Korean J Clin Microbiol.  1998 Sep;1(1):113-116.

A Case of Leclercia adecarboxylata Isolated from Dialysate in a Patient with Continuous Ambulatory Peritoneal Dialysis

• Hwang HY
• Jeong SH
• Rim H
• Kim MH
• Jeong TJ
• Choi BG

Abstract

A 60-year-old male with continuous ambulatory peritoneal dialysis was admitted because of abdominal discomfort and turbid dialysate. He had a history of chronic renal failure due to diabetic nephropathy. His WBC count of perpheral blood was 8,500/mm3 (neutrophil 92%), and that of dialysate was 1,400/mm3 (polymorphonuclear leukocyte 69%, lymphocyte 31%). Pure growth of Leclercia adecarboxylata was isolated from dialysate. The L. adecarboxylata isolate was susceptible to ampicillin, ampicillin/sulbactam, cephalothin, cefoperazone, cefoxitin, cefotaxime, ceftazidime, aztreonam, imipenem, gentamicin, tobramycin, amikacin, tetracycline, trimethoprim- sulfamethoxazole and ciprofloxacin. Cephalothin & amikacin were added into dialysate, and his clinical symptoms and turbidity of dialysate were resolved. L. adecarboxylata has been rarely isolated from clinical specimens. To our knowledge, this is the first report of L. adecarboxylata isolated from clinical specimen in Korea. On review of the world literature, we found only 7 cases of L. adecarboxylata infections. This microorganism has been isolated from lower extremity wounds and sputum as part of a mixed flora in 3 cases and 1 case, respectively, but it was the only microorganism isolated from cultures of blood in 3 cases. These 3 patients with bacteremia due to L. adecarboxylata had severe underlying diseases, and clinical symptoms were developed after invasive procedures. All of the L. adecarboxylata isolates from clinical specimens were susceptible to antimicrobial agents tested, and the responses to antibiotic therapy were excellent. It is difficult to identify this organism because its biochemical reactions are similar to those of Escherichia coli, therefore careful identification is required. And additional studies are necessary to determine the pathogenic potential and route of infection of this organism.

Keyword

Leclercia adecarboxylata; Continuous ambulatory peritoneal dialysis

MeSH Terms

Amikacin
Ampicillin
Anti-Infective Agents
Aztreonam
Bacteremia
Cefoperazone
Cefotaxime
Cefoxitin
Ceftazidime
Cephalothin
Ciprofloxacin
Diabetic Nephropathies
Enterobacteriaceae*
Escherichia coli
Gentamicins
Humans
Imipenem
Kidney Failure, Chronic
Korea
Leukocytes
Lower Extremity
Lymphocytes
Male
Middle Aged
Peritoneal Dialysis, Continuous Ambulatory*
Sputum
Sulfamethoxazole
Tetracycline
Tobramycin
Wounds and Injuries
Amikacin
Ampicillin
Anti-Infective Agents
Aztreonam
Cefoperazone
Cefotaxime
Cefoxitin
Ceftazidime
Cephalothin
Ciprofloxacin
Gentamicins
Imipenem
Sulfamethoxazole
Tetracycline
Tobramycin