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Wound infection with multidrug-resistant Providencia rettgeri: About a case report and littérature review
S Belmahi1,2, A Saddari1,2, H Zrouri1,2
1Laboratory of Microbiology, Faculty of Medicine and Pharmacy (University Mohammed the First), Oujda, Morocco.
Introduction And Importance:
Providencia rettgeri, a member of the Morganellaceae family within the Enterobacterales order, is predominantly associated with urinary tract infections in hospitalized individuals, particularly those with indwelling urinary catheters. However, wound infections caused by P. rettgeri are exceedingly rare, with an estimated incidence of around 0.1 %. Here, we present a case of wound infection in a healthy child caused by P. rettgeri, highlighting the rarity of the organism and emphasizing the importance of prompte identification and appropriate antibiotic therapy.
Case Report:
A 4-year-old child presented with a soft tissue abscess in the left calf, following an injury sustained from a tree trunk a few days prior. The patient underwent wound debridement and abscess drainage, followed by empirical antibiotic therapy with amoxicillin and clavulanic acid. Bacteriological samples collected intraoperatively revealed colonies of P. rettgeri, identified with high certainty using the BD Phoenix™ 100 automated system. Antimicrobial susceptibility testing showed resistance to several antibiotics but sensitivity to third-generation cephalosporins, amikacin, and aztreonam. Antibiotic therapy was adjusted accordingly, leading to clinical improvement and discharge after ten days of hospitalization.
Discussion:
P. rettgeri, a Gram-negative bacillus, is a rare causative agent of wound infections. While predominantly associated with nosocomial urinary tract infections, it can rarely lead to various other infections, including wound infections, particularly in hospitalized or immunocompromised individuals. Resistance to multiple antibiotics, including carbapenems, poses challenges in treatment selection.
Conclusion:
This case underscores the importance of considering P. rettgeri as a potential pathogen in wound infections, even in healthy individuals. Awareness of its presence and antibiotic susceptibility patterns is crucial for appropriate management and prevention of complications. Further studies are warranted to elucidate the epidemiology and clinical significance of P. rettgeri infections in different patient populations.
Insights
Providencia rettgeri is a rare cause of wound infections, even in healthy children. Prompt identification and appropriate antibiotic therapy are crucial for managing these uncommon infections.
Area of Science:
- Medical Microbiology
- Infectious Diseases
Background:
- Providencia rettgeri, a Gram-negative bacillus from the Morganellaceae family, is primarily linked to nosocomial urinary tract infections, especially in catheterized patients.
- Wound infections caused by P. rettgeri are exceptionally rare, with an estimated incidence of approximately 0.1%.
Observation:
- A case report details a 4-year-old healthy child who developed a soft tissue abscess in the left calf following a tree trunk injury.
- Intraoperative samples identified P. rettgeri, which showed resistance to several antibiotics but sensitivity to third-generation cephalosporins, amikacin, and aztreonam.
Findings:
- The identified P. rettgeri strain exhibited a challenging antimicrobial resistance profile.
- Successful treatment involved adjusting antibiotic therapy to sensitive agents, leading to clinical improvement.
Implications:
- This case highlights the importance of considering P. rettgeri in wound infections, even in immunocompetent individuals.
- Accurate identification and antimicrobial susceptibility testing are vital for effective management and preventing complications associated with P. rettgeri infections.
