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The Journal of the Japanese Society for Clinical Microbiology |
Biblioraphy Information
| ArticleTitle |
Postoperative abscess caused by IMP-6 carbapenemase-producing Leclercia adecarboxylata in a patient with intrahepatic cholangiocarcinoma |
| Language |
J |
| AuthorList |
Takami Sasagaki1), Kohei Ueda2), Michio Tanaka3), Yasufumi Matsumura3) |
| Affiliation |
1) Department of Clinical Laboratory, Toyonaka Municipal Hospital
2) Division of Infection Control, Toyonaka Municipal Hospital
3) Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine |
| Publication |
J.J.C.M.: 30 (3), 135-138, 2020 |
| Received |
October 8, 2019 |
| Accepted |
February 19, 2020 |
| Abstract |
A male patient in his 50s had fever and experienced pain in the right hypochondrium for one week. When he visited a local doctor, abdominal ultrasound revealed a 30 mm-mass measuring in the liver. He was then referred to the gastrointestinal medicine department of our hospital. Based on contrast CT, the patient was diagnosed with a hepatic tumor penetrating the transverse colon. Extended resection of the anterior segment of the liver and cholecystectomy were performed. On postoperative day two, Gram staining of the drainage discharge from liver revealed gram-negative bacilli. The bacteria was identified as Leclercia adecarboxylata by VITEK2 and mass-spectrometry. The patient developed septic shock on postoperative day 7 and required intensive care. L. adecarboxylata isolate was meropenem resistant (minimum inhibitory concentration > 4 μ/mL) and carbapenemase production was confirmed using the modified carbapenemase inactivation method. Genomic analysis revealed the presence of the IMP-6 carbapenemase gene on a plasmid, suggesting its acquisition of the carbapenemase by plasmid transfer. L. adecarboxylata are usually susceptible to antimicrobials and are rarely isolated from humans. However, recently it has been described as an emerging human pathogen with the potential to cause severe infection in some situation. The present case raises concerns about the spread of carbapenem-resistant L. adecarboxylata. |
| Keywords |
Leclercia adecarboxylata, IMP-6 |
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