Extended-spectrum beta-lactamase-producing and carbapenemase-producing Enterobacter cloacae ventriculitis successfully treated with intraventricular colistin

6533b835fe1ef96bd129ffaf

RESEARCH PRODUCT

Extended-spectrum beta-lactamase-producing and carbapenemase-producing Enterobacter cloacae ventriculitis successfully treated with intraventricular colistin

Salvatore Giordano Chiara Iaria Giuseppina Barberi Antonio Cascio Antonino Odierna Maria Lina Mezzatesta Francesca Di Bernardo Stefania Stefani

subject

Male Microbiology (medical)Intraventricular medicine.medical_treatment Tigecycline Fosfomycin Ceftazidime beta-Lactamases Cerebral Ventriculitis Microbiology Bacterial Proteins Enterobacteriaceae Drug Resistance Multiple Bacterial Enterobacter cloacae Ventriculitis polycyclic compounds Ventriculitis medicine Humans Meningitis Cefoxitin Carbapenemases Colistin Enterobacter cloacae Amikacin biology Colistin business.industry Enterobacteriaceae Infections General Medicine Enterobacter biochemical phenomena metabolism and nutrition Carbapenemases bacterial infections and mycoses medicine.disease biology.organism_classification Anti-Bacterial Agents Treatment Outcome Infectious Diseases Child Preschool Beta-lactamase Colistin bacteria Administration Intravenous lipids (amino acids peptides and proteins)Teicoplanin business Enterobacter cloacae medicine.drug

description

SummaryWe present a case of post-neurosurgical ventriculitis caused by carbapenemase-producing Enterobacter cloacae successfully treated with intraventricular colistin. Enterobacter spp are intrinsically resistant to aminopenicillins, cefazolin, and cefoxitin due to the production of constitutive chromosomal AmpC beta-lactamases. Moreover, extended-spectrum beta-lactamase-producing Enterobacter spp have been identified in the USA and Europe, and carbapenems are considered the drug of choice in these cases. Our isolate was sensitive only to fosfomycin, tigecycline, and colistin, and 6 days of intravenous colistin had failed to eradicate the infection. This case provides clinical evidence to support the administration of intraventricular colistin in such patients.

year	journal	country	edition	language
2014-03-01	International Journal of Infectious Diseases

10.1016/j.ijid.2013.11.012 http://dx.doi.org/10.1016/j.ijid.2013.11.012

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