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Infection

, Volume 43, Issue 1, pp 59–64 | Cite as

Clinical characteristics of Raoultella ornithinolytica bacteremia

  • S. Chun
  • J. W. Yun
  • H. J. Huh
  • N. Y. LeeEmail author
Original Paper

Abstract

Purpose

Raoultella ornithinolytica is not well known as a clinical pathogen. We performed a retrospective review of R. ornithinolytica bacteremia to investigate its clinical features, antimicrobial susceptibility, and overall patient outcomes.

Methods

R. ornithinolytica bacteremia cases were collected from an electronic database of all cases of bacteremia over a 10-year period. Medical records were retrospectively reviewed. Demographic data, clinical information, the presence of underlying comorbidities, the results of antimicrobial susceptibility testing, and the antimicrobial regimen administered were investigated.

Results

R. ornithinolytica was isolated from blood culture specimens in 16 cases. The majority of these patients had an underlying malignant condition of advanced stage (15 patients, 94 %). Seven of these patients had a solid tumor with lesions or metastases that extended to the bile duct or biliary tract. Neutropenic fever following hematologic stem cell transplantation was found in three cases. No resistance to piperacillin/tazobactam or imipenem was found. Four cases showed resistance to cefoxitin, while one of these cases showed resistance to multiple cephalosporins. In overall outcomes, seven patients (44 %) did not recover from the infection and subsequently expired.

Conclusions

R. ornithinolytica bacteremia occurs mainly in patients with underlying malignancies. The overall outcome was not favorable, despite favorable antimicrobial susceptibility test results. The findings of this study contradict those of other studies that demonstrated that infection from Raoultella species have good prognoses.

Keywords

Raoultella ornithinolytica Bacteremia Microbial sensitivity test Antibacterial agents Klebsiella 

Notes

Conflict of interest

The authors have no conflicts of interest relevant to this article to report.

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;51:925–32.PubMedCrossRefGoogle Scholar
  2. 2.
    Shaikh MM, Morgan M. Sepsis caused by Raoultella terrigena. JRSM Short Rep. 2011;2:49.PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Chun S, Yun JW, Huh HJ, Lee NY. Low virulence? Clinical characteristics of Raoultella planticola bacteremia. Infection. 2014;42:899–904.PubMedCrossRefGoogle Scholar
  4. 4.
    Ershadi A, Weiss E, Verduzco E, Chia D, Sadigh M. Emerging pathogen: a case and review of Raoultella planticola. Infection. 2014. doi: 10.1007/s15010-014-0638-9.
  5. 5.
    Freney J, Fleurette J, Gruer LD, Desmonceaux M, Gavini F, Leclerc H. Klebsiella trevisanii colonisation and septicaemia. Lancet. 1984;1:909.PubMedCrossRefGoogle Scholar
  6. 6.
    Hadano Y, Tsukahara M, Ito K, Suzuki J, Kawamura I, Kurai H. Raoultella ornithinolytica bacteremia in cancer patients: report of three cases. Intern Med. 2012;51:3193–5.PubMedCrossRefGoogle Scholar
  7. 7.
    Haruki Y, Hagiya H, Sakuma A, Murase T, Sugiyama T, Kondo S. Clinical characteristics of Raoultella ornithinolytica bacteremia: a case series and literature review. J Infect Chemother. 2014;20:589–91.PubMedCrossRefGoogle Scholar
  8. 8.
    Mau N, Ross LA. Raoultella ornithinolytica bacteremia in an infant with visceral heterotaxy. Pediatr Infect Dis J. 2010;29:477–8.PubMedCrossRefGoogle Scholar
  9. 9.
    CLSI. M100-S21. Performance standards for antimicrobial susceptibility testing. 2012; 21st informational supplement.Google Scholar
  10. 10.
    Olson DS Jr, Asare K, Lyons M, Hofinger DM. A novel case of Raoultella planticola urinary tract infection. Infection. 2013;41:259–61.PubMedCrossRefGoogle Scholar
  11. 11.
    Zuberbuhler B, Abedin A, Roudsari A. A novel case of chronic conjunctivitis in a 58-year-old woman caused by Raoultella. Infection. 2014;42:927–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Garcia-Lozano T, Pascual Pla FJ, Aznar Oroval E. Raoultella ornithinolytica in urinary tract infections. Clinical and microbiological study of a s eries of 4 oncologic patients. Med Clin (Barc). 2013;141:138–9.CrossRefGoogle Scholar
  13. 13.
    Park JS, Hong KH, Lee HJ, Choi SH, Song SH, Song KH, Kim HB, Park KU, Song J, Kim EC. Evaluation of three phenotypic identification systems for clinical isolates of Raoultella ornithinolytica. J Med Microbiol. 2011;60:492–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Renaud FN, Bergeron E, Tigaud S, Fuhrmann C, Gravagna B, Freney J. Evaluation of the new Vitek 2 GN card for the identification of gram-negative bacilli frequently encountered in clinical laboratories. Eur J Clin Microbiol Infect Dis. 2005;24:671–6.PubMedCrossRefGoogle Scholar
  15. 15.
    Risch M, Radjenovic D, Han JN, Wydler M, Nydegger U, Risch L. Comparison of MALDI TOF with conventional identification of clinically relevant bacteria. Swiss Med Wkly. 2010;140:w13095.PubMedGoogle Scholar
  16. 16.
    Stock I, Wiedemann B. Natural antibiotic susceptibility of Klebsiella pneumoniae, K. oxytoca, K. planticola, K. ornithinolytica and K. terrigena strains. J Med Microbiol. 2001;50:396–406.PubMedGoogle Scholar
  17. 17.
    Meatherall BL, Gregson D, Ross T, Pitout JD, Laupland KB. Incidence, risk factors, and outcomes of Klebsiella pneumoniae bacteremia. Am J Med. 2009;122:866–73.PubMedCrossRefGoogle Scholar
  18. 18.
    Cleveland KO, Mazumder SA, Gelfand MS. Association of Raoultella bacteremia with diseases of the biliary tract. Scand J Infect Dis. 2014;46:541–2.PubMedCrossRefGoogle Scholar
  19. 19.
    de Jong E, Erkens-Hulshof S, van der Velden LB, Voss A, Bosboom R, Hodiamont CJ, Wever PC, Rentenaar RJ, Sturm PD. Predominant association of Raoultella bacteremia with diseases of the biliary tract. Scand J Infect Dis. 2014;46:141–3.PubMedCrossRefGoogle Scholar
  20. 20.
    Tempero M. Bile acids, ornithine decarboxylase, and cell proliferation in colon cancer: a review. Dig Dis. 1986;4:49–56.PubMedCrossRefGoogle Scholar
  21. 21.
    Castanheira M, Deshpande LM, DiPersio JR, Kang J, Weinstein MP, Jones RN. First descriptions of blaKPC in Raoultella spp. (R. planticola and R. ornithinolytica): report from the SENTRY antimicrobial surveillance program. J Clin Microbiol. 2009;47:4129–30.PubMedCentralPubMedCrossRefGoogle Scholar
  22. 22.
    Goncalves-Pereira J, Povoa P. Antibiotics in critically ill patients: a systematic review of the pharmacokinetics of beta-lactams. Crit Care. 2011;15:R206.PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Department of Laboratory Medicine & Genetics, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea

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