@article{MRA, author = {Ayoub Rafei and Hamza Oualhadj and Taoufik Houmich and Asmae Hanchi and Nabila Soraa}, title = { Wohlfahrtiimonas chitiniclastica bacteremia: First Documented Case in Morocco and North Africa}, journal = {Medical Research Archives}, volume = {12}, number = {7}, year = {2024}, keywords = {}, abstract = {Background: Wohlfahrtiimonas chitiniclastica is an emerging pathogen associated with severe infections, predominantly found in compromised individuals and often underestimated due to diagnostic challenges. This case report documents the first recorded instance of Wohlfahrtiimonas chitiniclastica bacteremia in Morocco and North Africa, arising from an infected external fixator. Case Presentation: A 24-year-old male presented to the emergency department with signs of severe sepsis. He had been previously treated with an external fixator for an open leg fracture. Despite having no significant past medical history or high-risk lifestyle behaviors, he developed rapidly progressing symptoms including cutaneous necrosis and systemic infection markers. Laboratory tests confirmed hyperleukocytosis, elevated C-reactive protein, and raised procalcitonin levels. Blood and tissue cultures identified Wohlfahrtiimonas chitiniclastica, along with Providencia stuartii and Enterococcus faecalis. The patient was treated in the intensive care unit with broad-spectrum antibiotics initially, followed by targeted therapy based on susceptibility profiles, and underwent surgical debridement of the infection site. Discussion: The identification of Wohlfahrtiimonas chitiniclastica in this case marks an important development in its epidemiological profile. Once thought to be limited to specific regions and vectors, it is now recognized globally, suggesting a wider ecological presence and varied transmission routes. This case notably links the bacterium’s infections to breaches in skin integrity, like wounds and chronic ulcers, highlighting them as primary infection gateways. The use of MALDI-TOF mass spectrometry was crucial for the swift and precise identification of Wohlfahrtiimonas chitiniclastica, proving more effective than traditional biochemical methods. Additionally, 16S rRNA gene sequencing offered valuable insights into the organism's taxonomy and resistance patterns, underscoring the critical role of these advanced diagnostics in modern clinical microbiology. Despite the bacterium's broad susceptibility to antibiotics, vigilance is crucial due to the potential for emerging resistance. This risk is heightened by antibiotic use in chronic wound management, emphasizing the need for continual surveillance and rigorous antibiotic stewardship to prevent therapeutic failures and resistance proliferation. Conclusion: This case highlights Wohlfahrtiimonas chitiniclastica's worldwide distribution and its link to compromised skin integrity. Advanced diagnostics like MALDI-TOF MS and 16S rRNA sequencing proved crucial in identifying this pathogen. The potential for antibiotic resistance necessitates ongoing surveillance and prudent management to control infections and curb resistance. This case reinforces the need to include W. chitiniclastica in differential diagnoses, especially in cases involving skin breaches.}, issn = {2375-1924}, doi = {10.18103/mra.v12i7.5430}, url = {https://esmed.org/MRA/mra/article/view/5430} }