Antagonistic effect between tigecycline and meropenem: successful management of KPC-producing Klebsiella pneumoniae infection

Sheng Bi; Xin Yao; Cheng Huang; Xia Zheng; Tianming Xuan; Jifang Sheng; Kaijin Xu; Beiwen Zheng; Qing Yang

doi:10.1007/s15010-019-01274-w

Antagonistic effect between tigecycline and meropenem: successful management of KPC-producing Klebsiella pneumoniae infection

Infection. 2019 Jun;47(3):497-500. doi: 10.1007/s15010-019-01274-w. Epub 2019 Feb 7.

Authors

Sheng Bi¹, Xin Yao², Cheng Huang^{1

3}, Xia Zheng⁴, Tianming Xuan⁵, Jifang Sheng¹, Kaijin Xu¹, Beiwen Zheng^{6

7}, Qing Yang⁸

Affiliations

¹ State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
² Department of Gastroenterology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
³ Department of Respiratory Medicine, Lihuili Hospital, Ningbo Medical Center, Ningbo, China.
⁴ Intensive Care Unit, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
⁵ Department of Cardiovascular, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
⁶ State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China. zhengbw@zju.edu.cn.
⁷ Institute of Animal Quarantine, Chinese Academy of Inspection and Quarantine, Beijing, China. zhengbw@zju.edu.cn.
⁸ Center of Clinical Laboratory, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China. yq721227@zju.edu.cn.

PMID: 30734249
DOI: 10.1007/s15010-019-01274-w

Abstract

Introduction: A woman infected by carbapenem-resistant Klebsiella pneumoniae is reported in this study.

Case report: Tigecycline and meropenem combination was used, and indeed, in vitro checkerboard synergy test confirmed the antagonism between the two antibiotics. Thus, meropenem was ceased and single high-dose tigecycline was successful against the infection. Subsequent experiments showed that the isolates of the KPC-2-producing K. pneumoniae ST11 clone caused the infection.

Conclusion: Therefore, tigecycline and meropenem combination should be used with caution.

Keywords: Antagonistic effect; Carbapenem-resistance; KPC-2-producing Klebsiella pneumoniae; Meropenem; Tigecycline.

Publication types

Case Reports

MeSH terms

Adult
Anti-Bacterial Agents*
China
Drug Resistance, Bacterial / genetics
Female
Gene Expression Regulation, Bacterial
Humans
Klebsiella Infections / drug therapy*
Klebsiella Infections / microbiology
Klebsiella pneumoniae / drug effects*
Meropenem / antagonists & inhibitors*
Microbial Sensitivity Tests
Tigecycline / antagonists & inhibitors*
beta-Lactamases / genetics*
beta-Lactamases / metabolism

Substances

Anti-Bacterial Agents
Tigecycline
beta-lactamase KPC-1
beta-Lactamases
Meropenem

Abstract

Publication types

MeSH terms

Substances

Grants and funding