[Fatal pneumonia caused by carbapenem resistant Klebsiella pneumoniae].
A 63-year-old Dutch man became colonized with a carbapenem resistant Klebsiella pneumoniae during a period of hospitalization in India. His recovery in the Netherlands was complicated by pneumonia due to this difficult-to-control multiresistant bacteria to which he eventually succumbed. Carbapenem resistance in Enterobacteriaceae, such as K. pneumoniae, is usually caused by carbapenemase (a betalactamase) production. Carbapenemase producing Enterobacteriaceae (CPE) are spreading throughout the world and cause difficult-to-treat infections that are associated with high mortality. This case report illustrates the clinical challenges associated with infection with these multiresistant Enterobacteriaceae. In the Netherlands, there are no guidelines for detection of CPE and carbapenemase production can frequently go undetected in clinical microbiology laboratories. As a consequence, adequate treatment of CPE infections and infection control measures to prevent the spread of CPE can be delayed. Expeditious development and implementation of existing Dutch draft guidelines for detection methods of CPE is therefore warranted.
Sint Lucas Andreas ziekenhuis, afd. Interne Geneeskunde, Amsterdam, the Netherlands. marjanvapeldoorn@gmail.com
Marjan
M
van Apeldoorn
Kamilla
K
Lettinga
Alexandra
A
Bernards
Sunita
S
Paltansing
Nashwan
N
alNaiemi
Jayant
J
Kalpoe
D015780:Carbapenems / Q000494:pharmacology* / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D024901:Drug Resistance, Multiple, Bacterial; D017809:Fatal Outcome; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000472:pathogenicity; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality
D015780:Carbapenems