Therapeutic strategy for pandrug-resistant Klebsiella pneumoniae severe infections: short-course treatment with colistin increases the in vivo and in vitro activity of double carbapenem regimen

Int J Infect Dis. 2015 Apr:33:132-4. doi: 10.1016/j.ijid.2015.01.011. Epub 2015 Jan 15.

Abstract

Infections due to carbapenemase-producing Klebsiella pneumoniae represent an emerging threat due to the high mortality rate and lack of valid antimicrobial combinations, especially when the strain is colistin-resistant. We report a case of bloodstream infection due to pandrug-resistant K. pneumoniae treated successfully with an innovative regimen comprising a combination of colistin plus double carbapenem, along with an in vitro analysis showing the synergistic and bactericidal effect.

Keywords: Bloodstream infection; Colistin; Double carbapenem; Pan-drug resistant K. pneumoniae.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Proteins / genetics
  • Bacterial Proteins / metabolism
  • Carbapenems / pharmacology
  • Carbapenems / therapeutic use*
  • Colistin / pharmacology
  • Colistin / therapeutic use*
  • Drug Resistance, Multiple, Bacterial / genetics*
  • Drug Synergism
  • Drug Therapy, Combination
  • Female
  • Humans
  • Klebsiella Infections / drug therapy*
  • Klebsiella pneumoniae / drug effects*
  • Klebsiella pneumoniae / enzymology
  • Klebsiella pneumoniae / genetics*
  • Microbial Sensitivity Tests
  • beta-Lactam Resistance / genetics*
  • beta-Lactamases / genetics
  • beta-Lactamases / metabolism

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Carbapenems
  • beta-Lactamases
  • carbapenemase
  • Colistin