A Case of Septic Shock Due to Serratia marcescens Pyelonephritis and Bacteremia in a Patient Receiving Empagliflozin

Abstract

Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been associated with serious urinary tract infections (UTIs) including pyelonephritis and urosepsis. The Food and Drug Administration (FDA) issued a label change to include this warning in December 2015 due to a small number of cases (n = 19) reported to the FDA Adverse Event Reporting System. Details of these cases are limited and none involved empagliflozin. To date, there has been no published literature comprehensively describing serious UTIs attributed to empagliflozin. We describe a case of septic shock due to Serratia marcescens pyelonephritis and bacteremia that required intensive care unit admission in a well-controlled, type 2 diabetic patient who had begun taking empagliflozin 2 months prior. The patient was treated successfully with intravenous antibiotics followed by oral ciprofloxacin. After discontinuation of empagliflozin and completion of antibiotic therapy, no subsequent UTIs were documented in the following 4 months.

Case of acute unilateral emphysematous pyelonephritis and bacteraemia on treatment with canagliflozin

“…A case of septic shock due to Serratia marcescens pyelonephritis and bacteraemia was reported in a patient with type 2 diabetes after 2 months of initiating empagliflozin 4. We did not find any previous report of emphysematous pyelonephritis associated with SGLT2-i.…”

Exploring the Anti-quorum Sensing and Antibiofilm Efficacy of Phytol against Serratia marcescens Associated Acute Pyelonephritis Infection in Wistar Rats

“…Most pyelonephritis infections are occurred by bacterial pathogens ascent through the urethra and urinary bladder. The etiologic agents of pyelonephritis are Escherichia coli, Proteus mirabilis, Pseudomonas aeruginosa , and Serratia marcescens (Ohno et al, 2003 ; Mittal et al, 2009 ; Chen et al, 2012 ; Kufel et al, 2016 ).…”

Fulminant Emphysematous Pyelonephritis by <b><i>Candida glabrata</i></b> in a Kidney Allograft

“…They act by inhibiting glucose reabsorption in the proximal renal tubules and thus increasing the amount of excreted glucose, resulting in decreased plasma glucose concentrations. Nevertheless, it has been reported that they can increase the risk of urogenital tract infections, being severe in some cases [29]. Thus, the FDA has issued warnings about occurrences of acute kidney injury, urosepsis, and pyelonephritis during post-marketing studies of these drugs [30].…”