Kocuria kristinae: an emerging pathogen in medical practice.

Introduction. Kocuria kristinae is becoming a growing public health challenge, especially for its ability to cause infections in immunocompromised patients. This bacterium is a Gram+coccus, catalase+, coagulase, and it is a common inhabitant of skin and oral mucosa.Aim. To investigate the spectrum of infections caused by K. K ristinae.Methodology. Between January-March 2018, we carried out a systematic search in PubMed utilizing the key search term 'Kocuria kristinae'. The selection criteria for studies were studies reporting cases of human infections due to K. kristinae, case-control and cohort studies and studies published in English or Spanish.Results. The literature search yielded 48 publications: after title, abstract and full-text analysis, 20 papers were consistent with the selection criteria. These studies were carried out in the period 2001-2017 in the USA, Japan, Taiwan, Hong Kong, Ukraine, Egypt, Bahrain, Serbia, India, Italy, Spain, Turkey and Mexico. K. kristinae was involved in 17 cases of central venous catheter-related bacteremia, four infective endocarditis, three acute peritonitis, one abdominal abscess, umbilical sepsis, acute cholecystitis and urinary tract infection. Additionally, K. kristinae was found in 40 % of carious cavities, although it is not clear whether they are directly involved in the development of caries. Antibiotic susceptibility testing has sometimes revealed multi-drug resistance.Conclusions. The clinical spectrum of K. kristinae infections has recently widened. The increasing spread of this underestimated bacterium and its resistance to antibiotics represent a new challenge for public health, which requires specific actions to limit it.