title: Septic arthritis due to extended spectrum beta lactamase producing Klebsiella pneumoniae.
abstract: METHODS
  Septic arthritis due to Klebsiella species is a rare but serious infection that may destroy a joint and cause serious immobility. This is a report of two immunocompromised adult patients presenting with acute septic arthritis due to extended spectrum beta lactamase producing Klebsiella pneumoniae. The infection was treated successfully with a course of meropenem and amikacin in combination with early arthroscopic washout of the joint. Little information has been published on the management of this infection. We are therefore presenting a systematic literature review summarizing risk factors, clinical presentation, laboratory diagnosis, treatment regimens and outcome of this condition.
  
  
  CONCLUSIONS
  On the basis of our study, we recommend an early diagnostic arthrocentesis of the joint for Gram stain microscopy, culture and antibiotic sensitivity testing to guide the appropriate use of antibiotics. In cases of hospital acquired infections where drug resistant Gram negative bacteria are suspected or prevalent, broad-spectrum antibiotics such as meropenem plus or minus amikacin may be given as the empirical treatment until the sensitivities are confirmed. In addition, adequate surgical joint lavage should be considered as the mainstay of treatment.
authors: Microbiology Department, Norfolk and Norwich University Hospital, Bowthorpe Road, Norwich, NR2 3TX, UK. sschelenz@doctors.org.uk
authors: Silke
authors: S
authors: Schelenz
authors: Kate
authors: K
authors: Bramham
authors: David
authors: D
authors: Goldsmith
mesh_terms: D000368:Aged; D000583:Amikacin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001170:Arthritis, Infectious / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D007711:Klebsiella pneumoniae / Q000201:enzymology / Q000302:isolation & purification*; D000077731:Meropenem; D008875:Middle Aged; D012307:Risk Factors; D013845:Thienamycins / Q000008:administration & dosage; D001618:beta-Lactamases / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D013845:Thienamycins; D000583:Amikacin; D001618:beta-Lactamases; D000077731:Meropenem