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

ABSTRACT 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 .

Bibliographic Details

Main Authors:	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
Format:	Digital revista
Language:	English
Published:	Instituto de Medicina Tropical de São Paulo 2019
Online Access:	http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652019005000510
Tags:	Add Tag No Tags, Be the first to tag this record!