A Dutch Case Report of Successful Treatment of Chronic Relapsing Urinary Tract Infection with Bacteriophages in a Renal Transplant Patient

Antimicrob Agents Chemother. 2019 Dec 20;64(1):e01281-19. doi: 10.1128/AAC.01281-19. Print 2019 Dec 20.


We report a case of a 58-year-old renal transplant patient who developed a recurrent urinary tract infection with an extended-spectrum β-lactamase (ESBL)-positive Klebsiella pneumoniae strain in the first month posttransplant. Even though it tested susceptible to carbapenems and despite repeated meropenem treatment, his infection recurred. The infection eventually evolved into epididymitis that was successfully treated with meropenem and bacteriophages. This case demonstrates the difficulty of treating relapsing ESBL-positive Gram-negative infections in renal transplant patients.

Keywords: Klebsiella pneumoniae; bacteriophages; extended spectrum β-lactamase; renal transplant; urinary tract infection.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Chronic Disease
  • Drug Resistance, Multiple, Bacterial
  • Humans
  • Kidney Transplantation / adverse effects*
  • Klebsiella Infections / drug therapy
  • Klebsiella Infections / etiology
  • Klebsiella Infections / therapy*
  • Klebsiella pneumoniae* / drug effects
  • Klebsiella pneumoniae* / enzymology
  • Male
  • Meropenem / administration & dosage
  • Microbial Sensitivity Tests
  • Middle Aged
  • Netherlands
  • Phage Therapy* / methods
  • Recurrence
  • Urinary Tract Infections / drug therapy
  • Urinary Tract Infections / etiology
  • Urinary Tract Infections / therapy*
  • beta-Lactamases / metabolism


  • Anti-Bacterial Agents
  • beta-Lactamases
  • Meropenem