Maladies neuroinfectieuses

Abstrait

Leclercia adecarboxylata: The First Reported Infection of Cerebrospinal Fluid and a Systematic Review of the Literature

Jill P Stone, Hannah St Denis-Katz, Claire Temple-Oberle, Phillipe Mercier, Jonah B Mizzau5 and Alim P Mitha

Background: Leclercia adecarboxylata is an emerging pathogen in the clinical setting. Initially considered an opportunist pathogen commonly associated with polymicrobial infections in immunocompromised individuals, recent evidence recognizes this pathogen in healthy individuals and with a growing antibiotic resistance profile. We report the first case of Leclercia adecarboxylata in cerebrospinal fluid of a young trauma patient and present a systematic review of the literature. Patient demographics and clinical history, outcomes and treatments are outlined. Methods: A systematic review identified relevant studies published through PubMed, Medline and ProQuest until July 2015. Search terms included “Leclercia adecarboxylata” and “Esherichia adecarboxylata”. Non-human cases and reports devoid of clinical infections were excluded. Results: A total of 40 articles (51 patients including the current case) were identified and included in our analysis. Patient age ranged from 24 weeks to 81 years old and included 18 female, 24 male, and 9 unknown. Immunocompromised (n=32) and healthy patients (n=15) revealed clinical isolates from blood and wound cultures most commonly (n=21 and 11). Sixteen isolates demonstrated antibiotic resistance. Thirty four cases were monomicrobial and fifteen were polymicrobial. Patient treatment and clinical outcome are reported. Conclusions: We present the most up to date review of Leclercia adecarboxylata infections. As the number of L. adecarboxylata cases continue to expand so does our insight into its pathogenicity and role in human clinical infections.