Aztreonam plus ceftazidime-avibactam as treatment of NDM-1-producing Klebsiella pneumoniae bacteraemia in a neutropenic patient: Last resort therapy?

Objectives: We report the successful treatment of a bloodstream infection caused by Klebsiella pneumoniae harbouring NDM-1 using aztreonam-ceftazidime-avibactam in a neutropenic patient in whom colistin and meropenem therapy had previously failed. Methods: A clinical isolate was evaluated to dete...

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Detalles Bibliográficos
Autores principales: Bocanegra Ibarias, Paola, Camacho Ortiz, Adrián, Garza González, Elvira, Flores Treviño, Samantha Maribel, Kim, Hyojin, Pérez Alba, Eduardo
Formato: Artículo
Lenguaje:inglés
Publicado: Elsevier 2020
Materias:
Acceso en línea:http://eprints.uanl.mx/22453/1/22453.pdf
Descripción
Sumario:Objectives: We report the successful treatment of a bloodstream infection caused by Klebsiella pneumoniae harbouring NDM-1 using aztreonam-ceftazidime-avibactam in a neutropenic patient in whom colistin and meropenem therapy had previously failed. Methods: A clinical isolate was evaluated to determine the presence of NDM, TEM, SHV, CTX, and CMY, and the killing kinetics of aztreonam (ATM; 4 mg/mL), aztreonam-avibactam (ATM-AVI; 4/4 mg/mL), and colistin (2 and 4 mg/mL) were tested. Results: ATM-AVI showed in vitro activity against the Klebsiella pneumoniae harbouring NDM-1, whereas colistin allowed re-growth. Conclusions: This report supports reconsideration of use of colistin for treatment of infections caused by K. pneumoniae harbouring NDM. CZA/ATM use should be kept in mind as a treatment option, perhaps earlier than colistin.