title: Klebsiella necrotizing soft tissue infections in liver transplant recipients: a case series.
abstract: Necrotizing soft tissue infections (NSTI) are rare but carry high mortality rates. NSTI with Klebsiella species have been previously described as associated with Klebsiella liver abscesses and endophthalmitis. Here, we describe 6 cases of NSTI in liver transplant recipients associated with Klebsiella pneumoniae, 4 of which were K. pneumoniae carbapenemase (KPC)-producing K. pneumoniae (CRKP). Increased awareness of this emerging pathogen and its association with necrotizing skin and soft tissue infection is critical, as early recognition and debridement may improve survival. Antimicrobial treatment of CRKP infections remains an ongoing challenge and implementation of enhanced infection control measures is essential.
authors.affiliation: Department of Medicine, Mount Sinai School of Medicine, New York, New York 10029, USA. meenakshi.rana@mssm.edu
authors.forename: M M
authors.initials: MM
authors.lastname: Rana
authors.forename: M
authors.initials: M
authors.lastname: Sturdevant
authors.forename: G
authors.initials: G
authors.lastname: Patel
authors.forename: S
authors.initials: S
authors.lastname: Huprikar
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000096:biosynthesis*; D015780:Carbapenems / Q000494:pharmacology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017192:Skin Diseases, Bacterial / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D018461:Soft Tissue Infections / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D001618:beta-Lactamases; C063912:carbapenemase
keywords: Klebsiella pneumoniae; carbapenem resistant; liver transplant; necrotizing fasciitis; necrotizing soft tissue infections