Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran.
BMC Infect Dis. 2024 Aug 22;24(1):850. doi: 10.1186/s12879-024-09762-7.
Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections are a major public health problem, requiring the use of last-resort antibiotics such as colistin. However, there is concern regarding the emergence of isolates resistant to this agent. The report describes two patients with urinary tract infection (UTI) and ventilator-associated pneumonia (VAP) infection caused by CRKP strains. The first case was a 23-year-old male with UTI caused by a strain of ST16 co-harboring bla, bla, bla, bla, bla genes. The second case was a 39-year-old woman with VAP due to hypervirulent ST337-K2 co-harboring bla, bla, bla iucA, rmpA2 and rmpA The patients' general condition improved after combination therapy with colistin (plus meropenem and rifampin, respectively) and both of them recovered and were discharged from the hospital. This study highlights the necessary prevention and control steps to prevent the further spread of CRKP strains should be a priority in our hospital.
耐碳青霉烯类肺炎克雷伯菌(CRKP)感染是一个主要的公共卫生问题,需要使用多黏菌素等最后手段的抗生素。然而,人们担心会出现对这种药物耐药的分离株。该报告描述了两例由 CRKP 菌株引起的尿路感染(UTI)和呼吸机相关性肺炎(VAP)感染的患者。第一例是一名 23 岁男性,因携带 blaCTX-M-15、blaDHA-1、blaOXA-48、blaGES-5 和 blaVEB-1 基因的 ST16 菌株引起的 UTI。第二例是一名 39 岁女性,因产超毒力 ST337-K2 菌株引起的 VAP,该菌株携带 blaKPC-2、blaCTX-M-15、blaDHA-1、blaOXA-48、blaGES-5、blaVEB-1、blaIucA、rmpA2 和 rmpA2 基因。两例患者在联合使用多黏菌素(分别加用美罗培南和利福平)治疗后,一般状况改善,均康复出院。本研究强调了预防和控制措施的必要性,以防止 CRKP 菌株的进一步传播,这应成为我们医院的优先事项。