Two cases of monomicrobial intraabdominal abscesses due to KPC - 3 Klebsiella pneumoniaeST258 clone

Autor: DI CARLO, Paola, PANTUSO, Gianni, CUSIMANO, Alessia, D'ARPA, Francesco, GIAMMANCO, Anna, GULOTTA, Gaspare, LATTERI, Mario, SALAMONE, Giuseppe, MAMMINA, Caterina, CASUCCIO, Alessandra, Madonia, S
Přispěvatelé: Di Carlo, P, Pantuso, G, Cusimano, A, D'Arpa, F, Giammanco, A, Gulotta, G, Latteri, M, Madonia, S, Salamone, G, Mammina, C, Casuccio, A
Rok vydání: 2011
Předmět:
Klebsiellae pneumoniae
medicine.medical_specialty
Abdominal Abscess
Settore MED/17 - Malattie Infettive
carbapenemases
medicine.drug_class
Klebsiella pneumoniae
Antibiotics
Minocycline
Case Report
Drug resistance
Tigecycline
beta-Lactamases
Bacterial Proteins
Drug Resistance
Multiple
Bacterial
Pancreatitis
Chronic
Internal medicine
medicine
Humans
lcsh:RC799-869
Settore MED/12 - Gastroenterologia
biology
Colistin
business.industry
Abdominal Infection
Liver Neoplasms
Gastroenterology
General Medicine
Middle Aged
biology.organism_classification
medicine.disease
Anti-Bacterial Agents
Electrophoresis
Gel
Pulsed-Field
Klebsiella Infections
Surgery
Pancreatic Neoplasms
Settore MED/18 - Chirurgia Generale
Pancreatitis
lcsh:Diseases of the digestive system. Gastroenterology
monomicrobial abscess
Klebsiellae pneumoniae
carbapenemases
Female
business
monomicrobial abscess
medicine.drug
Liver abscess
Zdroj: BMC Gastroenterology
BMC Gastroenterology, Vol 11, Iss 1, p 103 (2011)
ISSN: 1471-230X
Popis: Background Knowledge of the etiology of pyogenic liver and pancreatic abscesses is an important factor in determining the success of combined surgical and antibiotic treatment. Literature shows geographical variations in the prevalence and distribution of causative organisms, and the spread of Klebsiella pneumoniae carbapenemase-producing bacteria is an emerging cause of abdominal infections. Case presentation We herein describe two cases of intra-abdominal abscesses due to monomicrobial infection by Klebsiella pneumoniae Sequence Type 258 producing K. pneumoniae carbapenemase 3 (KPC-Kp). In case 1, a 50-year-old HIV-negative Italian woman with chronic pancreatitis showed infection of a pancreatic pseudocystic lesion caused by KPC-Kp. In case 2, a 64-year-old HIV- negative Italian woman with pancreatic neoplasm and liver metastases developed a liver abscess due to KPC after surgery. Both women were admitted to our hospital but to different surgical units. The clonal relationship between the two isolates was investigated by pulsed-field gel electrophoresis (PFGE). In case 2, the patient was already colonized at admission and inter-hospital transmission of the pathogen was presumed. A long-term combination regimen of colistin with tigecycline and percutaneous drainage resulted in full recovery and clearance of the multidrug-resistant (MDR) pathogen. Conclusions Timely microbiological diagnosis, the combined use of new and old antibiotics and radiological intervention appeared to be valuable in managing these serious conditions. The emergence and dissemination of MDR organisms is posing an increasing challenge for physicians to develop new therapeutic strategies and control and prevention frameworks.
Databáze: OpenAIRE
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