title: Community-Acquired Pyelonephritis in Pregnancy Caused by KPC-Producing Klebsiella pneumoniae.
abstract: Carbapenem-resistant Enterobacteriaceae (CRE) usually infect patients with significant comorbidities and health care exposures. We present a case of a pregnant woman who developed community-acquired pyelonephritis caused by KPC-producing Klebsiella pneumoniae. Despite antibiotic treatment, she experienced spontaneous prolonged rupture of membranes, with eventual delivery of a healthy infant. This report demonstrates the challenge that CRE may pose to the effective treatment of common infections in obstetric patients, with potentially harmful consequences to maternal and neonatal health.
authors.affiliation: MetroHealth Medical Center, Cleveland, Ohio, USA University Hospitals Case Medical Center, Cleveland, Ohio, USA.
authors.forename: Asma
authors.initials: A
authors.lastname: Khatri
authors.affiliation: MetroHealth Medical Center, Cleveland, Ohio, USA.
authors.forename: Nina
authors.initials: N
authors.lastname: Naeger Murphy
authors.affiliation: MetroHealth Medical Center, Cleveland, Ohio, USA Case Western Reserve University, Cleveland, Ohio, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Wiest
authors.affiliation: MetroHealth Medical Center, Cleveland, Ohio, USA Case Western Reserve University, Cleveland, Ohio, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Osborn
authors.affiliation: MetroHealth Medical Center, Cleveland, Ohio, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Garber
authors.affiliation: MetroHealth Medical Center, Cleveland, Ohio, USA Case Western Reserve University, Cleveland, Ohio, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Hecker
authors.affiliation: Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio, USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Hurless
authors.affiliation: Case Western Reserve University, Cleveland, Ohio, USA Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio, USA.
authors.forename: Susan D
authors.initials: SD
authors.lastname: Rudin
authors.affiliation: Case Western Reserve University, Cleveland, Ohio, USA University Hospitals Case Medical Center, Cleveland, Ohio, USA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Jacobs
authors.affiliation: MetroHealth Medical Center, Cleveland, Ohio, USA Case Western Reserve University, Cleveland, Ohio, USA.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Kalayjian
authors.affiliation: Case Western Reserve University, Cleveland, Ohio, USA University Hospitals Case Medical Center, Cleveland, Ohio, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Salata
authors.affiliation: University of North Carolina, Chapel Hill, North Carolina, USA.
authors.forename: David
authors.initials: D
authors.lastname: van Duin
authors.affiliation: Case Western Reserve University, Cleveland, Ohio, USA Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio, USA federico.perez@va.gov robert.bonomo@va.gov d.paterson1@uq.edu.au.
authors.forename: Federico
authors.initials: F
authors.lastname: Perez
authors.affiliation: Case Western Reserve University, Cleveland, Ohio, USA Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio, USA federico.perez@va.gov robert.bonomo@va.gov d.paterson1@uq.edu.au.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Bonomo
authors.affiliation: University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital, Brisbane, Australia federico.perez@va.gov robert.bonomo@va.gov d.paterson1@uq.edu.au.
authors.forename: David L
authors.initials: DL
authors.lastname: Paterson
authors.affiliation: University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital, Brisbane, Australia.
authors.forename: Patrick N A
authors.initials: PN
authors.lastname: Harris
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000378:metabolism*; D015780:Carbapenems / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006801:Humans; D007223:Infant; D007710:Klebsiella Infections / Q000188:drug therapy / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000378:metabolism / Q000472:pathogenicity*; D011247:Pregnancy; D011704:Pyelonephritis / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems