RESUMEN
In this study, we present two cases of Klebsiella pneumoniae, one KPC-33- and one NDM-1-producing, showing resistance to cefiderocol and ceftazidime/avibactam, collected in the intensive care unit of a hospital in Northern Italy from two patients who had recently undergone lung transplantation. Whole-genome sequencing was performed to investigate the molecular features of these strains.
Asunto(s)
Enterobacteriaceae Resistentes a los Carbapenémicos , Infecciones por Klebsiella , Humanos , Ceftazidima/farmacología , Ceftazidima/uso terapéutico , Antibacterianos/farmacología , Klebsiella pneumoniae/genética , Cefiderocol , Infecciones por Klebsiella/tratamiento farmacológico , Pruebas de Sensibilidad Microbiana , beta-Lactamasas/genética , Proteínas Bacterianas/genética , Compuestos de Azabiciclo/farmacología , Compuestos de Azabiciclo/uso terapéutico , Combinación de MedicamentosRESUMEN
Candida-related bloodstream infections (BSIs) represent a severe condition associated with health care in the critical patient, with an increasing incidence of Candida non-albicans species. These infections could lead to several and unusual complications in high-risk patients due to various factors, including a prolonged hospital stay and invasive medical interventions. Here we report a case of a Candida krusei septic thrombophlebitis in an ARDS patient admitted to the ICU, complicated by a late onset prostatic abscess. To our knowledge, our patient represents the first reported case of a prostatic abscess due to Candida krusei treated with pharmacological therapy alone.
Asunto(s)
Candidiasis , Oxigenación por Membrana Extracorpórea , Síndrome de Dificultad Respiratoria , Humanos , Absceso , Vena Cava Superior , Candida albicans , Candidiasis/complicaciones , Candidiasis/tratamiento farmacológico , Síndrome de Dificultad Respiratoria/etiología , Síndrome de Dificultad Respiratoria/terapiaRESUMEN
Millerozyma farinose is a halotolerant yeast that has recently been described as an emerging human pathogen, especially in immunocompromised patients. Both the diagnostic process and treatment options are still unclear. Here, we report a case of an immunocompetent oncological patient who developed a catheter-related bloodstream infection (CRBSI) with a concomitant respiratory tract infection caused by M. farinosa. In this report, we discuss how prompt microbiological identification and attentive evaluation of the patient's clinical status can play a significant role in the appropriate management of infections caused by uncommon fungi. MALDI-TOF technology has also substantially improved the timely diagnosis of rare fungi. Furthermore, our diagnosis was subsequently confirmed by 5.8S rRNA sequencing. In our patient, the rapid diagnosis of fungaemia was crucial, together with catheter removal and the initiation of antifungal treatment, for the patient's clinical improvement.