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CEN Case Reports

, Volume 7, Issue 2, pp 234–236 | Cite as

Roultella ornithinolytica infection in infancy: a case of febrile urinary tract infection

  • Laura De Petris
  • Ermanno Ruffini
Case Report

Abstract

Raoultella ornithinolytica is a Gram-negative, non-motile, encapsulated, aerobic bacillus belonging to the Enterobacteriaceae family. R. ornithinolytica is a not very common, but emergent causal agent of human infection, and its expression of beta-lactamase provides resistance to commonly used antibiotics. The pathogenetic potential of R. ornithinolytica isolates in human disease has become increasingly important. Several cases of hospital-acquired infection, mostly associated with invasive procedures, or in patients with co-morbidity caused by R. ornithinolytica, have been previously reported in the adult population. In pediatric population, two cases in immunocompromised children, one case in an infant with visceral heterotaxy and one case of catheter-related bacteraemia are described. Here, we present the first case of febrile urinary tract infection due to R. ornithinolytica in an 8-month-old infant, recovered from a previous febrile UTI caused by E. coli and without co-morbidity. The empiric therapy with ceftriaxone, followed by cefpodoxime proxetil, resolved symptoms: the clinical condition of the infant improved rapidly and the treatment eradicated urine from the R. ornithinolytica infection. Since other pathogens rather than R. ornithinolytica are usually identified in children with urinary tract infections, including Escherichia coli, Proteus, Klebsiella and Pseudomonas, the identification of this microorganism in our patient’s urine was also unexpected.

Keywords

Klebsiella Raoultella ornithinolytica Urinary tract infection Childhood 

Notes

Compliance with ethical standards

Conflict of interest

All the authors have declared no competing interest.

Ethical statement

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Drancourt M, Bollet C, Carta A, Rousselier P. Phylogenetic analyses of Klebsiella species delineate Klebsiella and Raoultella gen. nov., with description of Raoultella ornithinolytica comb. nov., Raoultella terrigena comb. nov. and Raoultella planticola comb. nov. Int J Syst Evol Microbiol. 2001;51(Pt 3):925 – 32.CrossRefGoogle Scholar
  2. 2.
    Seng P, Boushab BM, Romain F, Gouriet F, Bruder N, Martin C, Paganelli F, Bernit E, Le Treut YP, Thomas P, Papazian L, Raoult D, Stein A. Emerging role of Raoultella ornithinolytica in human infections: a series of cases and review of the literature. Int J Infect Dis. 2016;45:65–71.CrossRefGoogle Scholar
  3. 3.
    Hostacká A, Klokocníková A. Antibiotic susceptibility, serum response and surface properties of Klebsiella species. Microbios. 2001;104(408):115 – 24.PubMedGoogle Scholar
  4. 4.
    Cleveland KO, Mazumder SA, Gelfand MS. Cleveland Association of Raoultella bacteremia with diseases of the biliary tract. Scand J Infect Dis. 2014;46(7):541–2.CrossRefGoogle Scholar
  5. 5.
    Yamakawa K, Yamagishi Y, Miyata K, Shimomura Y, Iwata A, Hori T, Mikamo H, Okumura A. Bacteremia caused by Raoultella ornithinolytica in two children. Pediatr Infect Dis J. 2016;35(4):452–3.CrossRefGoogle Scholar
  6. 6.
    Sękowska A, Dylewska K, Gospodarek E, Bogiel T. Catheter-related blood stream infection caused by Raoultella ornithinolytica. Folia Microbiol [Praha]. 2015;60(6):493–5.CrossRefGoogle Scholar
  7. 7.
    Mau N, Ross LA. Raoultella ornithinolytica bacteremia in an infant with visceral heterotaxy. Pediatr Infect Dis J. 2010;29(5):477–8.CrossRefGoogle Scholar
  8. 8.
    Alberici I, Bayazit AK, Drozdz D, Emre S, Fischbach M, Harambat J, Jankauskiene A, Litwin M, Mir S, Morello W, Peco-Antic A, Sallay P, Sever L, Simonetti GD, Szczesniak P, Teixeira A, Vidal E, Wuehl E, Mehls O, Weber LT, Schaefer F, Montini G, ESCAPE Study Group; PREDICT Trial. Pathogens causing urinary tract infections in infants: a European overview by the ESCAPE study group. Eur J Pediatr. 2015;174(6):783–90.CrossRefGoogle Scholar
  9. 9.
    Kanki M, Yoda T, Tsukamoto T, Shibata T. Klebsiella pneumoniae produces no histamine: Raoultella planticola and Raoultella ornithinolytica strains are histamine producers. Appl Environ Microbiol. 2002;68(7):3462–6.CrossRefGoogle Scholar
  10. 10.
    De Jong E, de Jong AS, Smidts-van den Berg N, Rentenaar RJ. Differentiation of Raoultella ornithinolytica/planticola and Klebsiella oxytoca clinical isolates by matrix-assisted laser desorption/ionization-time of flight mass spectrometry. Diagn Microbiol Infect Dis. 2013;75(4):431–3.CrossRefGoogle Scholar

Copyright information

© Japanese Society of Nephrology 2018

Authors and Affiliations

  1. 1.Department of Pediatrics and Neonatology“G. Mazzoni” HospitalAscoli PicenoItaly

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