[PP-120]Uroepsis caused by Kluyvera Ascorbata in a pregnant patientAkif Erbin1, Hasan Tahsin Gözdaş2, Halil Lütfi Canat32Abant Izzet Baysal University, Department of Infectious Disease, Bolu, Turkey 3Okmeydani Traning and Research Hospital, Department of Urology, Istanbul, Turkey INTRODUCTION: Kluyvera is a gram-negative bacterium belonging to Enterobacteriaceae family. There are three pathogenic species; K.ascorbata, K. cryocrescensa and K.species group 3. We have no data on whether one of the Kluyvera genus can cause a clinically significant infection in pregnancy. We report a case of urosepsis caused by K ascorbata in a pregnant woman. CASE PRESENTATİON: A 23-year old pregnant woman, at 26 weeks of gestation, presented to the hospital with left flank pain and vomiting. Urinary ultrasonography showed left grade-3 hydronephrosis, ureteral dilatation and 10-mm distal ureteral stone. The pain was severe and it was not completely cured despite of adequate medical treatment. The patient was performed laser lithotripsy and JJ placement. The patient was discharged on the second day. Ten days later, the patient was re-admitted to hospital with complaints of nausea, vomiting, dizziness and fever. The patient appeared toxic; temperature, pulse rate, respiratory rate and blood pressure were 39,8oC, 120 beats/min, 32 breaths/min, and 85/52 mmHg, respectively. The initial laboratory results showed significant leukocytosis with a WBC count of 18.1 K/µL, elevated CRP with 146 mg/L On urinary analysis, large amounts of red cells, white cells and numerous bacteria were observed. The patient was diagnosed with urosepsis. The empirical antibiotherapy (ceftriaxone 2 g/day) and aggressive intravenous hydration were begun. On third day of treatment, it was learned that K ascorbata was grown in urine culture. The growth count of K ascorbata was 1×105 cfu/mL. According to clinical status of the patient and antimicrobial susceptibility testing, treatment was switched to ertapenem 1×1 gr/day which was continued for 14 days. The fever and general clinical status responded well to the treatment established. To the best of our knowledge, this is the first report showing that K ascorbata can be isolated from a pregnant woman and it can cause urosepsis in pregnancy. CONCLUSION: Clinicians should be aware of the potantial risks of Kluyvera species. K ascorbata can be isolated from a pregnant patient and it can cause urosepsis in pregnancy. |