Clinical Report: Bloodstream Infection from Multidrug-Resistant Leclercia adecarboxylata

Overview

This case study reports a catheter-associated bloodstream infection caused by multidrug-resistant Leclercia adecarboxylata in a 71-year-old patient with colon cancer. Initial treatment with cefoperazone-sulbactam was ineffective, necessitating a switch to meropenem, which led to clinical improvement.

Background

Leclercia adecarboxylata is an opportunistic pathogen that can cause severe infections, particularly in immunocompromised patients. Catheter-associated bloodstream infections (CABSI) are a significant concern in healthcare settings, especially among oncology patients. Understanding the resistance patterns of such pathogens is crucial for effective treatment and management.

Data Highlights

Key Findings

• Leclercia adecarboxylata was isolated from both peripheral blood and central venous catheter cultures.
• The patient initially received cefoperazone-sulbactam without improvement.
• Switching to meropenem resulted in clinical improvement and resolution of fever.
• Antimicrobial susceptibility testing is essential for effective treatment of multidrug-resistant infections.
• Catheter-associated bloodstream infections pose a high risk in patients with malignancies.

Clinical Implications

Healthcare providers should consider the potential for multidrug-resistant organisms like L. adecarboxylata in patients with central venous catheters, especially those with underlying malignancies. Prompt identification and sensitivity testing are critical for guiding appropriate antibiotic therapy.

Conclusion

This case underscores the importance of vigilance for multidrug-resistant infections in oncology patients and the need for tailored antimicrobial therapy based on susceptibility profiles.

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