The case presentation discusses the clinical evaluation and treatment of a two-year-old female exhibiting symptoms such as dysuria, constipation, and foul-smelling urine. Upon evaluation, the patient was found to be co-infected with Raoultella planticola and Escherichia coli. This co-infection poses unique challenges in diagnosis and treatment, as both pathogens may contribute to the manifestation of symptoms. The initial diagnosis of Raoultella planticola is notable, given its relatively rare occurrence and the potential for misdiagnosis. This case study contributes to our understanding of diagnosing and distinguishing symptoms at various stages of the illness, particularly in cases of co-infection. Following an initial urinalysis and urine culture confirming the presence of both pathogens, a 10-day course of antibiotics was prescribed. Subsequent examinations at Rady Children\'s Hospital-San Diego included kidney and abdomen imaging to rule out underlying issues. The co-infection underscores the importance of thorough diagnostic procedures and tailored treatment approaches. Additionally, it highlights the need for heightened awareness among healthcare providers regarding emerging pathogens and their potential clinical implications.

Raoultella planticola is an emerging bacterial pathogen responsible for causing infections in both humans and animals. Unfortunately, sporadic reports of carbapenem-resistant R. planticola (CRRP) have been documented worldwide. Here we first reported the complete genome sequence of a CRRP isolate RP_3045 co-carrying blaIMP-4 and blaSHV-12, recovered from a patient in China, and its genetic relatedness to 82 R. planticola strains deposited in the NCBI GenBank database, sourced from humans, animals, and the environment. Whole-genome sequencing was performed using the Illumina NovaSeq 6000 and Oxford Nanopore MinION platforms. Phylogenetic analysis was also performed and visualized using a single nucleotide polymorphism (SNP)-based strategy. The complete genome of R. planticola strain RP_3045 was determined to be 6,312,961 bp in length, comprising five contigs that included one chromosome and four plasmids. RP_3045 was found to be multidrug-resistant and harbored several antimicrobial resistance genes, including both blaIMP-4 and blaSHV-12 genes located on a single plasmid. The most closely related strain was hkcpe63, recovered from humans in Hong Kong, China, in 2014, with 506 SNP differences. R. planticola strains were distributed globally and exhibited strong associations among isolates obtained from different sectors. This study provides evidence for the potential of R. planticola to disseminate carbapenem resistance across different sectors, highlighting the critical need for active and continuous surveillance of CRRP.

UNASSIGNED: Nanoparticles can be chemically, physically, or biologically synthesized. Biosynthesis of silver nanoparticles (AgNPs) utilizing microbes is a promising process due to the low toxicity and high stability of AgNPs. Here, AgNPs were fabricated by Gram-negative Raoultella planticola.
UNASSIGNED: This study aimed to assess the ability of Raoultella planticola to produce nanoparticles (NPs) and evaluate their antibacterial potential against multidrug-resistant pathogens (MDR). Additionally, the study aimed to compare the antibacterial activity of biosynthesized nanoparticles to well-known conventional antibiotics Azithromycin and Tetracycline.
UNASSIGNED: AgNPs were characterized using visual observation, UV-visible spectroscopy (UV-vis), X-ray diffraction (XRD), transmission electron microscopy (TEM), scanning electron microscopy (SEM), and Fourier-transform infrared spectroscopy (FTIR). The TEM and SEM were used to determine the size and shape of the nanoparticles. The XRD data were recorded in the 2θ ranging from 20-80° to analyze the crystalline structure of nanoparticles. The antibacterial activity was detected using a 96-well microtiter plate.
UNASSIGNED: The UV-vis absorption recorded from the 300 - 900 nm spectrum was well defined at 420 nm, and the XRD pattern was compatible with Braggs\'s reflection of the silver nanocrystals. FTIR showed absorbance bands corresponding to different functional groups. TEM and SEM images showed non-uniform spherical and AgNPs of 10-80 nm. XRD data confirmed that the resultant particles are AgNPs. The AgNPs showed effective activity against multi-drug resistant (MDR) Pseudomonas aeruginosa, Salmonella sp., Shigella sp., E. coli, Enterobacter sp., Staphylococcus aureus, and Bacillus cereus. The AgNPs demonstrated effectiveness in lower concentrations compared to broad-spectrum antibiotics.
UNASSIGNED: These data reveal that AgNP generated by R. planticola was more efficient against MDR microorganisms than commercial antibiotics. However, the cytotoxicity of these nanoparticles must be further studied.

We present a case of Raoultella planticola (R. planticola) infection that resulted in community-acquired pneumonia in an immunocompetent patient with an eight-week history of productive cough. This gram-negative bacterium is typically found in the environment and has the potential to infect humans. Raoultella planticola infections in humans have been recorded in several case reports from throughout the world in recent years, usually affecting immunocompromised patients. Although R. planticola is sensitive to most antibiotic groups, recent studies have revealed an increase in the infrequent acquisition of resistance genes in R. planticola, such as carbapenem resistance, making this pathogen a potential emergent threat. Our patient acquired R. planticola pneumonia in the absence of any underlying risk factors, making this the first case in the UK of R. planticola causing community-acquired pneumonia in an immunocompetent person.

Infective endocarditis remains a condition associated with high morbidity and mortality, regardless of advances in diagnosis and therapeutics. The etiology, microbiology, and epidemiology of infective endocarditis have changed in the last years, with healthcare-associated infective endocarditis being responsible for a myriad of cases. Raoultella planticola is rarely the cause of infective endocarditis. We present a 72-year-old Caucasian female with a history of mitral valve replacement for rheumatic valve disease two months before the current presentation, without any immunosuppressive pathologies, diagnosed with Raoultella planticola infective endocarditis. Long-drawn antibiotic treatment led to a full recovery with no evidence of recurrence or relapse. This report highlights the importance of a multimodal approach for the diagnosis of bacterial etiology, the importance of selection and duration of an appropriate antibiotic regimen, and the presence of a rare opportunistic bacteria that has proven pathogenicity in a wide range of organ systems, usually in patients with several risk factors.

Bullous lung lesions from coronavirus disease 2019 (COVID-19) pneumonia, causing pneumothorax, are a rare complication, affecting up to 1% of infected patients. Raoultella planticola is an aerobic, gram-negative bacteria known to cause opportunistic infection. We present a rare case of spontaneous pneumothorax from rupture of lung bulla as a late sequela from COVID-19 pneumonia and superinfection of the bulla by R. planticola. Although superinfection of bullous lesions is known, this is the first reported case of R. planticola pneumonia in a patient with COVID-19 lung bullae. COVID-19 patients are at heightened risk for bullous lung lesions and superinfection by opportunistic organisms; thus, they should be followed up closely.

We present a case of a 39-year-old male patient who was previously diagnosed with myasthenia gravis. He presented in a myasthenic crisis secondary to a lower respiratory tract infection, with the implicated organism being Raoultella planticola. He was referred to the intensive care unit (ICU) and required ventilatory support due to respiratory insufficiency. Early broad-spectrum antibiotics for a suspected bacterial infection were provided in combination with management specific to the myasthenic crisis. The patient made a full recovery and has displayed a good clinical response. This case report explores his presentation and aims to provide further literature on the incidence and description of R. planticola.

Raoultella planticola was previously considered an environmental organism in soil, water, and plants. However, several cases of human infection have recently been reported in association with R. planticola, some of which have been life-threatening. Most cases were in adults with reduced immunity, with few cases in children. To our knowledge, there have only been two reported cases of urinary tract infection (UTI) caused by R. planticola in children, including one case of cystitis. Here, we present the first case of UTI caused by R. planticola with congenital anomalies of kidney and urinary tract (CAKUT) in a 4-month-old male infant. The patient presented to the emergency department with fever and was diagnosed with UTI. We started third-generation cephalosporins empirically for gram-negative bacteria in the urine, presuming infection with Escherichia coli. On day 1, the patient\'s fever resolved immediately. On day 2, urine culture was positive for a rare pathogen, R. planticola, and we narrowed antibiotics to first-generation cephalosporins. The patient\'s fever did not return and he was discharged on day 7. The patient was seen in the clinic 1 week after discharge, with complete resolution of symptoms. Magnetic resonance urography and dynamic renal scintigraphy performed 2 months after discharge revealed severe bilateral hydronephroureter and obstruction of urine flow in the right kidney. As of 6 months after UTI onset, we have continued low-dose cephalexin (10 mg/kg) to prevent the recurrence of UTI and there has been no recurrence. As in this case, children with UTI caused by R. planticola may be associated with CAKUT; therefore, we should actively screen to detect CAKUT. Patients with CAKUT are at high risk of UTI recurrence, so long-term use of unnecessary broad-spectrum antibiotics should be avoided to prevent antimicrobial resistance. However, R. planticola infection is sometimes life-threatening. Hence, it is also important to use sufficiently strong antibiotics for an appropriate period. Although the optimal management of R. planticola infection in children has not been clearly established, we suggest that we can treat UTI caused by R. planticola mainly using first-generation cephalosporins.

Raoultella planticola is a gram-negative, aerobic, nonmotile bacteria that can be found in soil and water. This is a relatively rare organism with few case reports on it and only three reports of R. planticola-induced urinary tract infection (UTI) have been reported. Here we present a case of acute cystitis caused by R. planticola in a woman with atrial fibrillation and recurrent UTIs.

The genus Raoultella was established in 2001. Species of Raoultella and Klebsiella share many ecological, biochemical, clinical, and microbiological features. Given the shortcomings of available technology for species identification in the clinical microbiology laboratory, are practically indistinguishable. Since the late 2000s there has been an increase in case reports of human Raoultella infections. Therefore, several authors are postulating that Raoultella spp. are rare and/or emerging pathogens. Conclusions: Raoultella spp. are very similar to Klebsiella spp. The epidemiology and the clinical relevance of the human Raoultella spp. infections is uncertain and further studies are required. The previous difficulties in the identification of Raoultella spp. and the introduction of more precise identification techniques may explain the recent increase in the number of case reports. Raoultella spp. might be rather underdiagnosed than rare or emerging pathogens.