Salvage therapy with tigecycline for recurrent infection caused by ertapenem-resistant extended-spectrum β-lactamase-producing Klebsiella pneumoniae.
Optimal antimicrobial therapy for infections due to ertapenem-resistant Enterobacteriaceae remains undetermined. In this study, a diabetic patient with recurrent pyomyositis and osteomyelitis caused by extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae developed ertapenem resistance after imipenem/cilastatin treatment, which was a currently recommended therapy. He was finally treated successfully using tigecycline. Ertapenem resistance was in part explained by the production of SHV-type ESBL and the absence of an outer membrane protein, OmpK36. Our observation suggests that tigecycline may be an alternative for invasive infections caused by ESBL-producing Enterobacteriaceae with decreased susceptibility to carbapenem.
Chen
Po-Lin
PL
Department of Medicine, National Cheng Kung University Medical College, Tainan, Taiwan.
Yan
Jing-Jou
JJ
Wu
Chi-Jung
CJ
Lee
Hsin-Chun
HC
Chang
Chia-Ming
CM
Lee
Nan-Yao
NY
Ko
Nai-Ying
NY
Wang
Li-Rong
LR
Shih
Hsin-I
HI
Lee
Ching-Chi
CC
Ko
Wen-Chien
WC
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D048909:Diabetes Complications; D000077727:Ertapenem; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D010019:Osteomyelitis / Q000188:drug therapy / Q000382:microbiology; D052880:Pyomyositis / Q000188:drug therapy / Q000382:microbiology; D012008:Recurrence; D016879:Salvage Therapy / Q000379:methods*; D000078304:Tigecycline; D016896:Treatment Outcome; D047090:beta-Lactams / Q000494:pharmacology*
D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D000078304:Tigecycline; D008911:Minocycline; D000077727:Ertapenem