Biomedicine

Abstract

Kluyvera is a recently described member of the family Enterobacteriaceae. It can be found in soil, water, sewage, and the healthcare environment. Though associated with human infection, it is poorly studied. We present a case of a 4-year-old child diagnosed with pre-B cell acute lymphoblastic leukemia on induction chemotherapy who presented in the third week of treatment with diarrhea. When a stool sample was examined for diarrheal etiology, we identified the isolated organism as K. ascorbata by generic identification, using manual biochemicals and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF). Antimicrobial susceptibility of the organism was performed by both disc diffusion and VITEK and was confirmed to be a sensitive strain of K. ascorbata. The diarrhea was resolved within a few days after receiving appropriate treatment. Although it is a normal flora of the gastrointestinal tract, it has been significantly associated with opportunistic infections in immunocompromised individuals, including children and the elderly. K. ascorbata is a less frequently encountered organism causing diarrhea and is probably underestimated because its biochemical identification patterns are similar to those of other related genera. This organism sometimes remains unidentified, leading to the usage of inappropriate antibiotics and gaining antibiotic-resistant genes, which in turn give rise to multidrug-resistant K. ascorbata