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New Delhi Metallo-Beta-Lactamase (NDM-1)-Producing Klebsiella Pneumoniae Isolated from a Burned Patient
Santiago Petersen-Morfin1, Paola Bocanegra-Ibarias2, Rayo Morfin-Otero1,3
1Civil Hospital of Guadalajara, Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.
Abstract:
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.
Insights
Burn patients face severe infections from resistant bacteria like Klebsiella pneumoniae. This case highlights the critical need for effective antibiotic strategies against multidrug-resistant pathogens in immunocompromised individuals.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Microbiology
Background:
- Burn patients are susceptible to healthcare-associated infections (HAIs) caused by common pathogens.
- Antibiotic resistance, particularly carbapenemase production, complicates treatment of these infections.
- Emergence of multidrug-resistant (MDR) bacteria poses a significant threat in clinical settings.
Observation:
- A case report details a burn patient with polymicrobial HAIs.
- The patient developed a bloodstream infection with New Delhi metallo-beta-lactamase (NDM-1)-producing Klebsiella pneumoniae.
- Treatment challenges arose with MDR Pseudomonas aeruginosa and NDM-1 positive K. pneumoniae isolates.
Findings:
- Initial antibiotic regimens were partially effective against some pathogens.
- Subsequent bacterial isolates exhibited MDR, necessitating complex antibiotic combinations.
- The patient's clinical status worsened despite intensive treatment.
Implications:
- This case underscores the necessity of robust antibiotic stewardship in managing burn wound infections.
- Vigilance for emergent carbapenemase-producing MDR bacteria in burn patients is crucial.
- Early identification and tailored therapy are vital for improving outcomes in critically ill patients.
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