New Delhi Metallo-Beta-Lactamase (NDM-1)-Producing Klebsiella Pneumoniae Isolated from a Burned Patient
Unusual clinical course, Diagnostic / therapeutic accidents
Santiago Petersen-Morfin, Paola Bocanegra-Ibarias, Rayo Morfin-Otero, Elvira Garza-González, Hector Raul Perez-Gomez, Esteban González-Diaz, Sergio Esparza-Ahumada, Gerardo León-Garnica, Gabriel Amezcua-Salazar, Eduardo Rodriguez-Noriega
Civil Hospital of Guadalajara, Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
Am J Case Rep 2017; 18:805-809
Infections affecting burn patients are frequently caused by Staphylococcus aureus, Pseudomonas aeruginosa, and Enterobacteriaceae species. Infections with these pathogens have become increasingly difficult to treat due to evolving antibiotic resistance mechanisms, including the production of carbapenemases.
CASE REPORT: The present case report describes the evolution of a burn patient with polymicrobial healthcare-associated burn infections, including a bloodstream infection due to an emergent multidrug-resistant New Delhi metallo-beta-lactamase (NDM-1)-producing Klebsiella pneumoniae. During hospitalization, initial antibiotic treatment eradicated some of the infecting species. Newer isolates were found to be multidrug-resistant and required unique antibiotic combinations. The patient’s condition continued to deteriorate after the isolation of multidrug-resistant P. aeruginosa and NDM-1-positive K. pneumoniae from the blood.
CONCLUSIONS: This case report illustrates the need for adequate antibiotic therapies in burn patients with subsequent infections due to a carbapenemase-producing multidrug-resistant bacteria. The potential danger of new bacterial pathogens should be considered in this group of susceptible patients.
Keywords: Bacteremia, Burn Units, Genes, MDR, Klebsiella pneumoniae