Raoultella spp
- R. ornithinolytica
- R. planticola
- R. terrigena
Gram Stain
- Gram negative bacilli - fermenter
Clinical Significance
These organisms are widely distributed in nature.
R. ornithinolytica – found in aquatic environments and rarely causes human infection. It has been associated with diabetic foot wounds, brain abscesses, meningitis, osteomyelitis, pneumonia, urinary tract, cellulitis, hepatobiliary / medical device related infections, and enteric fever. This organism is similar biochemically to Klebsiella oxytoca.
R. planticola – is similar in pathogenicity to K. pneumoniae. It is associated with bacteremia, osteomyelitis, urinary tract and medical device related infections following invasive procedures in immunocompromised patients.
R. terrigena – an aquatic and soil organism. Human infections are rare.
Usual Susceptibility Pattern
Raoultella spp. produce a chromosomal Class A penicillinase and are intrinsically resistant to all penicillins (despite in vitro susceptible results).
They are typically susceptible to beta lactamase inhibitor combinations, aminoglycosides, quinolones, and nitrofurantoin.
Susceptibility to TMP/SMX, and tetracycline is variable. These organisms are predictably resistant to fosfomycin.
Empiric Therapy |
---|
TMP/SMX |
or |
Ciprofloxacin |