[A report of rarely observed resistance pattern to carbapenems in a clinical isolate of Enterobacter cloacae].
The paper reports on the emergence of strain in which Enterobacter cloacae has demonstrated an unusual form of resistance to carbapenems mediated by enzyme IMI-1, class A beta-lactamase. The strain was isolated from a wound swab in the patient who had a surgical wound infection previously treated with meropenem. Limited choice of antibiotics that can treat infections caused by these pathogens indicates the necessity of accurate identification of multiple resistant gram-negative microorganisms and mechanisms of their resistance. Recognition of multiresistant gram-negative microorganisms emphasizes the importance of continuous microbiological monitoring of patients, especially in intensive care units. In the investigated institution there was no secondary spread of this strain. Identifying new mechanisms of resistance will be helpful to clinicians in selection of targeted therapy, while important for efficient prevention of spreading infections caused by multiple resistant microorganisms.
Zavod za klinicku mikrobiologiju i hospitalne infekcije, KB Sveti Duh. dbejuk@kbsd.hr
Danijela
D
Bejuk
Odjel za kardiovaskularnu kirurgiju, Magdalena--klinika za kardiovaskularne bolesti Medicinskog fakulteta Sveucilista J. J. Strossmayera u Osijeku.
Mladen
M
Novkoski
Odjel za kardiovaskularnu kirurgiju, Magdalena--klinika za kardiovaskularne bolesti Medicinskog fakulteta Sveucilista J. J. Strossmayera u Osijeku.
Vlado
V
Juranko
Odjel za kardiovaskularnu kirurgiju, Magdalena--klinika za kardiovaskularne bolesti Medicinskog fakulteta Sveucilista J. J. Strossmayera u Osijeku.
Davorka
D
Prajdić-Predrijevac
Odjel za kardiovaskularnu kirurgiju, Magdalena--klinika za kardiovaskularne bolesti Medicinskog fakulteta Sveucilista J. J. Strossmayera u Osijeku.
Nives
N
Todorić
Odjel za klinicku farmakoIogiju i toksikologiju, Klinika za unutarnje bolesti Medicinskog fakulteta Sveucilista u Zagrebu, KB, Sveti Duh.
Ivana
I
Mikacić
Zavod za klinicku mikrobiologiju, Klinika za infektivne bolesti Dr. Fran Mihaljević Medicinskog fakulteta Sveucilista u Zagrebu, Referentni centar Ministarstva zdravlja za pradenje rezistencije bakterija na antibiotike.
Marija
M
Guzvinec
Zavod za klinicku mikrobiologiju, Klinika za infektivne bolesti Dr. Fran Mihaljević Medicinskog fakulteta Sveucilista u Zagrebu, Referentni centar Ministarstva zdravlja za pradenje rezistencije bakterija na antibiotike.
Arjana Tambić
AT
Andrasević
D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D017523:Croatia; D024881:Drug Resistance, Bacterial; D016972:Enterobacter cloacae / Q000187:drug effects* / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000382:microbiology*; D006801:Humans; D008297:Male; D000077731:Meropenem; D013845:Thienamycins / Q000494:pharmacology*; D001618:beta-Lactamases / Q000378:metabolism
D000900:Anti-Bacterial Agents; D013845:Thienamycins; D001618:beta-Lactamases; D000077731:Meropenem