New Delhi Metallo-Beta-Lactamase (NDM-1)-Producing Klebsiella Pneumoniae Isolated from a Burned Patient

Abstract

Patient: Male, 32Final Diagnosis: NDM-1-producing Klebsiella pneumoniae • bacteremiaSymptoms: FeverMedication: —Clinical Procedure: NoneSpecialty: Infectious DiseasesObjective:Diagnostic/therapeutic accidentsBackground:Infections affecting burn patients are frequently caused by Staphylococcus aureus, Pseudomonas aeruginosa, and Enterobacteriaceae species. Infections with these pathogens have become increasingly difficult to treat due to evolving antibiotic resistance mechanisms, including the production of carbapenemases.Case Report:The present case report describes the evolution of a burn patient with polymicrobial healthcare-associated burn infections, including a bloodstream infection due to an emergent multidrug-resistant New Delhi metallo-beta-lactamase (NDM-1)-producing Klebsiella pneumoniae. During hospitalization, initial antibiotic treatment eradicated some of the infecting species. Newer isolates were found to be multidrug-resistant and required unique antibiotic combinations. The patient’s condition continued to deteriorate after the isolation of multidrug-resistant P. aeruginosa and NDM-1-positive K. pneumoniae from the blood.Conclusions:This case report illustrates the need for adequate antibiotic therapies in burn patients with subsequent infections due to a carbapenemase-producing multidrug-resistant bacteria. The potential danger of new bacterial pathogens should be considered in this group of susceptible patients.

The Revival of Aztreonam in Combination with Avibactam against Metallo-β-Lactamase-Producing Gram-Negatives: A Systematic Review of In Vitro Studies and Clinical Cases

“…MBL producers are mostly resistant to all β-lactams, including carbapenems and β-lactam/β-lactamase inhibitor combinations (BLBLICs). The optimal treatment of infections sustained by MBL-producing Enterobacterales or P. aeruginosa is not well defined, being associated with limited clinical experience and with few therapeutic alternatives (i.e., colistin, fosfomycin, cefiderocol) [ 4 , 5 , 6 , 7 , 8 ]. Moreover, the most recently approved BLBLICs (i.e., ceftazidime/avibactam, meropenem/vaborbactam, ceftolozane/tazobactam and imipenem/relebactam) are not active against MBL producers.…”

Droplet Microarray as a Powerful Platform for Seeking New Antibiotics Against Multidrug‐Resistant Bacteria

“…Double or triple antibiotic combinations are required to treat infections caused by K. pneumoniae . [ 11 ] S. aureus A1 mec A r is a Gram‐positive bacterium, which is methicillin‐resistant (MRSA), causing potential fatal diseases including bloodstream infections, pneumonia, or surgical site infections. [ 12 ]…”

A case–control study of infections caused by Klebsiella pneumoniae producing New Delhi metallo-beta-lactamase-1: Predictors and outcomes

“…NDM-1 has been discovered in different bacterial species in patients with nosocomial infections related to horizontal transfer and intraspecies spread in Mexico ( Duran-Bedolla et al., 2019 ). The persistent dissemination of diverse NDM-1-producing bacteria in Mexico has caused outbreaks with an endemic pattern punctuated by cyclic outbursts ( Bocanegra-Ibarias et al., 2017 ; Petersen-Morfin et al., 2017 ; Garza-Gonzalez et al., 2021 ; Fernandez-Garcia et al., 2022 ).…”

“…The persistent dissemination of diverse NDM-1-producing bacteria in Mexico has caused outbreaks with an endemic pattern punctuated by cyclic outbursts (Bocanegra-Ibarias et al, 2017;Petersen-Morfin et al, 2017;Fernandez-Garcia et al, 2022).…”