title: Evolution of tigecycline resistance in Klebsiella pneumoniae in a single patient.
abstract: Carbapenemase-producing Klebsiella pneumoniae infections carry serious clinical and infection-control implications. Isolates possessing such hydrolyzing enzymes have been described in the United States and around the world. Besides being resistant to carbapenems, they usually confer resistance to fluoroquinolones, piperacillin-tazobactam, and extended-spectrum cephalosporins. Tigecycline demonstrates in vitro activity against these organisms, but reported resistance raises concern about tigecycline use for these infections. We describe a carbapenemase-producing K pneumoniae evolving resistance to tigecycline in a 75-year-old male after a prolonged stay in a critical care unit.
authors.affiliation: King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. nalqadheeb@kfshrc.edu.sa
authors.forename: Nada S
authors.initials: NS
authors.lastname: Al-Qadheeb
authors.forename: Sahar
authors.initials: S
authors.lastname: Althawadi
authors.forename: Abdulaziz
authors.initials: A
authors.lastname: Alkhalaf
authors.forename: Suleiman
authors.initials: S
authors.lastname: Hosaini
authors.forename: Abdulrahman A
authors.initials: AA
authors.lastname: Alrajhi
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001426:Bacterial Proteins / Q000096:biosynthesis*; D017714:Community-Acquired Infections / Q000188:drug therapy; D024901:Drug Resistance, Multiple, Bacterial; D017809:Fatal Outcome; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy* / Q000201:enzymology*; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000201:enzymology*; D008297:Male; D008911:Minocycline / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D000078304:Tigecycline; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D000078304:Tigecycline; D001618:beta-Lactamases; C063912:carbapenemase; D008911:Minocycline