title: Early-onset septicemia due to CMY-2-producing Escherichia coli in a woman with blunt abdominal trauma.
abstract: Escherichia coli remains one of the most common etiologies of secondary peritonitis. CMY-2 is the most prevalent AmpC enzyme identified in nosocomial E. coli isolates causing bacteremia in Taiwan. This report is of a patient who underwent surgery for intestinal perforations due to blunt abdominal trauma and developed unexpected CMY-2-producing E. coli septicemia in the early postoperative period. The AmpC-type CMY-2 enzyme might partially contribute to the poor response to antimicrobial therapy of amoxicillin-clavulanic acid or flomoxef. Late changes in antibiotic therapy to an appropriate regimen of cefpirome based on the culture results did not result in a positive outcome and the patient died. Whether selection of an anti-AmpC regimen is appropriate as first-line treatment for traumatic abdomen-associated septicemia should be an area of further investigation in Taiwan.
authors.affiliation: Department of Intensive Care Medicine, Chi-Mei Medical Center, Tainan, Taiwan.
authors.forename: Khee-Siang
authors.initials: KS
authors.lastname: Chan
authors.forename: Wen-Liang
authors.initials: WL
authors.lastname: Yu
authors.forename: Chen-Yi
authors.initials: CY
authors.lastname: Kuo
authors.forename: Chi-Lun
authors.initials: CL
authors.lastname: Tsai
authors.forename: Yin-Ching
authors.initials: YC
authors.lastname: Chuang
mesh_terms: D000007:Abdominal Injuries / Q000150:complications* / Q000601:surgery; D000328:Adult; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D004926:Escherichia coli / Q000201:enzymology* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000175:diagnosis* / Q000382:microbiology; D005260:Female; D006801:Humans; D018805:Sepsis / Q000382:microbiology*; D013624:Taiwan; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D019980:Amoxicillin-Potassium Clavulanate Combination; C103022:beta-lactamase CMY-2; D001618:beta-Lactamases; C045693:flomoxef