Salvage therapy with tigecycline for recurrent infection caused by ertapenem-resistant extended-spectrum β-lactamase-producing Klebsiella pneumoniae.

Abstract

Optimal antimicrobial therapy for infections due to ertapenem-resistant Enterobacteriaceae remains undetermined. In this study, a diabetic patient with recurrent pyomyositis and osteomyelitis caused by extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae developed ertapenem resistance after imipenem/cilastatin treatment, which was a currently recommended therapy. He was finally treated successfully using tigecycline. Ertapenem resistance was in part explained by the production of SHV-type ESBL and the absence of an outer membrane protein, OmpK36. Our observation suggests that tigecycline may be an alternative for invasive infections caused by ESBL-producing Enterobacteriaceae with decreased susceptibility to carbapenem.

• Authors: Po-Lin Chen, Jing-Jou Yan, Chi-Jung Wu, Hsin-Chun Lee, Chia-Ming Chang, Nan-Yao Lee, Nai-Ying Ko, Li-Rong Wang, Hsin-I Shih, Ching-Chi Lee, Wen-Chien Ko
• Journal: Diagnostic microbiology and infectious disease (Diagn Microbiol Infect Dis) Vol. 68 Issue 3 Pg. 312-4 (Nov 2010) ISSN: 1879-0070 [Electronic] United States
• PMID: 20846813 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2010 Elsevier Inc. All rights reserved.

Chemical References

• Anti-Bacterial Agents
• beta-Lactams
• Tigecycline
• Minocycline
• Ertapenem

Topics

• Anti-Bacterial Agents (pharmacology, therapeutic use)
• Diabetes Complications
• Ertapenem
• Humans
• Klebsiella Infections (drug therapy, microbiology)
• Klebsiella pneumoniae (drug effects, isolation & purification)
• Male
• Middle Aged
• Minocycline (analogs & derivatives, pharmacology, therapeutic use)
• Osteomyelitis (drug therapy, microbiology)
• Pyomyositis (drug therapy, microbiology)
• Recurrence
• Salvage Therapy (methods)
• Tigecycline
• Treatment Outcome
• beta-Lactams (pharmacology)