Carbapenem-resistant Klebsiella pneumoniae endocarditis in a young adult. Successful treatment with gentamicin and colistin.
BACKGROUND
Enterobacteriaceae are rarely the etiologic agents of endocarditis, with Klebsiella species being especially rare. From the end of 2005, isolates of carbapenem-resistant Klebsiella pneumoniae began to appear in various hospitals across Israel, sensitive only to colistin and gentamicin. We present a case of hospital-acquired endocarditis caused by carbapenem-resistant K. pneumoniae in a young adult.


METHODS
An 18-year-old man with 40% full thickness burns developed acute bacterial endocarditis complicated by embolic myocardial infarction. Carbapenem-resistant K. pneumoniae carrying the blaKPC3 gene was isolated from multiple blood cultures. He recovered fully after antibiotic treatment with colistin and gentamicin.


CONCLUSIONS
To our knowledge, this is the first reported case of acute bacterial endocarditis caused by carbapenem-resistant K. pneumoniae. The combination of intravenous colistin and gentamicin was effective and resulted in the cure of this patient's endocarditis without the need for surgical intervention.
Benenson
Shmuel
S
Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Kiryat Hadassah, POB 12000, il-91120, Jerusalem, Israel. Benenson@hadassah.org.il
Navon-Venezia
Shiri
S
Carmeli
Yehuda
Y
Adler
Amos
A
Strahilevitz
Jacob
J
Moses
Allon E
AE
Block
Colin
C