Clinical profile and treatment outcomes of patients with urinary tract ınfections caused by raoultella planticola
Öz
Aim: This study aimed to evaluate the clinical characteristics, treatment approaches, and outcomes in patients diagnosed with urinary tract infections (UTIs) caused by Raoultella planticola.
Material and Methods: This retrospective study included 25 adult patients with culture-confirmed Raoultella planticola UTIs admitted between January 2010 to January 2021. Clinical data such as demographics, presenting symptoms, comorbidities, laboratory findings, antibiotic treatments, and patient outcomes were retrospectively analyzed.
Results: The mean patient age was 67.8 ± 16.8 years. The most frequent comorbidities included diabetes mellitus (28%), chronic heart failure (24%) and chronic renal failure (24%). Anemia (64%), bacteriuria (60%), arthritis (56%), and altered sensorium (52%) were the most common clinical presentations. Bacteremia was identified in all patients. Acute cystitis was diagnosed in 80% of cases, while sepsis was identified in 20%. Ceftriaxone (32%) and ciprofloxacin (24%) were the most frequently administered antibiotics. The median hospital stay was 5 days (IQR: 3-14). Two patients died during hospitalization (8% mortality); both had bacteremia without sepsis criteria, and one had underlying pancreatic cancer.
Conclusion: Raoultella planticola UTIs predominantly affect older adults with significant comorbidities. While generally responsive to standard antimicrobial therapy, mortality may occur, particularly in patients with bacteremia and severe underlying diseases.
Anahtar Kelimeler
Raoultella planticola urinary tract infections bacteremia antibiotic therapy clinical outcomes mortality
Etik Beyan
study was performed in accordance with the Declaration of Helsinki, and was approved by the Maltepe University Clinical Research Ethics Committee (Date: 02.05.2023, Approval No: 2023/900/26).
Kaynakça
- Sahu KK, Sherif AA, and Davaro R. A Rare Cause of Cellulitis: Photobacterium damselae. J Microsc Ultrastruct. 2020;8(1):25-26.
- Sahu KK, Mishra AK, Lal A, and Abraham GM. Mycobacterium avium complex: A rare cause of pancytopenia in HIV infection. Journal of Microscopy and ultrastructure. 2020;8(1):27-30.
- Howell C and Fakhoury J. A case of Raoultella planticola causing a urinary tract infection in a pediatric patient. Transl Pediatr. 2017;6(2):102-03.
- Castillo-Macias A, Flores-Arechiga A, Llaca-Diaz J, Perez-Chavez F, and Casillas-Vega N. [Microbiology of genus Raoultella, clinical features and difficulties in its diagnosis]. Rev Med Inst Mex Seguro Soc. 2019;56(5):486-90.
- Chun S, Yun JW, Huh HJ, and Lee NY. Low virulence? Clinical characteristics of Raoultella planticola bacteremia. Infection. 2014;42(5):899-904.
- Mihu AG, Susan MM, Strauti CN, et al. First Case of Raoultella planticola Urinary Tract Infection Reported in Western Romania. Medicina (Kaunas). 2023;59(3)
- Hong G, Yong HJ, Lee D, et al. Clinical characteristics and treatment outcomes of patients with pneumonia caused by Raoultella planticola. J Thorac Dis. 2020;12(4):1305-11.
- Sekowska A. Raoultella spp.-clinical significance, infections and susceptibility to antibiotics. Folia Microbiol (Praha). 2017;62(3):221-27.
- Olson DS, Jr., Asare K, Lyons M, and Hofinger DM. A novel case of Raoultella planticola urinary tract infection. Infection. 2013;41(1):259-61.
- Xu M, Xie W, Fu Y, Zhou H, and Zhou J. Nosocomial pneumonia caused by carbapenem-resistant Raoultella planticola: a case report and literature review. Infection. 2015;43(2):245-8.
- Alampoondi Venkataramanan SV, George L, Sahu KK, and Abraham GM. A 5-Year Retrospective Analysis of Raoultella planticola Bacteriuria. Infect Drug Resist. 2021;14:1989-2001.
- Demiray T, Koroglu M, Ozbek A, and Altindis M. A rare cause of infection, Raoultella planticola: emerging threat and new reservoir for carbapenem resistance. Infection. 2016;44(6):713-17.
- Ulukent SC, Sarici IS, Alper Sahbaz N, Ozgun YM, Akca O, and Sanli K. Is It Necessary to Specifically Define the Cause of Surgically Treated Biliary Tract Infections? A Rare Case of Raoultella planticola Cholecystitis and Literature Review. Case Rep Infect Dis. 2017;2017:4181582.
- Tugcu M, Ruhi C, Gokce AM, Kara M, and Aksaray S. A case of urinary tract infection caused by Raoultella planticola after a urodynamic study. Braz J Infect Dis. 2017;21(2):196-98.
- Rowe TA and Juthani-Mehta M. Urinary tract infection in older adults. Aging health. 2013;9(5)
- Storme O, Tiran Saucedo J, Garcia-Mora A, Dehesa-Davila M, and Naber KG. Risk factors and predisposing conditions for urinary tract infection. Ther Adv Urol. 2019;11:1756287218814382.
- Kaur R and Kaur R. Symptoms, risk factors, diagnosis and treatment of urinary tract infections. Postgrad Med J. 2021;97(1154):803-12.
- Zhou Y, Zhou Z, Zheng L, et al. Urinary Tract Infections Caused by Uropathogenic Escherichia coli: Mechanisms of Infection and Treatment Options. Int J Mol Sci. 2023;24(13)
- Bell-Cohn A, Mazur DJ, Hall C, Schaeffer AJ, and Thumbikat P. Uropathogenic Escherichia coli-induced fibrosis, leading to lower urinary tract symptoms, is associated with type 2 cytokine signaling. Am J Physiol Renal Physiol. 2019;316(4):F682-F92.
- Wagenlehner FM, Lichtenstern C, Rolfes C, et al. Diagnosis and management for urosepsis. Int J Urol. 2013;20(10):963-70.
- Choi MH, Kim D, Park Y, and Jeong SH. Impact of urinary tract infection-causative microorganisms on the progression to bloodstream infection: A propensity score-matched analysis. J Infect. 2022;85(5):513-18.
- Klein RD and Hultgren SJ. Urinary tract infections: microbial pathogenesis, host-pathogen interactions and new treatment strategies. Nat Rev Microbiol. 2020;18(4):211-26.
- Fager C and Yurteri-Kaplan L. Urinary tract infection with rare pathogen Raoultella Planticola: A post-operative case and review. Urol Case Rep. 2019;22:76-79.
- Walckenaer E, Poirel L, Leflon-Guibout V, Nordmann P, and Nicolas-Chanoine MH. Genetic and biochemical characterization of the chromosomal class A beta-lactamases of Raoultella (formerly Klebsiella) planticola and Raoultella ornithinolytica. Antimicrob Agents Chemother. 2004;48(1):305-12.
- Tufa TB, Fuchs A, Feldt T, et al. CTX-M-9 group ESBL-producing Raoultella planticola nosocomial infection: first report from sub-Saharan Africa. Ann Clin Microbiol Antimicrob. 2020;19(1):36.
- Castanheira M, Deshpande LM, DiPersio JR, Kang J, Weinstein MP, and Jones RN. First descriptions of blaKPC in Raoultella spp. (R. planticola and R. ornithinolytica): report from the SENTRY Antimicrobial Surveillance Program. J Clin Microbiol. 2009;47(12):4129-30.
- Hajiyeva K and Oral M. Raoultella planticola Bacteremia-Induced Fatal Septic Shock and Sepsis-Induced Coagulopathy in a Patient with Pancreatic Cancer: A Case Report and Literature Review. International Journal of Clinical Medicine. 2021;12(01):36.
Raoultella planticola kaynaklı idrar yolu enfeksiyonu olan hastaların klinik profili ve tedavi sonuçları
Öz
Amaç: Bu çalışmanın amacı, Raoultella planticola kaynaklı idrar yolu enfeksiyonu (İYE) tanısı alan hastaların klinik özelliklerini, uygulanan tedavi yöntemlerini ve tedavi sonuçlarını değerlendirmektir.
Gereç ve Yöntemler: Ocak 2010 ile Ocak 2021 tarihleri arasında, kültür ile doğrulanmış Raoultella planticola kaynaklı İYE tanısı ile yatırılan 25 erişkin hasta retrospektif olarak incelendi. Hastalara ait demografik veriler, başvuru semptomları, eşlik eden hastalıklar, laboratuvar bulguları, uygulanan antibiyotik tedavileri ve klinik sonuçlar değerlendirildi.
Bulgular: Hastaların ortalama yaşı 67,8 ± 16,8 yıldı. En sık görülen eşlik eden hastalıklar diyabetes mellitus (%28), kronik kalp yetmezliği (%24) ve kronik böbrek yetmezliği (%24) idi. Başvuruda en sık gözlenen klinik bulgular anemi (%64), bakteriüri (%60), artrit (%56) ve bilinç değişikliği (%52) idi. Tüm hastalarda bakteremi tespit edildi. Hastaların %80’inde akut sistit tanısı konurken, %20’sinde sepsis saptandı. En sık uygulanan antibiyotikler seftriakson (%32) ve siprofloksasin (%24) idi. Medyan hastanede kalış süresi 5 gün olarak bulundu (IQR: 3-14). Hastane yatışı sırasında iki hasta (%8) hayatını kaybetti; her iki hastada da bakteremi mevcuttu ancak sepsis kriterlerini karşılamıyorlardı ve bir hastada altta yatan pankreas kanseri vardı.
Sonuç: Raoultella planticola kaynaklı idrar yolu enfeksiyonları çoğunlukla ileri yaşta ve ek hastalığı olan bireyleri etkilemektedir. Bu enfeksiyonlar genellikle standart antibiyotik tedavisine iyi yanıt verse de, özellikle bakteremi ve ağır komorbiditeleri olan hastalarda mortalite görülebilmektedir.
Anahtar Kelimeler
Raoultella planticola idrar yolu enfeksiyonları bakteremi antibiyotik tedavisi klinik sonuçlar mortalite
Kaynakça
- Sahu KK, Sherif AA, and Davaro R. A Rare Cause of Cellulitis: Photobacterium damselae. J Microsc Ultrastruct. 2020;8(1):25-26.
- Sahu KK, Mishra AK, Lal A, and Abraham GM. Mycobacterium avium complex: A rare cause of pancytopenia in HIV infection. Journal of Microscopy and ultrastructure. 2020;8(1):27-30.
- Howell C and Fakhoury J. A case of Raoultella planticola causing a urinary tract infection in a pediatric patient. Transl Pediatr. 2017;6(2):102-03.
- Castillo-Macias A, Flores-Arechiga A, Llaca-Diaz J, Perez-Chavez F, and Casillas-Vega N. [Microbiology of genus Raoultella, clinical features and difficulties in its diagnosis]. Rev Med Inst Mex Seguro Soc. 2019;56(5):486-90.
- Chun S, Yun JW, Huh HJ, and Lee NY. Low virulence? Clinical characteristics of Raoultella planticola bacteremia. Infection. 2014;42(5):899-904.
- Mihu AG, Susan MM, Strauti CN, et al. First Case of Raoultella planticola Urinary Tract Infection Reported in Western Romania. Medicina (Kaunas). 2023;59(3)
- Hong G, Yong HJ, Lee D, et al. Clinical characteristics and treatment outcomes of patients with pneumonia caused by Raoultella planticola. J Thorac Dis. 2020;12(4):1305-11.
- Sekowska A. Raoultella spp.-clinical significance, infections and susceptibility to antibiotics. Folia Microbiol (Praha). 2017;62(3):221-27.
- Olson DS, Jr., Asare K, Lyons M, and Hofinger DM. A novel case of Raoultella planticola urinary tract infection. Infection. 2013;41(1):259-61.
- Xu M, Xie W, Fu Y, Zhou H, and Zhou J. Nosocomial pneumonia caused by carbapenem-resistant Raoultella planticola: a case report and literature review. Infection. 2015;43(2):245-8.
- Alampoondi Venkataramanan SV, George L, Sahu KK, and Abraham GM. A 5-Year Retrospective Analysis of Raoultella planticola Bacteriuria. Infect Drug Resist. 2021;14:1989-2001.
- Demiray T, Koroglu M, Ozbek A, and Altindis M. A rare cause of infection, Raoultella planticola: emerging threat and new reservoir for carbapenem resistance. Infection. 2016;44(6):713-17.
- Ulukent SC, Sarici IS, Alper Sahbaz N, Ozgun YM, Akca O, and Sanli K. Is It Necessary to Specifically Define the Cause of Surgically Treated Biliary Tract Infections? A Rare Case of Raoultella planticola Cholecystitis and Literature Review. Case Rep Infect Dis. 2017;2017:4181582.
- Tugcu M, Ruhi C, Gokce AM, Kara M, and Aksaray S. A case of urinary tract infection caused by Raoultella planticola after a urodynamic study. Braz J Infect Dis. 2017;21(2):196-98.
- Rowe TA and Juthani-Mehta M. Urinary tract infection in older adults. Aging health. 2013;9(5)
- Storme O, Tiran Saucedo J, Garcia-Mora A, Dehesa-Davila M, and Naber KG. Risk factors and predisposing conditions for urinary tract infection. Ther Adv Urol. 2019;11:1756287218814382.
- Kaur R and Kaur R. Symptoms, risk factors, diagnosis and treatment of urinary tract infections. Postgrad Med J. 2021;97(1154):803-12.
- Zhou Y, Zhou Z, Zheng L, et al. Urinary Tract Infections Caused by Uropathogenic Escherichia coli: Mechanisms of Infection and Treatment Options. Int J Mol Sci. 2023;24(13)
- Bell-Cohn A, Mazur DJ, Hall C, Schaeffer AJ, and Thumbikat P. Uropathogenic Escherichia coli-induced fibrosis, leading to lower urinary tract symptoms, is associated with type 2 cytokine signaling. Am J Physiol Renal Physiol. 2019;316(4):F682-F92.
- Wagenlehner FM, Lichtenstern C, Rolfes C, et al. Diagnosis and management for urosepsis. Int J Urol. 2013;20(10):963-70.
- Choi MH, Kim D, Park Y, and Jeong SH. Impact of urinary tract infection-causative microorganisms on the progression to bloodstream infection: A propensity score-matched analysis. J Infect. 2022;85(5):513-18.
- Klein RD and Hultgren SJ. Urinary tract infections: microbial pathogenesis, host-pathogen interactions and new treatment strategies. Nat Rev Microbiol. 2020;18(4):211-26.
- Fager C and Yurteri-Kaplan L. Urinary tract infection with rare pathogen Raoultella Planticola: A post-operative case and review. Urol Case Rep. 2019;22:76-79.
- Walckenaer E, Poirel L, Leflon-Guibout V, Nordmann P, and Nicolas-Chanoine MH. Genetic and biochemical characterization of the chromosomal class A beta-lactamases of Raoultella (formerly Klebsiella) planticola and Raoultella ornithinolytica. Antimicrob Agents Chemother. 2004;48(1):305-12.
- Tufa TB, Fuchs A, Feldt T, et al. CTX-M-9 group ESBL-producing Raoultella planticola nosocomial infection: first report from sub-Saharan Africa. Ann Clin Microbiol Antimicrob. 2020;19(1):36.
- Castanheira M, Deshpande LM, DiPersio JR, Kang J, Weinstein MP, and Jones RN. First descriptions of blaKPC in Raoultella spp. (R. planticola and R. ornithinolytica): report from the SENTRY Antimicrobial Surveillance Program. J Clin Microbiol. 2009;47(12):4129-30.
- Hajiyeva K and Oral M. Raoultella planticola Bacteremia-Induced Fatal Septic Shock and Sepsis-Induced Coagulopathy in a Patient with Pancreatic Cancer: A Case Report and Literature Review. International Journal of Clinical Medicine. 2021;12(01):36.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Bulaşıcı Hastalıklar, İç Hastalıkları, Üroloji |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Haziran 2025 |
| Gönderilme Tarihi | 21 Haziran 2025 |
| Kabul Tarihi | 30 Haziran 2025 |
| Yayımlandığı Sayı | Yıl 2025 |
Kaynak Göster
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