Fatal case of donor-derived colistin-resistant carbapenemase-producing Klebsiella pneumoniae transmission in cardiac transplantation
Braz. j. infect. dis
;
22(3): 235-238, May-June 2018. graf
Article
in English
| LILACS, SES-SP, SESSP-IDPCPROD, SES-SP
| ID: biblio-974217
ABSTRACT
ABSTRACT Herein we report a fatal case of donor-derived transmission of XDR-resistant carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) in cardiac transplantation. A 59-year-old male patient with non-obstructive hypertrophic cardiomyopathy underwent heart transplantation. On day 5 post-operation, blood cultures from the donor were positive for colistin-resistant carbapenemase-producing K. pneumoniae (ColR KPC-Kp) susceptible only to amikacin. Recipient blood cultures were also positive for ColR KPC-Kp with the same sensitivity profile as the donor isolate with an identical PFGE pattern. The patient was treated with double-carbapenems and amikacin. The patient evolved to pericarditis, osteomyelitis, and pulmonary necrosis, all fragment cultures positive for the same agent. The patient developed septic shock, multiple organ failure and died on day 50 post-transplantation. Based on current microbiological scenario worldwide the possibility of transmitting multidrug resistant (MDR) organisms should be considered.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Tissue Donors
/
Klebsiella Infections
/
Heart Transplantation
/
Transplant Recipients
/
Carbapenem-Resistant Enterobacteriaceae
/
Klebsiella pneumoniae
Type of study:
Etiology study
/
Risk factors
Limits:
Humans
/
Male
Language:
English
Journal:
Braz. j. infect. dis
Year:
2018
Type:
Article
Institution/Affiliation country:
Associação Fundo de Incentivo a Pesquisa - AFIP/BR
/
Instituto Dante Pazzanese de Cardiologia/BR
/
Universidade Federal de São Paulo/BR
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