Reactions 1704, p118 - 2 Jun 2018 Acquired resistance during treatment of Klebsiella pneumoniae: case report A man acquired resistance to colistin while receiving treatment for Klebsiella pneumoniae infection [route not stated]. The man was hospitalised for multiple bone fractures that occurred following a six floor fall. A routine rectal screening revealed Klebsiella pneumoniae FR-1. The first isolate of the test was resistant to fluoroquinolones, carbapenems, rifampicin and trimethoprim/sulfamethoxazole. He then developed high-grade fever. Due to an infection due to resistant Gram-negative bacteria was suspected, he received treatment with antibiotics of colistin 5 mg/kg of body weight/day and amikacin 15 mg/kg/day for two days. Eight days later, he developed a wound infection that revealed Klebsiella pneumoniae strain FR-2 (with the same resistance profile as FR-1). Therefore, he was switched to tigecycline 100 mg twice/day, colistin 5 mg/kg/day, and amikacin 15 mg/kg/day. Another Klebsiella pneumoniae isolate (FR-3) was found from the same wound and demonstrated additional resistance to colistin [duration of treatment to reaction onset not stated]. Therefore, antibacterials was changed to doripenem, fosfomycin and tigecycline, that cured the Klebsiella pneumoniae infection. Author comment: "Then, another K. pneumoniae isolate (FR-3) was recovered from the same wound and exhibited additional resistance to colistin." "Here, the genetic basis of the antibiotic resistance determinants of a carbapenem- and colistin-resistant K. pneumoniae isolate was investigated." Pillonel T, et al. Resistome analysis of a carbapenemase (OXA-48)-Producing and colistin-resistant klebsiella pneumoniae strain. Antimicrobial Agents and Chemotherapy 62: e00076-18, No. 6, May 2018. Available from: URL: http:// doi.org/10.1128/AAC.00076-18 - Switzerland 803323914 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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