this organism.