Scientific Poster Session IV - Case Reports

Case Reports
  Tuesday, November 14, 2023
  08:30 AM–10:00 AM

Abstract

Introduction:Cronobacter sakazakii, formerly known as Enterobacter sakazakii, is a Gram-negative, motile, facultative anerobic bacteria. It is an opportunistic foodborne pathogen and commonly found in contaminated dried infant formula. C. sakazakii infections are rare in immunocompetent individuals, but a few cases have been reported in neonates and older adults (> 55 years). Thus, we described a unique case of C. sakazakii ventilator-acquired pneumonia post-automobile injury.

Case: A 21-year-old Caucasian male presented to the emergency department with severe traumatic brain injury (TBI) with multiple intracranial hemorrhages and bilateral lung contusions after suffering a roll-over automobile collision. Patient underwent multiple surgeries to repair extensive facial and extremities injuries. Patient had worsening leukocytosis (WBC 15,000 cells/µL) with thick tan pulmonary secretions with extensive multifocal bilateral lung infiltrates seen in a chest computed tomography (CT). A bronchoalveolar lavage (BAL) culture was positive for C. sakazakii and methicillin-susceptible Staphylococcus aureus. The patient was initiated on cefepime 2g IV q8h extended infusion for 14 days, after which the pneumonia resolved. Subsequently, patient was transferred to a long-term acute care facility.

Discussion: To our best knowledge, our patient is the first reported case of C. sakazakii in an immunocompetent adult host with traumatic brain injuries who developed ventilator-acquired pneumonia. The pathogenesis of C. sakazakii remains unclear. Fortunately, C. sakazakii grows well on routine culture media and microbiological laboratories can detect C. sakazakii from blood or cerebrospinal fluid (CSF) samples using molecular testing methods. Although our case of C. sakazakii was highly susceptible to most antibiotics, there have been reports of the resistance in extended-spectrum penicillins, first-third generation cephalosporins, and fluoroquinolones.

Conclusion: Although C. sakazakii has been commonly associated with severe neonatal infections, delayed treatment in adults can result in morbidity and mortality. Due to conflicting reports of resistance profiles, a paradigmatic antimicrobial treatment for C. sakazakii remains to be established.

Presenting Author

Scott Volker PharmD
Midwestern University

Authors

Vanthida Huang Pharm.D., BSPHM, FCCP
Midwestern University, College of Pharmacy-Glendale

Tho H. Pham PharmD, BCIDP
Midwestern University College of Pharmacy-Glendale Campus

Chad M. VanDenBerg Pharm.D., M.S, BCPP
Midwestern University College of Pharmacy-Glendale