Evolution of tigecycline resistance in Klebsiella pneumoniae in a single patient

Ann Saudi Med. Sep-Oct 2010;30(5):404-7. doi: 10.4103/0256-4947.67087.

Abstract

Carbapenemase-producing Klebsiella pneumoniae infections carry serious clinical and infection-control implications. Isolates possessing such hydrolyzing enzymes have been described in the United States and around the world. Besides being resistant to carbapenems, they usually confer resistance to fluoroquinolones, piperacillin-tazobactam, and extended-spectrum cephalosporins. Tigecycline demonstrates in vitro activity against these organisms, but reported resistance raises concern about tigecycline use for these infections. We describe a carbapenemase-producing K pneumoniae evolving resistance to tigecycline in a 75-year-old male after a prolonged stay in a critical care unit.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Bacterial Proteins / biosynthesis*
  • Community-Acquired Infections / drug therapy
  • Drug Resistance, Multiple, Bacterial*
  • Fatal Outcome
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / microbiology
  • Humans
  • Klebsiella Infections / drug therapy*
  • Klebsiella Infections / enzymology*
  • Klebsiella pneumoniae / drug effects*
  • Klebsiella pneumoniae / enzymology*
  • Male
  • Minocycline / analogs & derivatives*
  • Minocycline / pharmacology
  • Minocycline / therapeutic use
  • Tigecycline
  • beta-Lactamases / biosynthesis*

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Tigecycline
  • beta-Lactamases
  • carbapenemase
  • Minocycline