A rare emergence of resistance to ceftolozane/tazobactam in Klebsiella pneumoniae causing urinary tract infection

2021 ◽  
Vol 14 (2) ◽  
pp. e240351
Author(s):  
Antony Arumairaj ◽  
Sanket Agarwal ◽  
Tarun Popli ◽  
Eliana Lopez
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Klebsiella Pneumoniae ◽  
Beta Lactamase ◽  
The Novel ◽  
Beta Lactam ◽  
Carbapenem Resistant ◽  
Emergence Of Resistance ◽  
Timely Administration

The management of infections caused by carbapenem-resistant organisms has been a challenge. We report a rare emergence of resistance to the novel beta-lactam/ beta-lactamase combination ceftolozane/tazobactam by Klebsiella pneumoniae, causing urinary tract infection. The K. pneumoniae, in this case, was reported to be sensitive to the other novel beta-lactam/ beta-lactamase combination of ceftazidime/avibactam. The timely administration of ceftazidime/avibactam resulted in prompt clinical resolution of the urinary tract infection caused by an extensively drug-resistant K. pneumoniae.

scholarly journals Efficacy of cefoxitin for the treatment of urinary tract infection due to extended-spectrum-beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates

2018 ◽  
Vol 6 ◽  
pp. 204993611881105
Author(s):  
Olivia Senard ◽  
Frédérique Bouchand ◽  
Laurene Deconinck ◽  
Morgan Matt ◽  
Lesly Fellous ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Klebsiella Pneumoniae ◽  
Care Hospital ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum

Introduction: Cefoxitin has a good in vitro activity and stability in resistance to hydrolysis by extended-spectrum beta-lactamases and is a good candidate for the treatment of urinary tract infection. However, data are scarce regarding its use in clinical practice. Methods: We conducted a retrospective study from September 2014 to November 2017, in a tertiary care hospital in Garches (France). We gathered all prescriptions of cefoxitin for urinary tract infection due to extended-spectrum beta-lactamase isolates. We compared the clinical outcomes between Escherichia coli and Klebsiella pneumoniae extended-spectrum-beta-lactamase-producing isolates after a 90-day follow-up. When available, we assessed whether cefoxitin-based regimen was associated with an emergence of resistance. Results: The treatment of 31 patients with a mean age of 60 ± 18 years was analyzed. We observed a clinical cure of 96.7% ( n = 30/31) at day 30 and of 81.2% ( n = 13/16) and 85.7% (12/14) at day 90 for extended-spectrum beta-lactamase Escherichia coli and Klebsiella pneumoniae isolates, respectively ( p = 0.72). No adverse events were reported. One patient who relapsed carried a Klebsiella pneumoniae isolate that became intermediate to cefoxitin in the follow-up. Conclusion: In a period of major threat with a continuous increase of extended-spectrum beta-lactamase obliging to a policy of carbapenem-sparing regimens, it seems detrimental to deprive physicians of using cefoxitin for extended-spectrum beta-lactamase Enterobacteriaceae for the treatment of urinary tract infection while our data show its efficacy.

scholarly journals Complicated urinary tract infection with Extensive Drug resistant Klebsiella pneumoniae treated with combinatorial therapy of CSE-1034 along with Carbapenems. A case report and the review of literature

2018 ◽  
Vol 11 (11) ◽  
pp. 4
Author(s):  
Sanjith Saseedharan
Keyword(s):  
Urinary Tract Infection ◽  
Case Report ◽  
Urinary Tract ◽  
Tract Infection ◽  
Klebsiella Pneumoniae ◽  
Therapeutic Option ◽  
Complicated Urinary Tract Infection ◽  
Review Of Literature ◽  
Present Case Report ◽  
Carbapenem Resistant

Colistin is considered one of the last available therapeutic options to treat infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP).However, with an increase in the use of colistin to treat CRKP infections, colistin resistance is emerging and there are no standard treatment regimensfor these type of infections. In the present case report, we are discussing a case of 64-year-old male patient having complicated urinary tract infection(cUTI) by CRKP, treated successfully with ceftriaxone+sulbactam+EDTA (CSE-1034) and carbapenem combination therapy. Conclusively, CSE-1034 incombination with or without carbapenems could be a successful therapeutic option for the treatment of CRKP cUTI cases.

scholarly journals Incidence of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in patients with urinary tract infection

2012 ◽  
Vol 130 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Sobhan Ghafourian ◽  
Zamberi Sekawi ◽  
Vasanthakumari Neela ◽  
Afra Khosravi ◽  
Mohammad Rahbar ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Klebsiella Pneumoniae ◽  
Clinical Isolates ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Different Seasons ◽  
Tract Infections

CONTEXT AND OBJECTIVES: Resistant bacteria are emerging worldwide as a threat to favorable outcomes from treating common infections in community and hospital settings. The present investigation was carried out to study the incidence of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae in patients with urinary tract infection in different seasons of the year, in order to determine the prevalence of the genes blaTEM, blaSHV and blaCTX-M, which are responsible for ESBL production among ESBL-producing K. pneumoniae, in three cities in Iran, and to investigate the antimicrobial susceptibility pattern of K. pneumoniae in different seasons. DESIGN AND SETTING: Retrospective study carried out among patients with urinary tract infections in five hospitals in Iran. METHOD: Two hundred and eighty-eight clinical isolates of K. pneumoniae were collected between March 2007 and April 2008 from five hospitals in three cities in Iran. ESBLs were identified by phenotypic and genotypic methods. ESBL-producing Klebsiella pneumoniae were evaluated against non-beta-lactam antibiotics. Genes coding for ESBLs (blaSHV, TEM and CTX-M) were screened. RESULTS: Among the 288 clinical isolates of K. pneumoniae, 37.7%, 46.7% and 15.6% were obtained from hospitals in Ilam, Tehran and Tabriz, respectively, of which 39.4%, 50.7% and 45.8% were ESBL-producing K. pneumoniae in Ilam, Milad and Emam Reza hospitals, respectively. CONCLUSION: According to the results from this study, resistance to third-generation cephalosporins is higher during the cold months than during the warm months.

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