Kluyvera co-infection in two solid organ transplant recipients: an emerging pathogen or a colonizer bystander?

Transpl Infect Dis. 2007 Mar;9(1):83-6. doi: 10.1111/j.1399-3062.2006.00198.x.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Enterobacteriaceae Infections / drug therapy
  • Enterobacteriaceae Infections / etiology*
  • Female
  • Humans
  • Kidney Transplantation / adverse effects*
  • Kluyvera* / pathogenicity
  • Liver Abscess / etiology*
  • Liver Transplantation / adverse effects*
  • Pyelonephritis / etiology*
  • Treatment Outcome
  • Virulence

Substances

  • Anti-Bacterial Agents