Case Report
Cedecea davisae bacteremia in a neutropenic patient with acute myeloid leukemia

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Summary

Cedecea are the new members of Enterobacteriacea. Because of their inherent resistance to some antibiotics, the clinical response could be unpredictable making management of Cedecea infection in immunocompromised patients challenging. We report a case of acute myeloid leukemia with central line-related Cedecea bacteremia.

Introduction

Cedecea are gram negative bacilli and members of the Enterobacteriaceae family that were designated as a separate genus in 1980. Invasive infection with Cedecea species is extremely rare. We present a case of successful treatment of Cedecea davisae bacteremia in an immunocompromised host and present a brief review of the literature.

Section snippets

Case report

A 52 year-old Caucasian male with acute myeloid leukemia (AML) was admitted to the hospital for chemotherapy. On the day of admission, a tunneled catheter was placed in the right internal jugular vein and induction chemotherapy was started with cytarabine, cladaribine and idarubicin. On day nine post-induction, he became neutropenic with an absolute neutrophil count of 710/μl with further decline to 40/μl next day. Prophylactic antibiotics including levofloxacin, fluconazole and valacyclovir

Discussion

Cedecea was first identified to be a new genus in the family enterobacteriacea at the Centers for Disease Control (CDC) and the organism was later named Cedecea from the letters CDC.8 They are more closely related to Serratia but do not hydrolyze gelatin or DNA. The detail biochemical properties of Cedecea have been previously described.8 The genus includes five species.

The organism has been isolated from various clinical specimens including sputum, cutaneous ulcers, oral ulcer, scrotal

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  • Expanding spectrum of opportunistic Cedecea infections: Current clinical status and multidrug resistance

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    Citation Excerpt :

    The clinical cases summarized in Table 1 indicate the opportunistic nature of Cedecea pathogenesis, underscoring the importance of aggressive management of these bacterial infections in immunocompromised populations. The PubMed search revealed a total of 13 cases in which C. davisae was isolated from various clinical specimens, including blood (Dalamaga et al., 2008b; Peretz et al., 2013; Perkins et al., 1986; Abate et al., 2011; Akinosoglou et al., 2012; Kanakadandi et al., 2019), sputum (Bae et al., 1981; Ismaael et al., 2012), urine (Ammenouche et al., 2014), cutaneous and oral ulcers (Dalamaga et al., 2008b; Mawardi et al., 2010), and a scrotal abscess (Bae and Sureka, 1983). The identification of C. davisae from different host sites indicates an extended clinical spectrum of infections.

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    This microorganism was rarely reported in humans (Hess et al., 2008). There are very few reports of Cedecea isolation from eggshells and the clinical significance of Cedecea is not fully understood (Abate et al., 2011). In the present study, out of all Enterobacteriaceae genus reported, Escherichia was reported most frequently.

  • Bacteraemia due to Cedecea davisae in a patient with sigmoid colon cancer: A case report and brief review of the literature

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    To the best of our knowledge, there are only 7 reported cases of Cedecea bacteraemia, among which 4 were C. davisae, 2 C. neteri, and 1 C. lapagei. Three cases (Abate et al., 2011; Aguilera et al., 1995; Perkins et al., 1986) developed Cedecea bacteraemia after long hospitalization (25–45 days), indicating the possibility that the infection may have been of nosocomial origin. Two more cases were described within a short period of time (15 days apart) in the same hospital (1 room apart from each other), suggesting a potential common source of the organism or cross infection, possibly of intranosocomial origin (Bae et al., 1981).

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