title: Therapeutic strategy for pandrug-resistant Klebsiella pneumoniae severe infections: short-course treatment with colistin increases the in vivo and in vitro activity of double carbapenem regimen.
abstract: Infections due to carbapenemase-producing Klebsiella pneumoniae represent an emerging threat due to the high mortality rate and lack of valid antimicrobial combinations, especially when the strain is colistin-resistant. We report a case of bloodstream infection due to pandrug-resistant K. pneumoniae treated successfully with an innovative regimen comprising a combination of colistin plus double carbapenem, along with an in vitro analysis showing the synergistic and bactericidal effect.
authors.affiliation: Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università, Piazzale Aldo Moro, 00185 Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Oliva
authors.affiliation: Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università, Piazzale Aldo Moro, 00185 Rome, Italy.
authors.forename: Maria T
authors.initials: MT
authors.lastname: Mascellino
authors.affiliation: Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università, Piazzale Aldo Moro, 00185 Rome, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Cipolla
authors.affiliation: Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università, Piazzale Aldo Moro, 00185 Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: D'Abramo
authors.affiliation: Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università, Piazzale Aldo Moro, 00185 Rome, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: De Rosa
authors.affiliation: Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università, Piazzale Aldo Moro, 00185 Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Savinelli
authors.affiliation: Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università, Piazzale Aldo Moro, 00185 Rome, Italy.
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: Ciardi
authors.affiliation: Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università, Piazzale Aldo Moro, 00185 Rome, Italy; UOC Malattie Infettive, Fondazione Eleonora Lorillard Spencer Cenci, Sapienza Università, Latina, Italy. Electronic address: claudio.mastroianni@uniroma1.it.
authors.forename: Claudio M
authors.initials: CM
authors.lastname: Mastroianni
authors.affiliation: Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università, Piazzale Aldo Moro, 00185 Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Vullo
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism; D015780:Carbapenems / Q000494:pharmacology / Q000627:therapeutic use*; D003091:Colistin / Q000494:pharmacology / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy*; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics*; D008826:Microbial Sensitivity Tests; D018440:beta-Lactam Resistance / Q000235:genetics*; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D001618:beta-Lactamases; C063912:carbapenemase; D003091:Colistin
keywords: Bloodstream infection; Colistin; Double carbapenem; Pan-drug resistant K. pneumoniae