Use of meropenem by continuous infusion to treat a patient with a Bla(kpc-2)-positive Klebsiella pneumoniae blood stream infection

Surg Infect (Larchmt). 2011 Aug;12(4):325-7. doi: 10.1089/sur.2010.072.


Background: Gram-negative bacterial resistance to antibiotics is of increasing concern. Carbapenem resistance among strains of Klebsiella pneumoniae is a relatively new phenomenon. Resistance attributable to production of carbapenemases is notoriously difficult to combat.

Methods: Case report and review of the pertinent English-language literature.

Results: A patient, hospitalized for aortic dissection complicated by intra-abdominal catastrophe and acute kidney injury, developed bacteremia exhibiting meropenem non-susceptibility secondary to expression of bla(KPC-2). High-dose, continuous-infusion meropenem achieved serum drug concentrations above the minimum inhibitory concentration and eradicated the infection.

Conclusion: This is the first report of a meropenem-non-susceptible carbapenamase-positive Klebsiella pneumoniae blood stream infection treated successfully with high-dose, continuous-infusion meropenem. Application of this regimen in certain patients, such as those with mild-to-moderate renal insufficiency, may be a reasonable option for multi-drug-resistant nosocomial infections.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / pharmacokinetics
  • Bacteremia / drug therapy*
  • Bacteremia / microbiology
  • Humans
  • Infusions, Intravenous / methods
  • Klebsiella Infections / drug therapy*
  • Klebsiella Infections / microbiology
  • Klebsiella pneumoniae / enzymology*
  • Klebsiella pneumoniae / isolation & purification
  • Male
  • Meropenem
  • Microbial Sensitivity Tests
  • Middle Aged
  • Serum / chemistry
  • Thienamycins / administration & dosage*
  • Thienamycins / pharmacokinetics
  • Treatment Outcome
  • beta-Lactam Resistance
  • beta-Lactamases / metabolism*


  • Anti-Bacterial Agents
  • Thienamycins
  • beta-Lactamases
  • beta-lactamase KPC-2, Klebsiella pneumoniae
  • Meropenem