{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T19:34:21Z","timestamp":1776454461250,"version":"3.51.2"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,1,2]],"date-time":"2024-01-02T00:00:00Z","timestamp":1704153600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec><jats:title>Key Clinical Message<\/jats:title><jats:p>Antimicrobial resistance (AMR) is a public health challenge. It causes unresponsiveness to treatment with antimicrobials, leads to sepsis, septic shock, and increased hospital mortality. This is compounded by new multidrug resistant organisms. We present and discuss a case of sepsis caused by a rare multi\u2010drug resistant bacterium <jats:italic>Raoultella ornithinolytica<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p>Antimicrobial resistance is a major public health concern worldwide, associated with nearly 5\u2009million deaths. The highest mortality attributed to AMR is seen in sub\u2010Saharan Africa. <jats:italic>Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae<\/jats:italic>, <jats:italic>Streptococcus pneumoniae<\/jats:italic>, <jats:italic>Acinetobacter baumannii<\/jats:italic>, <jats:italic>and Pseudomonas aeruginosa<\/jats:italic> contribute to most deaths attributed to AMR globally. However, other uncommon microorganisms have been implicated. Few cases of resistant, extended\u2010spectrum beta\u2010lactamase (ESBL) producing <jats:italic>Raoultella ornithinolytica<\/jats:italic> have been reported to cause sepsis worldwide. To our knowledge, no case of <jats:italic>R<\/jats:italic>. <jats:italic>ornithinolytica<\/jats:italic>\u2010induced sepsis has been reported in our settings. We report a case of sepsis due to <jats:italic>R<\/jats:italic>. <jats:italic>ornithinolytica<\/jats:italic> in an injured young adult. We received a 36\u2010year\u2010old man, a professional banker involved in a road traffic accident 2\u2009h before admission. He sustained a deep degloving wound on the right ankle with exposure of the lateral malleolus and presented with severe pain, and bleeding at the injury site. x\u2010Rays confirmed a comminuted intra\u2010articular distal tibia and fibular fracture. Surgical debridement and external fixation were aseptically done on the same day. Below knee amputation was done on the 7th day post\u2010admission due to extensively injured and infected limb with sepsis. Local pus culture isolated ESBL\u2010positive <jats:italic>R<\/jats:italic>. <jats:italic>ornithinolytica<\/jats:italic> susceptible only to meropenem, ciprofloxacin, and amikacin. Introducing these antibiotics on the 11th post\u2010admission day averted sepsis and enhanced patient recovery. With the threat of AMR, newly emerging highly resistant microbes should be expected and suspected. Early recognition of sepsis and its focus and precise intervention with antimicrobials guided by specimen culture and susceptibility profile is highly recommended and should be standard practice. It highly reduces morbidity and mortality due to sepsis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccr3.8402","type":"journal-article","created":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T04:28:48Z","timestamp":1704256128000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A rare case of <scp>multi\u2010drug<\/scp> resistant <i>Raoultella ornithinolytica<\/i><scp>\u2010induced<\/scp> sepsis in a healthy young man in Uganda"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1520-5706","authenticated-orcid":false,"given":"Elias Rugaatwa","family":"Ndibarema","sequence":"first","affiliation":[{"name":"Department of Medicine St Francis Hospital Nsambya  Kampala Uganda"},{"name":"Mother Kevin Postgraduate Medical School, School of Medicine Uganda Martyrs University  Kampala Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1289-0111","authenticated-orcid":false,"given":"Ronald","family":"Olum","sequence":"additional","affiliation":[{"name":"Department of Medicine St Francis Hospital Nsambya  Kampala Uganda"},{"name":"School of Public Health Makerere University  Kampala Uganda"},{"name":"School of Public Health Imperial College London  United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Ogavu","sequence":"additional","affiliation":[{"name":"Department of Medicine St Francis Hospital Nsambya  Kampala Uganda"},{"name":"Mother Kevin Postgraduate Medical School, School of Medicine Uganda Martyrs University  Kampala Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Makhoba","sequence":"additional","affiliation":[{"name":"Department of Medicine St Francis Hospital Nsambya  Kampala Uganda"},{"name":"Mother Kevin Postgraduate Medical School, School of Medicine Uganda Martyrs University  Kampala Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,1,2]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02724-0"},{"key":"e_1_2_11_3_1","unstructured":"O'NeillJ.Tackling drug\u2010resistant infections globally: final report and recommendations.2016."},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/14787210.2021.1951705"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-021-06799-w"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12223-015-0390-2"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S191387"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.68.7.3462-3466.2002"},{"issue":"5","key":"e_1_2_11_9_1","first-page":"174","article-title":"Emergence of Raoultella ornithinolytica on O'ahu: a case of community\u2010acquired R. Ornithinolytica urinary tract infection","volume":"74","author":"Nakasone ES","year":"2015","journal-title":"Hawaii J Med Public Health"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.11648\/j.ajhr.20140206.19"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2018.12.011"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1089\/mdr.2019.0016"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.00054-13"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-019-0488-4"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2016.02.014"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.12890\/2021_003023"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/1710271"},{"key":"e_1_2_11_19_1","unstructured":"World Health Organization.SEPSIS Fact Sheets.2020."},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-02950-2"},{"key":"e_1_2_11_21_1","unstructured":"ReinhartK.How Antimicrobial Resistance Ampli fi es the Burden of Sepsis.2021By Keynote Contributor 1\u20136."},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2014.05.005"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.20975"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpra.2022.04.004"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.8402","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T03:53:12Z","timestamp":1706845992000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.8402"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1002\/ccr3.8402"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.8402","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"2023-10-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e8402"}}