Bacteremia due to a rare opportunistic pathogen, Kluyvera intermedia, with atypical antimicrobial susceptibility in the absence of β-lactamases

June 12, 2025
Clinical Microbiology
Tevan Luong, Anatasia Weiland, Lanny Hsieh, Ayesha Khan
Pathogen:Kluyvera intermedia
Infection Type:Bacteremia
Pathogen Type:Bacteria

Summary

A patient presented with bacteremia caused by Kluyvera intermedia, a rare opportunistic pathogen. Diagnosis was confirmed through blood cultures and molecular methods. The organism exhibited atypical antimicrobial susceptibility, notably resistance to piperacillin-tazobactam and meropenem, despite the absence of β-lactamase genes (blaKPC, blaNDM, blaVIM, blaIMP, blaOXA-48-like) typically associated with such resistance. This unusual profile necessitated careful antimicrobial stewardship and further investigation into resistance mechanisms. The patient's clinical course improved with targeted therapy.

Key note: Kluyvera intermedia can present with unexpected antimicrobial resistance patterns independent of common β-lactamase production, highlighting the importance of comprehensive susceptibility testing.

DOI: 10.1128/asmcr.00047-25