Abstract

Moellerella winconsensis is a new member of the Enterobacteriaceae family. Although the pathogenic features of M. wisconsensis are not completely explained in humans, it is associated with diarrhea and acute cholecystitis with or without secondary bacteremia only in a few cases. In this report, a case of central venous catheter-related bloodstream infection caused by M. wisconsensis is presented. A 53-year-old female patient with chronic renal failure was admitted to our hospital with the complaints of fever, anorexia and weakness for seven days. Physical examination revealed redness and tenderness at and around hemodialysis catheter insertion site. Empirical antibiotic therapy with ceftriaxone and vancomycin was initiated owing to high suspicion of catheter-related infection. Isolate from the patient’s peripheral and catheter blood cultures was identified as M. wisconsensis by Phoenix 100 (Becton Dickinson Co., Sparks, MD, USA) automated system and, was found susceptible to ampicillin-sulbactam, imipenem, meropenem, piperacillin-tazobactam, cefepime and trimethoprim-sulphametoxazole, whereas resistant to amikacin, gentamicin, ciprofloxacin, cefoxitin, aztreonam, ceftriaxone and ceftazidime. Identification was confirmed by BD BBL Crystal GN (Becton Dickinson Co., Sparks, MD, USA) identification system. Other distant infectious focuses explaining the positive blood culture result were not determined. The patient’s clinical condition improved completely and she was discharged after two weeks of intravenous antibiotic therapy. This report is the first case of central venous catheter-related bloodstream infection caused by M. wisconsensis in medical literature as well as the first reported case of M. wisconsensis in Turkey.