Meropenem-Vaborbactam as Salvage Therapy for Ceftazidime-Avibactam-Resistant Klebsiella pneumoniae Bacteremia and Abscess in a Liver Transplant Recipient

被引：69

作者：

Athans, Vasilios ^{[1
]}

Neuner, Elizabeth A. ^{[1
]}

Hassouna, Habiba ^{[2
]}

Richter, Sandra S. ^{[3
]}

Keller, George ^{[3
]}

Castanheira, Mariana ^{[4
]}

Brizendine, Kyle D. ^{[2
]}

Mathers, Amy J. ^{[5
,6
]}

机构：

[1] Cleveland Clin, Dept Pharm, Cleveland, OH 44106 USA

[2] Cleveland Clin, Dept Infect Dis, Cleveland, OH 44106 USA

[3] Cleveland Clin, Dept Lab Med, Cleveland, OH 44106 USA

[4] JMI Labs, North Liberty, IA USA

[5] Univ Virginia Hlth Syst, Dept Med, Div Infect Dis & Int Hlth, Charlottesville, VA 22903 USA

[6] Univ Virginia Hlth Syst, Dept Pathol, Clin Microbiol Lab, Charlottesville, VA 22903 USA

来源：

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY | 2019年 / 63卷 / 01期

关键词：

Klebsiella pneumoniae carbapenemase; carbapenem-resistant Enterobacteriaceae; carbapenemase-producing Klebsiella pneumoniae; ceftazidime-avibactam; meropenem-vaborbactam; INFECTIONS; KPC; ENTEROBACTERIACEAE; MORTALITY; COLISTIN;

D O I：

10.1128/AAC.01551-18

中图分类号：

Q93 [微生物学];

学科分类号：

071005 ; 100705 ;

摘要：

We report a case of a 24-year-old liver transplant recipient who developed hepatic artery thrombosis and graft failure, which was complicated by subphrenic abscess and persistent Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae bacteremia. Ceftazidime-avibactam treatment led to emergence of resistance, and alternative combination therapy failed due to persistent infection and toxicity. The infection resolved after initiation of meropenem-vaborbactam, which created a bridge to retransplantation. Treatment-emergent ceftazidime-avibactam resistance is increasingly recognized, suggesting a role for meropenem-vaborbactam.

引用

页数：8

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