Development of ertapenem resistance in a patient with mediastinitis caused by Klebsiella pneumoniae producing an extended-spectrum β-lactamase

被引：30

作者：

Skurnik, David ^{[1
]}

Lasocki, Sigismond

Bremont, Sylvie ^{[2
]}

Muller-Serieys, Claudette ^{[1
]}

Kitzis, Marie Dominique ^{[3
]}

Courvalin, Patrice ^{[2
]}

Andremont, Antoine ^{[1
]}

Montravers, Philippe

机构：

[1] Univ Paris 07, Hop Bichat Claude Bernard, AP HP, Bacteriol Lab, F-75877 Paris 18, France

[2] Inst Pasteur, Unite Agents Antibacteriens, F-75724 Paris, France

[3] Fdn Hop St Joseph, Paris, France

来源：

JOURNAL OF MEDICAL MICROBIOLOGY | 2010年 / 59卷 / 01期

关键词：

COMPLICATED INTRAABDOMINAL INFECTIONS; PORIN EXPRESSION; DOUBLE-BLIND; CARBAPENEMS; SUSCEPTIBILITY; RESTRICTION; THERAPY; OMPK36; TRIAL; DNA;

D O I：

10.1099/jmm.0.012468-0

中图分类号：

Q93 [微生物学];

学科分类号：

071005 ; 100705 ;

摘要：

The aim was to study the clinical and microbiological features associated with a carbapenem-resistant Klebsiella pneumoniae isolate that had been selected in vivo by an ertapenem-containing regimen in a patient with mediastinitis despite high blood and mediastinal levels of ertapenem. Carbapenem resistance was characterized by conjugation, PCR, DNA sequencing and analysis of outer-membrane proteins. The isolates susceptible and resistant to the carbapenems were compared by ribotyping and PFGE. Resistance to all available beta-lactams was most probably due to combined production of extended-spectrum beta-lactamase (ESBL) CTX-M-15 and loss of OmpK36 porin. The results of ribotyping and PFGE suggest that the carbapenem-resistant strain was a derivative of the original mediastinal isolate rather than a superinfecting isolate. This observation stresses the risk of selection of pan-penem resistant strains of enterobacteria. when ertapenem is used for the treatment of severe infections due to ESBL-producing enterobacteria.

引用

页码：115 / 119

页数：5

共 17 条

[1] A COMPLEMENTATION ANALYSIS OF RESTRICTION AND MODIFICATION OF DNA IN ESCHERICHIA COLI [J].