title: Failure of cefepime therapy in treatment of Klebsiella pneumoniae bacteremia.
abstract: A case of failure of cefepime treatment of a bloodstream infection with AmpC-producing Klebsiella pneumoniae is reported. The failure was attributed to extended-spectrum beta-lactamase (ESBL) acquisition by the isolate, possibly during therapy. Problems encountered with ESBL detection in AmpC-producing isolates are discussed.
authors.affiliation: Center for Research in Antiinfectives and Biotechnology, Department of Medical Microbiology and Immunology, Creighton University School of Medicine, Omaha, NE 68178, USA.
authors.forename: Wonkeun
authors.initials: W
authors.lastname: Song
authors.forename: Ellen S
authors.initials: ES
authors.lastname: Moland
authors.forename: Nancy D
authors.initials: ND
authors.lastname: Hanson
authors.forename: James S
authors.initials: JS
authors.lastname: Lewis
authors.forename: James H
authors.initials: JH
authors.lastname: Jorgensen
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: Thomson
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy* / Q000382:microbiology; D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism; D000077723:Cefepime; D002511:Cephalosporins / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics; D008826:Microbial Sensitivity Tests; D017211:Treatment Failure; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D002511:Cephalosporins; D000077723:Cefepime; C048795:AmpC beta-lactamases; D001618:beta-Lactamases