Kluyvera ascorbata sepsis in an extremely low birth weight infant

Area of Science:

• Microbiology
• Neonatal Medicine
• Infectious Diseases

Background:

• Kluyvera ascorbata, a Gram-negative bacterium from the Enterobacteriaceae family, is typically a commensal organism.
• Rarely, K. ascorbata can cause severe infections, particularly in vulnerable populations like neonates.
• This organism often exhibits resistance to first-line antibiotics used in neonatal intensive care units.

Observation:

• A case report details an extremely low birth weight infant presenting with sepsis, multi-organ dysfunction, shock, and pulmonary hemorrhage on day 4 of life.
• The infant exhibited elevated C-reactive protein and thrombocytopenia, indicative of severe neonatal sepsis.
• Blood cultures confirmed the presence of Kluyvera ascorbata.

Findings:

• Despite aggressive supportive care and meropenem treatment, the infant expired on day 5 of life.
• The case highlights the potential pathogenicity of K. ascorbata in neonates.
• Antimicrobial susceptibility patterns indicate that third-generation cephalosporins, fluoroquinolones, and aminoglycosides may be effective against Kluyvera strains.

Implications:

• This case underscores the importance of considering K. ascorbata in the differential diagnosis of neonatal sepsis, especially with resistant organisms.
• Further research into the virulence factors and optimal treatment strategies for K. ascorbata infections in neonates is warranted.
• Enhanced surveillance and antimicrobial stewardship are crucial for managing rare bacterial infections in neonatal intensive care units.