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IMP-6 Carbapenemase-Producing Enterobacteriaceae Bacteremia Successfully Treated with Amikacin-Meropenem in Two
Ichiro Nakakura1,2, Yoshihiko Ogawa3, Kota Sakakura1,2
1Department of Infection Control and Prevention, National Hospital Organization Osaka National Hospital, Osaka, Japan.
Abstract:
Infections caused by carbapenemase-producing Enterobacteriaceae (CPE) are becoming increasingly common worldwide. Although CPE infections can be fatal, few reports in the literature have described effective and successful treatments for infectious diseases caused by several types of IMP CPE, and, to our knowledge, no reports have described the successful treatment of IMP-6 CPE infections. We describe two patients who developed bacteremia caused by IMP-6 CPE after surgery for cancer who were successfully treated with amikacin plus high-dose prolonged-infusion meropenem. Both patients were treated over a 2-week period using amikacin 15 mg/kg at various intervals based on therapeutic drug monitoring and meropenem 2000 mg infused over 3 hours every 12 hours. The dosages of amikacin and meropenem were determined based on the creatinine clearance of each patient. Both patients were cured of their bacteremia and did not experience any antibiotic-related adverse effects. Based on the outcomes of these patients, it appears that amikacin plus high-dose prolonged-infusion meropenem may be safe and effective for the treatment of bacteremia caused by IMP-6 CPE.
Insights
This study highlights a successful treatment for carbapenemase-producing Enterobacteriaceae (CPE) infections, specifically IMP-6 CPE. Two patients with cancer surgery-related bacteremia were effectively treated with amikacin and high-dose meropenem.
Area of Science:
- Infectious Diseases
- Microbiology
- Pharmacology
Background:
- Carbapenemase-producing Enterobacteriaceae (CPE) infections are a growing global health concern.
- Effective treatments for infections caused by specific carbapenemase types, like IMP-6, are scarce in medical literature.
- CPE infections can lead to severe outcomes, including fatality.
Observation:
- Two patients developed bacteremia caused by IMP-6 CPE following cancer surgery.
- These patients received a treatment regimen of amikacin (15 mg/kg) and high-dose prolonged-infusion meropenem (2000 mg over 3 hours every 12 hours) for two weeks.
- Dosages were individualized based on each patient's creatinine clearance and therapeutic drug monitoring.
Findings:
- Both patients achieved a cure for their IMP-6 CPE bacteremia.
- No antibiotic-related adverse effects were observed in either patient during the treatment period.
- The combination therapy demonstrated successful clinical outcomes.
Implications:
- Amikacin combined with high-dose, prolonged-infusion meropenem shows promise as a safe and effective treatment strategy for IMP-6 CPE bacteremia.
- This therapeutic approach may offer a viable option for managing challenging CPE infections.
- Further research and clinical trials are warranted to validate these findings in a broader patient population.
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