Two for the price of one : emerging carbapenemases in a returning traveller to New York City

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We report a case of a complex orthopaedic infection in a patient returning to New York City from Bangladesh where he was involved in a serious motor vehicle accident. He developed extensive osteomyelitis with a carbapenem-resistant Klebsiella pneumoniae The isolate was unique due to the coexistence of New Delhi metallo-β-lactamase-1 and Oxacillinase type-181 carbapenemases, which are relatively uncommon in North America and were presumably acquired in Bangladesh. Herein, we explore challenges associated with management of carbapenem-resistant Enterobacteriaceae infections, including limited available data on effective antimicrobial therapy. We also highlight the added value of rapid diagnostic technology in guiding clinical management. Ultimately, the patient required both aggressive surgical management and combination therapy with aztreonam and ceftazidime-avibactam for true source control and favourable clinical outcome.

Medienart:

E-Artikel

Erscheinungsjahr:

2018

Erschienen:

2018

Enthalten in:

Zur Gesamtaufnahme - volume:2018

Enthalten in:

BMJ case reports - 2018(2018) vom: 18. Juli

Sprache:

Englisch

Beteiligte Personen:

Mittal, Jaimie [VerfasserIn]
Szymczak, Wendy A [VerfasserIn]
Guo, Yi [VerfasserIn]
Levi, Michael H [VerfasserIn]
Chen, Liang [VerfasserIn]
Kreiswirth, Barry N [VerfasserIn]
Riska, Paul F [VerfasserIn]
Nori, Priya [VerfasserIn]

Links:

Volltext

Themen:

9M416Z9QNR
Anti-Bacterial Agents
Avibactam, ceftazidime drug combination
Azabicyclo Compounds
Aztreonam
Beta-Lactamase Inhibitors
Bone and joint infections
Case Reports
Ceftazidime
Drug Combinations
G2B4VE5GH8
Infections
Journal Article

Anmerkungen:

Date Completed 16.11.2018

Date Revised 26.09.2023

published: Electronic

Citation Status MEDLINE

doi:

10.1136/bcr-2018-225440

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM286623110