Kocuria kristinae: A true pathogen in pediatric patients

Background: Kocuria kristinae is a Gram-positive microorganism, which has rarely been reported as a pathogen that causes infection in humans. Recently, a few studies had concluded that this pathogen can indeed cause infection in immunocompromised hosts. However, the number of reports on Kocuria kristinae infection in pediatric patients is still relatively limited. Methods: Clinical data on pediatric patients who had Kocuria kristinae cells isolated from their blood specimens during the period from January 2008 to May 2012 in a tertiary-care hospital in northern Taiwan were gathered and analyzed. Results: Among 12 patients with Kocuria kristinae cells isolated from their blood specimens, laboratory test results confirmed seven to have Kocuria kristinae bloodstream infection. Six of them were premature babies, and one had acute leukemia. The infections were all healthcare associated. All the six premature babies had clinical presentation of sepsis and were inserted with percutaneous central venous catheters. One patient had two sets of blood culture positive for Kocuria kristinae infection, and two premature patients had two sets of Kocuria kristinae isolated, one from blood culture and the other from catheter tip culture, both of which were done at the same time. The leukemic child was inserted with a Broviac catheter and had Kocuria kristinae isolated from both blood specimen and Broviac catheter. In the remaining five patients, Kocuria kristinae infection was considered to be contaminant because they had only one set of positive blood culture and had other recognized infections. Conclusion: Kocuria kristinae can cause infections in premature babies and immunocompromised pediatric patients using long-term intravenous catheters. Therefore, Kocuria kristinae should be considered as a true pathogen and proper treatment should be provided to all susceptible pediatric patients. Copyright (C) 2013, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC. All rights reserved.