Insight into Kytococcus schroeteri Infection Management: A Case Report and Review

Abstract

Kytococcus schroeteri is a member of normal skin microflora, which can cause lethal infections in immunosuppressed hosts. In this review we attempted to draw patterns of its pathogenicity, which seem to vary regarding host immune status and the presence of implantable devices. Evidence suggest this pathogen houses many resistance-forming proteins that enhance the challenge in curing it. Available information on K.schroeteri antibacterial susceptibility is scarce. In this situation a novel, genome-based antibiotic resistance analysis model, previously suggested by Su et al.[1], could aid clinicians dealing with unknown infections. In this study we merged data form observed antibiotic resistance patterns with resistance data demonstrated by DNA sequences. Methods: We reviewed all available articles and reports on K.schroeteri, from peer-reviewed online databases (ClinicalKey, PMC, Scopus and WebOfScience). Information on patients was then subdivided into patient profiles and tabulated independently. We later performed K.schroeteri genome sequence analysis for resistance proteins to understand the trends K.schroeteri exhibits. Results: K.schroeteri is resistant to beta-lactams, macrolides, and clindamycin. It is susceptible to aminoglycosides, tetracyclines and rifampicin. We combined data from the literature review and sequence analysis and proved evidence for the exitance of PBP, PBP-2A and efflux pumps as likely determinants of K.schroeteri. Conclusions: Reviewing the data permits the speculation that baseline immune status plays a role in the outcome of a Kytococcal infection. Nonetheless, our case report demonstrates that the outcome of a lower baseline immunity could still be favorable, possibly using rifampicin in first-line treatment of infection caused by K.schroeteri.

Kytococcus schroeteri is a member of normal skin microflora, which can cause lethal infections in immunosuppressed hosts. In this review we attempted to draw patterns of its pathogenicity, which seem to vary regarding host immune status and the presence of implantable devices. Evidence suggest this pathogen houses many resistance-forming proteins that enhance the challenge in curing it. Available information on K.schroeteri antibacterial susceptibility is scarce. In this situation a novel, genome-based antibiotic resistance analysis model, previously suggested by Su et al.[1], could aid clinicians dealing with unknown infections. In this study we merged data form observed antibiotic resistance patterns with resistance data demonstrated by DNA sequences. Methods: We reviewed all available articles and reports on K.schroeteri, from peer-reviewed online databases (ClinicalKey, PMC, Scopus and WebOfScience). Information on patients was then subdivided into patient profiles and tabulated independently. We later performed K.schroeteri genome sequence analysis for resistance proteins to understand the trends K.schroeteri exhibits. Results: K.schroeteri is resistant to beta-lactams, macrolides, and clindamycin. It is susceptible to aminoglycosides, tetracyclines and rifampicin. We combined data from the literature review and sequence analysis and proved evidence for the exitance of PBP, PBP-2A and efflux pumps as likely determinants of K.schroeteri. Conclusions: Reviewing the data permits the speculation that baseline immune status plays a role in the outcome of a Kytococcal infection. Nonetheless, our case report demonstrates that the outcome of a lower baseline immunity could still be favorable, possibly using rifampicin in first-line treatment of infection caused by K.schroeteri.