Abstract
Introduction:Species of the genus Kocuria are Gram-positive cocci of the family Micrococcacceae that are ubiquitous in the environment and part of the normal skin and oral flora in humans. A paucity of cases have been reported of Kocuria as human pathogens and there are currently no evidence-based guidelines for managing these uncommon infections.Case presentation:We present two paediatric cases of central line infections with species of the genus Kocuria that required line removal despite antimicrobial therapy.Conclusion: Species of the genus Kocuria are uncommon human pathogens that have rarely been reported to cause opportunistic infections in both adult and paediatric populations. The cases presented here add to the growing body of literature documenting the pathogenicity of these organisms and the possible need for line removal to achieve clinical cure in central line-associated bacteraemia caused by species of the genus Kocuria.
Highlights
Species of the genus Kocuria are Gram-positive cocci of the family Micrococcacceae that are ubiquitous in the environment and part of the normal skin and oral flora in humans
The few cases that have been reported of members of the genus Kocuria as human pathogens describe infections usually affecting immunocompromised patients and patients with indwelling catheters
We present two paediatric cases of Kocuria central line infections that occurred within a short time frame at our institution, both of which required line removal despite antimicrobial therapy
Summary
Species of the genus Kocuria are Gram-positive cocci of the family Micrococcaceae that are non-motile, catalase-positive and coagulase-negative. The organism was identified as Kocuria kristinae (VITEK 2; bioMerieux) and was persistently isolated from her dialysis catheter for six consecutive days despite treatment with vancomycin (MIC=1 mcg mlÀ1; Table 1). Her symptoms improved by hospital day 3 and she had her dialysis catheter removed on hospital day 7. A 7-month-old male with a medical history significant for congenital intestinal atresia status post repair with subsequent short gut syndrome and requiring TPN, presented with fever for two days and no other symptoms He had mild leukocytosis (16000 cells μlÀ1) on his complete blood count. On hospital day 7, he had his broviac catheter removed and blood cultures sent thereafter from a new central line were negative
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