Successful treatment of infective endocarditis due to pandrug-resistant Klebsiella pneumoniae with ceftazidime-avibactam and aztreonam

被引:0
|
作者
Majed F. Alghoribi
Moayad Alqurashi
Liliane Okdah
Bassam Alalwan
Yahya S. AlHebaishi
Abdulmajeed Almalki
Maha A. Alzayer
Abdulrahman A. Alswaji
Michel Doumith
Mazin Barry
机构
[1] King Abdullah International Medical Research Center,Infectious Diseases Research Department
[2] King Saud Bin Abdulaziz University for Health Sciences,Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City (KAMC)
[3] Ministry of National Guard Health Affairs (MNGHA),Division of Adult Infectious Diseases, Department of Medicine
[4] Prince Sultan Military Medical City,Department of Adult Cardiology
[5] Prince Sultan Cardiac Center,Division of Infectious Diseases, College of Medicine
[6] King Saud University,undefined
来源
关键词
D O I
暂无
中图分类号
学科分类号
摘要
Pandrug-resistant (PDR) K. pneumoniae refractory to conventional treatment has been reported worldwide, causing a huge burden on the healthcare system, patient safety and the economy. K. pneumoniae is a prominent opportunistic pathogen causing hospital-acquired and community-acquired infections, but is rarely associated with infective endocarditis. Currently, there are sparse data guiding the optimal regimen when commonly used antibiotics fail, notably for the treatment of endocarditis infections. Here we report our experience in treating a 40-year-old female with PDR K. pneumoniae infection of cardiovascular implantable electronic device (CIED) and right-sided infective endocarditis. Initial susceptibility testing of the incriminated pathogen showed an apparent susceptibility to colistin but the prolonged course of colistin, gentamicin and meropenem did not resolve the infection. However, the synergistic combinations of aztreonam with ceftazidime-avibactam was able to overcome resistance and clear the infection rapidly. Genome sequencing showed that the PDR K. pneumoniae isolate belongs to the international high-risk clone ST14. The isolate harbored genes encoding NDM-1, OXA-48, CTX-M-14b, SHV-28 and OXA-1, explaining resistance to all β-lactams, including carbapenems. It carried the armA gene conferring resistance to all clinically important aminoglycosides and had alterations in GyrA, ParC and MgrB, explaining resistance to ciprofloxacin and colistin.
引用
收藏
相关论文
共 50 条
  • [1] Successful treatment of infective endocarditis due to pandrug-resistant Klebsiella pneumoniae with ceftazidime-avibactam and aztreonam
    Alghoribi, Majed F.
    Alqurashi, Moayad
    Okdah, Liliane
    Alalwan, Bassam
    AlHebaishi, Yahya S.
    Almalki, Abdulmajeed
    Alzayer, Maha A.
    Alswaji, Abdulrahman A.
    Doumith, Michel
    Barry, Mazin
    [J]. SCIENTIFIC REPORTS, 2021, 11 (01)
  • [2] Successful Treatment of Pandrug-resistant Klebsiella pneumoniae Infection With Ceftazidime-avibactam in a Preterm Infant A Case Report
    Coskun, Yesim
    Atici, Serkan
    [J]. PEDIATRIC INFECTIOUS DISEASE JOURNAL, 2020, 39 (09) : 854 - 856
  • [3] Successful rescue treatment of sepsis due to a pandrug-resistant, NDM-producing Klebsiella pneumoniae using aztreonam powder for nebulizer solution as intravenous therapy in combination with ceftazidime/avibactam
    Sieswerda, Elske
    van den Brand, Marre
    van den Berg, Roland B.
    Strater, Joris
    Schouls, Leo
    van Dijk, Karin
    Budding, Andries E.
    [J]. JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2020, 75 (03) : 773 - 775
  • [4] Successful Treatment of Carbapenemase-Producing Pandrug-Resistant Klebsiella pneumoniae Bacteremia
    Camargo, Jose F.
    Simkins, Jacques
    Beduschi, Thiago
    Tekin, Akin
    Aragon, Laura
    Perez-Cardona, Armando
    Prado, Clara E.
    Morris, Michele I.
    Abbo, Lilian M.
    Canton, Rafael
    [J]. ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2015, 59 (10) : 5903 - 5908
  • [5] Antibacterial Activity and Optimal Treatment of Ceftazidime-Avibactam and Aztreonam-Avibactam Against Bloodstream Infections Caused by Carbapenem-Resistant Klebsiella pneumoniae
    Yu, Wei
    Chen, Yunbo
    Shen, Ping
    Ji, Jinru
    Ying, Chaoqun
    Liu, Zhiying
    Xiong, Luying
    Qiu, Yunqing
    Xiao, Yonghong
    [J]. FRONTIERS IN PHARMACOLOGY, 2021, 12
  • [6] Successful ceftazidime-avibactam therapy in a patient with multidrug-resistant Pseudomonas aeruginosa infective endocarditis
    Lima, Olalla
    Sousa, Adrian
    Filgueira, Anton
    Otero, Anton
    Cabaleiro, Andrea
    Martinez-Lamas, Lucia
    Vasallo, Francisco
    Perez-Rodriguez, M. Teresa
    [J]. INFECTION, 2022, 50 (04) : 1039 - 1041
  • [7] Ceftazidime-avibactam in the treatment of infections from carbapenem-resistant Klebsiella pneumoniae Ceftazidime-avibactam against CR- KP infections
    Gu, Jie
    Xu, Jie
    Zuo, Ting-ting
    Chen, Yan-bin
    [J]. JOURNAL OF GLOBAL ANTIMICROBIAL RESISTANCE, 2021, 26 : 20 - 25
  • [8] In Vitro Comparison of Aztreonam/Amoxicillin-Clavulanate Versus Aztreonam/Ceftazidime-Avibactam on Ceftazidime-Avibactam Resistant Stenotrophomonas maltophilia
    Cremet, Lise
    Joffraud, Leo
    Eschapasse, Emmanuel
    Bihouee, Tiphaine
    Tissot, Adrien
    Gibaud, Sophie
    Persyn, Elise
    [J]. MICROBIAL DRUG RESISTANCE, 2022, 28 (08) : 877 - 881
  • [9] Klebsiella pneumoniae Carbapenemase Variants Resistant to Ceftazidime-Avibactam: an Evolutionary Overview
    Hobson, Claire Amaris
    Pierrat, Gautier
    Tenaillon, Olivier
    Bonacorsi, Stephane
    Bercot, Beatrice
    Jaouen, Ella
    Jacquier, Herve
    Birgy, Andre
    [J]. ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2022, 66 (09)
  • [10] Ceftazidime-Avibactam for Hospital Acquired Pneumonia Due to Extended Drug-Resistant Klebsiella pneumoniae
    Amit Ranjan Rup
    Arun Kumar Dash
    Sibabratta Patnaik
    [J]. The Indian Journal of Pediatrics, 2021, 88 : 290 - 291