Kluyvera co-infection in two solid organ transplant recipients: an emerging pathogen or a colonizer bystander?
Kluyvera species are opportunistic, gram-negative bacilli in the family Enterobacteriaceae. Ordinarily occurring as a commensal, Kluyvera have been reported to cause serious infections in immunosuppressed and immunocompetent hosts, causing diarrhea, urinary infections, peritonitis, and cholecystitis. We report Kluyvera infections in 2 solid organ transplant recipients. An 18-year-old female with alpha-1 antitrypsin deficiency underwent living donor liver transplantation and presented 6 months later with a liver abscess. The abscess aspirate grew mixed organisms including Kluyvera cryocrescens. A 22-year-old female with renal failure secondary to focal segmental glomerulosclerosis underwent a deceased donor kidney transplant and presented 3 months later with pyelonephritis; the urine culture grew Kluyvera ascorbata. Both patients improved only when their antibiotic coverage was broadened to include Kluyvera. The isolation of Kluyvera as a pathogen in transplant patients emphasizes that this commensal organism may be virulent in this patient population.
Cheruvattath
R
R
Division of Transplantation Medicine, Mayo Clinic Hospital, Phoenix, AZ 85054, USA.
Balan
V
V
Stewart
R
R
Heilman
R L
RL
Mulligan
D C
DC
Kusne
S
S
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D044086:Kluyvera / Q000472:pathogenicity; D008100:Liver Abscess / Q000209:etiology*; D016031:Liver Transplantation / Q000009:adverse effects*; D011704:Pyelonephritis / Q000209:etiology*; D016896:Treatment Outcome; D014774:Virulence
D000900:Anti-Bacterial Agents