Cedecea infections in humans - A narrative review

Background

Cedecea species are Gram-negative, facultative anaerobic, non-sporulating, catalase-positive, oxidase-negative and motile rod shaped bacteria belonging to Enterobacteriaceae family. Members of the genus Cedecea are rarely reported to cause human infections. These infections primarily occur in immunocompromised patients with severe underlying medical conditions. The objective of this review was to collect and evaluate all published documented cases of Cedecea spp. human infections.

Methods

We searched PubMed and Scopus databases for articles providing data related to the epidemiology, clinical features and microbiology of Cedecea human infections.

Results

A total of 49 studies involving 50 patients with Cedecea infections were regarded as eligible for inclusion in our review. The mean patient age was 53.3 years and most (72 %) were male. Comorbidities were common in 88 % of the patients. The most common types of infection were bacteremia, respiratory tract infections, soft tissue infections and urinary tract infections, and more than half of them were healthcare-associated. C. lapagei was the predominant species, followed by C. davisae and C. neteri. High rates of resistance were recorded for ampicillin (47.6 %), gentamicin (38.1 %), amoxicillin-clavulanate, cephalothin, and ceftazidime (33.3 %) each. Ciprofloxacin was the most frequently used antibiotic, followed by meropenem. The median treatment duration was 14 days. The outcome was favorable for the majority of the patients (87.8 %). The mortality rate attributed to the infection was 10.2 %.

Conclusions

Physicians should be aware of this rare pathogen that exhibits resistance to many antibiotics, so they can tailor antimicrobial treatment based on susceptibility testing results to optimize outcome.