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Surg Infect (Larchmt). 2011 Aug;12(4):325-7. doi: 10.1089/sur.2010.072.

Use of meropenem by continuous infusion to treat a patient with a Bla(kpc-2)-positive Klebsiella pneumoniae blood stream infection.

Author information

1
Department of Surgery, Weill Cornell Medical College, New York, New York 10065, USA. vah9004@nyp.org

Abstract

BACKGROUND:

Gram-negative bacterial resistance to antibiotics is of increasing concern. Carbapenem resistance among strains of Klebsiella pneumoniae is a relatively new phenomenon. Resistance attributable to production of carbapenemases is notoriously difficult to combat.

METHODS:

Case report and review of the pertinent English-language literature.

RESULTS:

A patient, hospitalized for aortic dissection complicated by intra-abdominal catastrophe and acute kidney injury, developed bacteremia exhibiting meropenem non-susceptibility secondary to expression of bla(KPC-2). High-dose, continuous-infusion meropenem achieved serum drug concentrations above the minimum inhibitory concentration and eradicated the infection.

CONCLUSION:

This is the first report of a meropenem-non-susceptible carbapenamase-positive Klebsiella pneumoniae blood stream infection treated successfully with high-dose, continuous-infusion meropenem. Application of this regimen in certain patients, such as those with mild-to-moderate renal insufficiency, may be a reasonable option for multi-drug-resistant nosocomial infections.

PMID:
21859337
DOI:
10.1089/sur.2010.072
[Indexed for MEDLINE]

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