Revista do Instituto de Medicina Tropical de Sao Paulo · 2019
Post-neurosurgical meningitis caused by KPC-producing Klebsiella pneumoniae: report of two cases.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Patrial Yasmin Coelho, Tortorelli Luma Petri, Rodrigues Ana Claudia Souza, Santos Ivson Cassiano de Oliveira, Volpe-Chaves Cláudia Elizabeth, Capato Gislaine Souza, Barbosa Gustavo Augusto Ribeiro, Carvalho-Assef Ana Paula D'Alincourt, Chang Marilene Rodrigues
Аннотация
Nosocomial bacterial infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) is associated with high mortality in neurosurgical patients. There are few reports in the literature on meningitis caused by CRKP. We report two cases of CRKP meningitis after neurosurgery. The K. pneumoniae identification and antimicrobial susceptibility testing were performed using the Vitek Compact System. Minimum inhibitory concentrations of polymyxin B were determined using the broth microdilution method. Molecular typing of K. pneumoniae isolates was investigated using multilocus sequence typing. Antimicrobial susceptibility testing showed that the K. pneumoniae isolates were multidrug resistant and co-produced extended-spectrum β-lactamases and KPC enzymes. The patients were treated with intrathecal polymyxin. Genetic polymorphism analyses revealed two different K. pneumoniae clones (ST1298 and ST2687), which were observed for the first time in CRKP infections. We recommend intravenous administration of intrathecal polymyxin for treating meningitis caused by multidrug-resistant K. pneumoniae .