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