title: Long-term, low-dose tigecycline to treat relapsing bloodstream infection due to KPC-producing Klebsiella pneumoniae after major hepatic surgery.
abstract: A 68-year-old male underwent a right hepatectomy, resection of the biliary convergence, and a left hepatic jejunostomy for a Klatskin tumour. The postoperative course was complicated by biliary abscesses with relapsing bloodstream infections due to Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae (KPC-Kp). A 2-week course of combination antibiotic therapy failed to provide source control and the bacteraemia relapsed. Success was obtained with a regimen of tigecycline 100mg daily for 2 months, followed by tigecycline 50mg daily for 6 months, then 50mg every 48h for 3 months. No side effects were reported.
authors.affiliation: General Surgery Unit, Department of Oncology Transplantation and New Technologies, University of Pisa, Via Paradisa 2, Pisa 56124, Italy; EndoCAS (Centre for Computer-Assisted Surgery), University of Pisa, Pisa, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Morelli
authors.affiliation: General Surgery Unit, Department of Oncology Transplantation and New Technologies, University of Pisa, Via Paradisa 2, Pisa 56124, Italy. Electronic address: dario261184@gmail.com.
authors.forename: Dario
authors.initials: D
authors.lastname: Tartaglia
authors.affiliation: General Surgery Unit, Department of Oncology Transplantation and New Technologies, University of Pisa, Via Paradisa 2, Pisa 56124, Italy.
authors.forename: Niccolò
authors.initials: N
authors.lastname: Furbetta
authors.affiliation: General Surgery Unit, Department of Oncology Transplantation and New Technologies, University of Pisa, Via Paradisa 2, Pisa 56124, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Palmeri
authors.affiliation: Infectious Diseases Unit, Department of Gastroenterology and Infectious Diseases, University of Pisa, Pisa, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Ferranti
authors.affiliation: Infectious Diseases Unit, Department of Gastroenterology and Infectious Diseases, University of Pisa, Pisa, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Tagliaferri
authors.affiliation: General Surgery Unit, Department of Oncology Transplantation and New Technologies, University of Pisa, Via Paradisa 2, Pisa 56124, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Di Candio
authors.affiliation: General Surgery Unit, Department of Oncology Transplantation and New Technologies, University of Pisa, Via Paradisa 2, Pisa 56124, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Mosca
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy*; D001426:Bacterial Proteins / Q000096:biosynthesis; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy*; D007711:Klebsiella pneumoniae / Q000201:enzymology; D008099:Liver / Q000601:surgery*; D008297:Male; D008911:Minocycline / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011183:Postoperative Complications / Q000188:drug therapy*; D000078304:Tigecycline; D001618:beta-Lactamases / Q000096:biosynthesis
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D000078304:Tigecycline; D001618:beta-Lactamases; C063912:carbapenemase; D008911:Minocycline
keywords: Hepatectomy; Klebsiella pneumoniae; Long-term therapy