%0 Journal Article
%A Cano, Angela
%A Guzman-Puche, Julia
%A Garcia-Gutierrez, Manuel
%A Caston, Juan Jose
%A Gracia-Ahufinger, Irene
%A Perez-Nadales, Elena
%A Recio, Manuel
%A Natera, Alejandra M
%A Marfil-Perez, Eduardo
%A Martinez-Martinez, Luis
%A Torre-Cisneros, Julian
%T Use of carbapenems in the combined treatment of emerging ceftazidime/avibactam-resistant and carbapenem-susceptible KPC-producing Klebsiella pneumoniae infections: Report of a case and review of the literature.
%D 2019
%U http://hdl.handle.net/10668/14699
%X To describe the case of a patient with infection due to a KPC-producing Klebsiella pneumoniae (K. pneumoniae) isolate developing ceftazidime-avibactam resistance with restored carbapenem susceptibility during ceftazidime-avibactam therapy. To review the clinical/microbiological cure and survival rates using carbapenems in other similar case reports and case series. A patient with an intra-abdominal infection due to K. pneumoniae producing the KPC-48 variant (L169P-A172T) (resistant to ceftazidime/avibactam and susceptible to carbapenems) who was treated with imipenem-cilastatin in combination with tigecycline and gentamicin. The literature was reviewed in order to summarise the in vivo (clinical/microbiological cure and survival rate) use of carbapenems in this emerging scenario. The patient was successfully treated with the indicated regimen. In other reported cases (mostly with pneumonia) all-cause mortality was 50% and clinical cure was 62.5%. Meropenem-vaborbactam has been successful used in an additional case. A carbapenem-based regimen of combination therapy seems to be an option for treating patients infected with K. pneumoniae resistant to ceftazidime/avibactam and susceptible to carbapenems, at least when the risk of mortality is low.
%K Carbapenems
%K Ceftazidime/avibactam-resistance
%K Klebsiella pneumoniae
%~