Case series of carbapenemase-producing Enterobacteriaceae osteomyelitis: Feel it in your bones

B Davido; L Noussair; A Saleh-Mghir; E Salomon; F Bouchand; M Matt; C Lawrence; T Bauer; J L Herrmann; C Perronne; J L Gaillard; M Rottman; A Dinh

doi:10.1016/j.jgar.2020.08.007

Case series of carbapenemase-producing Enterobacteriaceae osteomyelitis: Feel it in your bones

J Glob Antimicrob Resist. 2020 Dec:23:74-78. doi: 10.1016/j.jgar.2020.08.007. Epub 2020 Sep 1.

Authors

B Davido¹, L Noussair², A Saleh-Mghir³, E Salomon⁴, F Bouchand⁵, M Matt³, C Lawrence², T Bauer⁶, J L Herrmann⁷, C Perronne³, J L Gaillard⁸, M Rottman⁷, A Dinh³

Affiliations

¹ Service des Maladies Infectieuses, Centre Hospitalier Universitaire Raymond Poincaré, AP-HP, Garches, France. Electronic address: benjamin.davido@aphp.fr.
² Laboratoire de Microbiologie, Centre Hospitalier Universitaire Raymond Poincaré, AP-HP, Garches, France.
³ Service des Maladies Infectieuses, Centre Hospitalier Universitaire Raymond Poincaré, AP-HP, Garches, France.
⁴ Laboratoire de Microbiologie, Centre Hospitalier Universitaire Ambroise Paré, AP-HP, Boulogne-Billancourt, France.
⁵ Pharmacie Hospitalière, Centre Hospitalier Universitaire Raymond Poincaré, AP-HP, Garches, France.
⁶ Service d'Orthopédie, Centre Hospitalier Universitaire Ambroise Paré, AP-HP, Boulogne-Billancourt, France.
⁷ Laboratoire de Microbiologie, Centre Hospitalier Universitaire Raymond Poincaré, AP-HP, Garches, France; UMR UVSQ INSERM U1173, UFR Simone Veil des Sciences de la Santé, Montigny le Bx, France.
⁸ Laboratoire de Microbiologie, Centre Hospitalier Universitaire Ambroise Paré, AP-HP, Boulogne-Billancourt, France; UMR UVSQ INSERM U1173, UFR Simone Veil des Sciences de la Santé, Montigny le Bx, France.

PMID: 32882450
DOI: 10.1016/j.jgar.2020.08.007

Abstract

Objectives: Limited data have been reported regarding osteomyelitis due to carbapenemase-producing Enterobacteriaceae (CPE), including co-infections with extended-spectrum β-lactamase (ESBL)-producing micro-organisms.

Methods: We conducted a retrospective study in a reference centre for bone and joint infections from 2011 to 2019 among patients infected with CPE.

Results: Nine patients (mean age 46.8 ± 16.6 years), including three with infected implants, were identified. Infections were mostly polymicrobial (n = 8/9), including Staphylococcus aureus (n = 6/9). CPE were mainly OXA-48-type, associated with ESBL-producing Enterobacteriaceae (n = 8/9), of which 5/9 isolates were Klebsiella pneumoniae. Control of the infection was achieved in seven cases.

Conclusions: CPE osteomyelitides are essentially polymicrobial and fluoroquinolone-resistant infections, highlighting the need for efficient surgery with implant removal.

Keywords: Bone; CPE; Carbapenemase; Enterobacteriaceae; Infection; Osteomyelitis.

MeSH terms

Adult
Bacterial Proteins / genetics
Carbapenem-Resistant Enterobacteriaceae*
Enterobacteriaceae Infections*
Humans
Middle Aged
Osteomyelitis*
Retrospective Studies
beta-Lactamases / genetics

Substances

Bacterial Proteins
beta-Lactamases