Endocarditis caused by extended-spectrum-beta-lactamase-producing Klebsiella pneumoniae: emergence of resistance to ciprofloxacin and piperacillin-tazobactam during treatment despite initial susceptibility - PubMed (original) (raw)
Case Reports
Endocarditis caused by extended-spectrum-beta-lactamase-producing Klebsiella pneumoniae: emergence of resistance to ciprofloxacin and piperacillin-tazobactam during treatment despite initial susceptibility
Oren Zimhony et al. Antimicrob Agents Chemother. 2006 Sep.
Abstract
Three episodes of bacteremia occurred in the course of prosthetic valve endocarditis caused by an extended-spectrum-beta-lactamase (ESBL)-producing Klebsiella pneumoniae strain. The second isolate developed resistance to ciprofloxacin and the third isolate to piperacillin-tazobactam (PIP-TZ) following sequential therapy with each agent. The first isolate was resistant to PIP-TZ only at high inocula, the second isolate acquired increased transcription of the acrA gene, and the third isolate became resistant to PIP-TZ due to loss of beta-lactamase inhibition by TZ. We question if and how PIP-TZ susceptibility should be reported for ESBL-producing Enterobacteriaceae.
Figures
FIG. 1.
Clinical course of treatment, including documentation of bacteremia and antimicrobial regimens used, for the patient described in the text. Cefepime was given at a dose of 2 g twice a day, ciprofloxacin at 400 mg twice a day, piperacillin-tazobactam at 4.5 g three times a day, amikacin at 500 mg twice a day, and meropenem at 1 g three times a day.
FIG. 2.
Determination of β-lactamase activity in cell-free crude extract by use of nitrocefin hydrolysis with and without tazobactam. β-Lactamase activity is expressed as units per milligram protein per minute.
Similar articles
- Piperacillin/tazobactam in the treatment of Klebsiella pneumoniae infections in neonates.
Pillay T, Pillay DG, Adhikari M, Sturm AW. Pillay T, et al. Am J Perinatol. 1998 Jan;15(1):47-51. doi: 10.1055/s-2007-993898. Am J Perinatol. 1998. PMID: 9475688 - In vitro and in vivo activities of piperacillin-tazobactam and meropenem at different inoculum sizes of ESBL-producing Klebsiella pneumoniae.
Harada Y, Morinaga Y, Kaku N, Nakamura S, Uno N, Hasegawa H, Izumikawa K, Kohno S, Yanagihara K. Harada Y, et al. Clin Microbiol Infect. 2014 Nov;20(11):O831-9. doi: 10.1111/1469-0691.12677. Epub 2014 Jun 14. Clin Microbiol Infect. 2014. PMID: 24813594 - In vitro killing of parenteral beta-lactams against standard and high inocula of extended-spectrum beta-lactamase and non-ESBL producing Klebsiella pneumoniae.
Burgess DS, Hall RG 2nd. Burgess DS, et al. Diagn Microbiol Infect Dis. 2004 May;49(1):41-6. doi: 10.1016/j.diagmicrobio.2003.11.007. Diagn Microbiol Infect Dis. 2004. PMID: 15135499 - Antibiotic policy and prescribing strategies for therapy of extended-spectrum beta-lactamase-producing Enterobacteriaceae: the role of piperacillin-tazobactam.
Peterson LR. Peterson LR. Clin Microbiol Infect. 2008 Jan;14 Suppl 1:181-4. doi: 10.1111/j.1469-0691.2007.01864.x. Clin Microbiol Infect. 2008. PMID: 18154544 Review. - Role of primary bacterial contamination of a pulmonary homograft for Ross operation: report of a case and review of the literature.
Blehm A, Schurr P, Lichtenberg A. Blehm A, et al. Thorac Cardiovasc Surg. 2013 Sep;61(6):541-2. doi: 10.1055/s-0031-1293601. Epub 2012 Jan 3. Thorac Cardiovasc Surg. 2013. PMID: 22215504 Review.
Cited by
- Diagnosis of E. coli tricuspid valve endocarditis: a case report.
Tsutsumi T, Hiraoka E, Kanazawa K, Akita H, Eron LJ. Tsutsumi T, et al. Hawaii Med J. 2010 Dec;69(12):286-8. Hawaii Med J. 2010. PMID: 21225584 Free PMC article. - Treatment with fluoroquinolones or with beta-lactam-beta-lactamase inhibitor combinations is a risk factor for isolation of extended-spectrum-beta-lactamase-producing Klebsiella species in hospitalized patients.
Wener KM, Schechner V, Gold HS, Wright SB, Carmeli Y. Wener KM, et al. Antimicrob Agents Chemother. 2010 May;54(5):2010-6. doi: 10.1128/AAC.01131-09. Epub 2010 Mar 8. Antimicrob Agents Chemother. 2010. PMID: 20211888 Free PMC article. - Gram-negative endocarditis.
Reyes MP, Reyes KC. Reyes MP, et al. Curr Infect Dis Rep. 2008 Jul;10(4):267-74. doi: 10.1007/s11908-008-0044-5. Curr Infect Dis Rep. 2008. PMID: 18765099 - Examining the Clinical Effectiveness of Non-Carbapenem β-Lactams for the Treatment of Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae.
Gibble AM, Gross AE, Huang AM. Gibble AM, et al. Antibiotics (Basel). 2015 Dec 15;4(4):653-66. doi: 10.3390/antibiotics4040653. Antibiotics (Basel). 2015. PMID: 27025645 Free PMC article. Review. - A statistical approach for determination of disk diffusion-based cutoff values for systematic characterization of wild-type and non-wild-type bacterial populations in antimicrobial susceptibility testing.
Valsesia G, Roos M, Böttger EC, Hombach M. Valsesia G, et al. J Clin Microbiol. 2015 Jun;53(6):1812-22. doi: 10.1128/JCM.03506-14. Epub 2015 Mar 11. J Clin Microbiol. 2015. PMID: 25762772 Free PMC article.
References
- Anderson, M. J., and E. N. Janof. 1998. Klebsiella endocarditis: report of two cases and review. Clin. Infect. Dis. 26:468-474. - PubMed
- Babini, G. S., M. Yuan, L. M. Hall, and D. M. Livermore. 2003. Variable susceptibility to piperacillin/tazobactam amongst Klebsiella spp. with extended-spectrum beta-lactamases. J. Antimicrob. Chemother. 51:605-612. - PubMed
- Dale, J. W., D. Godwin, D. Mossakowska, P. Stephenson, and S. Wall. 1985. Sequence of the OXA-2 β-lactamase: comparison with other penicillin-reactive enzymes. FEBS Lett. 191:39-44. - PubMed
- Endimiani, A., F. Luzzaro, M. Perilli, G. Lombardi, A. Coli, A. Tamborini, G. Amicosante, and A. Toniolo. 2004. Bacteremia due to Klebsiella pneumoniae isolates producing the TEM-52 extended-spectrum beta-lactamase: treatment outcome of patients receiving imipenem or ciprofloxacin. Clin. Infect. Dis. 38:243-251. - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources