Two for the price of one: emerging carbapenemases in a returning traveller to New York City.
BMJ Case Rep
; 20182018 Jul 18.
Article
en En
| MEDLINE
| ID: mdl-30021742
ABSTRACT
We report a case of a complex orthopaedic infection in a patient returning to New York City from Bangladesh where he was involved in a serious motor vehicle accident. He developed extensive osteomyelitis with a carbapenem-resistant Klebsiella pneumoniae The isolate was unique due to the coexistence of New Delhi metallo-ß-lactamase-1 and Oxacillinase type-181 carbapenemases, which are relatively uncommon in North America and were presumably acquired in Bangladesh. Herein, we explore challenges associated with management of carbapenem-resistant Enterobacteriaceae infections, including limited available data on effective antimicrobial therapy. We also highlight the added value of rapid diagnostic technology in guiding clinical management. Ultimately, the patient required both aggressive surgical management and combination therapy with aztreonam and ceftazidime-avibactam for true source control and favourable clinical outcome.
Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Osteomielitis
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Infecciones por Pseudomonas
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Infecciones por Klebsiella
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Farmacorresistencia Bacteriana Múltiple
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Enfermedad Relacionada con los Viajes
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Antibacterianos
Tipo de estudio:
Health_economic_evaluation
Límite:
Adult
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Humans
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Male
Idioma:
En
Revista:
BMJ Case Rep
Año:
2018
Tipo del documento:
Article
País de afiliación:
Estados Unidos