High-dose tigecycline and colistin for successful treatment of disseminated carbapenem-resistant Klebsiella pneumoniae infection in a liver transplant recipient.
Solid organ transplantation (SOT) is a risk factor for the acquisition of carbapenem-resistant Klebsiella pneumoniae. This infection is associated with a high mortality rate given the limited armamentarium of antibiotics for multidrug-resistant organisms along with continued immunosuppression to prevent graft rejection. We report a case of carbapenem-resistant K. pneumoniae pneumonia, bacteraemia and intra-abdominal infection in a newly transplanted liver recipient. The patient was successfully treated with a long course of high-dose tigecycline and colistin, along with surgical drainage. We discuss SOT-relevant epidemiology, therapeutic options and the rationale for our treatment choice.
Division of Infectious Diseases, University of California, San Diego, La Jolla, California, USA.
Jennifer Marie
JM
Dan
Division of Gastroenterology, University of California, San Diego, San Diego, California, USA.
Michel Henry
MH
Mendler
Division of Transplantation and Hepatobiliary Surgery, University of California, San Diego, San Diego, California, USA.
Alan W
AW
Hemming
Division of Infectious Diseases, University of California, San Diego, La Jolla, California, USA.
Saima
S
Aslam
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D003091:Colistin / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy*; D007711:Klebsiella pneumoniae; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000008:administration & dosage / Q000031:analogs & derivatives*; D009894:Opportunistic Infections / Q000188:drug therapy*; D000078304:Tigecycline
D000900:Anti-Bacterial Agents; D000078304:Tigecycline; D008911:Minocycline; D003091:Colistin