title: Clinically significant Kluyvera infections: a report of seven cases.
abstract: To determine the clinical significance of Kluyvera isolates at our institution, we retrospectively analyzed clinical microbiology data from January 1999 to September 2003. We identified 11 isolates classified as Kluyvera ascorbata, 7 of which were considered clinically significant pathogens: 3 cases represented urinary tract infections; 2, bacteremia; 1, a soft tissue infection of the finger; and 1, acute appendicitis with a subsequent intra-abdominal abscess. The age distribution of patients was wide, ranging from 2 months to 73 years. Antimicrobial susceptibility studies of the clinically significant and non-clinically significant Kluyvera isolates showed susceptibility patterns similar to those reported in the medical literature, namely trends of resistance to ampicillin and first- and second-generation cephalosporins. Of the 4 non-clinically significant isolates in our study, 1 was resistant to ciprofloxacin, a finding reported in only 1 other isolate of Kluyvera in the medical literature. Patient outcome after treatment with third-generation cephalosporins and aminoglycosides in the 7 clinically significant cases was good, with no long-term sequelae. The potential virulence of K ascorbata highlights the need for heightened scrutiny of its antimicrobial susceptibility patterns for adequate clinical treatment.
authors.affiliation: Department of Pathology, University of South Alabama, Medical Center, Mobile 36617, USA.
authors.forename: J Elliot
authors.initials: JE
authors.lastname: Carter
authors.forename: Tara N
authors.initials: TN
authors.lastname: Evans
mesh_terms: D000328:Adult; D000368:Aged; D000407:Alabama; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D006801:Humans; D007223:Infant; D044086:Kluyvera / Q000302:isolation & purification* / Q000472:pathogenicity; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies; D014774:Virulence
chemical_list: D000900:Anti-Bacterial Agents