Carbapenem-resistant Klebsiella pneumoniae endocarditis in a young adult. Successful treatment with gentamicin and colistin

Int J Infect Dis. 2009 Sep;13(5):e295-8. doi: 10.1016/j.ijid.2009.01.006. Epub 2009 Mar 28.


Introduction: Enterobacteriaceae are rarely the etiologic agents of endocarditis, with Klebsiella species being especially rare. From the end of 2005, isolates of carbapenem-resistant Klebsiella pneumoniae began to appear in various hospitals across Israel, sensitive only to colistin and gentamicin. We present a case of hospital-acquired endocarditis caused by carbapenem-resistant K. pneumoniae in a young adult.

Case report: An 18-year-old man with 40% full thickness burns developed acute bacterial endocarditis complicated by embolic myocardial infarction. Carbapenem-resistant K. pneumoniae carrying the blaKPC3 gene was isolated from multiple blood cultures. He recovered fully after antibiotic treatment with colistin and gentamicin.

Conclusions: To our knowledge, this is the first reported case of acute bacterial endocarditis caused by carbapenem-resistant K. pneumoniae. The combination of intravenous colistin and gentamicin was effective and resulted in the cure of this patient's endocarditis without the need for surgical intervention.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Bacterial Proteins / genetics
  • Carbapenems / pharmacology*
  • Colistin / therapeutic use*
  • Drug Therapy, Combination
  • Endocarditis, Bacterial / drug therapy*
  • Endocarditis, Bacterial / microbiology
  • Gentamicins / therapeutic use*
  • Humans
  • Klebsiella Infections / drug therapy
  • Klebsiella Infections / microbiology
  • Klebsiella pneumoniae / drug effects*
  • Klebsiella pneumoniae / enzymology
  • Klebsiella pneumoniae / genetics
  • Male
  • Treatment Outcome
  • beta-Lactam Resistance* / genetics
  • beta-Lactamases / genetics


  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Carbapenems
  • Gentamicins
  • beta-Lactamases
  • beta-lactamase KPC-3, Klebsiella pneumoniae
  • Colistin