THE EXPANDING SPECTRUM OF HUMAN INFECTIONS CAUSED BY KOCURIA SPECIES IN PAEDIATRIC PATIENTS: ONE YEAR OBSERVATIONAL, PROSPECTIVE HOSPITAL-BASED STUDY

Abstract

Intro: Kocuria species, which were uncommon in causing human infections, are now being increasingly reported as human pathogens, especially in immunocompromised patients. The advent of new and automated identification methods has led to better diagnosis of Kocuria infections. There are no welldefined treatment guidelines of Kocuria infections, hence its identification is of utmost importance in appropriate clinical management Methods: A total of 14 paediatric patients from January 2021- December 2021 were observed to be showing the presence of Kocuria isolates in various invasive samples (10 CSF, 1 each of BAL, Pus, Peritoneal fluid, Extra-ventricular drainage tip). The isolates were subjected to gram staining, culture plating, biochemical identification and then confirmed by Vitek 2 and MALDI-TOF-MS. Findings: Of total 14 isolates, 6 each of Kocuria kristinae (3 CSF, 1 Pus, 1 BAL, 1 EVD tip) and Kocuria rosea (5 CSF, 1 Peritoneal fluid) and 2 isolates of Kocuria rhizophila (2 CSF) were identified. Antibiotic susceptibility testing was performed by disc diffusion methods and zone interpretation was followed that of Staphylococcus due to lack of established criteria for Kocuria in CLSI. Antibiogram differed amongst the three species of Kocuria isolates. Kocuria was not isolated from any adult patient in that observation period. All the patients responded well to the therapy. Owing to economical and technical limitations, molecular methods such as PCR and sequencing could not be performed Conclusion: Due to the misidentification of Kocuria species, it is required that clinicians should not underestimate the pathogenic potential of Kocuria spp. especially in immunocompromised patients and when isolated from invasive samples. High cost and requirement of technical expertise involved in automated identification systems may limit their use in routine practice for Kocuria identification. Furthermore, lack of established guidelines for performing antibiotic susceptibility testing and treatment of Kocuria associated infections remains a cause of concern.