Petersen-Morfin Santiago, Bocanegra-Ibarias Paola, Morfin-Otero Rayo, Garza-González Elvira, Perez-Gomez Hector Raul, González-Diaz Esteban, Esparza-Ahumada Sergio, León-Garnica Gerardo, Amezcua-Salazar Gabriel, Rodriguez-Noriega Eduardo
Civil Hospital of Guadalajara, Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.
Department of Gastroenterology, University Hospital Dr. José Eleuterio González, Autonomous University of Nuevo Leon, Monterrey, Nuevo Leon, Mexico.
Am J Case Rep. 2017 Jul 18;18:805-809. doi: 10.12659/ajcr.903992.
BACKGROUND 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.
影响烧伤患者的感染通常由金黄色葡萄球菌、铜绿假单胞菌和肠杆菌科细菌引起。由于不断演变的抗生素耐药机制,包括碳青霉烯酶的产生,这些病原体引起的感染越来越难以治疗。病例报告:本病例报告描述了一名烧伤患者发生多微生物医疗保健相关烧伤感染的病程,包括因产超广谱β-内酰胺酶(NDM-1)的肺炎克雷伯菌引起的血流感染。住院期间,初始抗生素治疗根除了一些感染菌种。新分离出的菌株具有多重耐药性,需要独特的抗生素组合。从血液中分离出产多重耐药性的铜绿假单胞菌和NDM-1阳性肺炎克雷伯菌后,患者病情持续恶化。结论:本病例报告表明,对于因产碳青霉烯酶的多重耐药菌继发感染的烧伤患者,需要采用适当的抗生素治疗。在这组易感患者中应考虑新细菌病原体的潜在危险。