Kytococcus Species Infections in Humans-A Narrative Review

Abstract

Kytococcus belongs to the family Kytococcaceae, in the order Micrococcales, in the class Actinomycetes, and the phylum Actinomycetota. Kytococcus are aerobic, Gram-positive, non-spore forming bacteria that form coccoid, non-motile, non-encapsulated cells, and their colonies on agar have a yellow color. Infections by these species are increasingly identified nowadays. This narrative review aimed to present all available cases of Kytococcus spp. infections in humans, emphasizing data on the epidemiology, antimicrobial resistance, antimicrobial treatment, and mortality. A narrative review based on a literature search of the PubMed/MedLine and Scopus databases was performed. Results: In total, 26 articles providing data on 30 patients with Kytococcus spp. infections were included in this analysis. The median age was 59.5 years, while 56.7% were male. The presence of a prosthetic cardiac valve was the main predisposing factor in 36.7% of patients (100% among those with infective endocarditis), while immunosuppression due to underlying hematological malignancy under chemotherapy was the second most common. Bacteremia was the most common type of infection, with infective endocarditis being the most common subtype in this infection type, while respiratory tract infections and osteoarticular infections were also relatively common. K. schroeteri was the most commonly identified species. Microbial identification required the use of advanced molecular techniques such as 16s rRNA sequencing in most cases. Kytotoccus spp. was resistant to all beta-lactams with the exception of carbapenems and macrolides. The most commonly used antimicrobials were vancomycin and rifampicin. Mortality was significant (30%). Due to the potential of Kytotoccus spp. to cause infective endocarditis in patients with prosthetic cardiac valves and respiratory tract infections with concomitant bacteremia in patients with hematological malignancy under chemotherapy along with the difficulties in pathogen identification, clinicians and laboratory personnel should consider this pathogen in the differential diagnosis in patients with typical predisposing factors and clinical presentation, especially when traditional microbiological techniques are used for pathogen identification.

Keywords: Kytococcus; bacteremia; infection; infective endocarditis; osteomyelitis; respiratory tract infection.

Figure 1

Trial flow of this narrative review.