Ateş KARA, Ali Bülent CENGİZ, Yasemin ÖZSÜREKCİ, Yakut AKYÖN2, Eda ÖNCEL KARADAĞ, Deniz GÜR2

Çocuklarda Kluyvera ascorbata enfeksiyonları: olgu serisi

Kluyvera insanlarda nadiren enfeksiyonlara neden olan, Enterobacteriaceae ailesinin göreceli olarak yeni tanımlanan üyelerindendir. Çocuk toplumda, bu etkenle ilişkili idrar yolu enfeksiyonundan çoklu organ yetersizliği ile seyredebilen sepsise kadar değişen ciddi enfeksiyonlar tanımlanmıştır. Bu makaledeki amacımız merkezimizde çocuk hastalarda görülen klinik önemli K.ascorbata enfeksiyonlarını tanımlamaktır. İki bin altı yılından bu yana klinik mikrobiyolojik veriler geriye dönük olarak tarandığında; enfeksiyona neden olan dört izolat saptanmıştır. Bu dört izolat; sepsis, santral venöz kateter ilişkili bakteriyemi, piyelonefrit ve karın içi koleksiyon gelişen dört olguda tanımlanmıştır. Bu hastaların yaş aralığı yedi ay ile 17 yaş arasındadır. Tüm hastalara uygun antimikrobiyal tedavi duyarlılık testi temel alınarak erken dönemde başlanmış ve tamamında iyi klinik yanıt alınmıştır. Başarılı tedavi tercihleri içinde üçüncü kuşak sefalosporinler, aminoglikozidler, betalaktam-betalaktamaz inhibitörleri ve karbapenemler yer almaktadır. Klinisyenler Kluyvera türleri ile ilişkili hastalığın geniş yelpazede görülebilmesi ve klinik öneminin giderek artması nedeniyle dikkatli olmalıdır.

Kluyvera ascorbata infections in children: a case series

Kluyvera is a relatively newly described member of the Enterobacteriaceae family that rarely causes infections in humans. In the pediatric population, it is described in association with clinically significant infections ranging from urinary tract infections to sepsis with multiorgan failure. Our aim is to determine the clinical significance of K. ascorbata infections in the pediatric population at our institution. We retrospectively analyzed clinical microbiology data as from 2006 and identified four clinically significant isolates in this period. The isolates were from four cases who presented with sepsis, bacteremia associated with central venous catheter, pyelonephritis and intraabdominal collection. The ages of these patients ranged between seven months to 17 years. All patients received prompt antimicrobial treatment on the basis of susceptibility testing and good clinical response was obtained in all patients. Successful treatment options include third-generation cephalosporins, aminoglycosides, betalactams with beta-lactamase inhibitors and carbapenems. Clinicians should be aware of the spectrum of disease and increasing clinical importance associated with this pathogen.

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