Multidrug-resistant Serratia liquefaciens urinary tract infection in chronic kidney disease: a case report
Abstract
Abstract Background: Serratia liquefaciens is an uncommon opportunistic Gram-negative bacillus that has been reported in healthcare-associated infections but is rarely implicated as a urinary pathogen in human clinical practice. Its isolation from urine requires careful clinical correlation, particularly in patients with renal disease, urinary tract abnormalities, recurrent healthcare exposure, and limited antimicrobial options. Case presentation: A 66-year-old Indian woman presented with a 15-day history of cloudy, foul-smelling urine, generalized weakness, and decreased appetite. She had chronic kidney disease, systemic hypertension, ischemic heart disease, non-obstructive uropathy, bilateral hydronephrosis, and previous emphysematous cystitis. Urine examination showed trace albumin and plenty of pus cells. Imaging demonstrated bilateral pyelitis with cystitis, bilateral small kidneys, and a small cortical cyst with internal debris in the lower pole of the left kidney. Urine culture grew Serratia liquefaciens , identified using an automated bacterial identification system. The isolate showed resistance to beta-lactam/beta-lactamase inhibitor combinations, cephalosporins, carbapenems, gentamicin, ciprofloxacin, and trimethoprim-sulfamethoxazole, while susceptibility was reported to tigecycline, fosfomycin, and colistin. Blood culture showed no growth. Empirical piperacillin-tazobactam and vancomycin were started, and antimicrobial therapy was subsequently reviewed according…
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