Failure of Cephalosporin Treatment for Bloodstream Infection Caused by Apparently Susceptible Klebsiella pneumoniae which Produced DHA-1 beta-Lactamase Induced by Clavulanic Acid.
- Author:
Cheol In KANG
1
;
Hyunjoo PAI
;
Sung Han KIM
;
Hong Bin KIM
;
Myoung don OH
;
Eui Chong KIM
;
Kang Won CHOE
Author Information
1. Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea. mdohmd@snu.ac.kr
- Publication Type:In Vitro ; Original Article
- Keywords:
Klebsiella;
beta-lactamase;
Cephalosporin resistance
- MeSH:
Bacteremia;
beta-Lactamases*;
Cephalosporin Resistance;
Cephalosporins;
Clavulanic Acid*;
Humans;
Isoelectric Focusing;
Klebsiella pneumoniae*;
Klebsiella*;
Phenotype;
Pneumonia;
Treatment Failure
- From:
Infection and Chemotherapy
2004;36(3):127-131
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The therapeutic option is limited for the infections caused by organisms producing plasmid- mediated AmpC beta-lactamases, increasingly identified worldwide. Two sporadic patients with bacteremia caused by K. pneumoniae possessing an unusual inducible beta-lactam resistant phenotype were found in a university hospital. RESULTS:We conducted antibiotic susceptibility test according to NCCLS guideline. Also, we characterized beta-lactamase by isoelectric focusing. RESULTS: DHA-1 gene conferred the resistant phenotype. The patients had experienced treatment failure when treated with extended-spectrum cephalosporin. For the isolates the cephalosporin resistance was induced by clavulanic acid (and cefoxitin). CONCLUSION: Theses results suggest that the extended-spectrum cephalosporins might not provide optimal therapeutic option for inducible DHA-1-producing K. pneumoniae infection, even when the pathogens are susceptible in vitro.
