Pneumonia Due to Multidrug-resistant Cedecea lapagei in Mexico. Case Report

Abstract

Introduction: Cedecea lapagei  is an opportunistic gram-negative bacteria that belongs to the Enterobacteriaceae family. It is considered an opportunistic pathogen.

Case study: a 56-year-old male with long standing HIV infection abandoned therapy for 3 years. He started developing symptoms for 6 months characterized by weight loss, abdominal pain and dyspnea. He was diagnosed with poorly differentiated gastric adenocarcinoma, oral candidiasis and molluscum contagiosum infection. He developed respiratory distress and required mechanical ventilation. A sputum culture reported multi-resistant Cedecea lapagei.

Discussion: we report the sixth case of pneumonia due to Cedecea lapagei in the world. Two of these cases have been reported in Mexico, both in an immunocompromised patient and requiring isolation measures during hospitalization.

Conclusion: due to the lack of clinical and epidemiological information on this pathogen, in addition to the MDR characteristics found in this case, the need to have cultures of respiratory secretions before starting treatment with empirical antibiotics is reaffirmed, as well as the need to expand our knowledge on this pathogen, since it is not found in the EUCAST or CLSI clinical guidelines.

This pathogen should be studied as an emergent opportunist due to its ability to infect people that suffer from some type of immunosuppression and are also hospitalized.