Failure of ceftazidime-amikacin therapy for bacteremia and meningitis due to Klebsiella pneumoniae producing an extended-spectrum beta-lactamase

Antimicrob Agents Chemother. 1990 Jun;34(6):1290-3. doi: 10.1128/AAC.34.6.1290.

Abstract

A multiple trauma patient failed treatment with ceftazidime and amikacin for bacteremia and meningitis due to a Klebsiella pneumoniae strain that produced a novel, plasmid-mediated beta-lactamase. Both pre- and posttreatment isolates were resistant to ceftazidime (MIC, greater than or equal to 64 micrograms/ml) and various penicillins but not to other expanded-spectrum cephalosporins. The beta-lactamase had a pI of 5.25 and was encoded on a conjugal plasmid of approximately 150 kilobases. DNA hybridization studies indicated that the enzyme was a TEM derivative.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Amikacin / therapeutic use*
  • Blotting, Southern
  • Ceftazidime / therapeutic use*
  • DNA, Bacterial / isolation & purification
  • Drug Resistance, Microbial / genetics
  • Drug Therapy, Combination / therapeutic use
  • Humans
  • Klebsiella Infections / drug therapy*
  • Klebsiella Infections / etiology
  • Klebsiella pneumoniae / enzymology
  • Male
  • Meningitis / drug therapy*
  • Meningitis / etiology
  • Meningitis / microbiology
  • Microbial Sensitivity Tests
  • Sepsis / drug therapy*
  • Sepsis / etiology
  • Wounds and Injuries / complications
  • beta-Lactamases / biosynthesis

Substances

  • DNA, Bacterial
  • Amikacin
  • Ceftazidime
  • beta-Lactamases