Induction and nosocomial dissemination of carbapenem and polymyxin-resistant Klebsiella pneumoniae

Rev Soc Bras Med Trop. 2015 Jul-Aug;48(4):483-7. doi: 10.1590/0037-8682-0041-2015. Epub 2015 Jun 26.

Abstract

Introduction: Polymyxins are antimicrobial agents capable of controlling carbapenemase-producing Klebsiella pneumoniae infection.

Methods: We report a cluster of four patients colonized or infected by polymyxin-resistant and Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae.

Results: Three patients were hospitalized in adjacent wards, and two were admitted to the intensive care unit. The index case maintained prolonged intestinal colonization by KPC-producing K. pneumoniae. Three patients received polymyxin B before the isolation of polymyxin-resistant K. pneumoniae.

Conclusions: Colonization by KPC-producing K. pneumoniae and previous use of polymyxin B may be causally related to the development of polymyxin-resistant microorganisms.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / pharmacology*
  • Carbapenems / pharmacology
  • Cross Infection / microbiology*
  • Drug Resistance, Bacterial
  • Female
  • Humans
  • Klebsiella Infections / microbiology*
  • Klebsiella pneumoniae / drug effects*
  • Klebsiella pneumoniae / isolation & purification
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Polymyxins / pharmacology*

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • Polymyxins