# Catheter-Related Bloodstream Infection with Leclercia adecarboxylata and Enterobacter cloacae Complex Co-Infection: A Case Report and Literature Review

## TL;DR

A rare case of bloodstream infection caused by two bacteria in a cancer patient is reported, emphasizing the importance of considering uncommon pathogens in catheter-related infections.

## Contribution

First documented case of co-infection by Leclercia adecarboxylata and Enterobacter cloacae complex in a catheter-related bloodstream infection.

## Key findings

- Both isolates were susceptible to β-lactams, quinolones, and aminoglycosides.
- The patient recovered after ciprofloxacin treatment and chemoport removal.
- The case highlights the clinical relevance of rare environmental Gram-negative organisms in immunocompromised hosts.

## Abstract

Catheter-related bloodstream infections (CRBSIs) caused by Leclercia adecarboxylata are uncommon, and polymicrobial cases are even rarer. We report the first documented case caused by co-infection with Leclercia adecarboxylata and Enterobacter cloacae complex (ECC) in a woman with breast cancer undergoing chemotherapy through an indwelling chemoport. Antimicrobial susceptibility testing revealed that both isolates were susceptible to β-lactams, quinolones, and aminoglycosides. The patient achieved complete clinical recovery following intravenous ciprofloxacin therapy and prompt removal of the chemoport. This case highlights the emerging clinical relevance of Leclercia adecarboxylata and Enterobacter cloacae complex as potential pathogens capable of causing polymicrobial bloodstream infections in immunocompromised hosts and underscores the importance of considering rare environmental Gram-negative organisms as potential causes of catheter-related infections, particularly in patients with malignancy or long-term vascular access.