Urosepsis caused by Kluyvera Ascorbata in a Pregnant Woman

Among the Kluyvera species, K. ascorbata has been isolated from only a few adult cases. Furthermore, there is little or no information in the literature as to whether the species of Kluyvera can cause a clinically significant infection in pregnant women. We report a case of urosepsis caused by K. ascorbata in a 23-year pregnant woman at 26 weeks of gestation who presented with left flank pain. Ultrasonography showed left grade 3 hydronephrosis, ureteral dilatation, and a 10-mm distal ureteral stone. The patient underwent laser lithotripsy and JJ placement. Ten days later, she was readmitted with urosepsis and empirical antibiotherapy and aggressive hydration were initiated. On the third day, K. ascorbata growth was detected in the urine culture. Based on the clinical status of the patient and the antimicrobial susceptibility testing, the treatment was switched to ertapenem 1×1 g/day and was continued for 14 days. Among the Kluyvera species, K. ascorbata is the most frequent pathogen which may be isolated from pregnant women and can cause urosepsis. To the best of authors' knowledge, this is the first report showing the isolation of K. ascorbata in a pregnant woman which caused urosepsis.