Liao Wenjian, Zhao Tiantian, Zhang Zhizhe, Yan Fuyi, Peng Xiong, Cui Jian, Zuo Wei
Department of Respiratory and Critical Care, The First Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, P.R. China.
Jiangxi Institute of Respiratory Disease, The First Affiliated Hospital of Nanchang University, Nanchang, China.
Microb Drug Resist. 2023 Jan;29(1):28-33. doi: 10.1089/mdr.2022.0193.
This study reported a fatal stent-associated respiratory tract infection (SARTI) caused by carbapenem-resistant hypervirulent (CR-hvKP). A bare-metal stent in the left main bronchus and a Y-shaped stent graft in the tracheal bronchus were placed successively in a 50-year-old woman due to shortness of breath after undergoing multiple chemotherapy treatments for lung cancer. Unfortunately, the followed SARTI and lung abscess in our patient caused by CR-hvKP eventually led to the death of the patient, despite our aggressive clearing of phlegm and potent antibiotics. The genomic analysis showed it was caused by a KPC-2-producing extensively drug-resistant K64-ST11 hypervirulent harboring several virulence and antimicrobial resistance genes. This study highlights the risk of SARTI caused by CR-hvKP in immunocompromised individuals.
本研究报告了1例由耐碳青霉烯类高毒力肺炎克雷伯菌（CR-hvKP）引起的致命性支架相关性呼吸道感染（SARTI）。1名50岁女性因肺癌接受多次化疗后出现呼吸急促，先后在左主支气管置入裸金属支架，在气管支气管置入Y形支架移植物。不幸的是，尽管我们积极排痰并使用强效抗生素，但该患者随后由CR-hvKP引起的SARTI和肺脓肿最终导致患者死亡。基因组分析显示，其由一株产KPC-2的广泛耐药K64-ST11高毒力菌株引起，该菌株携带多个毒力和抗菌耐药基因。本研究强调了CR-hvKP在免疫功能低下个体中引起SARTI的风险。
