Evolution of tigecycline resistance in Klebsiella pneumoniae in a single patient

Carbapenemise producing Klebsiella pneumoniae infections carry serious clinical and infection control implications Isolates possessing such hydrolyzing enzymes have been described in the United States and around the world Besides being resistant to carbapenems they usually confer resistance to fluoro quinolones piperacillin tazobactam and extended spectrum cephalosporins Tigecycline demonstrates in vitro activity against these organisms but reported resistance raises concern about tigecycline use for these infections We describe a carbapenemase producing K pneumoniae evolving resistance to tigecy cline in 75 year old male after a prolonged stay in a critical care unit