Clinical significance and antibiotic resistance patterns of Leminorella spp., an emerging nosocomial pathogen

Although Leminorella spp,, members of the family Enterobacteriaceae, were p reviously isolated from feces and urine specimens, clinical correlates have not been studied. We conducted a retrospective study to investigate the cl inical significance and disease spectrum of these organisms, as well as the ir antibiotic susceptibility patterns. Identification and susceptibility te sting were performed by an automated system. Eighteen cases were identified retrospectively during a 28-month period (1/97 to 4/99), representing an i ncidence of 11 cases per 100,000 patient admissions. The medical records of 14 patients were reviewed. The average patient age was 67 years, and 78% w ere males. Patients had multiple and diverse underlying conditions which mi ght have predisposed them to infection. Leminorella spp, were classified as definite pathogens in 43% of the cases, probable pathogens in 29%, and pos sible pathogens in 21%, In one case of asymptomatic bacteriuria, the isolat e had no clinical significance. All infections but one were nosocomial, Cli nical syndromes included urinary tract infection in six patients, surgical site infection in three patients, and primary bacteremia, peritonitis, resp iratory tract infection, and soft tissue infection in one patient each. Iso lates were uniformly susceptible to imipenem, Other beta-lactam agents had poor activity against the isolates. We conclude that Leminorella spp, are s ignificant nosocomial pathogens that are capable of causing a variety of cl inical syndromes and are resistant to multiple antibiotic agents.