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Post-neurosurgical meningitis caused by KPC-producing Klebsiella pneumoniae: report of two cases

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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Instituto de Medicina Tropical 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6907419/
https://www.ncbi.nlm.nih.gov/pubmed/31859846
http://dx.doi.org/10.1590/S1678-9946201961069
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author 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
author_facet 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
author_sort Patrial, Yasmin Coelho
collection PubMed
description 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 .
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spelling pubmed-69074192019-12-20 Post-neurosurgical meningitis caused by KPC-producing Klebsiella pneumoniae: report of two cases 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 Rev Inst Med Trop Sao Paulo Case Report 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 . Instituto de Medicina Tropical 2019-12-20 /pmc/articles/PMC6907419/ /pubmed/31859846 http://dx.doi.org/10.1590/S1678-9946201961069 Text en https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
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
Post-neurosurgical meningitis caused by KPC-producing Klebsiella pneumoniae: report of two cases
title Post-neurosurgical meningitis caused by KPC-producing Klebsiella pneumoniae: report of two cases
title_full Post-neurosurgical meningitis caused by KPC-producing Klebsiella pneumoniae: report of two cases
title_fullStr Post-neurosurgical meningitis caused by KPC-producing Klebsiella pneumoniae: report of two cases
title_full_unstemmed Post-neurosurgical meningitis caused by KPC-producing Klebsiella pneumoniae: report of two cases
title_short Post-neurosurgical meningitis caused by KPC-producing Klebsiella pneumoniae: report of two cases
title_sort post-neurosurgical meningitis caused by kpc-producing klebsiella pneumoniae: report of two cases
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6907419/
https://www.ncbi.nlm.nih.gov/pubmed/31859846
http://dx.doi.org/10.1590/S1678-9946201961069
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