title: Fulminant endocarditis and disseminated infection caused by carbapenem-resistant Acinetobacter baumannii in a renal-pancreas transplant recipient.
abstract: Acinetobacter baumannii is an important cause of healthcare-associated infections, and is particularly problematic among patients who undergo organ transplantation. We describe a case of fulminant sepsis caused by carbapenem-resistant A. baumannii harboring the blaOXA-23 carbapenemase gene and belonging to international clone II. This isolate led to the death of a patient 6 days after simultaneous kidney-pancreas transplantation. Autopsy findings revealed acute mitral valve endocarditis, myocarditis, splenic and renal emboli, peritonitis, and pneumonia. This case highlights the severe nature of certain A. baumannii infections and the vulnerability of transplanted patients to the increasingly intractable "high-risk" clones of multidrug-resistant organisms.
authors: Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors: G
authors: G
authors: Patel
authors: F
authors: F
authors: Perez
authors: A M
authors: AM
authors: Hujer
authors: S D
authors: SD
authors: Rudin
authors: J J
authors: JJ
authors: Augustine
authors: G H
authors: GH
authors: Jacobs
authors: M R
authors: MR
authors: Jacobs
authors: R A
authors: RA
authors: Bonomo
mesh_terms: D000151:Acinetobacter Infections; D040981:Acinetobacter baumannii / Q000235:genetics; D016470:Bacteremia; D001426:Bacterial Proteins / Q000235:genetics; D015780:Carbapenems; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D024881:Drug Resistance, Bacterial / Q000235:genetics; D004697:Endocarditis, Bacterial; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation; D011183:Postoperative Complications; D001618:beta-Lactamases / Q000235:genetics
chemical_list: D001426:Bacterial Proteins; D015780:Carbapenems; D001618:beta-Lactamases; C063912:carbapenemase
keywords: Acinetobacter baumannii; carbapenem resistance; endocarditis; simultaneous kidney-pancreas transplantation