title: Treatment of a meningitis due to an Enterobacter aerogenes producing a derepressed cephalosporinase and a Klebsiella pneumoniae producing an extended-spectrum beta-lactamase.
abstract: A case of nosocomial meningitis due to a Klebsiella pneumoniae producing a CAZ-5 extended-spectrum beta-lactamase and an Enterobacter aerogenes producing a derepressed cephalosporinase is reported. The intrathecal catheter incriminated was removed and a treatment with ceftazidime (4 g/24 h) and amikacin (1.5 g/24 h) was started. After 24 h ceftazidime was replaced by imipenem (2 then 4 g/24 h). This treatment failed to obtain cerebrospinal fluid sterilization; therefore the imipenem dosage was increased to 8 g/24 h and two intrathecal infusions of amikacin (50 mg) were carried out. Thereafter the patient recovered.
authors.affiliation: Service de Bactériologie Virologie, Hôpital Saint-Jacques, Clermont-Ferrand, France.
authors.forename: C
authors.initials: C
authors.lastname: de Champs
authors.forename: D
authors.initials: D
authors.lastname: Guelon
authors.forename: D
authors.initials: D
authors.lastname: Joyon
authors.forename: D
authors.initials: D
authors.lastname: Sirot
authors.forename: M
authors.initials: M
authors.lastname: Chanal
authors.forename: J
authors.initials: J
authors.lastname: Sirot
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002510:Cephalosporinase / Q000096:biosynthesis; D003428:Cross Infection / Q000188:drug therapy* / Q000382:microbiology; D004352:Drug Resistance, Microbial; D004754:Enterobacter / Q000201:enzymology / Q000302:isolation & purification*; D004756:Enterobacteriaceae Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000201:enzymology / Q000302:isolation & purification*; D008297:Male; D008581:Meningitis / Q000188:drug therapy* / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D001618:beta-Lactamases / Q000096:biosynthesis; D047090:beta-Lactams
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D002510:Cephalosporinase; D001618:beta-Lactamases