Meropenem
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Development of carbapenem resistance in Klebsiella pneumoniae infection: case report A 49-year-old man with progressive B-cell lymphoma developed neutropenic fever while receiving chemotherapy. He was initially treated with piperacillin/tazobactam and gentamicin, but treatment was switched to meropenem 500mg four times daily [route not stated] after isolation of an extended-spectrum β-lactamase-producing strain of Klebsiella pneumoniae in blood cultures. His symptoms initially improved, but despite normalisation of his neutrophil count and treatment with meropenem, amphotericin B and vancomycin, his fever persisted. Blood cultures remained sterile until a second episode of neutropenia 26 days later. Carbapenem-resistant K. pneumoniae and a vancomycinresistant Enterococcus spp. were isolated. Ciprofloxacin and linezolid were commenced, and led to microbiological cure. Due to progression of his haematological malignancy, he died 25 days later. Author comment: "In summary, we have shown the emergence of carbapenem resistance in a strain of K. pneumoniae through porin loss during treatment with meropenem." Webster DP, et al. Emergence of carbapenem resistance due to porin loss in an extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae strain during meropenem therapy. International Journal of Antimicrobial Agents 36: 575-576, No. 6, Dec 2010. Available from: URL: http://dx.doi.org/10.1016/ 803047514 j.ijantimicag.2010.08.003 - United Kingdom
0114-9954/10/1334-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 15 Jan 2011 No. 1334
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