Sarria J C, Vidal A M, Kimbrough R C
Division of Infectious Diseases, Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA.
Clin Infect Dis. 2001 Oct 1;33(7):E69-74. doi: 10.1086/322686. Epub 2001 Sep 5.
Kluyvera is a relatively newly described genus in the family Enterobacteriaceae that infrequently causes infections in humans. The organism has been isolated from various clinical specimens, but its significance has not been clearly established. In fact, it has been regarded alternatively as saprophytic, opportunistic, or pathogenic. Since the redefinition of this genus in 1981, case reports of diverse clinical infections occurring under various host conditions have been published. Here we present a critical review of all Kluyvera infections reported in the literature, along with our experience involving 5 additional cases. Most patients received prompt antimicrobial treatment on the basis of susceptibility testing, and overall the clinical outcomes were good. Antimicrobial agents active against most Kluyvera strains include third-generation cephalosporins, fluoroquinolones, and aminoglycosides. In contrast, the resistance to ampicillin, extended-spectrum penicillins, and first- and second-generation cephalosporins is significant. Kluyvera is a potentially virulent pathogen that deserves aggressive treatment designed with an awareness of the organism's antimicrobial resistance patterns.
克吕沃菌属是肠杆菌科中一个相对较新描述的菌属，很少引起人类感染。该菌已从各种临床标本中分离出来，但其意义尚未明确确定。事实上，它被认为既是腐生菌，又是机会致病菌或病原菌。自1981年该菌属重新定义以来，已发表了在各种宿主条件下发生的多种临床感染的病例报告。在此，我们对文献中报道的所有克吕沃菌感染进行了批判性综述，并分享了我们另外5例病例的经验。大多数患者根据药敏试验及时接受了抗菌治疗，总体临床结果良好。对大多数克吕沃菌株有效的抗菌药物包括第三代头孢菌素、氟喹诺酮类和氨基糖苷类。相比之下，对氨苄西林、广谱青霉素以及第一代和第二代头孢菌素的耐药性较为显著。克吕沃菌属是一种潜在的致病病原体，鉴于该菌的抗菌耐药模式，对其进行积极治疗是必要的。
