Ventilator-associated pneumonia caused by colistin-resistant KPC-producing Klebsiella pneumoniae: a case report and literature review

Respir Investig. 2015 May;53(3):124-8. doi: 10.1016/j.resinv.2015.01.001. Epub 2015 Feb 20.

Abstract

Klebsiella pneumoniae producing KPC-type carbapenemase causes severe nosocomial infection at a high mortality rate. Nosocomial pneumonia in particular is associated with high mortality, likely due to the unfavorable pulmonary pharmacokinetics of the antibiotics used against this agent. Therefore, early and accurate microbiological identification and susceptibility evaluation are crucial in order to optimize antibiotic therapy. We report a case of ventilator-associated pneumonia caused by colistin-resistant K. pneumoniae producing KPC-type carbapenemase treated using a carbapenem-sparing therapy and tailored according to the serum procalcitonin concentration in order to limit the duration of antibiotic therapy.

Keywords: Colistin-resistant KPC producing Klebsiella pneumoniae; Drug pharmacokinetics; Intensive care unit; Ventilator-associated pneumonia.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Bacterial Proteins / biosynthesis
  • Calcitonin / blood
  • Calcitonin Gene-Related Peptide
  • Colistin / administration & dosage
  • Colistin / analogs & derivatives
  • Cross Infection / drug therapy
  • Cross Infection / etiology*
  • Cross Infection / microbiology*
  • Drug Resistance, Bacterial
  • Drug Therapy, Combination
  • Equipment Contamination*
  • Fosfomycin / administration & dosage
  • Humans
  • Klebsiella Infections / drug therapy
  • Klebsiella Infections / etiology*
  • Klebsiella Infections / microbiology*
  • Klebsiella pneumoniae / isolation & purification
  • Klebsiella pneumoniae / metabolism
  • Klebsiella pneumoniae / pathogenicity*
  • Male
  • Minocycline / administration & dosage
  • Minocycline / analogs & derivatives
  • Pneumonia, Bacterial / drug therapy
  • Pneumonia, Bacterial / etiology*
  • Pneumonia, Bacterial / microbiology*
  • Protein Precursors / blood
  • Tigecycline
  • Treatment Outcome
  • Ventilators, Mechanical / adverse effects*
  • Ventilators, Mechanical / microbiology*
  • beta-Lactamases / biosynthesis

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • CALCA protein, human
  • Protein Precursors
  • Fosfomycin
  • Tigecycline
  • Calcitonin
  • colistinmethanesulfonic acid
  • beta-Lactamases
  • carbapenemase
  • Minocycline
  • Calcitonin Gene-Related Peptide
  • Colistin